Dermatology beyond hospital walls

While dermatologists are not directly involved in the care of COVID-19 patients, the impact of the pandemic on the dermatology practice is evident.

For many people, the pandemic has caused an increase in skin problems opens in new tab/window related to the use of personal protective equipment (PPE) and the increase in personal hygiene measures such as the frequent use of hand sanitizers, hand washing, and the mask-wearing.

As patients become hesitant to visit hospitals to minimise the risk of Covid-infection, it made the detection and treatment of skin diseases or skin cancer challenging as in-person consultation significantly declined.

Offering evidence-based treatment wherever possible, enabled by mobile technology has been key in making providence of care more accessible.

Providing dermatology care at a time of social distancing

In dermatology, visual examination is a principal step for diagnosis, monitoring and treatment.

While teledermatology is not yet widely practiced in India, dermatologists and clinicians have started to lean on emails and messaging platforms such as WhatsApp to communicate with patients in a safe, convenient and timely manner. Its ease of use, accessibility and convenience has lowered barriers of seeking medical help for many.

The increased use of mobile technology for remote consultations is also due to the growing digital adoption in India, which is expected to reach 900 million smartphone users by 2025 opens in new tab/window.

Popular messaging platforms thus offer facilitation of remote consultation in dermatology through its numerous functionalities. For example, a smartphone’s camera allows patients to take images of skin lesions which they can send to their doctors to triage skin conditions.

However, for patients who have severe or chronic conditions, in-person consultations are still necessary. With this approach, the challenge is to replicate the same standard of medical care for physical consultations. Another area of concern with teledematology is on data security and privacy, particularly with the use of third-party applications, that are not specifically designed for teleconsultations.

Nonetheless, the benefits of remote consultations are undeniable. For patients, teleconsultations are both money and time efficient. Remote consults eliminate the need to travel to physical clinics, which lowers the barrier of seeking medical help, especially for those with busy schedules and live far away from cities where most clinics are located, thus it is likely that teledermatology will likely play a greater role in providing care even post-pandemic. The implementation of digital safety and privacy opens in new tab/window measures may be the key to driving adoption to this new method of care.

As conventional consultation models and patient management systems are being adopted for this new modality of care, clinicians in dermatology, like any other medical specialities, must be trained and become comfortable with this approach.

Keeping clinicians’ knowledge up-to-date

Medical knowledge and sources of evidenced-based information are evolving constantly, and the ways in which clinicians access information to find what they need are wider and more varied than ever. Therefore, clinicians can also benefit from the use of mobile technology for medical training and to access clinical information, particularly at the point of care.

Unfortunately, it is still difficult for clinicians in India to access timely, high quality and relevant knowledge in dermatology despite the plethora of resources available online.

For many medical dermatologists, there are barriers to using evidence-based knowledge to inform clinical decision-making in both remote and the hospital setting. While new drugs and biologics are constantly introduced in the field, limited access to literature opens in new tab/window, cost and limited case studies in India were barriers to its application for the common people.

Ease of access of research will not only support objectivity in offering courses of treatment. Solutions with treatment flow-charts and algorithms particularly at the point of care will also help clinicians be more efficient, compared to referring to full literature, which can be time consuming. The use of mobile technology for medical training and to access clinical information, is thus necessary to improve patient outcomes.

Ensuring that a clinician’s medical knowledge is guided by evidence-based information can also create a positive impact in patient engagement. This is because clinicians play an important role to help patients understand what is being communicated to them, in order to actively participate in their healthcare decision-making and care plan adherence.

Evolving with new technology

The advancements in mobile technology will continue to transform the dermatology practice in the years to come. For instance, one local start-up launched an AI-driven platform opens in new tab/window in 2020 to enable online skin consultations in small and rural areas.

Therefore, as patients increasingly embrace such technology, there is a need for evidence-based clinical knowledge to be accessible, trusted, and relevant.

And while modes of teleconsultation in India are still limited, the functionalities afforded by smartphones are providing new opportunities to deliver remote care when they are most needed. This, without a doubt, is something that we need to adapt and live with in the new normal.