BT11 Bringing clinical photography closer to home: reporting on a prototype Community and Locality Imaging Centre model

Abstract

Abstract Teledermatology services are widely used and operate using different models. We work with a long-established teledermatology service across a mixed rural and urban population, where primary care attaches images of variable quality to secondary care referrals. We have previously reported that introduction of a high-quality image to select patients in this system can improve diagnostic accuracy. We now report on the establishment of a prototype Community and Locality Imaging Centre (CLIC) designed to capture high-quality photographs, including standardized macro, localizing and dermoscopy views to reduce travel for selected patients. We assessed the potential impact of this model over a 2-week period in one locality of our catchment area in spring 2022 through data review. In total, 203 referrals were screened by a single consultant over the 2 weeks of interest: 122 (60.1%) lesions and 81 (39.9%) rashes. Of all lesions referred, 51 (41.8%) were vetted to CLIC for the capture of additional, higher-quality images. Eighty-six per cent of patients referred to the CLIC attended their appointment. Of those who attended, 70% attended within 1–2 weeks, and just over 91% of patients attended within 4 weeks. Ninety-five per cent of patients who attended lived within a 10-mile radius. Of those who attended the CLIC, 36% were returned to primary care with advice or reassurance and did not require face-to-face appointments. The remaining patients were booked for appointments, with some given advice on treatment that could be initiated immediately while awaiting appointment. Our existing system allowed 29% of patients to be managed remotely. The introduction of a prototype CLIC permitted an extra 8% of referrals to be managed without attending dermatology, bringing this to a total of 37%. The prototype CLIC combined with the primary care image-capture teledermatology model allowed more patients to be managed remotely, and also permitted patients to bypass initial consultation and be appointed directly to services such as surgery, phototherapy and patch testing. The 91% attendance rate for the CLIC within 4 weeks suggests that patients found the model accessible. Meanwhile, shorter travel distances could potentially reduce overall patient carbon emission. The CLIC model can benefit patients who return to primary care, as they only need to attend for clinical photography instead of waiting for an in-person appointment. The introduction of a CLIC on an already efficient teledermatology model will enhance the patient journey and support efficient decision-making. The CLIC model is being developed through the use of a mobile app by trained nurses, with the intention to produce standardized, high-quality data suitable for real-world AI use.