More than skin deep: how technology is clearing up Dermatology’s problem areas
One in four people in England and Wales, 13.2 million, see their GP about a dermatological condition every year, with 3.5m outpatient or day surgery attendances every year. In our previous blog we discussed how Isla reduced waiting times and improved outcomes across teledermatology services for urgent skin cancer referrals, but the technology has also been adopted as part of routine dermatology pathways, reducing service pressure and improving clinical pathways.
Isla is a secure cloud-based storage platform that has been adopted in over 30 NHS Trusts across over 40 specialties, including many dermatology services from urgent diagnosis cancer pathways to psoriasis and eczema.
Automated caseload management in routine pathways reducing service pressure
In terms of routine patients, Isla supports consultants to set up automated remote models of care whereby at predefined and scheduled intervals patients receive an SMS with a link allowing them to submit images and PROMs (DLQI, CADI etc). Patients do not need to download an app or have sign in credentials and so patient engagement is very high – around 78% of patients respond to a request for information on Isla.
Across Chelsea and Westminster NHS Foundation Trust’s routine clinics (acne, eczema, psoriasis etc), Isla has allowed the Trust to reduce follow up appointments by 15%. They have also shifted a large share of tele-appointments to a 5-minute virtual review rather than a 15-minute consultation and this is all made possible through facilitating an automated, asynchronous flow of patient-generated information into the healthcare setting.
At Alder Hey Children’s NHS Foundation Trust, Isla is used to triage patients through questionnaires with conditional logic. They are able to essentially send the same questionnaire out to all patients and with the questionnaire adapting to a patient’s answers. The impact is that the service has been able to double the capacity of their clinics through effective triage and patient prioritisation. This model has been so successful that it is now being replicated in other Trusts.
Responsive questionnaires add PIFU for safeguarding layer
At Harrogate and District NHS Foundation Trust, Isla is being used to support Dermatology’s PIFU (Patient Initiated Follow-Up) pathways whereby remote patient submissions and Isla’s scheduling functionality acts as a safety net which is less administratively intensive.
Streamlining biologic medications for psoriasis
Of the estimated over 2 million psoriasis sufferers in the UK approximately 10% are eligible for biologic medications; a clinical pathway that requires ongoing monitoring due to the immunosuppressant nature of the medication. Due to the workload of monitoring huge numbers of patients, Nottinghamshire University Hospital (NUH) sought to streamline this process for patients and clinicians.
Patients are sent SMS requests 7 days prior to clinic appointments where their submissions will be reviewed. These requests will then be sent out on a three monthly schedule for submission of pathway-specific information. Since the requests are triggered automatically by their appointment date and clinic code, after initial set-up, the admin time needed to request this vital data is minimal.
This pathway saves clinical time without reducing the quality of care. This remote model saves approximately 5 mins per appointment in paperwork and 15 mins in consultation time allowing more patients to be seen.
Dermatological conditions can severely affect the quality of life of sufferers and in some instances be life threatening. It is vital that the NHS master its response to these high volume, often complex, cases. Here we have seen a few examples of Trusts looking ahead to find solutions that will adapt to meet the changing needs of patients and clinicians.
