Teledermatology in Veterinary Medicine

Since 2000, dermlink buenos aires offers veterinarians an excellent option to treat animal patients with skin problems, that live in distant or rural areas,or that cannot be taken to a veterinary dermatologist practice, or when a veterinary dermatologist is out of reach in the area where they live.
 
This Veterinary Teledermatology Service allows the veterinary practicioner to resolve difficult cases with the help of a specialist working at a distance.
 
The Service is offered only to veterinarians and by veterinarians, in order to guarantee that at both ends of the line there will be a licensed veterinarian who is capable of handling the animal and carrying out the consultation procedure. No consultations are done directly to owners or breeders or general public. We strongly recommend that owners and breeders ask their veterinarians for this service.


Teledermatology
 
Teledermatology means provision of dermatologic medical assistance in veterinary medicine and to veterinary patients, by way of electronic and audiovisual means. at a distance . Those patients that need to be seen by a veterinary dermatologist and by several reasons cannot have a physically close consultation with a specialist, would benefit of its use. Teledermatology is cost – effective, because neither the animal nor the specialist need to travel long distances , so the feee remains almost the same of that of a specialty consultation – without travel fees. 
Teledermatology ( a field of Telemedicine ) is a modality of medicine that is being accepted worldwide by medical and health associations , and is being adopted as a way of providing better medical specialty care to patients that cannot attend a medical specialty  center , and also offering a quality service option for colleagues. 
Till this very moment, there are two ways of providing teledermatology consultation that can be applied to veterinary medicine , and both are available at dermlink buenos aires since 2000. They can be used alone or combined.  
 
Teledermatology Mode Store & Forward S&F
Teledermatology Mode R.I.C R.I.C.
 
Teledermatology Mode Store & Forward S&F
The veterinary practicioners receive the patient ( dog, cat, horse, pets) at a distant area where specialty consultation is not available , and fill in the questionnaire before they can have access to the service. Then they have to take the required pictures / videos following the steps and standards we describe in our S&F Service Instructions in order to have the best possible idea about the case.  Then, all the information must be sent by email to the specialized center , where all data would be analized as soon as possible ( in special cases we can consider accepting other ways of receiving the information ). The specialists would give their opinion about the case and can suggest the general practicioner to take new samples of the patient to rule out from their list of differential diagnosis .
Once all data is analized- together with the questionnaire and pictures-, a tentative / presumptive diagnosis is given to the referring veterinarian, a treatment plan can be prescribed and future laboratory work can be scheduled for the patient.
 
This type of consultation is preferred by colleagues who work in areas without fast / wide bandwidth internet access,  because sending data and pictures has less requirements and does not need a high speed platform to be supported. There are several ways of compressing and processing images that can give them a format that allows transmission of images in dial-up or low speed internet connections. 
 
Consultation fees must be paid in advance by interbank deposit and the fee charged varies upon monthly consultation by the referring veterinarian, an also depending on the volume of data, images and videos that must be processed.
 
With this mode of Teledermatology, the patient ( and also its owner and the referring veterinarian ) can have a diagnostic and therapeutic orientation that would have never been available for them by regular means. It is of most benefit in domestic species, small animals and equine.  
 
Teledermatology Mode R.I.C R.I.C.
The general practicioner in veterinary medicine is the one who receives the patient at the remote center (B) for a real time video-consultation  . The animal is at the practice / office / barn and the clinician performs a teleconsultation in real time by electronic means / data transfer, image processing, internet, telephone, etc. . 
The veterinary dermatologist is at the other end of the line ( remote center A ). The specialist must receive the questionnaire at least 24 hours before the consultation takes place, together with all the available data like previous laboratory analysis and studies performed on the animal that is to be examined, in order to allow better use of the time and resources. 
The specialist guides the colleague at the remote center B through a webcam and a microphone / telephone, under standardized image quality conditions, previously described by dermlink buenos aires following general consensus and personal experience on this matter, in order to guarantee the best conditions for the consultation to take place, and to try to get the best quality of images possible under the remote center B conditions.
If necessary, the specialist can suggest the colleague at the remote center B, which areas should be sampled or are best suitable for sampling, and which procedures should be used in order to pursue the best results. It can also be suggested that the colleague captures one or more images during the procedure with the webcam, or that digital  photographs should be taken at that time and sent to dermlink buenos aires by email.
 
Samples obtained might be processed at the remote center B – where the patient lives or nearby – if adequate quality veterinary laboratories ( or other ) are available there. If not, or if the colleague does not wish to perform the tests, the samples might be sent to laboratories suggested by dermlink buenos aires, upon type of sample. Those samples can be processed and analyzed in Argentina or in other countries, by certified specialists. 
This type of consultation has specific requirements and standards that determine its quality, efficiency and the length of time it demands. It depends on the internet bandwith available at both sides, the type of connection both ends are using, the image load, the use of speakers, lightning and the quality of the cameras.
Consultation fees must be paid in advance by interbank deposit and the fee charged varies upon monthly consultation by the referring veterinarian, an also depending on the volume of data, images and videos that must be processed.

dermlink buenos aires Teledermatology Service is offered in the above described 2 modes :
 
Store and Forward S&F
 
Remote Imaging Consultation R.I.C. 
 
Professional fees:
Professional fees must be paid by interbank deposit or you can consult us about other ways of payiment.
The ammount charged varies depending on the monthly volume / traffic of consultation your clinic has. Other item that has to be considered is the number and type of images sent with each case , the length of the videos sent, the length of the videoconference. We also have to consider the time of the day , and the day of the week in which the service was used, and also its urgence . 
More information can be obtained via email .
 
Minimum Imaging Requirement:
Images should attain to certain basic rules that will allow us a correct evaluation of each case. We call these requirements “ Image Obtention Standards” and we set them based on our personal professional experience and recommendations on the same matter by Medical Associations working in the field of Teledermatology in the world. These involve : 
  • Lights of the room where the patient is ( type of lamps, ammount  of light , positioning the animal, type and colour of the surface where the animal should be placed, type of background suggested ).
  • Image format ( JPG, TIFF, etc.)
  • Size and compression of images ( pixels, dpi, % of  compressión, etc.)
  • Definition of the digital camera that the referring colleague will be using  ( in Megapixels, zoom, macro lenses, flash, etc. )
  • Body areas to be photographed, number of pictures per area ( head, laterals, abdomen, dorsum, neck, ears, feet, tail, details, etc.)

Minimum Data Requirement to accompany the Medical Record :

  • Remote – distance- veterinary ledical consultation contract
  • Basic Questionnaire ( provided by, to be send at least 24 hs before the consultation takes place ).
  • Previous results from the patient ( blood work, chemistry profiles, hormone level measurement, endocrine tests, citologies, skin scrapings, biopsies, other ) 
  • Identification of the different samples obtained and their matching pictures
  • If available, pictures of the animal when it first started to show clinical signs of skin disease.

If it were necessary, , dermlink buenos aires will suggest you what kind of samples you should get grom your patient and how, and also which studies to perform on them. You can send them to your preferred laboratory, or we can suggest you a laboratory to have them tested – in Argentina or in other countries. Samples must be sent via courier service ( please ask us about this feature ).

To receive more information on Dermlink Buenos Aires - Veterinary Teledermatology Service, please send us an email.


www.dermlink.com.ar