What you need to know about teledermatology

If you’re one of the millions of Americans asked to stay home during the COVID-19 pandemic and you have an active skin condition — or need care or medication for a chronic condition, you might be concerned about getting the care you need. Your dermatologist’s office may be temporarily closed or limit emergency room appointments. Or maybe you’re just not comfortable going to the doctor during the current health crisis. Fortunately, there is another option that is becoming more and more available: teledermatology, a personalized real-time videoconference with your dermatologist.

A growing number of dermatologists nationwide have started offering virtual appointments to help their patients during the COVID-19 crisis. That’s partly because many of us feel responsible for continuing to care for our patients in any way we can – even if it’s via smartphone or computer screen.

If you’re interested in a virtual visit with your dermatologist, here are some key takeaways.

  • Call your dermatologist’s office or check their website to see if they offer teledermatology. If they are not yet, keep checking; unfortunately, the pandemic is not expected to end quickly, so they may start online dating soon.
  • Yes, it is necessary to make an appointment. Typically, your dermatologist will contact you at the time of your appointment.
  • Most teledermatology visits don’t require you to be particularly tech-savvy. Many doctors will contact you directly on your smartphone or by e-mail, and can guide you and contact you with the click of a button.
  • You must have a camera enabled on your device. By definition, a regular phone call is not teledermatology – your doctor needs to be able to see your skin so they can discuss their findings and make treatment recommendations.
  • Be aware that teledermatology visits are generally billed to insurance, as are regular office visits. This means that copays apply and the cost of the meeting may be charged against your deductible, if you have one.
  • Make sure you are in a quiet, well-lit area for your appointment, and wear loose clothing if you have a particular location that requires an assessment – for example, do not take the call while seated in your car, wrapped up in a coat, with the deafening stereo.
  • Keep expectations reasonable, as online tours have limits. Dermatologists often need to see, feel, and study your skin up close, ideally with the help of a dermatoscope (a handheld tool that increases diagnostic accuracy). A clear diagnosis often cannot be made when your doctor squints at a blurry image on a computer screen. That’s why, at the end of your virtual visit, your dermatologist may suggest an in-person visit to assess a spot, consider a biopsy, or provide treatment.
  • Skin issues that are well suited for Virtual Dermatology include acne, rosacea, psoriasis, eczema, mild rashes, check-ups for 1-3 points of concern, and routine visits for medication refills.
  • Concerns that are not well suited to virtual dermatology include full skin exams (they are simply not possible), complicated rashes and conditions that require close evaluation or skin biopsies, and examination of multiple moles or small skin lesions.
  • Pictures are worth a thousand words, and for a dermatologist, they are actually much more helpful than video in accurately diagnosing skin lesions and rashes. Your doctor can help you more effectively if you send or upload photos of your pimples, rashes, or concerns before your virtual appointment.
  • While your doctor remains committed to patient privacy, it’s important to know that not all teledermatology platforms strictly adhere to patient privacy laws (HIPAA). For the pandemic, the government has temporarily relaxed restrictions on privacy rules to allow more patients and doctors to connect virtually. Currently accepted channels include Google Hangouts, Skype, Facebook Messenger, FaceTime, etc. Several teledermatology platforms are secure and HIPAA compliant, however; these include doxy.me, Epic, Azova, Medweb, Epic and Zoom for Healthcare. If you have specific privacy concerns, be sure to ask your dermatologist’s office what platform they use for teledermatology and whether it’s HIPAA compliant.

Finally, if you don’t have a dermatologist, but are looking for a consultation online, be aware that not all online or virtual appointments are supported by a board-certified dermatologist (even if “dermatology” is listed in the application name or website). Some sites rely on nurse practitioners, physician assistants or other health care providers who may vary in their level of training in dermatology. Dermio.com and DirectDerm.com are among the websites run by board-certified dermatologists, who have completed and passed the board-certified exam and over 3 years of intensive training in dermatology only after medical school and the internship.

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