Trips to see the doctor have never been this easy before for children with eczema. If their condition is stable, they do not need to visit the clinic. In fact, they only need to see the pharmacist and even this is done through a video call. Known as telemedicine, it is one of the services available at KK Women’s and Children’s Hospital (KKH).

Following an initial face-toface appointment with a doctor, patients with mild to moderate eczema are subsequently counselled by a trained pharmacist at the hospital. After this, they are monitored by a trained dermatology pharmacist through video calls. Associate Professor Mark Koh, Head and Senior Consultant, Dermatology Service, KKH, said that the department sees about 200 paediatric eczema cases a week, of which about 32 cases each month are suitable for video consultations with a dermatology pharmacist.

“The pharmacyled eczema counselling service and video conferencing review have helped many patients with mild to moderate eczema understand more about their disease and treatment. It replaces a follow-up appointment with the doctor and saves an extra visit, especially if the eczema is well-controlled,” he said.

Medication re-supplied

Eczema is a skin condition where parts of the skin become inflamed, cracked, and itchy. It is usually managed with creams or oral medication, or both, to reduce the itch and inflammation. Moisturisers are also prescribed to help the skin heal and prevent flare-ups.

During the video consultation, the dermatology pharmacist will first assess the condition of the patient’s skin, and then advise caregivers on the next course of action.

For instance, medication may be adjusted if needed, or re-supplied if the condition is well-controlled. The medication can be couriered to the patient’s home, saving the patient and caregivers a trip to the hospital.

If the condition of the eczema is stable, a discharge letter will be issued, and the patient will continue to be cared for by a primary care physician. But if it is not well-controlled or shows signs of worsening, an earlier face-to-face appointment with the dermatologist-in-charge will be scheduled.

Throughout, the dermatologist is kept updated on the patient’s care plans, and advice is sought as and when needed.

The initiative not only allows for earlier intervention in uncontrolled cases, but also empowers dermatology pharmacists to play a bigger role in managing paediatric eczema.

“Many patients have found the service very useful and many of their conditions have improved. They are able to better cope with the disease after counselling by our pharmacists,” said Prof Koh.

Privacy assured

This service has other benefits, too.

“During the follow-up video conference, our pharmacists assess the patient’s condition, and decide whether he or she needs to be seen in the clinic or can continue treatment in the primary care setting. This saves our patients time and cost, and gives our doctors more time to manage more complicated cases.”

The addition of this service allows healthcare to be more patient-centric and accessible, bringing medical care to the doorstep of patients and their caregivers, said Dr Eileen Lew, Campus Director, Medical Innovation and Care Transformation, and Chairman, Division of Clinical Support Services, KKH.

With the advancement of technology and as it is harnessed for healthcare, concerns that may arise, such as privacy issues, have been addressed by the team at KKH.

“The security features of this new platform add assurance — for our patients and us as healthcare providers — that confidentiality of patient information and data is safeguarded,” said Dr Lew.