The development of an evidence-based teledermatology scale-up framework and roadmap

Abstract

The objectives of South Africa's (SA) ehealth strategy recognise the value proposition that telemedicine holds for rural and urban referrals, but a lack of accepted and formalized scale-up implementation and financial planning has impeded unlocking these benefits. Because HIV/AIDS remains a major cause of morbidity and mortality in South Africa, and because skin pathology is often the first sign of an HIV/AIDS infection, swift, organised, and efficacious dermatology referral is essential. While there are examples of teledermatology, both synchronous and asynchronous, in South Africa’s public health system these remain localised and have not been widely implemented or scaled-up and have not realised the intended telemedicine objectives. This has placed the public health system at a disadvantage in making the dermatology referral pathway neither effective nor efficient. This paper presents the development of an evidenced-based Teledermatology Scale-up Framework (TDSF) and supporting roadmap to assist with ensuring sustainable scale-up.