Innovative teledermatology service speeds up care for patients

Patients with rashes and skin complaints can receive a diagnosis within just 48 hours under the Circle Nottingham Teledermatology service.

This revolutionary service is key in delivering a more efficient patient experience.

Patients who previously could have waited months for a hospital appointment are now instead having pictures of their condition sent for diagnosis via virtual consultant.

Over 20% of GP appointments are taken up by people concerned about skin abnormalities,and with the general population having more exposure to the sun, this will only increase the pressure on GPs and specialist dermatological resources.

The implementation of Telederm as part of the Nottingham Dermatology service has given local GPs a way to manage patients in a more efficient manner, which has freed up appointment times and crucially enabled perfectly healthy patients to be reassured more quickly or those that require treatment to start this a lot sooner.

Circle Nottingham’s Telederm is a fully integrated service with the ability and technology to take clear, detailed images of skin abnormalities and send the images securely to a Consultant Dermatologist to diagnose whether further treatment is necessary. The photographs are taken using a sophisticated dermatoscope lens attached to the camera of an image capturing device.

The set of high-quality images of the affected area are uploaded onto Circle Nottingham’s online portal, together with the patient’s record and then reviewed by a consultant.

The service is saving the NHS thousands of pounds in unnecessary referrals and has relieved pressure on hospital services because only those conditions that cannot be managed in primary care are sent for further treatment at the hospital. So far, over half of the cases referred to Telederm do not need to be physically seen by a Consultant Dermatologist and the service has saved the NHS over £100,000.

But this service is not just about saving money for the NHS. It is about delivering an improved, quicker and more reassuring service for patients.

The feedback from patients using the Telederm service has also been overwhelmingly positive. Patients report that the service reduces anxiety about their conditions because of provided reassurance quickly and offered treatment or intervention in a timelier manner. One patient remarked: “My GP was able to get a quick second opinion and start treatment without me having to wait for ages to see someone at the hospital” and another patient praised the avoidance of “repeat GP visits whilst waiting for an outpatient appointment”.

Patients can experience Telederm via two routes. The first enables primary care to take photographs of a patients skin complaint with a dermatoscope available within their own practice and immediately upload the images for assessment by a consultant on the online patient portal.

For surgeries without a dermatoscope available in their own practice, the second route enables a GP to refer the patient directly to Circle Nottingham and then patients are offered an appointment at one of several hub sites for images of the condition to be taken and referred for assessment on the electronic portal.

All images uploaded to the electronic portal system are reviewed by a consultant within 48 hours resulting in a decision that no treatment is needed, a referral for an outpatient hospital appointment or crucially, a referral to a two week cancer pathway.

The ability of Telederm to assist and speed up cancer diagnosis is crucial. Skin cancer is one of the most common cancers for people in the United Kingdom to suffer from.

The service offered by Telederm can result in a patient who complains of skin problems to a GP, receiving specialist skin cancer diagnosis within two weeks of their complaint.

For example, a patient who attended a GP appointment complaining of a skin abnormality on their cheek, had images of their complaint taken using Telederm and attended an appointment in a specialist cancer clinic only 11 days after originally presenting with their complaint. This would simply not have been possible without Telederm; the old system would have resulted in the patient being caught up in a slow and ineffective referral system and could have impacted the patient’s chances of recovery.

In an NHS care system that is experiencing a chronic shortage of consultant dermatologists, Telederm is helping to reduce the strains upon a sector that is struggling to effectively deal with the pressure that it is under. Put simply, Telederm has saved the NHS both time and money, while making sure that the patients who need treatment are not held up by patients who do not.

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