Serving the Underserved via Teledermatology During COVID-19

The pandemic, and lifted restrictions in telehealth delivery, are hastening the adoption teledermatology in underserved patient populations.

Teledermatology expansion may greatly benefit underrepresented and underserved populations during the coronavirus-19 (COVID-19) pandemic,according to an article published in the Journal of the American Academy of Dermatology.

As the Centers for Medicare and Medicaid Services (CMS) issued a waiver that eliminated barriers that prevented widespread teledermatology practice,dermatologists are now able to provide care to Medicare patients whether or not they are in state and receive full compensation for these services.

For underserved populations, the expansion of teleheath creates an opportunity for increased access to dermatologic care. In ethnic minorities, the uninsured, and people with lower incomes there are higher rates of skin cancer and other diseases, yet their access to appropriate care is not proportionate to their need; most rural counties do not have a dermatologist and minority communities are often lacking in dermatologists. The commentary noted that 77% of primary care providers in low income communities reported that dermatology appointments are difficult for their patients to obtain. Of  surveyed physicians, only 9% have used teledermatology although 88% indicated they were interested in the tool.

To support telehealth’s expansion into underserved communities, it is suggested that providers in community health centers be encouraged to refer their patients to a practice that offers teledermatology services. Outreach efforts that include multilingual website and social media platforms were also encouraged.

Introducing teledermatology to these communities includes a number of challenges, it was noted.

Technology. Not all patients have access to virtual platforms. However, having patients submit photographs before a phone consultation may eliminate this barrier.

Navigation difficulty of platforms. Elderly patients in particular may find it hard to navigate the online platforms for a telehealth visit. However, having access to technical assistance, step-by-step guides, and phone support may reduce this challenge.

New patient admission. As the need for in person meetings prior to telehealth visits has been waived, dermatologist will need to implement new procedures for patient onboarding.

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The authors concluded that the COVID-19 pandemic creates an opportunity to “close a gap in healthcare disparities” by making dermatologic care accessible to all.

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Ashrafzadeh S, Nambudiri VE. The COVID-19 crisis: A unique opportunity to expand dermatology to underserved populations. J Am Acad Dermatol. [published online May 4, 2020] doi: 10.1016/j.jaad.2020.04.154