Hello! Tell us about yourself.
I’m a dermatology registrar at Kingston Hospital, on the South West London training scheme. After my undergraduate training in Edinburgh, I was drawn to dermatology for it’s variety. We get to practice medicine and surgery, a bit of paeds, and there’s ward work and acute referrals from A+E as part of the working day too.
When and how did you start using Pando?
It started when our medical photographer left our department last year. Without a service to capture clinical photos, we were in trouble! Then we heard about Pando. A bit like the stethoscope has been, the smart phone’s now your constant handheld tool. All of us in the department are using the app constantly; it’s just faster to whip out your phone than call someone else in for a photo!
In what way has Pando benefited the care you can deliver for patients?
The biggest factor has been expedited discharges from A+E and from the wards. Previously, a referral would involve a description of the pathology and then an in person review - often with an associated delay if we were in clinic or theatre. Now, we’re sent a picture and often able to diagnose and advise management remotely.
For example, A+E had a patient with a query squamous cell carcinoma that was bleeding. I could advise over the phone having seen photos, and the patient went home. Also, the medical admissions unit had a patient waiting for a dermatology opinion before discharge. I was tied up in clinic for the whole day, but using Pando could advise a plan for his dermatitis from my desk.
So, what next?
I’m tracking instances where we use Pando to triage and then seeing how this reduces the number of in person referrals we handle, which is needed! We’re also setting up an ask advice group to streamline our use of Pando, and hoping to present our work at the British Association of Dermatologist conference next year.
Any top tips?
Always take a faraway locating view first followed by a close up or dermoscopic image if required. When using a dermatoscope, have a fixed process for capturing the image, so distance from skin etc are kept consistent.