| Position Statement on Telemedicine (Approved by the Board of Directors February 22, 2002)
I. Credentialing and Privileging
Recommendation: Dermatologists should adhere to credentialing and privileging requirements of institutions where they perform telemedicine consultations. II. Medical Records Recommendation: Appropriate medical records should be available to the consulting dermatologist prior to or at the time of the telemedicine encounter. This information should include specific questions requested by the referring physician. A copy of the record generated by the telemedicine consultation should be subsequently available at both the consultant and the referral sites. These records should be maintained according to the policies of each site. III. Privacy and Confidentiality Hotel a BerlinoRecommendation: Privacy and confidentiality must be maintained at a level comparable to a face to face physician/patient encounters and in compliance with the Health Insurance Portability and Accountability Act. (The American Medical Informatics Association has developed guidelines for the clinical use of e-mail [Kane and Sands, JAMIA, 1998 Jan-Feb, 5(1): 104-111] Adherence to these guidelines is recommended.) IV. System Capabilities Recommendation: Imaging and communications hardware used for telemedicine consultations should possess at least the following minimal capabilities. The color rendered by the monitor and camera should represent true colors (24 bit color depth). Adequate lighting is important for accurate diagnoses. (A useful website for comparing images from different digital cameras is
http://www.imaging-resource.com/IMCOMP/COMPS01.htm. For individuals using systems that capture and display images in analogue format (television monitors and analogue cameras), the recommended display resolution and camera output is 450 lines. In addition, all video-conferencing equipment should adhere to the standards set forth by the International Telecommunications Union (ITU). For individuals with traditional computer-based (CRT) monitors, a minimum of 640 x 480 pixel resolution with 24-bit color on a monitor with a minimum of 0.28 dot pitch is recommended. A digital camera with a minimum of a one megapixel resolution with close-up/macro capability is recommended for capture of images for store and forward purposes. V. Licensing Recommendation: Laws vary from state to state, and the AAD advises all dermatologists to be in compliance with all regulations, including individual state licensure. VI. Reimbursement Recommendation: In the interest of making dermatologic expertise available to all patients, reimbursement for telemedicine consultations by public (Medicare and Medicaid) and private third party payers is supported at the same level as an office consultation. Although this is recognized to be predominantly an American problem, it may have international implications. Each healthcare funding system will need to resolve reimbursement issues locally. hotel rooms CannesVII. Member Involvement in Telemedicine Recommendation: The Telemedicine Task Force will provide guidance to dermatologists interested in becoming involved in Teledermatology. The Telemedicine Task Force will assist the Academy with its responsibility to keep the membership informed of evolving issues in telemedicine. VIII. Telemedicine Research Recommendation: The AAD recognizes the body of literature on the effectiveness of teledermatology. (The American Telemedicine Association Teledermatology Annotated Bibliography of this literature can be found at www.atmeda.org/ICOT/sigtelederm.htm)
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