Please select the eligibility criteria that correspond to the clinical trial below.
Title: Teledermatology Mobile Apps: Implementation and Impact on Veterans' Access to Dermatology
Brief Summary: This study was designed to measure the impact of two teledermatology apps to provide direct to patient teledermatology follow up care, Patient Viewer and My VA Images, with a trial on access to dermatology care. The overall hypothesis was that sites implementing Department of Veterans Affairs' (VA) teledermatology mobile apps would significantly augment the use of teledermatology and improve Veterans' access to skin care relative to control sites. Specifically, the investigators hypothesized that these apps would improve established patients' ability to follow-up with dermatology care remotely, reducing patient travel to dermatology clinics while opening up dermatology clinic space for other patients. Due to a lack of participation by sites during the study which was conducted during the novel coronavirus (COVID-19) pandemic, the groups examined are Veterans who live in rural areas compared to those in urban areas.

Previously the study included a parallel trial to evaluate another teledermatology mobile app, VA Telederm. This trial was no longer feasible within this study's funding timeline due to limitations imposed on the mobile app by Office of Information \& Technology that were not under the control of the PI or the operational partner, Office of Connected Care (OCC).


Options:
A: Inclusion Criteria:

* All non-life-threatening emergency calls, which do not obligatory require an EMS physician on scene and which do not solely require an ambulance vehicle staffed with paramedics. study.

Exclusion Criteria:

* All life-threatening emergency cases, where a physically present EMS physician on scene is obligatory required. These include:

  1. Patient condition related indications:

     * Apnea
     * Acute respiratory failure
     * Cardiocirculatory arrest
     * ST-elevation myocardial infarction (STEMI)
     * Unconsciousness
     * Persistent seizure
     * Life- threatening rhythm disorder
     * Major trauma
     * Complex psychiatric disorders
     * Age \< 18 years
  2. Emergency case related indications

     * Major vehicle accident
     * (Traffic) accident with children
     * Fall from a height (\> 3m)
     * Gunshot-, stab-, or blow injuries in the head, neck and torso area
     * Fires with reference to personal injury
     * Carbon monoxide intoxication
     * Explosion-, thermic or chemical accidents with reference to personal injury
     * High-voltage electrical accident
     * Water connected accidents (drowning-, diving accident, fall through ice)
     * Entrapment or accidental spillage
     * Hostage-taking, rampage or other crimes with potential danger for human life (preventive deployment, police consultation)
     * Immediate threatening suicide
     * Immediate forthcoming delivery or preceding delivery
B: Inclusion Criteria:

* The inclusion criterion for the trial with direct to patient facing apps was that a site had greater than or equal to 9% of all Fiscal Year (FY) 2018 dermatology encounters under secondary stop codes 695/696.
* This indicated considerable pre-existing experience with consultative teledermatology and the likely presence of dermatology reader and support personnel needed to implement direct to patient facing apps.
* The investigators identified 31 sites eligible for direct to patient facing apps.
* We followed above criteria but due to low enrollment, an additional criteria was added that patients were included if they received a request to use the patient-facing mobile app.

Exclusion Criteria:

* VA medical centers with no 695/696 stop code activity in FY2018 or with zero full-time equivalent dermatologists were excluded since these sites likely lacked the expertise, support, and infrastructure to feasibly adopt teledermatology during the study period.
* The investigators also excluded sites outside the continental U.S., and sites without a dermatology clinic.
C: Inclusion Criteria:

* diabetic, at least 18 years old, patient at a participating health clinic
D: Inclusion Criteria:

* Be age 18 years and older
* Have physician-diagnosed plaque psoriasis
* Have access to internet and a digital camera or a mobile phone with camera features
* Have a primary care provider or the ability to establish primary care

Exclusion Criteria:

-

Answer: B