Access to specialized medical services is an important challenge in the Quebec health care system. Many patients awaiting a specialist consultation are often confronted with long delays. Among the specialties concerned, dermatology is on the verge of making a major change in its practices to deal with this reality: teledermatology. In fact, dermatologists in the province will soon be responding to requests for virtual consultations. This will allow them to make diagnoses and prescribe treatments remotely within a short timeframe and with no need for patients to travel. To achieve this, they will consult photos of lesions as well as clinical information transmitted by an authorized professional. Virtual dermatology is a practice that has been proven elsewhere in the world. It has been shown that this mode of consultation allows for a diagnosis with a level of accuracy equivalent to that obtained during in-person consultations, when the cases referred are suitable.
Therefore, during a visit to a general practitioner, patients who need a dermatology referral can be offered this method of consultation. If they consent, a registered dermatologist will perform the consultation remotely and provide the referral physician with the appropriate actions to be taken within a very short time frame. Participating patients will therefore be able to know the truth about their condition much more quickly and initiate the appropriate treatment with their treating physician. This new approach does not eliminate the need for face-to-face consultations, which will continue to take place if the medical situation requires it or if the patient so chooses. In fact, some virtual consultations will result in requests for in-person consultations when the dermatologist deems it necessary.
The first teledermatology consultations will take place in the spring of 2022. The Laurentians, Laval and Lanaudière regions have been targeted to begin these new activities. The other regions will be added progressively to achieve complete provincial coverage. The deployment sequence will be determined by the volume of dermatology waiting lists in each region. General practitioners will receive information on this new dermatology referral modality in advance, as well as instructions to facilitate its use.
The work leading to the launch of this new service was piloted by the Ministère de la Santé et des Services sociaux and involved resources from the Réseau québécois de la télésanté (RQT) as well as the Association des médecins spécialistes dermatologues du Québec (AMSDQ). Collaboration with the two medical federations (FMSQ and FMOQ) and the Centre d’Excellence sur le Partenariat avec les Patients et le Public (CEPPP) was also instrumental.
The new Provincial Virtual Care Platform
This evolution towards telehealth practices is made possible in a large part by the upcoming arrival of the new Provincial Virtual Care Platform. This platform will facilitate and support the implementation of several virtual care paths in Quebec. The first phase involving virtual consultations in dermatology will allow for the validation of technological, clinical and administrative processes in order to prepare the ground for future deployments in other specialized medical disciplines.
The Provincial Virtual Care Platform will offer several features, such as:
- Virtual consultation with or without the presence of the patient;
- Communication between clinicians and patients (questionnaires, educational material, document exchange, messaging, etc.);
- Communication and collaboration between health professionals (document exchange, video-conferencing, messaging, etc.);
- The possibility for clinical teams to make requests for the implementation of new virtual service paths.
The Ministère de la Santé et des Services sociaux and the Réseau québécois de la télésanté are proud to work towards the development of digital health practices. The implementation of the RQT Web portal more than a year ago, the upcoming arrival of the provincial platform and the enthusiasm of institutions to implement new virtual services are concrete signs of this change. More and more patients using telehealth are seeing improvements in terms of access to services and are enjoying the benefits of not having to travel. For the health and social services network, these changes tend to reduce costs and promote timely access to patient interventions with a spirit of continuous improvement of the care quality.