Online dermatological consults save patients time, money, and frustration

Blog Author: Clare O'Callaghan

In the past, when Salt Spring Island family physician Dr Shane Barclay had a patient with an unusual rash or a suspicious growth, he had two options: guesswork or sending the patient off-island to Victoria or, more recently, Vancouver to be assessed by a dermatologist (increasingly limited access to Victoria-based specialist care means patients are frequently going as far as the Lower Mainland for treatment).
 
But a new Teledermatology program funded by the Shared Care Committee, a joint committee of the BC Medical Association and the BC Ministry of Health, is working to change this by providing an alternate system for dermatological consults.

Now Barclay can take a digital photo of the affected area and submit this, along with relevant information from the patient’s medical record, to a secure web site to be viewed and assessed by a specialist. The specialist then provides a diagnosis and treatment recommendations, usually within a week. 

Known as store and forward (SF), this process eliminates the prolonged wait times for dermatologists that patients in rural, remote, and even urban areas of BC usually endure.

The Shared Care Teledermatology program builds on the consultderm.com system that’s been in use for more than 2 years in Alberta. Developed by University of Alberta dermatologist Dr Jaggi Rao, the system is currently used by more than 400 family physicians from Alberta and the Northwest Territories.

To date, systems using digital technology and aspects of the Internet have proven to:

• Have good diagnostic accuracy compared with face-to-face consultation.
• Decrease wait times and improve access for patients.
• Be favorably accepted by patients.
• Lower costs of patient care.
• Facilitate timely management of malignant skin lesions.

Currently there are four dermatologists (including one pediatric dermatologist) participating in the Shared Care Teledermatology program, and Salt Spring Island is one of a number of prototype sites. Situated off the coast of Vancouver Island, approximately 9 kilometres from Victoria,  it is the test ground for the SF system in a “rural close” community. 

Other sites include rural remote regions (Fraser Lake/Burns Lake/ Ft. St James/Vanderhoof and Prince Rupert and surrounding area) and an urban centre (Vancouver Downtown Eastside).

Plans are underway for an assessment of patient and physician satisfaction with the Salt Spring Island project, as well as an economic analysis of it.

Visit www.bcma.org/partners-patients for more information on the Shared Care Committee and its programs.