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
    Telemedicine is the use of medical information exchanged from one site to another via electronic communications to improve a patient’s clinical health status. Telemedicine includes a growing variety of applications and services using two-way video, email, smart phones, wireless tools and other forms of telecommunications technology.

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    What are the benefits of telemedicine?

    Telemedicine has been growing rapidly because it offers four fundamental benefits:

    Improved access—For over 40 years, telemedicine has been used to bring health-care services to patients in distant locations. Not only does telemedicine improve access to patients, it also allows physicians and health-care facilities to expand their reach beyond their office walls. Given the provider shortages throughout the world—in both rural and urban areas—telemedicine has a unique capacity to increase service to millions of new patients.

    Cost efficiencies—Reducing or containing the cost of healthcare is one of the most important reasons for funding and adopting telehealth technologies. Telemedicine has been shown to reduce the cost of healthcare and increase efficiency through better management of chronic diseases, shared staffing, reduced travel times, and fewer or shorter hospital stays.

    Quality—Studies have consistently shown that the quality of health-care services delivered through telemedicine can be as good as that given in traditional in-person consultations. However, there are some skin findings for which an in-person examination by a dermatologist provides additional information that may not otherwise be obtainable by teledermatology alone.

    Patient satisfaction—The greatest impact of telemedicine is on the patient, their family, and their community. Using telemedicine technologies reduces travel time and related stresses for the patient. Over the past 15 years, study after study has documented patient satisfaction and support for telemedical services. Such services offer patients access to providers that might not be available otherwise, as well as medical services without the need to travel long distances.

     
     



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


  • Choosing a vendor

    B-Vendors.jpgAfter you have determined that teledermatology interests you, the next step will be to determine which vendor is most appropriate for your practice.  If you currently have an electronic health record (EHR), consult with your vendor to determine if they have a telemedicine offering through your platform.

    If you do not have an EHR in your practice or your EHR does not offer an integrated telemedicine software solution, consult the following tips to help you select the appropriate vendor:

    •  If choosing a direct to patient platform, you should ensure that:
      • The vendor discloses to the patient the name, credentials, and location of the clinician, and gives the patient some choice of physician, rather than using random assignment.
      • If the vendor accepts consults from patients who are distantly located from the physician, that they have relationships with local dermatologists, so the telemedicine provider has somewhere to refer the patient if they need a biopsy, have a medication side-effect, or have some other need for in-person follow-up.
      • The platform allows the clinician to collect relevant medical history, and provides easy opportunities to ask follow-up questions of the patient to obtain additional history.
      • The platform has an easy way to send lab studies local to the patient when needed.
      • The platform has mechanisms to obtain meaningful informed consent, including a detailed and clear discussion of medications (side-effects, etc.)
    • Determine what type of telemedicine offering you want to provide– direct to the patient (please see the AAD Position Statement on Teledermatology), or provider to provider. Then decide whether this will be done via store and forward, or live interactive telemedicine.
    • Try out each vendor’s software to determine which one is best suited to your physicians and clinical staff. Also figure out how much training will be involved with each option, as this will help you determine how easy one product is for your staff compared to another.
    • Calculate all of the costs involved with the vendor including any additional hardware purchases and staff time.
    • If you are interested in live interactive, determine what kind of broadband access you will need and if you will need to upgrade any of your services for that particular vendor.
    • Ensure the vendor is HIPAA-compliant and willing to sign a business associate form.
      If you prefer using your smartphone for telemedicine visits, ensure the vendor offers an app.
    • Try out the vendor’s customer service to determine how helpful it is and which vendor offers the best service.
    • Look at the software from the patient’s experience to determine which vendor offers the easiest platform for your patients to use.

  • Integration

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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.