Teledermatology – Advantages of Remote Skin Consultation

Last 3 weeks we have covered 3 posts in this 5-part series on Teledermatology:

• Different Forms of Skin Consultation
• Skin Images and Patient Information
• Shortfalls in Teleconsultation

Teledermatology takes away the need to travel and meet in person with the skin specialist. This brings about numerous advantages such as:

Shorter wait time – Compared to traditional referrals, a referring physician that a patient sees (nearer and more accessible) can help to capture, store and transmit the patient information and skin images to a dermatologist. The access to a dermatologist is therefore faster.

Accessibility for patients who live in areas without dermatology care – Singapore is small but in many other countries, specialist dermatology department may only be available in certain areas and teledermatology is a way for patients living in more remote areas to have access to specialist care.

Familiarity – For skin issues that both the referring clinician and the dermatologist feel that it is appropriate for the dermatologist to prescribe a skin management plan and the referring clinician to administer and be responsible for the patient interaction and care, the patient will then be seeing the same doctor (referring clinician) who he/she has already established a relationship with.

Convenience – Potentially faster, cheaper and less stressful than to travel and visit another doctor.

More detailed record – As the process of teledermatology is reliant on the transmission of patient information, images and then the relay of the diagnosis and treatment plan, followed with the outcome of previous treatment, there is a well documented record of the patient information and the skin condition. This record may be more detailed in in-person consultation.

Reduction of waiting lists at dermatology clinics – As certain skin conditions do not warrant establishing a relationship with dermatologist but rather straightforward in the diagnosis and treatment, the waiting lists at dermatology clinics can be shortened.

However, it is NOT ALWAYS that these advantages can materialize and both the referring physician and dermatologist can take actions and have systems in place to ensure success in teledermatology:

At the Referring Physician

1. Proper record of patient information, medical history and the history of the skin lesions
2. Staff to take skin images that meet the guidelines of images in teledermatology – dermatology nurse trained to take high quality skin images
3. Integrated system at the referring physician to incorporate teledermatology
4. Proper planning of the consultation process at the referring physician to take the images required after the consultation
5. Selection of patient – Patients who are resistance to teledermatology, for instance, elderly, shy or young patients, or with rash at private parts should not be pressured to consent to teledermatology
6. Educational materials on the diagnosed skin condition to be available for the patient and the care team

At the Dermatologist

1. Dermatologists who signed up for teledermatology should have the resources to promptly feedback on the information provided by the referring clinician
2. Dermatologists should have resources for the referring clinician and his/her clinic on various skin conditions
3. Close communication and record of patient care with a system to obtain feedback and address weakness in the process
4. Patients should not have to furnish information all over again if referred for an in-person consultation at the skin specialist clinic, i.e. teledermatology should be integrated with the specialist clinic system
5. Patients should have a shorter waiting time for in-person specialist skin consultation compared to traditional referral
6. Patients should have easy access to dermatologist for face-to-face session
7. Patients should be given clear skin management plan

If traveling to the dermatologist is not an issue to begin with and the mode of teledermatology is video conferencing, there may not be much cost/time-savings involved. On the other hand, it benefits certain situations such as elderly living in a home who may not have access to specialist care if not for teledermatology.

If you want to understand more of the quality standards in teledermatology, do read British Association of Dermatologists’ standards. Share in the comments if you have benefited from teledermatology and what advice you have for patients to get the most out of it, your sharing will help another!