WA News Letters Caution for telehealth dermatology
Caution for telehealth dermatology
Written by Dr Genevieve Sadler
Thursday, 03 August 2017

Dear Editor,

The recent letter, Telehealth for Rural Patients (June issue), raises some interesting points. The value of improving access to health services in remote and regional areas is acknowledged. To avoid compromising care, it is important to recognise the limitations of managing dermatological conditions via telehealth.

Poor quality images, particularly with videoconferencing, and the inability to do a systematic full-skin examination, including palpation, for cutaneous malignancy or to determine the distribution of an eruption, are just some of the challenges. Biopsies may be required with careful consideration of the site and type of sample, and analysis by a skilled dermatopathologist.

The medicolegal considerations surrounding collection, transfer, storage and subsequent use of clinical images can be complex, as outlined in recently published guidelines.

Dermatology is generally more suited to a store-and-forward style of telehealth, rather than the current MBS reimbursed model. An established free service of this type can be accessed by any rural GP via www.acrrm.org.au/subscribers/rhof/apply-for-free-limited-access-to-telederm. Advice on individual cases is provided by a WA dermatologist, who can facilitate face-to-face follow-up if required. If funding is forthcoming, an enhanced model could be developed locally.

The WA Dermatology Faculty is committed to improving rural health. Many dermatologists regularly provide informal support to their rural primary health care and specialist colleagues through telephone advice and email contact.

There are about 1300 full-day Rural Outreach Dermatology Clinics operating each year throughout WA, as well as one dermatologist permanently based in Bunbury. We hope to work with WACHS to reinstate Dermatology Registrar involvement with these visits to promote and foster interest in working in remote areas. We are also proud to host the Rural Dermatology Meeting in Broome on August 11-13.

Dr Genevieve Sadler, Chair, WA Faculty of Dermatologists