Abstract
The COVID-19 pandemic has required health services worldwide to adapt to dramatically changing healthcare needs and risks across all medical specialties. In the dermatology department at Princess Alexandra Hospital, Brisbane, Australia, we developed and implemented a teledermatology system with 1 week's notice to help reduce infection risk bidirectionally, while saving patients many hours of travel and waiting time with acceptable technological substitutes for the clinical encounters. In this study, we report the efficacy and tolerability of our telephone consultation and store and forward imaging system, including patient experience from validated survey data. Our design, implementation and usage of a remote-default system provides experience and lessons to draw upon in developing future telemedicine systems to address dermatology service maldistribution – an issue affecting large areas of Australia – as well as preparedness for future infection mitigation requirements.
Highlights
The COVID-19 pandemic has required health services worldwide to adapt to dramatically changing healthcare needs and risks across all medical specialties.In the dermatology department at Princess Alexandra Hospital, Brisbane, Australia we developed, and instituted a teledermatology system with 1 week’s notice
In-person clinic attendance was reduced by 95% at the initial peak of the pandemic while maintaining high clinical throughput: a sample of medical dermatology clinic sessions in the first 2 months of the teledermatology system showed higher patient numbers than the same period the year prior
Surgical clinic sessions were more negatively impacted by the pandemic: appointment counts under the teledermatology system were only 11% lower than usual, these appointments served only as a safety check – urgent, complex lesions were subsequently booked for in-person management; patients were otherwise advised to see their general practitioner for other skin concerns
Summary
The COVID-19 pandemic has required health services worldwide to adapt to dramatically changing healthcare needs and risks across all medical specialties. In the dermatology department at Princess Alexandra Hospital, Brisbane, Australia we developed, and instituted a teledermatology system with 1 week’s notice. This system comprised of appointments conducted by telephone, and the capacity to receive images by email. We discuss the successes and lessons of implementing this simple system which helped reduce in-person patient numbers and infection risk bidirectionally, while saving patients many hours of travel and waiting time. Until the current pandemic, face-to-face assessment had been the modality for most routine and urgent appointments and comprised the vast majority of patient care
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