Teledermatology Toolkit

A-teledermatologyToolkit_300px.jpgAAD's Teledermatology Toolkit offers a host of resources to help you and your practice implement telemedicine, choose a vendor, and connect with AAD experts through an online community.

 

 

  • Overview

    Recently, a combination of advancements in information technology (IT), including electronic health records (EHRs), high-definition video conferencing, remote patient monitoring, mobile devices and networks, and ubiquitous broadband networks, has created an opportunity to leverage telehealth services to improve our national health care system. Health care workers can use this technology to provide clinical services to patients, to monitor patient health, to consult with other health care providers, and to provide patients access to educational resources.


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    Importantly, the technology has reached the point where, in many situations, health care providers can use IT to offer quality clinical health care services remotely. For example, the widespread adoption of mobile devices, as well as the deployment of mobile broadband networks, means that a large number of Americans have access to low-cost, high-quality video conferencing capabilities. While telehealth services will certainly not replace in-person clinical visits, they have the potential to serve as an additional tool for caring for patients.

    The Center for connected Health Policy’s (CCHP) annual State Telehealth Laws and Reimbursement Policies report offers the nation’s most current summary guide of Medicaid provider manuals, applicable state laws, and telehealth-related regulations for all fifty states and the District of Columbia. This report serves as a vital resource for health care professionals on how each state defines, governs, and regulates technology-enabled health care, noting policy trends across eleven key categories as indicated in the 50 State Scan of Telehealth Reimbursement Laws and Medicaid Policies - Factsheet.

    What are the key elements of telemedicine?

     

    1. Provide clinical support.

    2. Overcome geographical barriers, connecting patients with providers who are not in the same physical location.

    3. Implement the use of various types of technology such as synchronous and asynchronous video clinical encounters, store and forward transmission of health data, and remote patient monitoring.

    4. Facilitate value-based care and improved patient outcomes

    What are the benefits of telemedicine?

    • With telehealth technologies, providers can deliver quality care at a lower cost, a critical imperative in the accelerating era of value-based payment. Other key benefits are profiled below.
    • Increasing access to care and reaching new markets by enabling virtual consultation regardless of geographic location
    • Addressing misdistribution of subspecialists
    • Reducing emergency department visits preventing overcrowding and significantly lowering health care costs.
    • Addressing problems quickly before they become more serious.
    • Lowering health care costs as remote medical encounters are less expensive than in-person visits,
    • Facilitating patient compliance with referred care and recommended treatment plans.

    Telehealth resources

    To learn more about Teledermatology in today’s healthcare environment consider the resources below:

    State Coverage for Telehealth Services
    The health care workforce is stretched to its limits in most states. Despite   programs operated by state, federal and local governments aimed at recruiting and retaining primary care professionals to rural and underserved areas, the need outpaces the supply in many communities.  

    Telehealth Policy Trends and Considerations
     Telehealth presents one strategy to help achieve the triple aim of    better health care, improved health outcomes and lower costs


     
     


    This Dermatology World video outlines key considerations for physicians interested in practicing teledermatology.

  • Choosing a vendor

    B-Vendors.jpgThere is more than one way to introduce teledermatology to your practice. Below are options for you to consider when selecting how your practice will participate in teledermatology.

    Teledermatology using an EHR

    Certain Electronic Health Record (EHR) vendors will offer a telemedicine option in their portfolio of service offerings.  Consult with your vendor to learn how to utilized their telemedicine platform.

    Teledermatology without an EHR

    If you do not have an EHR in your practice or your EHR does not offer an integrated telemedicine software solution, consider working with an external vendor. Below are tips in selecting an appropriate vendor for your practice.

    Try out each Telemedicine vendor’s platform to determine which one is best suited to your physicians and clinical staff. Questions to consider:

    • Does the vendor provide staff training?
    • If you prefer using your smartphone for telemedicine visits, does the vendor offer an app?
    • Does the platform allow the clinician to collect relevant medical history, and provides easy opportunities to ask follow-up questions of the patient to obtain additional history?
    • Does the platform have the capability to send lab studies local to the patient when needed?
    • What are the costs involved with the vendor including any additional hardware purchases and staff time?
    • If you are interested in live interactive, what kind of broadband access will you need? Will you need to upgrade any of your services for that particular vendor?
    • Is the vendor HIPAA-compliant and willing to sign a business associate form?

