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Clinicians rely on videos of seizures in order to support triage, diagnosis and monitoring. Traditional methods of in-person consultations limit patient contribution and clinician-to-clinician sharing of data.

Glaucoma are a group of neurodegenerative eye conditions causing progressive optic neuropathy. Patients can develop chronic changes to their eyes leading to progressive changes in vision. Patients are monitored for changes to the retina and can be managed conservatively, medically or surgically.

Patients on Isotretinoin  treatment (often called known by brand-name Roaccutane and often prescribed for acne) had to present negative pregnancy tests in face-to-face clinics. Female patients to submit pregnancy test results directly onto Isla which  the Trust pharmacists can access, allowing the pharmacy to administer the drug without delay.

Patients may also submit their outcome measure forms (DLQI, CADI, PHQ) the day before their appointment sent via an SMS with an encrypted link and outcome measures are then stored digitally and can be aggregated for a specified cohort.

Two-Week Wait patients are those with potentially cancerous lesions, due to the potential high risk, the standard is that the patients should be seen within 14 days. There is a huge demand for this service, however many of the lesions referred are benign. In order to differentiate the two, typically patients would previously be seen by a dermatologist in a face-to-face appointment. 

The teledermatology pathway instead gives the patients an appointment with a medical photographer, with a high-resolution camera, and the photos are reviewed by the consultant the next day. Patients also fill out a questionnaire on Isla prior to their appointment, and the responses  are stored and managed securely via Isla, a digital platform designed specifically for this purpose.

Isla integrates seamlessly with existing clinical systems and has been easy for patients and clinicians to use.

The aim of Two-Week Wait Telederm is to streamline the pathway, allow for shorter appointment times and provide clinicians with the information needed to make a swift diagnosis, reducing waiting lists and meeting the 14-day standard.

Patients requiring specialist rheumatological input often need long-term treatments and plans for their chronic conditions. Diseases can progress and flare unpredictably, and can lead to debilitating symptoms and such patients may struggle to engage with multiple face-to-face appointments.
Allowing clinicians a secure and simple way to remotely request photographs and videos from patients can reduce the burden on both the patient and the clinician. Patient questionnaire and Patient Reported Outcome Measures (PROMS) can also be requested or from the patients through Isla, allowing pre-emptive management of disease. Clinicians can view longitudinal progress of disease on Isla, and share these records among the wider MDT for continuation of care.

Community nursing teams provide care for patients in the community and in their own homes which can often be challenging due to the volume of caseloads and the complexity of some patient cases which may require further input such as safeguarding.
Isla allows nursing teams to support triage and monitoring of skin tears, wounds and other conditions and facilitating support recurring issues in relation to safeguarding and clinical monitoring. Patients and carers can remotely submit images and videos of conditions, allowing for close monitoring without the need for potentially disruptive and time-consuming visits. For continence management, Isla can send requests for assessments to be completed and photos to be captured remotely which can also be submitted by carers to inform clinical decision-making.

Surgical site infections following surgery contributes to a disease burden which ranges from superficial infections to life-threatening illness requiring intensive care.
Many of these infections are thought to be preventable and reducing these instances is a priority for health organisations given the high clinical costs to patients and the financial burden of preventable illness.
Isla provides a safe secure way for clinicians to upload baseline photos and videos of post-surgical sites and allows clinicians to monitor wound healing remotely in a secure, low-friction way.

Patients presenting with burns can require varying levels of clinical input depending on the nature and severity of the burn.
Isla provides a way for clinicians to request photos, videos and forms from patients or clinical referrers to aid triage and provide appropriate clinical care.
It also allows remote monitoring of burn healing where patients upload progress photos and pain forms at regular intervals for clinician review thus enabling early detection of infection and a review without a face to face follow up.

Eye disease can be monitored over time, and capturing high quality photographs of these changes over time is clinically valuable but often difficult to collate. Waiting lists for non-urgent disease can be long due to patient backlogs, exacerbated by Covid-19.
Isla allows clinicians to request patient photos, videos and quantitative values such as blood tests and PROMs to view remotely. They can also collect patient photographs during consultations and during follow-up periods.

