Teledermatology in Port St. Johns, South Africa

Port St. Johns is a small town on the Indian Ocean in the Eastern Cape Province of South Africa. It has +- 8000 inhabitants and another 75'000 in the region around and 2 doctors. Roughly 14% of the patients that see Dr. O'Mahony are suffering from a dermatological problem. The next dermatologist would be in East London, 300km from Port St. Johns Since 1999, Dr. O'Mahony has been using teledermatology to provide specialist dermatology services for patients in Port St. Johns. Besides, teledermatology has helped him to improve his own clinical dermatology skills in family practice.

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Methods

Dr. O'Mahony uses a simple store-and-forward teledermatology. In the beginning, images were sent by email directly to a dermatologist. Since 2002, Dr. O'Mahony has been using the iPath server to submit consultations, first the server in Basel and now the regional telemed server: at the University of Transkei.

Images are captured with a conventional digital camera (Olympus 1.4 Mega-pix, Fujifilm 2 Mega-pix). Then images are resized with Adobe Photoshop or GIMP: and then submitted to the iPath server by ordinary email. The dermatologists are automatically notified with an email. Later, they review the case and enter their diagnosis and possible suggestions for treatment. These comments are automatically returned to Dr. O'Mahony by email.

Results

A preliminary study is being conducted. The figure below shows the basic outcome. In 105 out of 110 consultations a dermatological diagnosis was possible. In 57 cases, the teledermatology consultation has lead to improvement of the treatment, while in 46 cases the GP had already come to the same conclusion. The GP rated the teledermatological consultation as helpful. Besides the direct outcome for the patient, teledermatology greatly helped Dr. O'Mahony to improve his clinical skills with dermatological problems.

 

References

• O'Mahony D et al. Teledermatology in a Rural Family Practice SA Fam Pract 2002, 25(6)