The Value of Hybrid Teledermatology in German Prisons: Analysis of Routine Telemedical Data.

Abstract

Introduction: German prisons face organizational and time-consuming difficulties in access to medical specialties. Since 2019, our institute offers interdisciplinary video consultations with spatially independent dermatological support for German prisons. Methods: Documentation of n = 200 consultations between February 2020 and July 2021 with retrospective analysis of dermatological conditions and consultation requests. Results: Most cases (98.0%; 196 of 200) were performed during a regular weekly teleclinic and only few cases on urgent demand. The average duration of the skin disease before request for consultation was 10.3 ± 26.9 months (mean ± standard deviation), the majority had first onset of their disease or acute recurrence of previously known skin diseases. With respect to medical complaints, 39.7% of patients reported severe itch and 7.7% indicated severe pain. For most cases (84.0%), topical treatment and for almost one-third (32.5%) we recommended systemic treatment. The predominant number of cases was only presented once (92.0%) and further treatment of the skin disease could be managed by the medical staff inhouse. Only few consultations could not be solved virtually and were referred to local physicians for face-to-face consultations or procedures. Discussion: Teledermatological care for prisoners effectively supports the inhouse medical resources of prisons. Our interdisciplinary approach enables general practitioners and medical staff of the respective prison to manage the case and shortens the time period until therapy starts.