The COVID-19 pandemic led many people to pursue telehealth options to replace their in-person appointments. But teledermatology has been around for over 25 years, and because dermatology is a highly visual field, it is especially suited for remote appointments. However, some of the more concerning skin conditions, like cancer, cannot be diagnosed virtually.
How does teledermatology work?
Telehealth has four modes of care, and they apply to teledermatology in the following ways.
|Live video||To facilitate real-time interaction between a dermatologist and their patient.||A patient schedules a video conference with their dermatologist to examine a skin condition.|
|Remote patient monitoring (RPM)||To track the patient’s progress virtually.||A patient supplies picture updates for a clear view of their progress.|
|Store-and-forward||To transfer medical records and other health data using a secure electronic platform.||A dermatologist reviews previous patient records and diagnostic results.|
|Mobile Health||To transmit health information using a smartphone or tablet.||A dermatologist offers educational materials through email or on their website.|
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What happens in a teledermatology session?
Your telehealth session should be similar to a standard in-person consultation. Depending on your dermatologist, you may run through the following steps.
- Your dermatologist sends you either an invitation or link to the session.
- Click or tap the link and connect to your session.
- Explain the reason for your appointment and answer the dermatologist’s questions.
- The doctor may ask you to use your camera to show your skin condition.
- The dermatologist may consult your medical records and give advice.
- The dermatologist can also prescribe any medication and make skincare recommendations.
- After the session is done, you can log out of the application.
Who can provide teledermatology?
According to the American Academy of Dermatology Association (AAD), any dermatologist can provide this service as long as the patient is within the state where they are licensed.
Additionally, the Centers for Medicare & Medicaid Services (CMS) has decided to waive the state licensing requirement for Medicare patients because of the pandemic. Some state requirements have changed as well to make sure safe medical services are available to as many people as possible.
How much does teledermatology cost?
Under AAD policy, your teledermatology appointment should cost the same as any in-person services. And while the cost of dermatologist services vary by physician and area, a routine exam costs an average of $150 without insurance. But some telehealth services advertise appointments for half that price.
Does health insurance cover teledermatology?
Generally, teledermatology services are covered the same as in-office visits, but a quick call to your insurer can give you the most accurate answer before you make your appointment.
|Private health insurance||According to the AAD, private insurance companies vary in how telehealth appointments are billed and paid, so it’s important to check with your insurance to make sure your teledermatologist appointment is covered. But most insurers have altered policies to allow for telehealth appointments because of the pandemic.|
|Medicare||CMS has issued special telehealth codes for billing, but otherwise treats a teledermatology visit the same as in-person visits and reimburses at the same rate.|
|Medicaid||Medicaid allows for all medical services they currently cover to be covered as telehealth services, according to CMS.|
Which conditions can teledermatology help with?
Teledermatology can effectively diagnose, treat and maintain treatments for many skin conditions, including the following:
- Poison ivy
- Skin infections
What is teledermatology not suitable for?
Not every dermatologist service can be done remotely. The following are services that require an in-person visit.
- In-person procedures and treatments that require dermatology equipment
- Skin cancer diagnosis
- Cosmetic procedures
- Conditions of the scalp if you have hair
Ask an expert: What should patients know about teledermatology?
When the pandemic hit, our office had to pivot quickly to accommodate our patients, and telemedicine has been an excellent addition to our practice. We see about 20% of our patients virtually now, and the opportunity to be seen this way continues to grow.
Though with everything, there are pros and cons.
Pros: A virtual visit is great for any Rx refill, a sudden onset of rash or other skin ailments, along with following up on status in general. Since dermatology is very visual and photos can be quickly sent, it’s straightforward to consult. Telemedicine is great for people who are unable to get into the clinic for whatever reason such as distance, low immunity or time. Typically, a patient can be seen the same day.
Cons: As you can imagine, mole exams are very challenging. As a provider, we use special tools to evaluate moles to determine if they are suspicious or not. Also, touching any skin ailments is so essential for an accurate diagnosis. We’re merely relying on what the patient is telling us, and unfortunately, what they say and what we see may be two different perceptions. If there is a suspicious growth, it can be a challenge to get the patient to be seen in person immediately as they may prefer to wait to be seen. A biopsy cannot be done virtually, either.
The benefits of teledermatology
Teledermatology was introduced in 1995, but as a primarily visual field, this form of telehealth has been effective in practice, with the vast majority of studies showing that both patients and providers like it and find the treatments effective.
- Encourages people to visit the dermatologist. The convenience of a remote appointment can help people with limited time to schedule a check-up. Plus, patients are highly satisfied with the care they get in their remote visits, which encourages them to follow up.
- Less expensive. If you use a telehealth service, your appointment may cost less, and you’ll save money on transportation to and from an office.
- Improves access to care. Because dermatology is a specialty, patients who live in rural and remote areas may not have access to in-person care.
- Saves time. You can take less time away from your other responsibilities by skipping the drive to the office and the time spent in the waiting room.
The drawbacks of teledermatology
Teledermatology has some drawbacks as well, including the following:
- Technological barriers. Not all patients have access to adequate Internet access or the computer technology they need to work with a doctor’s telehealth system.
- Not all treatments are available. Annual skin checks and skin cancer checks require in-office equipment, as do many cosmetic procedures.
How to find a teledermatology provider
You have a few options to find a dermatologist that offers telehealth services.
- Search the AAD Find a Dermatologist database using the Teledermatologist filter available in the Advanced Search filters.
- Check with your established dermatologist to see if they offer telehealth appointments.
- Explore your insurance database for teledermatology providers
- Research telehealth service groups online for dermatologists licensed in your state.
How secure is a teledermatology session?
Your safety during the pandemic is important, but so is your privacy. CMS guidance has loosened the HIPAA requirements for telehealth, allowing providers who don’t have an established telehealth system in place to use apps like Google Hangouts, Apple Facetime and Skype for appointments. But those apps come with some privacy risks, and providers are still not allowed to use public-facing applications like Facebook, Twitch or TicTok.
How to prepare for a teledermatology session
There are a few things you can do to make sure your session goes as well as possible.
- Send pictures ahead of time. To ensure your dermatologist doesn’t have to rely on the quality of your camera and internet connection, take clear pictures of the affected areas so the doctor has a clear view.
- Find a quiet, well-lit area in your home. Make sure you aren’t distracted and your dermatologist can see you clearly.
- Test your tech. Check your Internet connection and test your microphone and speakers for the clearest audio possible.
- Have a flashlight ready. Your dermatologist may ask you to use a flashlight to help them better see your skin condition as the exam proceeds.
Teledermatology can be a great way to save time and money on your dermatology visits, while also keeping you safe during the pandemic. But some of the more important dermatologist services, such as cancer checks, can’t be done without an in-person appointment.
Before you make your appointment, check your state laws on telehealth and give your health insurance company a call to make sure you’re covered.