Teledermatology Consultations Provide Specialty Care for Farmworkers in Rural Clinics


  • This research was supported by grant R01-ES012358 from the National Institute of Environmental Health Sciences. The authors thank William Willner for his assistance with photography training, and the staff of Harvest Family Clinic, Greene County Health Care, Inc., and Robeson Health Care Corporation for their assistance with data collection. For more information, contact: Thomas A. Arcury, PhD, Department of Family and Community Medicine, Wake Forest University School of Medicine, Medical Center Boulevard, Winston-Salem, NC 27157-1084; e-mail


ABSTRACT: Context: Rural patients have limited access to dermatologic care. Farmworkers have high rates of skin disease and limited access to care. Purpose: This exploratory study assessed whether teledermatology consultations could help meet the needs of health care providers for farmworkers in rural clinics. Methods: Dermatologists provided 79 consultations, using store-and-forward teledermatology, to farmworkers who presented with a skin disease to rural North Carolina clinics. Clinic providers rated the value of the consultation. Findings: Most requests for consultations (94%) came from family nurse practitioners or physician assistants. Twelve percent of consultations were rated somewhat helpful, and the remainder helpful or very helpful. After receiving the consultation, providers changed the diagnosis in 13% of cases. The consultation led providers to contact or attempt to contact 21% of patients to change treatment recommendations. Conclusions: Access to expert dermatologic services is needed by rural health care providers. Teledermatology consultations may be a helpful tool to meet this need.