March 22, 2018

Taking dermatology out of town

Online dermatology consults for rural Australians… how a ground-breaking new Teledermatologist platform is delivering specialist care to rural and remote patients.

Healthcare provider Murray Corbett cares about skin. Three years ago he took over two Newcastle and Maitland dermatology practices and recruited extra specialists to ensure patients could continue to receive treatment and care locally.

Corbett’s new initiative, Teledermatologist, enables Australians in far flung places to enjoy the same standard of service as their city cousins, via a secure on-demand telehealth platform.

Combatting the shortage

It’s a much-needed service, given the low number of dermatologists outside Australia’s capitals and larger regional towns, according to Corbett.

“Our country has one of the highest incidence of skin cancer in the world but we have only a handful of specialist dermatologists based in country areas,” he says.

“Many patients have to travel hundreds, if not thousands, of kilometres to reach their closest specialist and the waiting time can be many months.

“For example, if you live in Broome, the closest dermatologist is in Perth or Darwin. You’ve either got to drive for two days or jump on a plane, pay for accommodation when you get there and fly back – that’s a really expensive exercise.

“The upshot is that, unless it’s a life-threatening situation, rural and remote patients aren’t getting the sort of care that a city person would get.

Closing the gap

Corbett has spent the last two years developing Teledermatologist, a secure service that links country patients with dermatologists for diagnosis and treatment; ideally on the day they present to their GP.

Consultations are carried out by a roster of specialist dermatologists who can work casually or from home, or use the platform to fill in gaps in their schedules caused by last-minute cancellations.

GPs can make a referral by entering their patient’s details and photographs via an app. The information is sent to a coordinator based in Corbett’s Newcastle practice who allocates the file and arranges a consultation.

“The coordinator has a roster of dermatologists and their availability and they’re notified electronically when a referral comes in,” Corbett explains.

“Once a dermatologist has accepted the consultation, our coordinator works with the GP’s staff to get any additional information that’s needed and to book a slot, usually within a couple of hours. Both parties receive an email with a hyperlink and at the allotted time they click on that and meet in a secure video conference.”

The model works best when the patient’s GP is present, although it’s not imperative.

“Having the GP attending with their patient can help the dermatologist get direct medical feedback, and the GP qualifies for a Medicare telehealth consultation fee.

“A lot of rural patients live two or three hours from their GP so the idea is to make sure everything is done on the same day, so they don’t have to drive there and back more than once.”

Keeping costs down

Consultations are set at the same rate as normal consultations, and attract the Medicare telemedicine rebate, currently set at 150 per cent of the standard specialist consultation rate.

“We charge patients the same fees they’d pay at a normal dermatology practice and the rebate is greater so the patient is actually out of pocket for less than they would be after a face-to-face consult,” Corbett says.

Corbett is a long-time NAB client and the bank was a natural choice for his latest venture.

“I’ve had a number of businesses over the last 20 years and they’ve all been with NAB,” he says.

“They’ve always been the first bank I’ve turned to for support.”

Satisfied patients

It’s early days for Teledermatologist but the platform, Corbett says, has already received the thumbs-up from the out-of-town doctors and patients who’ve used it to obtain diagnosis and treatment for an array of skin conditions.

Providers of healthcare to isolated communities have also been receptive.

“Patients are happy – the convenience and access is far superior when compared to waiting months and travelling long distances,” Corbett says.

“GPs and remote nurses can see the benefit for their patients. Rural medicos are typically versatile, independent practitioners and Teledermatologist helps them get prompt specialist care for their patients.”

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