Optimizing Dermatologic Care Through Stanford E-Consults: The Mayo Clinic Experience

Michael Zhang of Mayo Clinic presented the institution’s experience with Stanford-style store-and-forward teledermatology e-consults, aiming to characterize patient and image features, identify vulnerable populations who benefit most, and assess outcomes. In about 2.5 months of data, most patients were women with a median age of 49, and only about 11–12% had documented physical vulnerability, likely an underestimate because mobility and transportation barriers are not fully captured in the chart. Roughly 20% of consults included dermoscopic images, and about 20% of photos were patient-submitted; clinic-acquired images were more likely to support management decisions, though patient photos were still sufficient in nearly 88% of cases. The most common consults were for single lesions, followed by inflammatory rashes. Among 800 analyzed consults, about 40% were managed without an in-person visit, while 60% were referred for in-person evaluation, often for patients with prior skin cancer history or suspicious lesions. Patients lived a median of 7 miles from the clinic, with some traveling much farther, and the median time to dermatology review was 38 days, making teledermatology an effective triage tool. The talk concluded that teledermatology improves access for underserved and vulnerable patients, but future work should focus on better capturing vulnerability, improving image quality, and evaluating cost-effectiveness to support ongoing reimbursement and adoption.