Referrals come in from virtual fracture clinics, orthopaedics and acute trauma centres. Nurses in the Fracture Liaison Service would need to phone patients twice throughout their patient pathway, a process that was time-consuming and inefficient. Using Isla, these phone calls can be replaced by digital forms sent to the patients.

Speech and Language treats a varied range of conditions in children and adults, responding to physical challenges, developmental issues and rehab from traumatic events. Treatment is a long process and tracking progress across time and referrals is a challenge.

The ability to easily take, request and share videos of a patient’s progress is vital. For children the ability to be recorded at home or school without the disruption of a clinic visit yields more accurate results.

Plastic surgery is used to repair and reconstruct missing or damaged tissue and skin. The Isla platform can be used for post-operative wound surveillance as well as to capture a photo at discharge for a patient and provide them with care instructions and further information on their recovery. Requests for photographs can be triggered at various points at which risk of infection has been shown to be higher.

The recovery from caesarean sections involve careful monitoring of the surgical wound to ensure good healing and to identify early signs of infection requiring further medical input.

Isla allows clinicians to request photos, videos and forms from patients, who can then submit such data remotely.
This is particularly useful given the difficulties patients may face in attending face-to-face clinics when recovering postnatally and attending with newborn babies.
Isla allows clinicians to view recovery over time and at regular intervals, requiring less travel time for patients and identifying signs of infection early.

Patients are referred to the Plastic Surgery’s Laser department for hemangiomas which may require further input.
Depending on the nature of the growth, it can be managed with a watch-and-wait approach or may require more urgent treatment such as surgery.
Traditionally, photographing such growths for assessment required lengthy pathway through the trusts hospital photography department, or used unsecure methods of transfer of data.

Isla provides a secure and seamless way for clinicians to request photos from patients remotely, which can be viewed immediately, reducing the need for multiple hospital trips and reducing the time to treatment.

The role of the Tissue Viability Nurse is to develop and maintain an efficient tissue viability service for patients/residents; families and the MDT to prevent potential tissue damage as well as advise on current wounds.

Nurses use Isla to request photos of skin tears and pressure wounds at the point of referral from patients, carers, or care homes.
Nurses, or their community nursing colleagues, additionally capture photos when they go out to patients to build up a library of images of a patient. This supports recurring issues, safeguarding, and monitoring recovery.

There is a difficulty in standardising the use of PROMs to establish a baseline and then monitor a patient’s’ progress remotely to validate that intervention was effective and qualify whether the condition is improving or deteriorating, as well as a need to ensure patients have the right equipment to recover at home once discharged from the hospital.

Using Isla

• Form requests can be scheduled so that monitoring patients out of hospitals becomes automated and streamlined.
• Form data sit digitally within Isla which clinicians can then manipulate and aggregate to suit their needs e.g. audit.
•  Photos and videos can be submitted alongside forms where a view on mobility or healing would be valuable.
• Requests can be sent to family members or carers so that they may respond on behalf of the patient.

Videos are a powerful tool for the management of ASD to show interactions made by children in their homes and other environments outside of the hospital for assessment and feedback to parents or guardians. Clinicians can request that parents/guardians submit videos of their child – either captured live or uploading existing files
This flow supports a more informed diagnosis as their behaviour is unaffected by the presence of a clinician and their interactions are more organic. Subsequent videos submitted on Isla can be shared over MS teams calls between clinicians and parents to provide feedback to parents.

When children and babies suffer from an allergic episode, it can be difficult for parents/guardians to bring them to hospital for diagnosis and subsequent treatment. Therefore, a process is needed to make a quick initial assessment of allergic rashes to determine whether hospital intervention is required.
Dieticians can use Isla to request photos of rashes or any ad hoc flare-ups. This provides the clinical context to decide if hospital intervention is needed or whether the condition can be self-managed. Additionally, Isla can be used to capture photos of feeding tubes, food storage and stoma sites.