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Innovation ensures seamless care experience

Dermatologists at a safety net hospital use telemedicine and strong cross-specialty collaboration to provide underserved patients with specialty care.

Dr. Senger's story

SkinSerious, Carolyn Senger, MD, MPH
Carolyn Senger, MD, MPH, Medical Director, Medical Specialty Clinics, San Mateo Medical Center
San Mateo Medical Center has been dedicated to serving our Bay Area community since its founding in 1919. As the safety net hospital for the San Mateo County area, we primarily see uninsured, underinsured patients. While no one is immune to the vulnerability that comes with illness and health concerns, the medical center provides a safe place for people to come for care.

Telemedicine was introduced at San Mateo Medical Center in 2010 to ensure patients and physicians can access specialty care in a timely manner for both acute and chronic health concerns. In dermatology, this is especially important as the skin—the body’s largest organ—is often an early indicator of systemic issues.

I recall one patient with multiple co-morbidities who visited his primary care physician for a rash. After the rash failed to improve with initial treatment, the physician requested a teledermatology consultation. The dermatologist and primary care physician worked together virtually to order labs, whittle down the differential diagnoses to ultimately diagnose the patient with a rare inflammatory condition and develop a complete treatment plan. This behind-the-scenes coordination ensured they could care for the patient in a comprehensive, evidence-based, and efficient manner, which is especially important for patients who face transportation barriers and juggle many life responsibilities and hardships.

Our teledermatology program is popular among patients and physicians alike. Approximately 90 percent of the center’s cases are triaged through teledemedicine, with an average 72-hour turnaround. Sixty-five percent of those cases are managed entirely by primary care with teledermatology support. That leaves in-person dermatology appointments available for the most complex and serious cases. We see telemedicine as an integral part of providing the right care, at the right time, for the patients we serve.

The expertise of board-certified dermatologists is critical for providing our patients with the care they need, and telemedicine helps make it possible.

The dermatologist's perspective

Innovation ensures seamless care experience

"Our country spends substantial amounts of money on health care, yet we still have serious health disparities. Working with underserved patients in the Bay Area is my life’s work. Marrying technologic innovation with health care delivery systems is the future of medicine. Our teledermatology collaboration with local hospitals enables the limited number of available dermatologists to provide care to the greater community, significantly opening access and reducing wait times. That efficient access to care really matters to patients’ health and well-being."

– Toby Maurer, MD, FAAD
Professor of Dermatology, Indiana University/AMPATH; Professor emeritus, University of California, San Francisco/Zuckerberg San Francisco General Hospital

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