There were two principal and longstanding issues that created the opportunity for
teledermatology to offer a solution to systematic diagnostic challenges in
Cheshire and Merseyside.
Firstly, historically poor IT integration meant the taking, transferring, and storage of
digital images was cumbersome, time consuming and unreliable for primary care
practitioners. For secondary care, the quality of images received was in most
circumstances insufficient to make any form of medico-legally sound clinical
assessment without first seeing a patient face to face in an outpatient setting.
The second issuewas the high level of inappropriate and benign moles and skin lesions
being referred by primary care to secondary care via the Two Week Wait (2WW) cancer
pathway, creating a significant pressure on trust dermatology departments.
Prior to the project roll-out:
- 30% of dermatology 2WW referrals were being referred unnecessarily
- this amounted to approximately 7,000 unnecessary referrals every year, at a cost of over £1 million.
The aspiration was to identify a smartphone/tablet app and software solution that could
easily take images, with the ability to attach a dermatoscope. These images required
safe storage and transfer into primary care systems and full integration with the patient
record before further processing and transfer into the NHS e-Referral Service system (e-RS)
for flow into hospital systems and secondary care opinion.