Tele-Dermatology App: FirstDerm

FirstDerm is an app that is freely available to patients across Europe and the States. They download the app, take a picture of the rash or lesion that they are worried about then upload the image – paying a fee – for an expert opinion. Given the current push for private online medicine, I’m surprised it’s not more popular – perhaps they need a bigger advertising budget?

While NHS England’s Top 10 high impact actions might suggest that we all advertise this service as a way of stopping people coming to us, my GP federation took a different view. We worked with FirstDerm to create a bespoke version of their app for the NHS.

Actually, app is the wrong word – it’s a web application that can run on a desktop or any variety of smartphone.

The ‘app’ is white-labelled for our federation and has a log on to prevent unauthorised use. They can easily white label a version for your federation/practice and give you a logon. You open the app take 2 photos of the skin lesion you aren’t sure about, one from a distance giving the coverage and one from close up including if possible a dermatoscopic view. You then enter some information about the patient and ask a question. It then uploads it to a secure cloud and usually within an hour but guaranteed within 24 hours you get a PDF reply with advice.

The advice comes from a group of their online consultants – both British and European and when we have reviewed the advice it tends to be very good. Of course the better the question you ask and the more info you give the better the answer will be.

People tend to want a diagnosis on something they aren’t sure of, or quick advice on what treatments to use/try. Our GP federation pays the cost of the advice from a pot of money we won to innovate and we are trying to convince our local CCG to continue the service.

We are not advising our GPs to refer everything, we suggest they only refer things that they aren’t certain of and don’t feel can wait or need an outpatients appointment. We aren’t really trying to use it as a referral vetting service, more a give me some advice to help deal with this. Of course, in some cases the advice comes back – refer or send for biopsy.

FirstDerm are more than willing to talk to you about offering the same or similar service (contact me and Ill put you in touch), one alternative we have thought about – is running a derm first type clinic where all pts asking for an appointment with a new skin lesion get send to an ANP or other HCP with some derm knowledge backed up by this service.

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