What is Teledermatology?


Teledermatology is the provision of dermatology services at a distance. Various information and communications technologies can be used to achieve this.

For example:

  • Video conferencing – this allows two health professionals to discuss a case, or a patient to consult a health professional directly. Modern technology using the Internet, virtual private networks or telephone systems can be very high quality almost as if both parties were in the same room.
  • E-mail – simple to use, but not very secure
  • Virtual Private Network – Secure store-and-forward system, as used by MoleMap NZ and Waikato Hospital's Virtual Lesion Clinic.
  • Web-based portal – specific websites that allow nonsynchronous messaging using a secure system to ensure privacy. New Zealand Teledermatology uses web-based Collegium Telemedicus.

Teledermatology reduces the difficulties of access to dermatological expertise and supports other health professionals care for their patients with skin diseases and conditions.

For more information about teledermatology, see links to other resources.

Explain the New Zealand Teledermatology concept

New Zealand Teledermatology's dermatologists offer advice to General Practitioners and other health practitioners about suitable dermatological cases, often reducing the need for a formal referral to an outpatient clinic.

Users log in at collegiumtelemedicus.org via desktop browser or our mobile application. They may browse options on the Main Menu page, list their cases and change their login/password as desired. The system informs users they have a message by sending them an email.

The co-ordinator

The contracting organisation (eg, DHB, PHO) appoints a co-ordinator. The coordinator's job is to liaise with and register referrers, to ensure quality and to manage each case.

The co-ordinator is also expected to review one or more cases as part of the Collegium Telemedicus monthly audit.

The referrer

Participating GPs, hospital doctors and nurse practitioners must first be approved by their co-ordinator, and registered as an individual referrer on the New Zealand Teledermatology network.

When a referrer adds a case, they are asked to provide clinical details. They can upload files including jpg images, text and PDF documents. There are fields for the patient's geographic location, NHI number, sex, age, and clinical information. No identifiable patient information is included.

Correspondence may ensue, and the specialist may request further information or suggest tests or treatment options. A progress report will be requested.

It is the referrer's responsibility to keep the patient informed about the consultation, and to manage their skin condition.

The dermatologist

Our dermatologists have been carefully selected by New Zealand Teledermatology. An advantage of a teledermatology consultation is that when a case is outside their expertise, they can ask for a second opinion from one of the other specialists.

They will endeavour to respond to messages in a timely fashion. They have the patient's best interests in mind. They will also provide educational feedback to the referrer.

We expect our dermatologists to tell the referrer if they do not have enough information on which to base a diagnosis or treatment recommendation, or if they think the patient should be referred to a local specialist for a physical examination.

The patient

The patient should be told about the teledermatology consultation and should have given informed consent to photographs and the consultation process. They may receive a copy of the messages if they wish.

Who can access case details?

For confidentiality, the specific case details can only be accessed by:

  • The referrer
  • The teledermatologist allocated to the case
  • Other signed-up doctors in the referrer's practice
  • Their organisation's co-ordinator
  • New Zealand Teledermatology co-ordinator
  • Collegium Telemedicus staff.

The referrer remains responsible for the care of the patient and may refer through their usual pathways in addition or on the suggestion of the teledermatologist.

Limitations

Teledermatology consultations are not suitable for all cases. Diagnosis and management recommendations are based on less data than at a face-to-face consultation when a physical examination takes place.

There are a number of published investigations of the reliability of store-and-forward systems like ours. These have shown that experts perform best when provided with very good clinical information and images.

The referrer should have some training in dermatology and dermatological terminology to effectively convey the patient history and to take appropriate clinical photographs.

Organisations and referrers should refer to the British Association of Dermatologists' Quality Standards for Teledermatology, which are mostly relevant to the New Zealand situation.

How do I join up?

Please contact us to discuss your individual needs. We can contract with healthcare organisations and individuals.

Referrers: find out how to upload your first case....



Video conference teledermatologyVideo conference teledermatology

Waikato registrars: Virtual Lesion ClinicWaikato Virtual Lesion Clinic

Message on Collegium TelemedicusCollegium Telemedicus message

Please note, New Zealand Teledermatology does not provide a direct-to-patient consultation service. Please see your own General Practitioner or other healthcare professional to find out how you can access a dermatologist. New Zealand Dermatologists are listed on the New Zealand Dermatological Society's website.
For further information about skin diseases and their treatment, refer to DermNet New Zealand at www.dermnetnz.org.