If you have ever tried to get an appointment with a dermatologist, you know that it can be weeks or even months for the next available opening. One reason, according to a Jan. 3, article in the New England Journal of Medicine’s digital magazine Catalyst, is that many primary care patients are unnecessarily referred to a dermatologist—a specialty experiencing a significant physician shortage—making it harder for those with serious and life-threatening skin conditions to get appointments.
Lynn Community Health Center is one of seven community health centers in Massachusetts participating in a pilot teledermatology program to increase access to dermatology in underserved communities. The successful pilot not only removed many barriers to care but proved effective in reducing unnecessary referrals and reducing the cost of care.
The CHC collaborative partnered with 3Derm Systems to provide primary care providers with high-resolution imaging devices that can take clinical-quality 2-D and 3-D images and securely upload them for remote review by a dermatologist. The dermatologist can, in many cases, diagnose and recommend treatment to be provided by the primary care provider, saving dermatology appointment slots for those with more serious conditions that need to be followed up with an in-person office appointment.
In the pilot, 50 percent of teledermatology consults ruled out the necessity of an in-person appointment. In Lynn the percentage of those who did not need to see a specialist was even greater—of the 508 consults since the program began, 300 were able to be treated in the primary care setting guided by the remote consult.
Without this service, these patients would have had to get a referral from their PCP, make an appointment with the specialist, travel to see the specialist, and assume the costs of travel and co-pays associated with the visit. In addition to being more convenient and less costly for the patient, these remote consults also reduced overall health care costs because they are reimbursed at a rate significantly less than an office visit with a specialist.
“This is a powerful tool for primary care providers, especially for those of us who work with vulnerable populations that often face challenges navigating the health care system,” said Brian Headley, PA, Telemedicine Director at LCHC. “In addition to saving the patient time and money, it lets them stay in an environment where they are comfortable, with a health care provider they already trust. The results have been very positive.”
To learn more about the pilot program visit https://catalyst.nejm.org and search for “teledermatology.”