# Improving dermatology access by direct-to-patient teledermatology and computer-assisted diagnosis

> **NIH VA I01** · VETERANS AFFAIRS MED CTR SAN FRANCISCO · 2021 · —

## Abstract

Background: Access to dermatology remains a significant problem in the Department of Veterans Affairs
(VA), particularly during the COVD-19 pandemic. To address this need, VA will deploy an asynchronous
teledermatology mobile app-My VA Images-which allows new dermatology patients to securely submit history
and photos of their skin for evaluation. The app may also eventually provide a conduit for patients to submit
skin images at will for analysis and triage by artificial intelligence (AI)-powered computer vision to a
dermatologist.
Significance: This project addresses the following gaps: 1) The impact of direct-to-patient teledermatology on
access to dermatology and on the satisfaction with such care by both patients and health care providers has
not been systematically studied; 2) Currently no AI-powered computer vision tool has been developed and
validated for patient-generated images; 3) The readiness of large healthcare organizations, such as VA, and
their stakeholders to engage in direct-to-patient teledermatology and AI is unknown.
Innovation and Impact: Two related innovations will be tested: 1) Direct-to-patient teledermatology for new
patients and 2) Evaluation of patient-submitted skin images by AI-powered computer vision. These separately
have the potential to transform remote access to expert skin care in VA and together are potentially synergistic.
At the conclusion of the project, we anticipate having a systematic understanding of how direct-to-patient
technologies perform and of the operational gaps that will need to be addressed by VA before these
technologies can be implemented enterprise-wide. The goal is to establish a critical scholarly and operational
foundation to safely move toward a transformative vision where Veterans will no longer be tied to a fixed time
and place for care, but instead will have the choice of self-directed, convenient and rapid access to expert-level
dermatology care wherever and whenever they need it.
Specific Aims: 1. Assess the impact of direct-to-patient teledermatology on access and health system
utilization. 2. Assess, refine and augment computer-assisted evaluation of patient-submitted images.
3. Assess readiness of VA and Veterans' acceptance to implement direct-to-patient care.
Methodology: Aim 1 will use a Type I hybrid pragmatic study design to compare the impact of the direct-to-
patient teledermatology intervention relative to usual in-person and usual consultative teledermatology
referrals, measuring access chiefly by data from VA's Central Data Warehouse. Aims 1 and 3 will measure
patient satisfaction and readiness for change using survey instruments and interviews. Aim 2 will include both
testing, training and refinement of the AI-powered computer vision and measure concordance with
dermatologists. Population: Veterans referred to Dermatology at three VA medical facilities. Intervention:
Eligible and medically appropriate patients will be offered the option to submit history and images t...

## Key facts

- **NIH application ID:** 10317682
- **Project number:** 1I01HX003473-01
- **Recipient organization:** VETERANS AFFAIRS MED CTR SAN FRANCISCO
- **Principal Investigator:** DENNIS H OH
- **Activity code:** I01 (R01, R21, SBIR, etc.)
- **Funding institute:** VA
- **Fiscal year:** 2021
- **Award amount:** —
- **Award type:** 1
- **Project period:** 2021-10-01 → 2026-09-30

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10317682

## Citation

> US National Institutes of Health, RePORTER application 10317682, Improving dermatology access by direct-to-patient teledermatology and computer-assisted diagnosis (1I01HX003473-01). Retrieved via AI Analytics 2026-05-23 from https://api.ai-analytics.org/grant/nih/10317682. Licensed CC0.

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