Top End’s Dermo Direct offers a new model of teledermatology

Skin cancers

By David Rowley

5 Apr 2019

Dr. Dev Tilakaratne

A new telehealth service is providing dermatology e-consultations direct to patients in regional and remote areas, without them needing to be with their GP.

Dermo Direct run by Darwin-based Dr Dev Tilakaratne and Adelaide-based Dr Christopher Ross, began “softly” as a telehealth operation around six months ago.

It differs from “store-and-forward” teledermatology services that had GPs sending photos of their patients and awaiting a response.

The direct service is simply a matter of the GP giving the patient a referral. After that the patient makes an online booking via the website and selects their preferred dermatologist.

Dr Tilakaratne told the limbic the service covered most dermatology consultations, excluding skin cancer checks and whole body checks. He noted that Medicare rebates were available for patients that have an active GP referral and live in a telehealth eligible area, which they could check via a postcode finder on the site.

He said a key issue with ‘store and forward’ was the limited amount of information exchanged with a back-and-forth discussion between GP and specialist, and the dermatologist often being unable to ask questions or discuss the condition with the patient directly. In contrast, the new service immediately had the patient dealing directly with the dermatologist.

He said the idea was borne out of the two doctors’ interest in outreach services and seemed like a logical extension.

They had initially envisaged the service would be Northern Territory-centric but word of the service had spread quickly and they were finding most patients came from wider populations of Queensland and Western Australia.

And while there were other dermatologists doing telehealth consultations for patients in the same region, Dr Tilakaratne believed many saw it as an extra burden or technologically challenging.

“But we really are comfortable with it,” he said. “Teledermatology is something we have been living and breathing for a while now, so for us it’s not a chore, it’s a pleasure and that’s why we have really taken a national approach.”

Currently the service’s average time from booking to appointment was a little over four days, with most consultations happening on Fridays daytime or after hours.

And with the operation growing quickly Dr Tilakaratne said he also expected it may possibly expand to take in other specialties beyond dermatology.

One of the most rewarding things of starting the service had been being able to see a growing number of non-urgent “cat 3″ patients who had been on long waiting lists – in one case for five years.

Direct teledermatology also helped isolated, near-reclusive patients with very bad dermatological issues who found it much easier to interface with a dermatologist via screen, he said.

“They’re feeling alone, they’ve given up on their skin, and don’t want to sit in a specialist’s waiting room or be gawked at.”

“Those are the ones where I think we’re really adding something.”

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