Teledermatology: Experience in Singapore

Abstract

Background The COVID-19 pandemic has accelerated the development and widespread adoption of teledermatology both locally and globally. As dermatology is predominantly a visual specialty, teledermatology is particularly useful for patient care and collaboration between health care professionals. Objective To share lessons learned from the local experience with teledermatology in Singapore. Methods The main models of teledermatology are asynchronous (store-and-forward), synchronous (real-time communication), and hybrid teledermatology (mixed combination of both asynchronous and synchronous elements). Results During the pandemic, teledermatology has enabled suitable patients to have continued access to clinical care in the comfort of their home, while at the same time supporting safe distancing measures to mitigate exposure to and spread of SARS-CoV-2. At the National Skin Centre in Singapore, asynchronous store-and-forward teledermatology is used for telecollaboration with doctors and nurses from external health care institutions, nursing homes, and primary care clinics. A hybrid model comprising synchronous phone or video teleconsultation with the patient, together with review of recent clinical photographs submitted by the patient, is used for the remote care of selected patients with mild and/or stable dermatological conditions. There is a high diagnostic concordance of 87% between teleconsultation and in-person consultation. As not all patients are suitable for teleconsultation, preteleconsultation triage is helpful. Conclusions Moving forward, even as we approach a new postpandemic era, teledermatology will continue to evolve and become an integral pillar of the health care landscape. Conflicts of Interest None declared.