by Toby Maurer, MD
Dermatologist and Symposia Medicus faculty member Dr. Toby Maurer shares her experiences with teledermatology (as telemedicine) and looks at the benefits and challenges of this new norm in healthcare.
I have been fortunate enough to work in teledermatology (as telemedicine) for over 10 years pre-COVID-19, if we can remember those days.
It has been a game changer in the delivery of health care; teledermatology allowed for close relationships to be made with my colleagues in primary care, it opened access to patients, many of whom had little access to health care (as evidenced in this pandemic) and it decreased wait times for patients from nine months to six days.
The biggest barrier to full implementation of telemedicine has been the financial model-who would pay for providing health care in this non-traditional way? Because of COVID and the need to find efficient ways of providing health care, payment models for telehealth have finally been constructed. As a result, telehealth companies are rushing to put together new platforms, many that have not yet been fully developed to service the providers and patients who could benefit from it.
How do we give access to patients and providers who might not be computer savvy or who might not have access to the tools or the broadband that is necessary to make it work? Workflows and best practices will need redesigning. Insuring image quality, providing security measures, maintaining connectivity, and guarding against fraudulent behavior by providers—these are emerging issues which will require attention immediately.
Rushed solutions have left a bad taste in the mouths of users but as a veteran of telemedicine, I see this as a time to use technology and develop innovative means by which to bolster the medical system and provide health care efficiently and with equity to patients worldwide.
We are using teledermatology and extending its use to other areas of medicine in refugee camps, in sub-Saharan Africa and Central Asia. We are using telemedicine to teach our students and residents. We are extending telemedicine to be used for subject recruitment and monitoring in clinical trials.
Because of the COVID crisis we have had to use technology to connect us. As Seema Verma, the head of Centers for Medicare and Medicaid Services (CMS) said, “the genie is out of the bottle.” With regard to telehealth-financial models, technology innovations and cultural attitudes need to catch up to allow telehealth to become the backbone of modern medicine.
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Dr. Maurer is professor emeritus at the University of California, San Francisco. She lives in San Francisco, California.