Implementation and Assessment of a Tele-Dermatology Strategy for Identification and Treatment of Skin Lesions in Elderly People

Abstract

Introduction: The world’s population is living longer which is resulting in a higher incidence of pressure ulcers. Objectives: (1) To describe the implementation of a teledermatology strategy to identify and treat skin lesions in institutionalised elderly patients; (2) To evaluate the established teledermatology strategy. Method: This study was carried out in a geriatric home (AMP) in Brazil, and included: (1) Implementation of a teledermatology method;  (2) Evaluation of the strategy through: a) professional knowledge assessment, b) professional satisfaction, c) clinical aspects evaluation. Results: (1) The team consisted of a remote consulting team, local care team, dermatologist and infectologist. Digital records of skin lesions and weekly monitoring was implemented and was standardised using the iPhone 5’s camera coupled with a dermatoscope in cases of minor lesions. Data were stored in the cloud using FotoFinder HubⓇ. (2) Professionals' knowledge (n=24): age 34.6±7.3 years; 16 responded to the post-test and there was no difference between the 2 tests (86.8± 7.1 and 84.5±9.5, P=0.38). Professional satisfaction (n=17): 16 (94.2%) showed interest in indicating this type of assistance modality to another professional. Clinical aspects’ evaluation: hypertension had the highest prevalence, 9 (50%). Pressure ulcers were identified in 18 patients (83.3%), the heels, 7 cases, were the most affected area (39%). Healing Process: 4 lesions (22.2%) took over 3 months to complete the re-epithelialisation and 6 patients (33.3%) died before the end of treatment. Conclusion: The proposed teledermatology strategy has resulted in better assistance for elderly patients