By Brenda Dintiman, MD
I first heard about the Academy’s volunteer teledermatology project by chance when I happened to sit next to Bill James, MD, at a legislative meeting a few years ago. He was working on a telemedicine project, along with Carrie Kovarik, MD, and some other members, and asked me if I was interested in participating. I was, and I kept following up with him until the Academy’s pilot program launched in September 2010. This pilot program later became AccessDerm.
When members volunteer in the AccessDerm program, they provide care via mobile devices and the Internet to underserved communities in the state where they’re licensed. Participants can download the AccessDerm app onto their iPhones, Android phones, or access it via the Internet.
Pictured are sample cases that illustrate what dermatologists receive on their mobile devices when they volunteer in the Academy’s AccessDerm teledermatology program.
Once you download the app or access it online, the system is very simple: During a consultation with a patient, the primary care clinician uses his or her phone to take pictures of the patient's skin condition and then emails them to me. The picture quality is very high, allowing me to clearly see the affected area or areas.
After receiving an email that alerts me to a new consultation, I have 48 to 72 hours to review the pictures and respond with my diagnosis. The volume of cases has been fairly low during these past few years, but the cases are generally more unusual than the ones I see in my practice.
By preventing clinicians from writing inappropriate prescriptions, you save hundreds of thousands of dollars in wasted medicine.
This kind of program is essential for patients who can’t easily get to a dermatologist’s office. When we talk about access problems, we probably think first about people in rural areas. But access problems are much more widespread. People in rural areas are physically farther away, but those in urban areas can have trouble getting bus money or taking time off from work.
Volunteering with AccessDerm is such an effective way to support a population in need. By diagnosing the patients quickly and accurately, you make sure they get the right care. In the case of precancerous lesions or melanomas, the time saved could be critical.
In addition, an accurate diagnosis saves money. A single tube of cream can cost $50 to $600. By preventing clinicians from writing inappropriate prescriptions, you save hundreds of thousands of dollars in wasted medicine.
Taking part in the program gives you the chance to build a relationship with a local clinic. In addition to teaching them how to perform consultations properly, you allow them to streamline their practices by referring some patients via AccessDerm.
The best clinics for you to approach about working with the AccessDerm program are the safety net clinics in your area. I’ve been fortunate to answer consults for a very bright internist who has been wonderful to work with.
If you’re considering getting involved with AccessDerm, you might be concerned about the time it could take away from your family or your practice. But this is an easy way to give back. You always have the option of recruiting help or limiting your participation to a certain number of consults per week or month. It allows you to help the underserved in your community from the comfort of your own home or office.
Dr. Dintiman is founder of The Fair Oaks Skin Care Center in Fairfax, Va., and has volunteered in the Academy’s pilot teledermatology and AccessDerm programs since 2010.
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Due to licensure requirements, a member only can provide remote consultation on cases that originate in a state where he or she is licensed. The following states currently have registered clinics:
The Academy seeks to increase participation by clinics in other states. If you are an AAD member who wishes to volunteer, and/or you would like to recommend a primary care clinic in your area for participation in the program, please submit your contact information.
- New York