Qualitative study aims to explore patients' perceptions of a teledermatology service

Reviewed by Emily Henderson, B.Sc.Aug 2 2022

JMIR Publications recently published "Patients' Experiences of Telemedicine for Their Skin Problems: Qualitative Study" in JMIR Dermatology which reported that this qualitative study aimed to explore patients' perceptions of a teledermatology service linking public primary care clinics to the national specialist dermatology clinic in Singapore.

Semistructured in-depth interviews were conducted with patients who had been referred to the teledermatology service.

The following 3 themes were identified from the data of patients' experiences:

1. Positive perceptions of teledermatology
2. Concerns about teledermatology
3. Ideas for improving the teledermatology service

The patients found the teledermatology service convenient, saving them time and expense and liberating them from the stresses incurred when making an in-person visit to a specialist facility.

This narrative exploration of users' experiences of teledermatology produced rich data enabling a better understanding of the patients' journey, the way they understand and interpret their experiences, and ideas for service refinement.

Dr. Helen Smith from The Nanyang Technological University said, "The Global Burden of Disease lists skin disease in the top 20 leading causes of disability-adjusted life years, and the 4th leading cause of disability worldwide."

With dermatological disorders being so prevalent, it is not surprising that many consultations with a primary care physician focus on skin symptoms. A study in the Netherlands reported that about 13% of patients visiting a primary care practice were seeking help for a skin problem, and in the UK, the estimate was even higher at 24%.

When there is diagnostic uncertainty or unresponsiveness to treatment, the primary care practitioner will need to refer the patient for an expert dermatological opinion.

JMIR Dermatology: Patients' Experiences of Telemedicine for Their Skin Problems: Qualitative Study https://t.co/jRw2DfCU6N pic.twitter.com/fe32atJS5n

-; JMIR Publications (@jmirpub) February 22, 2022

The store-and-forward teledermatology consultation involves digital images being sent to the expert for later review, whereas live videoconferencing consultations are synchronous, with the patient and the clinicians interacting in real time.

With the aim of bringing specialist care closer to patients in order to reduce the expenditure and waiting time for specialist referrals and to increase the dermatology skills of family physicians, the National Healthcare Group Polyclinics and the National Skin Centre collaborated to introduce the first teledermatology service in primary care for Singapore.

This teledermatology process is mediated by "Derm Champs," family physicians with a special interest in dermatology and with a graduate diploma in Family Practice Dermatology or a master's degree in Family Medicine.

The Smith Research Team concluded in their JMIR Publications Research Output that even though telemedicine has been available in many countries for more than 20 years, its incorporation into patient care has been patchy and often confined to remote areas, or where there is a paucity of appropriate expertise.

In countries where remuneration is fee-for-service, the adoption of telemedicine has been complicated by disputes over the disparities in pay for telemedicine versus in-person care.

With the COVID-19 pandemic in Singapore, we are seeing telemedicine being used more widely to reduce travel and enable safe distancing.

Perhaps this pandemic will provide the catalyst for practice redesign, with in-person health care becoming the second rather than the first option for patient care.