22 December 2020
A new app which speeds up patients’ skin care referrals – including suspected cancer cases – was hailed as a potential life-saver by a relieved Isle of Wight patient.
Nursing home worker Sandra Thompson was worried about a mole on her back and couldn’t believe the speed that what subsequently turned out to be a malignant melanoma was diagnosed and removed. Sandra was fast-tracked after a nurse practitioner at her GP surgery sent photos of the mole via a new Dermicus app to dermatology consultants the same day of her visit. She had a biopsy eight days after her referral, her results 30 days from the date of the referral and the mole removed just four days later.
Sandra (63), from Ryde, a patient at the Argyll House Surgery, said: “It was wonderful. It all happened so quickly and they took care of me so well. This could certainly be a life-saver. We had our bathroom changed to a wet room, and in the mirror I could see a black mark on my back which I wasn’t aware of before, and I was worried about it. When I went to my surgery for a blood pressure test I mentioned it and the nurse practitioner said she didn’t like the look of it because it had rough edges and different colours. Photos were taken and sent off to the consultant using the app. Within weeks I had the mole removed. I was told it was cancerous but they have now removed all the cancer cells, which is obviously very reassuring.”
The app, used by two GP practices last year - Argyll House Surgery, Ryde, and St Helens Medical Centre, St Helens - has been rolled out across the Island and staff at every surgery have been trained in its use to benefit their patients. The project has been shortlisted for a 2020 Health Service Journal award, recognising its outstanding contribution to healthcare. The team running it, comprising the NHS Isle of Wight Clinical Commissioning Group (CCG), Isle of Wight NHS Trust, Lighthouse Medical, Wessex Academic Health Science Network (AHSN) and Gnosco, will feature in the ‘Primary Care Innovation of the Year’ category.
The dermatology service has had 1,148 referrals from January 1 to the end of September 2020 – with nearly half of them in August (320) and September (243) because of the success of the app. The average time for a referral to be completed was 0.8 days. More than half the referrals (53%) have been managed with ‘advice and guidance’ only – avoiding an unnecessary trip for the patient for a face-to-face consultation with a dermatology specialist. Its success has also been welcomed by GPs and the AHSN, which played a key role in introducing the app on the island by approaching Lighthouse Medical, which then contacted the GP practices about it.
GPs and nurse specialists can take high-quality photographs, including greatly-magnified images, of any skin abnormality. The app is linked to technology that enables the images to be securely sent to the dermatology service for review. Hospital specialists review the photos and decide if the patient needs a biopsy, face-to-face appointment, referral to another service or no further action is needed.
Dr Michele Legg, clinical lead for the CCG, which commissions Lighthouse Medical to provide the dermatology service, said: “The app dramatically speeds up how quickly a skin problem can be seen by a hospital specialist, who can give the patient a much-faster diagnosis than before. “This can obviously help with the earlier detection of cancer and speed up the process for our patients receiving vital treatment. The app is also very easy to use.”
Nurse consultant Di Goring, the clinical director of Lighthouse Medical, said: “The island has a high rate of melanoma and so it’s crucial we embrace new and innovative technology like this app. Dermatology patients are no longer having to make unnecessary appointments, saving both them and the NHS a considerable amount of time and energy.”
Dr Richard Ashton, the consultant who reviewed Mrs Thompson’s images, said: “The ease of the system is to be highly commended. I was able to read the images on the mainland – without the patient having to travel from her home on the island.”
Matthew Williams, primary care innovations manager at Wessex AHSN, said: “We work with innovative companies to help improve services for patients and save NHS staff time and money. This app also allows specialists to share the images and confer with colleagues to come to a consensus to ensure the most accurate diagnosis, improving the knowledge of all concerned.
“The Dermicus app is already proving its worth in achieving both these aims, and we’re thrilled that patients on the Isle of Wight have the opportunity to access this new, exciting service and that all the island’s practices have embraced the benefits that it offers.”