The Use of Telemedicine for Penicillin Allergy Skin Testing.

The Use of Telemedicine for Penicillin Allergy Skin Testing.

J Allergy Clin Immunol Pract. 2018 May 08;:

Authors: Staicu ML, Holly AM, Conn KM, Ramsey A

Abstract
BACKGROUND: Penicillin skin testing (PST) is increasingly utilized as a tool to evaluate penicillin allergy in patients with a reported history. The limited availability of allergists, however, may be an impeding factor.
OBJECTIVE: We sought to assess the clinical utility of telemedicine to facilitate PST.
METHODS: Penicillin allergic inpatients receiving systemic antibiotics were prospectively identified between April and August 2017. Qualifying patients underwent PST performed by a trained Allergy/Immunology physician assistant (PA). Upon completion of PST, a telemedicine consultation, through the use of real-time interactive video conferencing (Microsoft Lync 2013, Redmond, WA), was performed remotely by an allergist. Patients were surveyed regarding their satisfaction with the telemedicine experience.
RESULTS: Fifty patients consented to PST through a telemedicine consultation. The average total time to complete a consultation was 128 minutes (SD ± 33). Of this, average PA travel time was 46 minutes (36%) with the remaining time spent on clinical services (82 minutes, 64%). The average physician telemedicine time per patient was 5 minutes (SD ± 2). Patients rated their experience as an average of 4.5 on a scale of 1 (highly unsatisfied) to 5 (highly satisfied). Of the 46 PST-negative patients, 33 were transitioned to a β-lactam antibiotic which reduced the use of vancomycin, metronidazole, aztreonam, aminoglycosides, and clindamycin (p<0.05). More than $30,000 was saved throughout the study period.
CONCLUSION: Telemedicine is an effective and novel approach to facilitate PST in the inpatient setting and carries a high degree of patient satisfaction. This method has the potential to optimize and improve access to Allergy/Immunology resources.

PMID: 29751152 [PubMed - as supplied by publisher]