Year: 2025
Type: conference-abstract
Abstract: Urgent suspected skin cancer demand has grown 10–14% yearly from 2021 to 2024 in our region. Within this time period, 70% of cases had benign diagnoses, and cancer conversion rates reduced from 3.8% to 2.6%. Consultant vacancies and a lack of available workforce to increase consultant capacity have led to increasing waiting times and backlogs, with over 100 patients waiting > 62 days for first cancer treatment in December 2023. Our objective was to establish a teledermatology service for consultants to assess low-complexity referrals with dermoscopic images and medical history questionnaires to reduce demand for in-person consultant appointments. Clinical leads confirmed eligibility criteria and medical history questionnaires. Clinic space was identified, photography studio equipment was purchased and support workforce was recruited. This included medical photographers trained in dermoscopy, nurse biopsy specialists to support surgical demand and administrators to coordinate patients. Literature reviews found that 16–65 years was the most effective patient age range for teledermatology clinical outcomes. The initial age range was 16–50 years for phasing the service into practice. One provider has an older patient demographic, opening the service to up to patients aged 70 years to improve uptake. A technological solution was procured to functionalize the pathway. This included a referral system link for uploads, a digital questionnaire for patients to provide their medical history, an image bank to upload dermoscopic images, a platform to assess and determine outcomes for patients and an activity performance dashboard to assess benefits gained. Between June 2023 and August 2024, over 11 000 referrals were directed to teledermatology, and around 8000 (73%) patients were eligible. Around 4000 of those eligible (40% of total directed referrals) were discharged after assessment with benign conditions manageable outside of secondary care. Clinical leads fed back that around 15 teledermatology photo assessments were done per hour, compared with four appointments per hour. For teledermatology patients discharged, this saved 89 consultant clinics and 1246 consultant appointments. The backlog of patients over 62 days reduced from 100 to 30 from December 2023 to January 2025. Staff provided positive feedback about the technological solution and waiting times being reduced for higher-risk patients due to freeing up consultant appointment capacity. A patient-related experience measures survey was carried out between June 2024 and January 2025, with 1765 patient responses recorded. Over 75% of patients found their results email clear and understandable, and were likely to use the teledermatology service if referred again.
Source: British Journal of Dermatology
Authors: Antonia D’Cruz, Imran Hafeez, Rakesh Patalay
Institution: Guy's and St Thomas' NHS Foundation Trust
Language: English
Subfield: Oncology
Field: Medicine
Domain: Health Sciences
Open Access status: bronze
OpenAlex ID: W4411732685