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teledermatology

Teledermatology

Teledermatology refers to the use of digital images to triage, diagnose, monitor or assess skin conditions without the patient being physically present.

<p>Teledermatology</p>

Teledermatology use in primary care has seen rapid expansion, with clinicians using Advice and Guidance  (A&G) services to obtain specialist advice and guidance on the management of patients. These services are provided by community and secondary care providers via NHS e-RS (Dermatology A&G FAQs) and other commercial platforms and apps. Advice and Guidance requests in e-RS can be directly converted to a routine, urgent or rapid skin cancer referral/appointment by the Dermatology team if clinically indicated. Many services now use A&G as an ‘Advice and Referral’ service, allowing optional two-way dialogue with the referrer, and interim advice to optimise primary care management while the patient waits for their dermatology appointment. Advice and Guidance / Advice and Referral services are recommended at the point that an outpatient referral would otherwise be considered, in line with Dermatology Referral Guidance.

Teledermatology can provide a rapid diagnostic pathway to support early diagnosis of skin cancer. The use of macroscopic and dermoscopic images taken in primary, community, or secondary care can help clinicians determine those patients who can be discharged back to the GP and those patients who require further review or triage to a surgical appointment.

The Community Diagnostic Centre (CDC) Programme is supporting the establishment of teledermoscopy use in over 30 CDCs over the next two years. In England the Skin Cancer Faster Diagnosis Standard supports the use of teledermatology and teledermoscopy to inform patients of a non-cancer diagnosis by letter or telephone and streamline patients requiring review to clinic or skin surgery.

Teledermatology brings new ways of working and its activity needs to be resourced appropriately and included in dermatology clinicians job plans. Any clinician undertaking dermatology work should be up to date in this area of practice. The British College of Dermatology (BCD) is also supporting the expansion of teledermoscopy courses for a wide range of health care professionals. This includes working collaboratively with the Institute of Medical Illustrators on their eLearning photography courses for Healthcare Professionals.

The BAD continues to support safe expansion of integrated teledermatology services with our stakeholder organisations. This includes advising on a number of guidance and resources which are outlined in the table below.

The national Teledermatology Roadmap has been updated to support the implementation of safe and effective teledermatology triage pathways and processes in England, and many of the principles are transferable across the UK.

NHS e-Referral Service

All GP practices in England are required to use the NHS e-Referral Service (e-RS) to refer into consultant-led new out-patient appointments. If commercial A&G platforms are used pre-referral, then any A&G requests converted to referral are required to be received through e-RS by the provider organisation.

e-Referral Service

NHS England Guidelines and Resources relevant to Teledermatology Clinical Pathways

NHS England have collaborated with the BAD to produce resources to support clinicians, commissioners, and service managers to optimise Teledermatology pathways to improve patient access to specialist care.

The NHSE Teledermatology Roadmap

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Specialist Advice: Clinical Responsibility and Medicolegal liability FAQs

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NHSE Systematic approach to referral optimisation in Dermatology

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Innovative approaches to support early diagnosis of skin cancer

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Implementing a timed skin cancer diagnostic pathway

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Advice and Guidance Toolkit for the NHS e-RS

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Dermatology e-RS Advice and Guidance FAQs

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NHS Transformation Directorate Dermatology Digital Playbook

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Teledermatology Training

Clinical Photography on Mobile Devices - Practical, legal and ethical requirements

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IMI Teledermatology Toolkit - Institute of Medical Illustrators

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NHSE Video demonstration for clinicians to take images

View

NHSE Video demonstration for the admin process to request advice and guidance

View

NHSE Video demonstration for patients to take and send images to their GP

View

UK guidance on the use of mobile photographic devices (2017)

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PCDS: Photography resources for patients and clinicians on taking images

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RCGP Dermatology Toolkit

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Quality Standards for Teledermatology (2013)

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Dermatoscope Comparison Table

View

Teledermatology Events and Educational Resources

The BAD Teledermatology subcommittee members provide and contribute to regular educational events and meetings.

EVENT

The Teledermatology Training Day 2023

The Teledermatology Training Day will run as a virtual course on Thursday 16th November 2023 with the option for delegates to watch the material for 1 month following the event.
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EVENT

The Annual UK Dermatology Course for Consultants 2023

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EDUCATION RESOURCE

Dermatology syllabus guidance (Aug 2021)

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EDUCATION RESOURCE

Dermatology curriculum (March 2020)

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Contact the Teledermatology Team in the Transformation Quality Improvement Unit
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