New Diagnosis Scheme To Reduce Waits For Suspected Skin Cancer Patients

A new GP initiative for referrals involving suspected skin cancer has been introduced in mid-Ulster and south Belfast.

The simple scheme uses digital images taken by a doctor and sent directly to a dermatologist for assessment, sparing patients of the agonising wait for a hospital appointment.

The system is designed to provide rapid and high quality assessments by consultants, and is believed to be a world first.

The SMARTderm app and device, designed by the HSC Primary Care Elective Transformation team, ensures that pictures are sent quickly and securely to the hospital.

It marks the first time on the island of Ireland that the SMARTderm app has been used to transfer images between primary and secondary care.

Approximately 12,000 patients in Northern Ireland are waiting over 9 weeks for their first dermatology outpatient appointment. The new service will also free up appointments as it will reduce the number of patients needing to be referred for a hospital outpatient appointment.

The scheme is among a number of primary care initiatives aimed at transforming the way services are provided. It is being taken forward by GPs and Dermatologists, in partnership with the Health and Social Care Board and Public Health Agency.

The GP-led service will see family doctors and practice nurses trained to take digital photos with the SMARTderm app and device. Once taken, the images are attached to the GP's referral letter and securely transferred to a dermatologist who will make the initial online assessment.
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Magherafelt-based GP Dr John Diamond is among one the first to get involved in the initiative. He commented: "This is a truly transformative scheme. Using our own specially designed equipment and the SMARTderm app, we can now take photos in our own practice and send them to our consultant colleagues so patients can be triaged in a more timely fashion and reduce the need for many of them to attend hospital.

"Within 72 hours the image will be examined, with a letter confirming the outcomes sent to the GP and patient. These include offering reassurance if there is no need for further assessment, booking an outpatient appointment or booking minor surgery or an onward referral to a plastic surgery specialist.

"It will avoid a potentially lengthy and anxious wait for a hospital appointment and also help free up appointments for other patients. We're grateful to all those involved, including the commissioners, who have worked tirelessly to make this project a reality."

Dr Diamond also highlighted the opportunities for other specialty areas which may benefit from photographic triage, such as dentistry and optometry.

An earlier pilot showed that, of 4,700 patients referred with a photograph, around 8 out of every 10 did not require to be seen at an outpatient clinic.

Roger Kennedy, from the Health and Social Care Board, said: "This pathway is a great example of how technology can be used to improve patient experience and clinical decision-making. Working in partnership with GPs, this pathway is one of a number of elective care initiatives that are truly transformational."

A total of 34 GP practices in mid-Ulster and South Belfast have completed their training. The Mid-Ulster practices began sending images at the end of October, with South Belfast practices starting in November.

It is anticipated that the new service will be rolled out across Northern Ireland in 2019.


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