Partnering with a senior living community to optimise teledermatology via full body skin screening during the COVID‐19 pandemic: A pilot programme

Abstract

Abstract Background Elderly patients in senior communities faced high barriers to care during the COVID‐19 pandemic, including increased vulnerability to COVID‐19, long quarantines for clinic visits, and difficulties with telemedicine adoption. Objective To pilot a new model of dermatologic care to overcome barriers for senior living communities during the COVID‐19 pandemic and assess patient satisfaction. Methods From 16 November 2020 to 9 July 2021, this quality improvement programme combined in‐residence full body imaging with real‐time outlier lesion identification and virtual teledermatology. Residents from the Sequoias Portola Valley Senior Living Retirement Community (Portola Valley, California) voluntarily enroled in the Stanford Skin Scan Programme. Non‐physician clinical staff with a recent negative COVID‐19 test travelled on‐site to obtain in‐residence full body photographs using a mobile app‐based system on an iPad called SkinIO that leverages deep learning to analyse patient images and suggest suspicious, outlier lesions for dermoscopic photos. A single dermatologist reviewed photographs with the patient and provided recommendations via a video visit. Objective measures included follow‐up course and number of skin cancers detected. Subjective findings were obtained through patient experience surveys. Results Twenty‐seven individuals participated, three skin cancers were identified, with 11 individuals scheduled for a follow up in‐person visit and four individuals starting home treatment. Overall, 88% of patients were satisfied with the Skin Scan programme, with 77% likely to recommend the programme to others. 92% of patients agreed that the Skin Scan photographs were representative of their skin. In the context of the COVID‐19 pandemic, 100% of patients felt the process was safer or comparable to an in‐person visit. Despite overall appreciation for the programme, 31% of patients reported that they would prefer to see dermatologist in‐person after the pandemic. Conclusions This programme offers a framework for how a hybrid skin scan programme may provide high utility for individuals with barriers to accessing in‐person clinics.