Benefits of teledermatology
In 2019-20 there were 3 million dermatology outpatient appointments in England, making it the sixth highest treatment function in terms of volume. Skin cancer is the most common cancer in the UK and dermatology services receive more urgent referrals for suspected cancer than any other speciality.
Departments struggle to meet this growing demand due to the limited consultant dermatologist workforce. The British Association of Dermatologists states in 2019, the unmet demand from new suspected cancers can mean that review appointments for patients with painful and debilitating inflammatory conditions are delayed, or clinics are overbooked.
Existing models of teledermatology triage services suggest a significant opportunity for managing demand for dermatology diagnosis, and in doing so releasing capacity for better quality and more timely treatment for those who need it.
A review of UK Teledermatology (Mehrtens, Shall, Halpern Clin Exp Dermatol 2019 44(8): 874-881) over fourteen-years found that 50% of cases were discharged to the GP with advice and 34% booked directly for surgery. A range of skin cancer teledermatology models have also been developed nationally.
Early skin cancer detection
An independent evaluation report has been completed looking at the deployment of the Dermicus teledermatology platform in NHS primary care on the Isle of Wight.
Waiting times between referral and review have decreased dramatically. Previously the average wait from referral to first consultant review was 26 days, for referrals that have been through the Dermicus platform the wait time is 0.6 days.
The case for change in delivery of dermatology outpatient services was already clear. The Third Phase of NHS Response To Covid-19 states that clinicians should consider avoiding asking patients to attend physical outpatient appointments where a clinically-appropriate and accessible alternative exists. Teledermatology triage provides that alternative for dermatology outpatient services and by taking advantage of available technologies can also improve productivity while providing the same level of access to high quality care, diagnostics and treatments.
An independent evaluation report states “Dermicus platform is of value in the current COVID-19 pandemic as it crucially keeps older patients out of the acute care setting. It will also be key to efficiently managing the glut of new referrals expected at the tail end of the pandemic, where patients who have delayed seeking advice on lesions may attend primary care.”
The national wound registry of Sweden (Riksår) has been using Dermicus for removing the variation in patient pathways for the management of chronic wounds. The benefits experience are numerous but most critically was an improvement in wound healing by 64%, a reduction in clinical time by 46% and antibiotic use declined by a third. A video detailing the experience of Dr Rut Öien of the national wound registry can be viewed here.