New age of telemedicine: Changes in practice to create opportunities, challenges

Jules Lipoff, MD, addressed teletriage.

Jules Lipoff, MD, addressed teletriage.

Technological advances have put high-quality cameras in the hands of millions of smartphone and tablet users, moving telemedicine from pipedream to reality. This change has opened a new set of opportunities and challenges for dermatologists who potentially could make better use of telemedicine than their colleagues in other specialties.

Five speakers addressed those topics Friday in “Teledermatology Working for You: Customizing Use in the Changing Healthcare Environment” (S013). Among the topics covered were reimbursement, different types dermatologic care delivered through telemedicine, medical education, legal concerns, and legislation.

“We wanted the session to be less academic and more practical. We wanted to demonstrate that the practicing dermatologist needs to understand telemedicine because it is going to become something they will use soon, mostly because reimbursement is likely going to happen,” said Carrie L. Kovarik, MD, the course director.

“We also have the ACA, increasing the numbers of insured patients coming into care, but the same number of dermatologists, so we need new ways to see these patients,” said Dr. Kovarik, associate professor of dermatology, dermatopathology, and infectious diseases at the University of Pennsylvania.

The speakers and their topics were:

  • Karen E. Edison, MD, presented “Health Care Policy and Telemedicine Reimbursement,” which is a hot topic because telemedicine reimbursement is rapidly changing in several states. In addition, the use of telemedicine has spread from rural areas to include more urban residents who are underserved and do not have adequate access.
  • Jules Lipoff, MD, presented “Teletriage, Teleconsult, Telecare — How It Impacts Your Practice.” With the increase in telemedicine, dermatologists could be called upon to triage patients without providing diagnosis and treatment, but refer patients to a provider based on patient history and images of a patient’s condition.
  • April W. Armstrong, MD, MPH, presented “Does the Evidence Support the Use of Telemedicine in Practice?” in which she reviewed evidence presented in recent studies.
  • Karolyn Wanat, MD, presented “Telemedicine: Improving the Educational Gap,” discussing how medical students and residents are increasingly being taught to use telemedicine because its use is expected to grow. A side benefit is that they are put into a position of making a diagnosis without prompting from an instructor.
  • Ivy Lee, MD, presented “Medico-legal Considerations in Teledermatology,” in which she discussed how providers can minimize their legal risks.
  • Dr. Kovarik presented “Telemedicine Legislation Update and Panel Discussion,” in which she also discussed changes in state legislation, including almost 200 pieces of new legislation.

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