NHS Isle of Wight Clinical Commissioning Group - early skin cancer diagnosis
An independent evaluation report completed by the Wessex Academic Health Science Network Primary Care workstream, highlights the benefits of the deployment of the Dermicus teledermatology platform in primary care on the Isle of Wight for early skin cancer diagnosis.
The Isle of Wight has the highest incidence of skin cancers and lesions in England, exacerbated by a sunny climate and an older population. Dermatology accounts for 60% of all referrals made from primary care on the Island. Whilst outpatient dermatology clinics take place on the Island, some treatment is only available on the mainland which places a significant travel burden on patients.
Dermicus was selected as the teledermatology platform for the Isle of Wight via the WAHSN Innovation Surgery and forms part of the Primary Care Demonstrator Site Programme.
Wessex AHSN were asked to undertake a real world evaluation to look at the deployment of Dermicus primary care on the Island – particularly its impact on patient & clinician experience, any efficiencies generated, impacts on clinicians’ medical education related to skin cancer and the scope of its use.
The independent evaluation of Dermicus was completed using the MAST framework (Model of Assessment of Telemedicine 2010).
The deployment of Dermicus into the GP practices has been a positive experience for both patients and referring clinicians.
For the patients
- Increase accessibility and equal treatment for patients
- No unnecessary face to face appointments – Covid-19
- Reduced travel to referrals appointments
- Evaluation study showed patients found the Dermicus fast, easy, reassuring and an improvement to skin examination.
For the customer
Waiting times – between referral and review decrease dramatically. Previously for the Isle of Wight 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.
- For routine referrals the wait time decreased from 33 days
- For urgent referrals the wait time decreased from 27 days
- For 2 week wait referrals the wait time decreased from 10 days
Budget savings – the report showed here was an outpatient cost saving Jan – Feb 2020 of between £2,420 and £3,814, achieved by moving from face-to-face to tele consultations. On this basis, if the expected 600 dermatology referrals each year were all made across the Dermicus platform then the expected savings would be between £14,000-£23,000 annually.
Implementation and Adoption – The Dermicus platform is not complex and referring clinicians on the Isle of Wight have felt able to adopt the new way of working easily.
Changing times – COVID-19
The report was carried out during the start of the COVID-19 pandemic and an unexpected outcome from the original objective was that the Dermicus platform is of value for the challenges presented by impact of COVID-19, as it crucially keeps older patients out of the acute care setting.
The report also stated that Dermicus is key to efficiently managing the glut of new referrals expected as lockdown eases and following further spikes in cases. where patients who have delayed seeking advice on lesions may attend primary care.
”We have been using the Dermicus app now for 4 months or so. This system has proved to be excellent. During the testing phase patients were reviewed in person following the initial Dermicus Referral via the app. All cases seen showed that the clinical features and Dermatoscopic images were adequate in making a reasonable clinical diagnosis. Amongst these were 3 cases of melanoma which were all diagnosed correctly, and there were no cases missed. Dermicus was very useful in separating the concerned/anxious patients with benign conditions or ones that can be easily treat in local GP Practice”
Dr Richard Ashton