Improving access to tertiary care - The rollout of a paediatric teledermatology advice and referral service for the lady cilento children's hospital, Queensland, Australia

Abstract

The state of Queensland, Australia has a paediatric population of approximately 1 million (1), physically spread across 1.8 million km2 (700, 000 miles2). Public tertiary medical services (including dermatology) are supplied by the Lady Cilento Children's Hospital (LCCH), located in Brisbane, in the most south-east corner of the state. Ensuring access to appropriate and timely paediatric dermatological advice to both primary care providers and regional facilities has historically proven to be a challenge. Over recent decades, remote dermatology delivery has evolved informally with technology with the use of telephones, digital cameras, smart phones, and email communication. 2017 has seen the rollout of a new Teledermatology platform for the LCCH, allowing cases to be referred to the department for assessment and advice in a formalised process. Primarily, the program offers a more robust conduit through which remote practitioners can get help for their patients, potentially avoiding the need for further travel for face-to-face assessment. Secondarily, it allows more accurate and efficient use of face-to-face outpatient clinic resources, and an opportunity for education for dermatology trainees and the referring practitioners alike. The process offers the collaborative opportunity for the patient to remain under the care of their local doctor, with the input of the tertiary service. Although similar platforms have been established in the adult population, this is the unique as it is purely for paediatric patients (0- 18 yo). We present an overview of our service, describing its rollout, evolution and learnings gained from its first 6 months. We also present some initial statistics, and interesting cases highlighting the utility of the program.L6172835362017-07-17 <br />