Teledermatology in Primary Care in Singapore: Experiences of Family Doctors and Specialists

Authors

  • Aloysius Chow
  • Sok Huang Teo
  • Jing Wen Kong
  • Simon Biing Ming Lee
  • Yee Kiat Heng
  • Maurice A.M. van Steensel
  • Helen E. Smith Family Medicine and Primary Care, Lee Kong Chian School of Medicine, Nanyang Technological University Singapore, 308232 Singapore, Singapore

DOI:

https://doi.org/10.2340/00015555-3847

Keywords:

qualitative research, telemedicine, dermatology, teledermatology, healthcare professionals’ experience

Abstract

Most teledermatology studies focus on patients’ satisfaction; fewer focus on the experiences of healthcare professionals. This qualitative study explored healthcare professionals’ perceptions of teledermatology used for linking public primary care clinics with the specialist dermatology centre in Singapore. Semi-structured in-depth interviews were conducted with 25 family physicians and dermatologists. Six themes were identified: satisfaction with the service; perceived patient benefits; rationale for introducing teledermatology; educational impact; challenges of virtual consultations; and desirable service refinements for the future. Family physicians and dermatologists were positive about the service, but highlighted a need to streamline referral processes and improve the quality of transmitted images. Reduced need for referral to the specialist centre could be achieved by expanding the polyclinic’s pharmacopoeia and treatment modalities. This study highlights the benefits of telemedicine for patient, professionals, and healthcare organizations, and these are reassuring given the widespread and rapid introduction of telemedicine through necessity during the COVID-19 pandemic.

Downloads

Download data is not yet available.

References

Karimkhani C, Dellavalle RP, Coffeng LE, Flohr C, Hay RJ, Langan SM, et al. Global skin disease morbidity and mortality: an update from the Global Burden of Disease Study 2013. JAMA Dermatol 2017; 153: 406–412.

Verhoeven EWM, Kraaimaat FW, van Weel C, van de Kerkhof PCM, Duller P, van der Valk PGM, et al. Skin diseases in family medicine: prevalence and health care use. Ann Fam Med 2008; 6: 349–354.

Schofield J, Fleming D, Grindlay D, Williams H. Skin conditions are the commonest new reason people present to general practitioners in England and Wales. Br J Dermatol 2011; 165: 1044–1050.

Perednia DA, Brown N. Teledermatology: one application of telemedicine. Bull Med Libr Assoc 1995; 83: 42.

Brinker TJ, Hekler A, von Kalle C, Schadendorf D, Esser S, Berking C, et al. Teledermatology: comparison of store-and-forward versus live interactive video conferencing. J Med Internet Res 2018; 20: e11871.

Trettel A, Eissing L, Augustin M. Telemedicine in dermatology: findings and experiences worldwide – a systematic literature review. J Eur Acad Dermatol Venereol 2018; 32: 215–224.

Janardhanan L, Leow YH, Chio MT, Kim Y, Soh CB. Experience with the implementation of a web-based teledermatology system in a nursing home in Singapore. J Telemed Telecare 2008; 14: 404–409.

Kong JW. Ethical issues behind teledermatology. introduction of standard of care INSIGHT. SMA News 2017; 49: 14–15.

QSR International Pty Ltd. NVivo (released in March 2018). 2018.

Burnard P. A method of analysing interview transcripts in qualitative research. Nurse Educ Today 1991; 11: 461–466.

Tong A, Sainsbury P, Craig J. Consolidated criteria for reporting qualitative research (COREQ): a 32-item checklist for interviews and focus groups. Int J Qual Health Care 2007; 19: 349–357.

McCleskey PE, Gilson RT, DeVillez RL. Medical student core curriculum in dermatology survey. J Am Acad Dermatol 2009; 61: 30–35.

Coates SJ, Kvedar J, Granstein RD. Teledermatology: from historical perspective to emerging techniques of the modern era: part I: history, rationale, and current practice. J Am Acad Dermatol 2015; 72: 563–574.

Song E, Amerson E, Twigg AR. Teledermatology in medical and continuing education. Curr Dermatol Rep 2020; 9: 136–140.

Iancu AM, Kemp MT, Alam HB. Unmuting medical students’ education: utilizing telemedicine during the COVID-19 pandemic and beyond. J Med Internet Res 2020; 22: e19667.

Davis C, Chong NK, Oh JY, Baeg A, Rajasegaran K, Chew CSE. Caring for children and adolescents with eating disorders in the current COVID-19 pandemic: a Singapore perspective. J Adolesc Health 2020; 67: 131–134.

Ying NL, Kin W, Han LC, Tiong C, Ali K. Rapid transition to a telemedicine service at Singapore community dialysis centers during Covid-19. NEJM Catal Innov Care Deliv 2020: 1–11.

Singapore MoH. Register for the online course on telemedicine. Singapore: Ministry of Health, 2020.

Duffy S, Lee TH. In-person health care as option B. N Engl J Med 2018; 378: 104–106.

Smith AC, Thomas E, Snoswell CL, Haydon H, Mehrotra A, Clemensen J, et al. Telehealth for global emergencies: implications for coronavirus disease 2019 (COVID-19). J Telemed Telecare 2020; 26: 309–313.

Additional Files

Published

2021-09-08

How to Cite

Chow, A., Teo, S. H., Kong, J. W., Lee, S. B. M., Heng, Y. K., van Steensel, M. A., & Smith, H. E. (2021). Teledermatology in Primary Care in Singapore: Experiences of Family Doctors and Specialists. Acta Dermato-Venereologica, 101(9), adv00540. https://doi.org/10.2340/00015555-3847