Telehealth May Be Led by Telederm

April Armstrong thinks the medical specialty that’s perfect for California’s nascent telehealth system is dermatology.

“Dermatology is visual,” according to Armstrong, director of the teledermatology program at UC-Davis Medical Center. “That’s the great thing about it, why it’s so suitable for telehealth, is that it’s a visual field. If the image quality is clear, you can tell a lot.”

Today, the Center for Connected Health Policy is scheduled to release an issue brief Armstrong authored on teledermatology. The brief was funded by the California HealthCare Foundation, which publishes California Healthline.

“We wanted to answer three questions,” she said. “So we interviewed all the current teledermatologists to find out what works and what doesn’t, from a Medi-Cal payment perspective. The second area, we looked at dermatologists who haven’t yet provided care through telehealth. And the third area, we asked rural primary care physicians, the high-volume referrers, what has worked for them.”

About 1,200 patients a year, mostly in rural areas, currently use the telehealth program at UC-Davis Med Center, she said. Dermatology is the most often-used telehealth specialty consult there.

“We found that dermatologists [across the state] are excited about the prospect of providing care through teledermatology,” she said. But most dermatologists who aren’t directly involved with it don’t know much about teledermatology, she said.

“In general, they lacked knowledge about setting that up as part of their practice, and they think telederm has a reduced rate of reimbursement,” she said.

Armstrong said reimbursement rates for telehealth visits are actually the same as face-to-face clinical encounters, but because many dermatology office visits are supplemented by quick in-office procedures, that’s something that can’t be done in telehealth.

“Clearly, it will be the wave of the future,” Armstrong said. “In dermatology you can do most things remotely, with the exception of procedures. And the technology will continue to improve, and generally patients will be less and less tolerant of traveling to the physician offices.”

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