Tele-Derm National: A decade of teledermatology in rural and remote Australia

Abstract

OBJECTIVE: To identify the current scope of Tele-Derm, the types of dermatological complaints experienced in the rural primary care setting, and to assess the quality of patient clinical information provided to the consultant dermatologist. DESIGN: Retrospective case analysis. SETTING: Tele-Derm National is an initiative of the Australian College of Rural and Remote Medicine and has been providing online educational and consultational services in dermatology to doctors Australia-wide for over a decade. PARTICIPANTS: Patient cases that were submitted to Tele-Derm for specialist dermatologist advice. INTERVENTIONS: Audit of submitted cases. MAIN OUTCOME MEASURES: The types of patient presentations and reason for submission for specialist opinion were analysed. The quality of clinical information provided was also evaluated. RESULTS: A total of 406 cases submitted over 2012-2013 were analysed. Most patients were from the outpatient setting with 'rash' or dermatitis (66%). Almost one-third of patients were paediatric cases. The average time from submission to dermatologist reply was 5.5 hours. Clinical photos were provided in 83% of cases and 73% of these were assessed as being of good quality. Management advice was provided in 77% of cases, of which reference to the case-based learning modules on Tele-Derm was made in 21% of cases. Patient outcome was largely unknown (83%). CONCLUSION: This study identified some of the common dermatological complaints presenting to rural and remote primary care doctors in Australia. The unique addition of professional development in Tele-Derm can be used as an adjunct to advice provided to the rural doctors seeking advice for patient management.