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A unique teledermatology partnership expands access for medicaid patients

Dr. colven's story

 
Video narrated by Roy Colven, MD, FAAD
Dermatologist, Harborview Medical Center, Seattle, WA

My dermatology practice is one of the few Medicaid providers in the Seattle area and for most of western Washington. Our availability is limited and we have patients waiting four to six months to see us, including Medicaid patients who live far away but have no other access to dermatology. The long wait times are frustrating for both patients and referring providers. To help remedy this, we partnered with rural community clinics, and with the help of our Community Health Plan of Washington, used teledermatology through the American Academy of Dermatology’s smartphone application to help triage patients.

Patients are referred by their primary care providers and their images and histories are electronically sent to us. Most of them are straightforward issues; we provide consultation on treatment and often, the patients can be managed by their primary care physician and don’t need to wait or travel to see a dermatologist. Our practice receives $50 per triage patient who doesn’t need a dermatology referral.

For a sliver of patients, they do need to see a dermatologist and in that case, I’ve have been able to work with other practices that previously hadn’t accepted Medicaid to see these few patients who need specialized care. This has helped patients gain access to a practice just down the street instead of traveling long distances for an appointment.

By participating in this process, primary care providers have sharpened their dermatology skills. Many are now able to identify and manage straightforward cases, and patients receive the care they need. We’ve also helped save the community health system a lot of money because each unnecessary referral we've prevented would have cost hundreds of dollars.

Overall, it's cost effective for us and in pairing with the Community Health Plan of Washington, we can provide better and faster care, and at the same time enhance the general knowledge of dermatology for non-dermatologists. Most states have their own community health plan system and could implement a similar process to improve access.