Teledermatology app helps GPs make fast, secure dermatology referrals
Brief
DMC Healthcare are a family-run healthcare provider who have been delivering clinically-led services to the NHS for more than 50 years. DMC approached NLS with an idea to develop a way for doctors to capture patient images of dermatology conditions more effectively. If these pictures – taken by a GP or healthcare professional (HCP) – could reach a consultant securely, reliably and quickly then DMC could cut consultation times, enable better triage and cut diagnosis and referral times for patients.
Solution
Teledermatology is a concept in which HCPs take photos of dermatology conditions then upload them to DMC through the NHS’ Electronic Referral System (ERS), so that a dermatologists can review the photos and often provide a swift diagnosis.
There are a number of challenges to overcome:
- Transferring photos manually from a camera or phone can be time-consuming and data can be lost
- Photos are often saved on the device – which is not compliant
- HCPs sometimes forget to remove patient photos from their camera, phone or PC.
NLS set out to develop a system that would beat these challenges and provide a restful and easy user experience. After conducting a series of stakeholder interviews with GPs and dermatologists we worked with DMC to develop a prototype which tested the user journey. We carefully constructed an end-to-end process including:
- Gaining patient consent for the pictures to be taken, using explanatory videos
- Capturing images and NHS numbers (using optical recognition if possible)
- Securely transferring optimised, compliant images and data into DMC systems and on into ERS
- Confirming to the patient and GP that images had been transferred securely
- Seeking feedback from patient and HCP
As well as the app itself, NLS also built an admin and permission system to enable DMCHealthcare to administrate image submissions and doctor access.
Results
The system was unveiled in summer 2019 and the DMCTelederm app is now in use by doctors’ surgeries in 8 Care Commissioning Groups (CCGs) across the UK, with more CCGs expressing interest in this technology.
The app has been downloaded by GPs and HCPs in these CCGs and their adoption of the new system is increasing on a week-by-week basis as the benefits of faster referrals and better triage become clear. They can now use either their own phones or a surgery tablet to capture the images, but these images are never resident on the device. Plug-in dermatoscopes can also be used to provide more image detail.
As the app is fully compliant with NHS developer guidelines, GDPR requirements and PCC requirements it is proving itself highly fit-for-purpose, and meets the NHS digital ambition to improve patient experience. Furthermore, as it has been built on a secure Azure cloud platform, it has almost limitless scalability for the growing adoption of this process.
“Initially we were interested in seeing if this technology could work to deliver better outcomes for patients in our surgeries. We worked with NLS to investigate the possibilities, and how best to approach the concept. As soon as we started, we were immediately impressed. Their thorough approach and technical understanding really stood out. NLS helped us unpick each of the challenges in turn and create something that has delighted HCPs and patients alike across our surgeries.
We knew we were onto something when NLS presented the ideas and prototype at our annual dermatology conference in 2018. Our consultants and GPs immediately recognised the value that this app could bring. Nevertheless, the execution was vital – throughout the project NLS have focussed unwaveringly on the end usability of the app as the key to success, and I’m pleased to say that that approach is now proven. HCPs and patients who use the app are finding it easy to use and facilitates better outcomes all round.”
Dr Ravi Gupta,Managing Director, DMC Healthcare
