According to a new study conducted by researchers from the Perelman School of Medicine and Independence Blue Cross and published in Telemedicine and e-Health, when patients’ primary care doctors were able to photograph areas of concern and share them with dermatologists, the response time for a consultation dropped from almost 84 days to under five hours—with no increase in cost.
“Telemedicine offers the opportunity to accelerate health care access by getting around infrastructure barriers: namely, heavily booked dermatology practices,” said Jules Lipoff, senior author and assistant professor of clinical dermatology, in a release. “Our study provides evidence that more patients can be cared for with the same amount of resources we’re using now.”
While the study was conducted pre-COVID, Denver, CO dermatologist Joel Cohen, MD says it certainly provides useful, practical and timely information. “While photographs are very often not adequate in providing us all the info we dermatologists may be interested in, such as how a lesion looks under a dermatoscope or how a lesion feels to the touch in a ‘live’ exam, sometimes, a simple photo can show enough concerning features to help triage a patient to come in for a dermatology evaluation right away—such as with a melanoma or other potentially aggressive skin cancers like squamous cell carcinoma, as well as other concerning dermatologic issues, including cases vasculitis or perhaps even life-threatening desquamating types rashes like Stevens-Johnson Syndrome.”
Likewise, Bay Harbor Islands dermatologist Stacy Chimento, MD goes as far to call the increased usage of telemedicine in the COVID era a “direct lifeline” between patients and providers.
“Traditionally, it could take weeks or even months before a patient could get into an office to see a dermatologist. Patients have reported that their conditions or problems either resolved on their own by the time they got into the office, and some patients have reported that they have self-treated, which can sometimes make the problem worse. But, more than often, their conditions have escalated uncontrollably, making it more difficult to treat.”
“Telemedicine provides timely, efficient and easy access from the comfort of the patient’s homes,” she adds. “All-around it is a better solution, and patients get the care that they need.”
Rochester, NY dermatologist Lesley Loss, MD has had a similar positive experience with telemedicine at her practice, pointing to a total of 98-percent telemedicine visits during March and April at the start of the pandemic.
“Regarding skin lesion checks, we had patients send us photos in advance of their appointment. At first, I was concerned that we would not be able to adequately assess skin lesions through video or photos, but it actually worked out quite well. Many times, the lesions were benign, but, if it was unclear, we had them come into the office for in-person assessment and possible biopsy. During the first four weeks of telemedicine, we diagnosed four melanomas, all early stage and very treatable.”
While Dr. Loss easy she hasn’t tried having primary care offices send photos of lesions (as the study discussed), she does think it would be a very useful way to get patients’ lesions assessed in a timely manner and to triage who needs to be seen more immediately. “Telemedicine also proved very useful for routine follow up visits for acne, patients on Accutane who require monthly follow up visits, psoriasis, eczema, medication refills, new onset rashes especially if they could send us good photos.”
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