Direct-to-patient Teledermatology and Computer-assisted Diagnosis
NCT ID: NCT05128006
Last Updated: 2026-01-23
Study Results
The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.
Basic Information
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RECRUITING
63200 participants
OBSERVATIONAL
2022-11-07
2026-09-30
Brief Summary
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Detailed Description
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1. Assess the impact of direct-to-patient teledermatology on access and health system utilization. In collaboration with the VA operational partner, Office of Connected Care, the My VA Images app will be deployed to three VA facilities where the app will be introduced as an option to refer eligible new patients for dermatology consultation. Multiple access metrics, including time to consult completion and geographic distance traveled. will be measured in exposed patients and compared with patients referred to usual in-person and consultative teledermatology pathways. Facility-centric measures of access such as clinic appointment wait times and in-person dermatology clinic and community care utilization will also be measured. To better understand end-user experiences, the investigators will survey patients and staff at each study site to evaluate their satisfaction with My VA Images as well as the overall process.
2. Assess, refine and augment computer-assisted evaluation of patient-submitted images. An artificial intelligence-powered computer vision model, trained and validated on clinic-captured images of melanoma and nevi, will be tested and refined on patient-submitted teledermatology images from the My VA images app. The investigators will also extend the computer vision model by using all patient submissions to train and validate the model on a wider variety of skin diagnoses. Patient-submitted teledermatology images at study sites will be prospectively evaluated by the investigators' own computer vision model as well as by a commercial system currently available to VA clinicians and patients, and results will be compared with benchmark diagnoses to measure concordance across a range of diagnostic categories.
3. Assess readiness of VA and Veterans' acceptance to implement direct-to-patient care. The investigators will survey Veterans and key VA leadership and staff at three selected VA facilities, supplemented by interviews of key VA stakeholders, to understand patients' and organizational readiness, including facilitators and barriers, for transitioning to patient-facing technologies in general, and direct-to-patient dermatologic care in particular. National Veteran surveys, and VA Mobile Health user satisfaction data will help place local observations in perspective. Implementation and sustainability of the patient-facing teledermatology app technology will also be measured.
Conditions
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Study Design
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CASE_CONTROL
RETROSPECTIVE
Study Groups
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In-person new VA dermatology patients
In-person dermatology patients that are new patients at three facilities
No interventions assigned to this group
New patient consultative Teledermatology users
New patient consultative Teledermatology users at three facilities
No interventions assigned to this group
New patient Mobile teledermatology users
New patient Mobile teledermatology users at three facilities
New patient teledermatology visit
new patient teledermatology visits
In-person new patient in Community Care
In-person new patient in Community Care
No interventions assigned to this group
Interventions
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New patient teledermatology visit
new patient teledermatology visits
Eligibility Criteria
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Inclusion Criteria
Exclusion Criteria
* Dermatology patients who are not seen at San Francisco, Decatur, and Aurora
* Dermatology patients at San Francisco, Decatur, and Aurora who have visits only before 2021 or after 2025
18 Years
ALL
Yes
Sponsors
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VA Boston Healthcare System
FED
Durham VA Health Care System
FED
Providence VA Medical Center
FED
VA Office of Research and Development
FED
Responsible Party
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Principal Investigators
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Dennis H. Oh, MD PhD
Role: PRINCIPAL_INVESTIGATOR
San Francisco VA Medical Center, San Francisco, CA
Locations
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San Francisco VA Medical Center, San Francisco, CA
San Francisco, California, United States
Rocky Mountain Regional VA Medical Center, Aurora, CO
Aurora, Colorado, United States
Atlanta VA Medical and Rehab Center, Decatur, GA
Decatur, Georgia, United States
Countries
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Central Contacts
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Facility Contacts
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Other Identifiers
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HX003473
Identifier Type: OTHER_GRANT
Identifier Source: secondary_id
IIR 21-103
Identifier Type: -
Identifier Source: org_study_id
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