AAD Annual Meeting: Teledermatology

This post originally appeared on The Dermatologist

Dermatology is one of the few medical specialties that has been at the forefront of telemedicine. The recent American Academy of Dermatology’s (AAD) annual convention in San Francisco provides the best pulse of telemedicine in dermatology. Even though the conference attracts more than 17,000 attendees across the globe, all of the telemedicine talks featured dermatologists practicing in the United States.

Despite dermatology’s long history of telemedicine activity, this year offered the most striking uptick in interest from private practice dermatologists. What follows are the 4 take-aways from a non-clinician attendee who’s been following teledermatology since 2008:

Finally, reimbursement is not the hot-topic

Historically, reimbursement has been one of the first questions asked by a dermatologist in the crowd. Can I get reimbursed? Under what conditions can I get reimbursed? These are usually the issues that are top of mind with dermatologists. No more!

Now, the first questions are around liability. Dermatologists, like a lot of physicians, are justified to think that they might be opening themselves up to yet more malpractice claims by practicing telemedicine. The good news, reported in one of the talks, is that there has been no litigation to date attributed to the practice of teledermatology.1 In reality, it is hard to say if this is indicative of the future given the scope of telemedicine practiced in most dermatology clinics. In my own experience and interviews, telemedicine can often be covered under a dermatologist’s existing professional liability policy if performed under the proper care model. To be safe though, every practice should examine their policy before adopting any telemedicine.

Dermatologists now have more choices

The market has been expanding to meet the increasing interest in telemedicine and at the recent AAD conference and exhibit hall in San Francisco, Calif. this was obvious. I counted six teledermatology companies attending the conference. Many of these companies are still very young with the oldest founded just 3 years ago.

With new telemedicine platforms popping up every day, I expect next year to have more than double the number of companies. This is great news for dermatologists because competition brings choice, lower prices and better products.

Dermatologists who study telemedicine aren’t comfortable with direct-to-consumer care models

Direct-to-consumer is a patient initiated visit in which a diagnosis is given remotely, via telemedicine, without ever establishing a prior patient-physician relationship in person. To be clear, this does not include patients receiving a teledermatology consult while under the supervision of a primary care physician or in a hospital setting. It is a trend which sparked a growth of telemedicine in dermatology the past couple of years however the AAD came out against this practice in a recent position paper last August.2

It is difficult to say how dangerous, if at all, this practice is except that there is little evidence to date to support its safety and efficacy. This is the area where there is probably the most contention between dermatologists in private practice and those focused in academic practice.

Young Derms Will Not be the Early Adopters of Telemedicine

This is probably the most counterintuitive fact I learned while at the conference. This year’s meeting showed the largest attendance to date at the telemedicine talks. But the seats weren’t occupied by newly minted dermatologist —most were taken by experienced, private-practice dermatologists in their forties and older.

However, with a little reflection this is should not be surprising. Older dermatologists are likely more comfortable with their diagnostic abilities and have an established and growing panel of patients. Based on comments from attendees like these, older dermatologists are looking to continue to grow their practice and teledermatology is one of the most effective ways to accomplish this.

Online dermatology visits becoming a reality

As a patient and health technology advocate, it is exciting to see the interest and adoption of teledermatology accelerating. Telemedicine reimbursement is finally a hot topic for state legislatures with new legislation expanding coverage like the recent proposal in Minnesota.3 This movement in reimbursement along with an acceleration of interest among dermatologist should make for a big year in telemedicine.

References

  1. Lee, Ivy. "Medico-Legal Considerations In Teledermatology&quot. The American Academy of Dermatology Annual Meeting 2015. San Francisco, CA. March 20, 2015.
  2. American Academy of Dermatology and AAD Association: Position Statements. Position Statement on Teledermatology. August 9, 2014. https://www.aad.org/Forms/Policies/Uploads/PS/PS-Teledermatology.pdf. Accessed April 3, 2015
  3. Browning, Dan. Minnesota telemedicine coverage would expand under new bill. February 26, 2015. http://www.startribune.com/lifestyle/health/294062701.html. Accessed April 3, 2015.