Health Innovation East Midlands awarded funding to evaluate a pilot project using Skin Analytics AI-Powered Teledermatology, at University Hospitals of Leicester NHS Trust. The project aimed to reduce unnecessary attendance within the acute hospitals and help to reduce waiting lists.

 The challenge

Dermatology services across England have experienced an extraordinary degree of strain due to the current demand surge with one in four individuals seeking consultation for skin, hair, or nail conditions each year. The COVID-19 pandemic caused approximately 30% fewer dermatology appointments during 2020/21 compared to the previous year. The post-pandemic influx of patient referrals continues to a challenge to the health systems with an increased patient load, rising case complexities.

Against this backdrop, the necessity for innovative solutions to enhance patient access to dermatology services has been acknowledged by several national and professional entities. Teledermatology, especially, has been widely endorsed as an effective method to expand service capacity and ensure equitable patient access to specialist care. An alternative is AI-Powered Teledermatology, which utilises AI technology for initial skin lesion assessment. 

The solution

The project enabled patients to be referred to a community based clinical hub in one of four pilot sites. A healthcare professional captured images of the skin lesion which was instantaneously reviewed by the Skin Analytics solution called DERM. Patients who received a diagnosis of concern were referred onwards to a Dermatology Consultant. Lesions identified as benign were reviewed by a Skin Analytics dermatologist to either validate the discharge decision or refer for additional assessment.

The technology was being used in the Skin Cancer Two-week Pathway as part of a pilot to improve patient access to dermatology diagnostics and achieve the two-week-wait (2WW) cancer targets.

The evaluation of the pilot’s effectiveness used both qualitative and quantitative data, gathered through staff and patient surveys and existing data from UHL and Skin Analytics.

Impact and Outcomes

• The evaluation confirmed that the solution led to a reduction in 2WW referrals, freeing up 1450 outpatient appointments. These appointments were made available to non-cancer patients. There was also a clinical time saving of 263 minutes per 100 patients.
• Cost-benefit analysis of this pilot to date showed cost effectiveness during the pilot, with greater benefits if the programme is continued further. The analysis found that for each pound spent on the AI-Powered Teledermatology Pathway for 2WW Skin Cancer, the health system received £1.05 in benefits. 
• 98% of patients surveyed would recommend the service to family and friends, and the majority (70%) did not feel that something was missing due to not seeing a doctor face-to-face.

It found that although some challenges remain with implementation and staff acceptability of the current model of delivery, there is the potential for this novel pathway to be cost-effective in the long-term and enable considerable benefits for Dermatology services, trust staff and the health system.

The study proposed several recommendations to enhance the programme's benefits and ensure that longer-term cost-effectiveness is achieved.

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