Video and telephone teledermatology consultations during COVID‐19 in comparison: patient satisfaction, doubts and concerns

Dear Editor,

Teledermatology represented one of the most important tools during the COVID‐19 pandemic, allowing physicians to continue caring for patients while avoiding the risk of infection for both. ¹ , ² To overcome restrictions on face‐to‐face (F2F) visits during the pandemic, we expanded our teledermatology services for patients, increasing the number of consultations through these services and also increasing the type of services available for patients. ³ In particular, we used video‐call and phone‐call consultations and email support for patients, to ensure continuity of care as much as possible, especially for patients with chronic skin diseases requiring long‐term treatment and follow‐up, such as psoriasis or hidradenitis suppurativa. ⁴ , ⁵ We report our findings using a questionnaire‐based study evaluating patient satisfaction about the use of teledermatology.

An eight‐item questionnaire was created to investigate patient opinion of our teledermatology services. Patients consulting at our clinic through teledermatology services were consecutively included in the study. Each enrolled patient was asked to anonymously complete a questionnaire after the consultation.

In total, 265 patients were consecutively enrolled in the study. However, 13 were excluded from the study due to incomplete questionnaires. Hence, a total of 252 fully completed questionnaires were assessed (Table 1).

Table 1.

Questionnaire and patients' answers (both video‐ and phone‐based consultations).

Questionnaire	Type of consultation
	Video	Phone
Clinical and demographic data
Gender
Male	53	69
Female	47	83
Age (years)
18–35	30	70
36–45	35	35
46–65	45	25
> 65	3	24
Condition
Acne	98	43
Psoriasis	55	50
Hidradenitis suppurativa	30	13
Alopecia (any type)	25	18
Other	23	19
Patient satisfaction
Rate your satisfaction for the teledermatology service (1–3unsatisfied; 4–6 satisfied; 7–10 very satisfied)
1–3	47	65
4–6	115	80
7–10	150	157
Would you choose teledermatology for future consultations?
Yes	168	198
No	114	54
Do you consider a teledermatology consultation as satisfactory as aface‐to‐face visit?
Yes	52	40
No	200	212
Do you have any concerns about teledermatology?
Yes	178	182
No	44	40
If you answered ‘Yes’ to the previous question, what concerns do you have?
Privacy (photo, video)	62	40
I feel uncomfortable with this technology	32	38
I feel uncomfortable receiving a prescription by teledermatology	22	34
I prefer a face‐to‐face visit	62	70

Interestingly, we found high levels of satisfaction using both video‐ and phone‐based teledermatology services. Patients using video‐based consultations were more (but not significantly) satisfied than phone‐based consultations, reporting that they will use this service in the future. Another interesting finding was that most of patients reporting satisfaction with the teledermatology services, both video‐ and phone‐based consultations, were younger patients with acne or chronic skin diseases (psoriasis and hidradenitis suppurativa), whereas older patients reported that they would prefer an F2F visit. ⁵ , ⁶

However, despite the high satisfaction level, most of the interviewed patients did not consider a teledermatology consultation as satisfactory as an F2F visit. This may be influenced by the platform used, difficulties that patients (especially older patients) may have using such technology, and privacy concerns.

Teledermatology had a central role during the COVID‐19 pandemic, which led to marked development of this type of service, resulting in widespread use and high satisfaction rates reported by both patients and physicians.

However, despite the widespread escalation of this technology, there are still major difficulties, such as privacy concerns and medicolegal issues, as an official and widely accepted form of informed consent during such consultations is lacking, as well as the absence of specified and safe online teledermatology platforms, which may represent obstacles to the further utilization and application of this useful service. Hence, official guidelines and recommendations are urgently needed to improve these services and increase the safety of and satisfaction with teledermatology consultations for patients and dermatologists.