Telemed J E Health - Teledermatology operational considerations, challenges, and benefits: the referring providers' perspective.

Tópicos

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Resumo

CKGROUND: Teledermatology has been used to provide increased specialty access for medically underserved communities. In California, policies enable the California Medicaid (Medi-Cal) program to provide reimbursement for both store-and-forward (S&F) and live-interactive teledermatology consultations. To assess the effectiveness of teledermatology operations for this population, understanding the referring providers' perspective is crucial. The primary objective of this study was to explore the perspective of referring primary care providers (PCPs) on teledermatology by focusing on the operational considerations, challenges, and benefits to participating in teledermatology referral in the context of the Medi-Cal population.SUBJECTS AND METHODS: We conducted hour-long one-on-one interviews with 10 PCPs who refer patients to teledermatology regularly and who together serve an average aggregate referral base of 2,760 teledermatology cases yearly.RESULTS: Of the 2,760 aggregate annual teledermatology referrals, PCPs reported that they serve predominantly uninsured or underinsured populations and participate in S&F consultations. The majority of surveyed PCPs treat common skin conditions themselves. However, these PCPs refer more patients to teledermatology consultations than in-person dermatology encounters. Several factors influence PCPs' decision to refer to teledermatology, which include complexity of the skin problem, distance to accessible dermatologist, patient's insurance, and patient's preferences. PCPs identified improved workflow, enhanced communication with dermatologists, and faster turnaround for recommendations as three areas that referring physicians would like improved in their experience with teledermatology.CONCLUSIONS: Understanding the referring provider's perspective and subsequently adopting policy and practice solutions to address their challenges are vital to prompting further teledermatology participation for underserved communities.

Resumo Limpo

ckground teledermatolog use provid increas specialti access medic underserv communiti california polici enabl california medicaid medic program provid reimburs storeandforward sf liveinteract teledermatolog consult assess effect teledermatolog oper popul understand refer provid perspect crucial primari object studi explor perspect refer primari care provid pcps teledermatolog focus oper consider challeng benefit particip teledermatolog referr context medic populationsubject method conduct hourlong oneonon interview pcps refer patient teledermatolog regular togeth serv averag aggreg referr base teledermatolog case yearlyresult aggreg annual teledermatolog referr pcps report serv predomin uninsur underinsur popul particip sf consult major survey pcps treat common skin condit howev pcps refer patient teledermatolog consult inperson dermatolog encount sever factor influenc pcps decis refer teledermatolog includ complex skin problem distanc access dermatologist patient insur patient prefer pcps identifi improv workflow enhanc communic dermatologist faster turnaround recommend three area refer physician like improv experi teledermatologyconclus understand refer provid perspect subsequ adopt polici practic solut address challeng vital prompt teledermatolog particip underserv communiti

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