An Australian telehealth dermatology service has been described as “five years in front of” anything else in its field at a recent global conference.
The Teledermatologist smartphone platform, developed by the team behind Newcastle Dermatology, offers same-day consultations for patients in rural and regional areas.
“At the World Congress of Teledermatology last year, the feedback from committee members was that our service is five years in front of anyone else in terms of the way we've done it and the platform we've used,” said Murray Corbett, who is CEO at Newcastle Dermatology and has dedicated much of the last two and a half years to developing Teledermatologist.
The platform, which has been in operation since July, involves two apps built around FileMaker Pro 16 and incorporating a custom video conferencing system and SSL/TLS 256-bit encryption.
The first app – the client-facing app – uses the phone's built-in camera to take high-definition photos of the area to be treated and collects basic patient information.
It can be used by patients, GPs and nurses to request a new case.
“The photos are all kept within our app – they're not stored on the doctor's or the patient's phone – and we're alerted to the fact that someone wants a consultation. Our coordinator then collects a referral and appoints one of our rostered dermatologists to the case, ” Corbett said.
“Generally speaking, we can hook someone up to a dermatology conference within a few hours, as opposed to them waiting six months and travelling hundreds or thousands of kilometres.”
Meanwhile, the dermatologist-facing app allows the specialist to easily navigate between the secure video conference, referral letter, patient details, photographs and notes section.
It allows dermatologists to not only diagnose, said Corbett, but also treat patients with the help of local healthcare professionals.
“If it's something like a rash or there's a suspicious spot that a GP is not able to identify, the dermatologist is able to give a likely diagnosis of the condition and advise the GP and/or the patient as to the optimal treatment options, he said.
In those instances that local treatment is not available or appropriate, Teledermatologist helps the patient coordinate treatment with the nearest dermatologist, plastic surgeon, or other appropriately trained health professional.
Corbett said a 150% Medicare rebate was available for all patients in aged care facilities, locations classified as Remote Area 2 and beyond, and those using Aboriginal and Torres Strait Islander health clinics.
The same-day service is made possible by the platform's ability to offer dermatologists flexible work.
“The dermatologist-facing app allows the dermatologists to nominate when they are available for consults. This is particularly helpful for those working part time or raising a family, who may have an hour here or there to spare for a couple of consultations,” Corbett said.
“This is a huge benefit to the community as it re-engages the skills of the dermatologist who would otherwise have been unavailable.”
When development of Teledermatologist first began, the quality of some older smartphone cameras presented a potential hurdle, Corbett said.
But with the latest smartphones that has largely been eliminated.
“If you use Apple as an example, anything past an iPhone 5 has a pretty good camera and focus lens in it,” he said.
“This technology is the next logical step beyond the tradition ‘store and forward’ method that has served medicine for the last 25 years,” Corbett said.
Now the biggest challenge is getting GPs to embrace the solution.
“Many country GP’s have had experiences with first generation video conference telemedicine over the last 10 years where it's often resulted in a frustrating experience,” Corbett said.
“We're trying to get GPs to trust that this really is easy – all they have to do is download an app or contact us, upload photos and send us a little bit of information. We do the rest."