The COVID-19 pandemic gave the move to telehealth some unexpected momentum but tele-dermatology advocates were already outlining best practice for their colleagues.

Practice guidelines for teledermatology in Australia, just published in the Australasian Journal of Dermatology, provide a comprehensive guide for clinicians from etiquette for online communication through to technology tips.

A review of the literature which supports the guidelines was also published recently.

The guidelines, developed by the University of Queensland’s Centre for Online Health in collaboration with the Australasian College of Dermatologists’ E-Health Committee, also recognise the increasing use of smartphones to capture and transmit images.

The guidelines regarding mobile devices recommend clinicians:

• Ensure devices are password protected and secure from unauthorised access.
• Ensure images do not auto-upload to any social media networks or backup sites.
• Delete the image from any personal device once it is saved to the patient record.

The guidelines also reference other complementary documents including the AMA’s Clinical images and the use of personal mobile devices and the Medical Board’s Guidelines for technology-based patient consultations.

Associate Professor Liam Caffery, director of telehealth technology at the Centre for Online Health, told the limbic that most dermatologists will say they are already using teledermatology.

Unfortunately much of that is informal requests from colleagues and consumers.

“Even before COVID-19, they were getting solicited and unsolicited text messages or emails saying ‘Can you have a look at this?’, Associate Professor Caffery said.

He said dermatologists will find having guidelines will help them better manage such requests and mitigate any medicolegal risk.

“Once you have got practice guidelines for it, then it becomes clearer.”

The practice guidelines note that the quality of images is critical to delivering effective and safe teledermatology services.

It recommends clinicians consider creating guidelines for referrers covering topics such as camera settings, technique for acquiring quality images and image acquisition.

Associate Professor Caffery said communication with referrers was critical in teledermatology as it can include much more collaborative care.

“In face-to-face settings, the dermatologist would typically manage the follow-up. If I lived in Mt Isa and was referred by a GP, the dermatologist doesn’t have that option of follow-up so has to engage the GP to manage excision of that lesion.”

“The practice of teledermatology does mean you are reliant on the GP or primary care provider to do some of the follow-up and management of the patient.”

The practice guidelines also address other issues such as patient selection, provider competency, informed consent and documentation and storage of medical records including images.