If photos taken by a GP or healthcare professional (HCP) could reach a consultant securely, reliably and quickly, then DMC could cut consultation times, enable better triage and mitigate diagnosis and referral delays for patients. This process is known as teledermatology; HCPs take photos of skin conditions then upload them to DMC through the NHS’ Electronic Referral System (ERS), so that a dermatologist can review the photos and often provide a swift diagnosis.

In teledermatology, there are a number of challenges:

• Transferring photos manually from a camera or phone can be time-consuming and data can be lost
• Photos must not be saved on the doctors’ devices
• HCPs sometimes forget to remove patient data from their camera, phone or PC

Digit set out to develop a system that would overcome these challenges while also providing a restful, accessible user experience. After conducting stakeholder interviews with GPs and dermatologists, we worked with DMC to develop a prototype which tested the whole user journey. We then carefully constructed an end-to-end process, including:

• Gaining patient consent for the pictures to be taken, using explanatory videos
• Capturing images and NHS numbers (using optical recognition if possible)
• Securely transferring optimised, compliant images and data into DMC systems and onto ERS
• Confirming to the patient and GP that images had been transferred securely
• Seeking feedback from patient and HCP

As well as the app itself, Digit also built an admin and permission system to enable DMC Healthcare to administrate image submissions and doctor access. “Initially we were interested in seeing if this technology could work to deliver better outcomes for patients in our surgeries. We worked with Digit to investigate the possibilities, and how best to approach the concept” commented Mike Perrett, Chief Technology Officer at DMC. “As soon as we started, we were immediately impressed. Their thorough approach and technical understanding really stood out. Digit helped us unpick each of the challenges in turn.”

Using the app, HCPs use either their own phones or a surgery tablet to capture the images, but these images are never resident on the device. Plug-in dermatoscopes can also be used to provide more image detail. The app is fully compliant with NHS developer guidelines, GDPR requirements and PCC requirements. Furthermore, as it has been built on a secure Azure cloud platform, it has almost limitless scalability.