NEW YORK – Teledermatology has not yet arrived at every office and institution, and reimbursement and training remain hurdles, but many researchers believe in its potential and maintain that advancements in technology will improve and expand the dermatology branch of telemedicine.
If you need a jolt of excitement, just watch our interview with Dr. Jeffrey Benabio, who is the physician director of healthcare transformation at Kaiser Permanente in San Diego. He spoke with us after a panel discussion about the role of technology in dermatology, held at the American Academy of Dermatology’s summer academy.
By January 2012, there were 37 active teledermatology programs in the United States. That number is down from 62 in 2003, according to a study by Dr. April Armstrong, director of teledermatology at the University of California, Davis, Health System, and one of the leading figures in teledermatology research. Dr. Armstrong and her colleagues published a survey of these programs in 2012.
But, "it’s not about starting a program, it’s about sustaining it,’ said Dr. Armstrong.
Her studies have shown that in practices that have sustained teledermatology over time, the median number of consultations per program nearly doubled, increasing from 184 in 2003 to 309 in 2011, albeit with a wide range.
Dr. Armstrong has reported that to sustain such practices, what’s needed are improvements in reimbursement models, technology platforms, communication with referring providers, and training.
Dr. April W. Armstrong
Many of the teledermatology programs in the United States are at academic institutions (49%), Veterans Administration hospitals (27%), private practices (16%), and health maintenance organizations such as Kaiser Permanente (8%), according to Dr. Armstrong’s research. Most are concentrated in California and along the east coast; those in the middle of the country, where there are greater issues with access to health care, are few and far-between.
Meanwhile, some dermatologists are experimenting with online-only practices, such as DermatologistOnCall, DirectDermatology, and YoDerm. In addition, the AAD has sponsored a teledermatology program called AccessDerm, allowing its members in several states to provide remote care via a mobile phone.
Although the future direction of teledermatology remains unclear, Dr. Armstrong predicted that the increased use of mobile technology, greater demand for direct patient-specialist interaction, and specialists’ acceptance of telehealth as a form of care delivery will eventually lead to an expanded use of teledermatology.
Dr. Armstrong has received honoraria from several companies, including Abbott Laboratories, Amgen, and Janssen-Ortho. Dr. Benabio has received consulting fees from Dove/Unilever. He is also on the editorial advisory board for Skin & Allergy News.
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