    It is also recommended that you try out the vendor’s customer service to determine how helpful it is and which vendor offers the best service. Finally, look at the software from the patient’s experience to determine which vendor offers the easiest platform for your patients to use.

    To learn more about the AAD and Teledermatology position read the AAD Position Statement on Teledermatology.

  • Compliance

    B-Overview-Compliance.jpgCompliance guidance

    If your practice is considering adding a teledermatology service, the following compliance issues must be addressed prior to implementation:

    • Ensure the telemedicine technology you are using is HIPAA-compliant.
    • If you need to install additional hardware or purchase mobile phones to run the telemedicine software on, follow your internal HIPAA security policies on these devices and encrypt PHI.
    • Sign business associate agreements with the telemedicine vendor and any other software/hardware providers who will have access to the PHI.
    • Ensure the telemedicine vendor is compliant with FDA regulations concerning telemedicine and smartphones.
    • Consult the AAD guidelines and AAD teledermatology position statement to ensure you are following appropriate and standard care when consulting with a teledermatology case.
    • Obtain and document informed consent through patient signatures in accordance with state law.
    • Maintain documentation of all patient records associated with teledermatology visits for the appropriate length as mandated by state law.
    • Ensure that the provider is legally permitted to practice medicine in the state where the patient is located.


  • Implementation

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    After determining that telemedicine is right for your practice and selecting an appropriate vendor, you should consult the following checklist to successfully integrate the technology into your practice.

     

     

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  • Resources

    B-Resources.jpgGetting started guides

    These checklists will help your practice get started in teledermatology:

     

     

     

    More information about teledermatology:

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    In this video, Karen Edison, MD, addresses pros and cons of teledermatology — specifically its potential to cut down on follow-up visits for acne patients and bring rising dermatology costs down. This video is a selection from Dermatology World's 2016 debate addressing key issues affecting the future of practice in the specialty.

  • AccessDerm

    B-Overview-AccessDerm.jpgAccessDerm

    AccessDerm is an Academy-sponsored teledermatology program that allows AAD dermatologists to provide care to underserved populations in the United States. By participating in the program, members and residents can consult remotely on dermatology cases using mobile devices and the Internet.

    The AccessDerm program gives primary care providers who work in participating clinics free access to AAD dermatologists’ expertise. Primary care clinicians submit consultations that dermatologists then receive on their personal mobile devices or the Internet via HIPAA-secure and compliant means.

    Download the app

    AAD members and residents who wish to participate can currently download the AccessDerm application for free on the following mobile platforms:

    Download_App_store_icon.jpgiPhone and iPad

     

    Download_Android_icon.jpg      Android

    Participants also can access the program via any Web browser (Internet Explorer, Mozilla Firefox, Google Chrome, Apple Safari, etc.). 

    Where you can use AccessDerm

    Due to licensure requirements, an AAD dermatologist only can provide remote consultation on cases that originate in a state where he or she is licensed. AccessDerm is currently being used in 16 states, however, the Academy seeks to increase participation by clinics in all 50 states.

    How to participate

    If you are an AAD member who wishes to participate, and/or you would like to recommend a primary care clinic in your area for participation in the program, please submit your contact information.

    If you have been involved in this volunteer activity, please log your hours. Logging your hours supports the Academy's efforts to enhance the image of the specialty by promoting your dedication to helping patients, communities and the profession.

    AAD members can now indicate in their AAD member profiles that they use teledermatology. Using the member directory telemedicine drop-down selection, members can search for and connect with colleagues who practice teledermatology. To indicate your teledermatology use, edit your member profile.

    If you are an AccessDerm participant and are experiencing technical issues, please complete this form and email it to Scott Weinberg at sweinberg@aad.org or fax it to (202) 842-4355.