The growth of a skin emergency teledermatology service from 2008 to 2014

To conduct an audit of the Skin Emergency Telemedicine Service at Princess Alexandra Hospital in Brisbane from January to December 2014, and determine whether there has been any change in the number, type and location of referrals.

Retrospective analyses of referrals to the teledermatology service were conducted and compared with the 2012 audit. Main outcomes assessed included the number of referrals, referral site location, telediagnosis categories, image characteristics and response times.

In 2014, 318 cases were referred to the teledermatology service. The highest number of cases (n = 140) were referred from Princess Alexandra Hospital and Queen Elizabeth II Jubilee Hospital emergency departments. However, referrals to the teledermatology service came from as far as 1600 km distant from Brisbane. The most common provisional telediagnoses were dermatitis or eczema, skin infection or drug eruption. Over half of all referrals (62%) received a response within 3 h and a further 20% were responded to within 3-6 h. Almost half all referring doctors (48%) attached very large image files (> 500 kb) to their referral.

The Skin Emergency Telemedicine Service has proved to be a successful, sustainable and valuable addition to the specialist dermatology services provided across Queensland. With adequate funding and resources and appropriate attention to ethical and legal considerations, our service could significantly change the management of Queenslanders with acute skin conditions.