The Children’s Hospital of Philadelphia proves Parents can get Paediatric Dermatology Diagnoses without the need for Office Visits in Most Cases if we let them just share Cameraphone photos

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“Using smartphone cameras, parents can reliably take high-quality photographs of their child’s skin condition to send to a dermatologist for diagnosis. This finding suggests that direct-to-patient dermatology can accurately provide pediatric dermatology care.

“Advances in smartphone photography, both in quality and image transmission, may improve access to care via direct parent-to-provider telemedicine,” said Patrick McMahon, MD, pediatric dermatologist at CHOP and senior author of the study. “Our study shows that, for the majority of cases, parents can take photographs of sufficient quality to allow for accurate teledermatology diagnoses in pediatric skin conditions. This is important because pediatric dermatologists are in short supply, with fewer than 300 board-certified physicians serving the nation’s 75 million children.”

Forty patient families participated in the study between March and September 2016. The study team provided photography instruction sheets to 20 families, while the other 20 received no instructions. The sample represented a wide range of ages, ethnicities, and socioeconomic backgrounds, as well as both genders equally. The majority of parents used an Apple iPhone, with the rest using an Android phone.

The researchers compared diagnoses made during in-person examinations with photograph-based diagnoses made by a separate clinician. Overall, of the 87 images submitted, the researchers found that 83 percent of the time, the photograph-based diagnosis agreed with the in-person diagnosis. Only three images did not permit a conclusive remote diagnosis, owing to poor photographic quality. Among the photographs considered high-quality enough to make a diagnosis (37 families), there was an 89 percent agreement in diagnoses.

McMahon noted that skin complaints represent 10 to 30 percent of all 200 million pediatric office visits each year, adding, “While many children’s skin conditions can be handled without input from a pediatric dermatologist, the national shortage of specialists is a known barrier to accessing care. Our findings suggest that telemedicine could improve access for patient families who have geographic, scheduling or financial limitations, as well as reducing wait times.” Media Contact: Joey McCool Ryan, McCool@email.chop.edu 267-426-6070
@chop_research http://www.chop.edu

mHealth Insights

It’s great to be able to share this news as there have been so many really low quality research efforts in this area over the years..

At the GP Continuing Professional Development (CPD) courses that I attend there’s typically a Dermatology Consultant giving a presentation where they will be giving brief clinical histories and showing images on a powerpoint slide show while polling the audience with a multiple choice set of answers to which the delegates must raise their hands. In most cases the GPs were completely wrong (eg. with only a small minority picking the correct answer) and the Consultant Dermatologists end up joking with them about how bad they are. It has me convinced that we should never leave the responsibility for diagnosis with a busy GP who doesn’t have a special interest in Dermatology when those pictures and a medical history (shared via a clinically validated medical history taking online questionnaire) could be now so easily supplied by Parents/Carers without the need for an office visit or the expensive/time consuming administrative mechanisms (of making an appointment with a GP, going to the GP, getting referred to the Practice Nurse to have a few pictures taken, getting the GP to enter a bit of history into a referral letter, waiting for the Consultant dermatologist’s secretary to receive/read the letter and schedule an appointment, the Patient then to make the appointment and get an accurate diagnosis and treatment plan – all the while worrying about the condition and possibly even experiencing symptoms getting worse).

In 2018 NHS GPs will see more than 13 million Patients reporting with skin problems and more than 750,000 will be referred on to see a dermatologist. Why can’t the NHS just enable Patients/Carers to just reach into their pockets and communicate with the tools of our time?

Related post: Perhaps it’s time we stopped saying ‘go and get help’?

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