by Jane Anderson
A pilot telemedicine program dramatically reduced the amount of
time it took for primary care physicians to consult with dermatologists on skin
ailments but did not increase utilization or cost, according to a new study
from Independence Blue Cross and the University of Pennsylvania.
"Dermatology is an ideal specialty for telemedicine due to the visual
nature of the clinical assessment," says study co-author Aaron
Smith-McLallen, director of health informatics and advanced analytics at
Independence Blue Cross. "Using telemedicine, patients can get quality
care very quickly and reduce wait times for patients with more acute needs that
are not suitable for telemedicine intervention."
The study provides a blueprint for teledermatology programs that plans could
potentially implement as soon as 2021, and also could show a path forward for
telemedicine in other specialties, says F. Randy Vogenberg, Ph.D., principal,
Institute for Integrated Healthcare in Greenville, S.C.
"Carriers are assessing how to best manage new technology-enabled care
delivery in a more systematic manner that addresses their need to control
financial risk while providing appropriate access to care," Vogenberg
tells AIS Health. "A study result like this clearly establishes the value
proposition of providing a win-win scenario by leveraging technology to aid
broader, easier access to care without increasing total costs associated with
such expanded care delivery."
The study, published in the journal Telemedicine and e-Health, examined implementation
of teledermatology at five University of Pennsylvania Health System primary
care practices in 2016 and 2017.
In the teledermatology arm of the study, dermatologists' average response time
was five hours, while in the "usual care" control arm, it took 84
days for primary care physicians to consult with dermatologists.
Teledermatology patients who were recommended for in-person evaluation
completed visits to the dermatologist in fewer than four weeks, compared with
longer than 14 weeks for controls, according to the study. Meanwhile, there
were no significant differences detected in average outpatient costs or total
medical costs between the two groups.
The store-and-forward evaluation approach has been used in other specialties,
such as radiology and pathology, and Independence is exploring ways to expand
its use, Smith-McLallen says.
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