Table 2:

Potential Teledermatology Practice Pitfalls

Inability to properly diagnose   - Inadequate information sent (insufficient history, lack of context)   - Inability to palpate lesions or perform complete physical exam   - Poor quality or wrong clinical photographs (out of focus, inadequate number, bias with regard to which lesions were photographed)   - Lack of imaging, equipment, or technique standards   - Lack of access to prior medication records

Inability to complete the circle of care   - Lack of continuity and/or longitudinal care   - Inability to see the patient in person if needed   - Inability or difficulty in preforming diagnostic or lab tests   - Lack of communication with primary care providers   - Lack of integration into health systems

Policy and legal risk   - Medico-legal/malpractice risk   - Security breaches   - HIPAA violations

Reimbursement for services/costs   - Lack of universal payment through Centers for Medicare & Medicaid Services in all states   - Lack of universal private payer parity   - Adoption and maintenance costs for individual systems