JMIR Publications

ABSTRACT

Background:

In developing countries in sub-Saharan Africa, access to specialty services such as dermatology is limited. Teledermatology is an innovative solution to address this issue; however, many initiatives have been trialed without sustained success. Recently, WhatsApp has been used as a store-and-forward telemedicine communication platform for consultation and education in Botswana.

Objective:

This study aims to describe the utilization of WhatsApp for teledermatology and satisfaction levels of participating providers.

Methods:

A retrospective review was performed of all WhatsApp communications received by dermatologists working in Botswana from January 2016 to December 2019. Sender information, format of communication/consultation, type of patient information provided, patient demographics, time to reply, diagnoses made, and outcome of consultations were collected. A cross-sectional survey was performed of healthcare providers who utilized WhatsApp during this period. Descriptive statistics were performed.

Results:

Over the study period, 811 communication threads occurred. The majority (62.0%) of communications were consultations from providers inquiring about a specific patient, followed by multidisciplinary care coordination communications (11.1%). Our in-depth analysis focused on the former. In 323 (64.2%) provider consultations, dermatologists responded within one hour. A diagnosis was made in 274 (54.5%) consultations. Dermatologists gave treatment recommendations remotely in 281 (55.9%) consultations and advised an in-person dermatology visit in 163 (32.4%). Of providers using WhatsApp for these services, 15.3% completed the survey. All respondents (100.0%) felt there was a need for teledermatology and improved teledermatology education in Botswana. Seventeen (73.9%) respondents strongly felt that the guidance received via WhatsApp was high quality and 22 (95.7%) respondents were satisfied with WhatsApp as a platform for teledermatology.

Conclusions:

WhatsApp is a quick, effective, and well-received method of communication between dermatologists and providers across Botswana. The application may offer a solution to the difficulties providers face in accessing specialty referral systems, point-of-care information, and medical-decision-making support for complex dermatologic cases in Botswana. The knowledge gained from this study can help increase the successful implementation of teledermatology in Botswana and inform the future growth of telemedicine platforms in other developing countries.