Early experience of inpatient teledermatology in Singapore during COVID-19

Inpatient Teledermatology: a Review

“…Many services considered to be non-essential were either discontinued or adapted to a virtual format, and previously underutilized electronic medical record applications for virtual and electronic visits quickly gained traction with providers [ 23 ]. Some hospitals in the USA as well as internationally (e.g., Singapore, Saudi Arabia) transitioned their dermatology visits to virtual encounters through teledermatology platforms [ 16 ••, 22 , 23 , 24 •, 25 , 26 ]. This switch was largely successful, with one study recognizing that the transition helped preserve scarce personal protective equipment (PPE) in the early months of the pandemic and spurred providers to work more efficiently and collaboratively [ 24 •].…”

“…Some studies have questioned the accuracy of teledermatology on the grounds that it may miss crucial details when a patient’s skin is incompletely or improperly photographed (i.e., incidental melanoma) [ 34 , 35 ]. Though these concerns are worth considering, others have found that store-and-forward inpatient teledermatology using only smartphone cameras is comparable to face-to-face care, and in one illustrative example, staff members at the Singapore General Hospital who did not have any formal photographic training were able to achieve an 89.2% diagnostic concordance between inpatient SAFT and live dermatologic examination [ 26 , 35 ]. Even where teledermatologic consultations are not perfectly accurate, they are substantially better than if patients were to receive no dermatology consultation at all, as supported by the frequent diagnostic, management substitution and accretion when patients are referred to the care of dermatologists after first being evaluated by non-dermatology physicians [ 36 , 37 ].…”