BT41 Piloting a hospital-based teledermatology and artificial intelligence service for urgent suspected skin cancer alongside an established community-based teledermatology advice and guidance service
The aim of this pilot was to assess the value of a hospital-based teledermatology hub for urgent suspected skin cancer referrals in a semirural integrated care system. The hub uses a new medical photography-led teledermoscopy service to assess both teledermatology and artificial intelligence (AI) co...
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| Published in: | British journal of dermatology (1951) Vol. 191; no. Supplement_1; pp. i207 - i208 |
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| Main Authors: | , , , , |
| Format: | Journal Article |
| Language: | English |
| Published: |
28-06-2024
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| Online Access: | Get full text |
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| Summary: | The aim of this pilot was to assess the value of a hospital-based teledermatology hub for urgent suspected skin cancer referrals in a semirural integrated care system. The hub uses a new medical photography-led teledermoscopy service to assess both teledermatology and artificial intelligence (AI) compared with face-to-face outpatient review in clinic. The deployment and this work were funded as part of the National Health Service AI in Health and Care Award. In parallel, the existing advice and guidance (A&G) service using images taken by general practice teams was promoted for all referrals other than urgent suspected skin cancer, including low-risk basal cell carcinomas and precancerous lesions. Analysis of the first 100 patients through the teledermoscopy–AI service showed that 18% of patients were diagnosed with benign lesions using the AI (and second-read dermatologist), 25% of patients required face-to-face review for diagnosis, 45% were triaged directly for a surgical procedure with a preoperative telephone call, 6% were prescribed topical therapy virtually, and 6% were discharged using images and telephone consultation without requiring treatment. Subsequent expansion of the dermatology medical photography team using both medical photographers and a trained healthcare assistant has supported extension of the teledermoscopy–AI service, with the pilot running to August 2024. Expansion to community hospital teledermoscopy hubs and extension of the urgent skin cancer service to the community diagnostic centre are changes supported by the pilot, to develop more streamlined pathways for patients with urgent suspected skin cancer. Through 2023 the community A&G service also expanded from around 250 requests per month to over 400 requests per month, with maintenance of conversion rates to referral of 30%, and redirection of patients with low-risk basal cell carcinomas to community skin surgery services. Development of the new urgent suspected skin cancer virtual teledermatology–AI pathway has required administrative adaptations within the hospital electronic patient record to support patient tracking, resourcing and job planning for image review. Training of photographers has been supported by online teledermoscopy resources developed by the Institute of Medical Illustrators. Selection of appropriate patients for the teledermoscopy–AI pathway while maintaining patient choice and safety has remained central to the teledermoscopy–AI pilot. |
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| ISSN: | 0007-0963 1365-2133 |
| DOI: | 10.1093/bjd/ljae090.438 |