Virtual Assistants in Teledermatology May Improve Quality of Life for Patients With Psoriasis

A prospective study found that patients and providers saw benefits while using a virtual assistant integrated into a teledermatology program.

Integrating a virtual assistant program into teledermatology for patients with psoriasis improved quality of life (QOL) and showed good usability, according to results of a yearlong prospective study. The findings, published in International Journal of Environmental Research and Public Health, are in line with prior research suggesting virtual assistants can elevate teledermatology.

Teledermatology typically includes apps and at-home platforms where patients can share images with dermatologists to track progress and responses to therapy. It provides additional opportunities for communication between patients and dermatologists between visits, which can lead to better treatment outcomes, and allows dermatologists to review many cases in a shorter time frame. Several apps for psoriasis monitoring already exist, as do tools for patient well-being.

Integrating virtual assistants, or chatbots, into teledermatology systems provides an additional resource for patients. These programs perform tasks or services for patients through voice or text. They have been tested in several contexts, including correcting misinformation in forums with automated responses. Studies have also shown virtual assistants or smartphone applications to improve medication adherence.

“Online care compared with in-person care showed equivalent improvements in disease severity among patients with psoriasis,” the authors wrote. “The improvement of QOL for online and in-person care was also studied, which found that the online model and the in-person care had similar enhancement for psoriatic patients.”

The new study built upon earlier findings and assessed the QOL impact that virtual assistants may have on patients with psoriasis. The virtual assistant program in this study was a smartphone chatbot run through Signal, an end-to-end encrypted messaging platform. In addition to QOL measures, participants were surveyed on the platform’s usability via the System Usability Scale (SUS).

Thirty patients with psoriasis and 4 health care professionals (3 dermatologists and 1 nurse) participated in the study. Eligible patients used the platform for at least 4 months depending on time of enrollment within the year, and they completed the final satisfaction survey. QOL surveys included the Psoriasis Quality of Life (PSOLIFE) and Dermatology Life Quality Index (DLQI) questionnaires. Patients used the virtual assistant for 52 remote consultations with providers and 29 photos submitted by 4 patients (13.3% of the cohort) were stored in the virtual assistant.

Overall, patient QOL improved with use of the platform. Average PSOLIFE score improved from 63.8 to 64.8, and the average DLQI score improved from 4.4 to 2.8. Treatment adherence also slightly improved, possibly because patients may pay more attention to treatment while using a tool related to their disease. Increased physician availability via messaging may also be a factor. The system had a SUS score of 70.1, indicating above-average usability. In the final questionnaire, 73.3% of patients and all the health care professionals liked the idea of using a virtual assistant after the study was over.

Additionally, 83.3% of patients reported that the ability to contact their dermatologists via a messaging app between consultations brought them a sense of security or peace of mind. Face-to-face consultations generally continued at the same rate they had prior to introducing the virtual assistant, emphasizing the role of the assistant as a complement to in-person appointments rather than a replacement.

Overall, the study supports the use of virtual assistants in teledermatology for patients with psoriasis.

“In the future, we will consider the integration of the virtual assistant with the hospital’s electronic medical record and using it for other chronic diseases,” the authors concluded. “We will also conduct detailed evaluations of long-term effects on health care professionals, such as the possible burnout created by the incorporation of virtual assistants to their working time.”


Roca S, Almenara M, Gilaberte Y, et al. When virtual assistants meet teledermatology: validation of a virtual assistant to improve the quality of life of psoriatic patients. Int J Environ Res Public Health. Published online November 5, 2022. doi:10.3390/ijerph192114527

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