Audit of rural and metropolitan dermatology telehealth services: a single centre experience

ABSTRACT

Aims: The landscape of health service delivery has changed significantly in the wake of the COVID-19 pandemic. The Australian Institute of Health and Welfare reports that health practitioners have delivered an increasing number of consultations via telehealth. To understand how this shift has manifested in dermatology, we present an audit of the Royal Melbourne Hospital dermatology telehealth service, comparing data collected between 2020 and 2021, and discuss factors affecting sustainability of clinics, the challenges faced, and lessons learnt. Methods: We performed a retrospective audit of all telehealth consultations (both telephone and video-conference) at the Royal Melbourne Hospital Department of Dermatology between February to September in 2020 and 2021. Data was manually extracted from electronic medical records. We collected data for the total number of visits, rural vs metropolitan status, rural health region if applicable, and Pharmaceutical Benefits Scheme billing data for each month. Results: 1,056 telehealth consults were conducted in the 2021 period, comprising 28% of the 3,795 total Dermatology consults performed. 31% of these telehealth visits (330 consults) were with rural patients, representing a 42% increase from 2020 (233 consults). Review consults for patients on biologic therapy were particularly amenable to telehealth delivery within this rural cohort, experiencing a 141% growth from 49 consultations in 2020 to 118 in 2021. The most common reason for telehealth appointment was for inflammatory conditions (50% of all consults), followed by biologics reviews (37%), immunobullous conditions (6%), vascular anomalies and infective conditions (3% each), and benign and malignant skin lesions (2%). Conclusions: Telehealth consultations have proved essential in the delivery of many dermatological services throughout the COVID-19 pandemic. Rural populations demonstrate an increasing benefit from telehealth services. Inflammatory and biologics reviews are visit indications which may be particularly amenable to telehealth delivery.