Posted: 8/31/2016
Officials considering expanding technology to other specialties
Dermatology patients of Parkland Health & Hospital System’s Community Oriented Primary Care (COPC) health centers can now have consultations without having to visit specialists at a clinic.
Patients at Parkland’s Southeast Dallas Health Center and three other COPC locations can now have specialists review their cases within one or two days, thanks to an innovative “tele-dermatology” program that Parkland officials expect to soon expand into other specialties.
“The goal is to improve access and reduce wait times for patients,” said Noel Santini, MD, Senior Medical Director, Ambulatory Services at Parkland. “COPC clinics are the entry point for many people into our health system but wait times for appointments with specialists at the dermatology clinic had been lengthy due to the high number of referrals.”
The tele-dermatology program is a collaborative effort between Parkland and the Dermatology Department at The University of Texas Southwestern Medical Center. Since its inception two years ago, more than 200 patients have received e-consultations and that number is expected to grow with the program’s recent expansion into the Bluitt-Flowers, Irving and Garland health centers.
When a primary care physician sees a patient with a dermatological condition requiring a specialist consultation at one of these Parkland health centers, the provider can take a photo and upload the image directly into EPIC, Parkland’s electronic health record software, where it is stored in the patient’s record. To protect patient confidentiality, no image is stored on a camera or phone. The referral is then made and a dermatologist can consult with the primary care physician about treatment.
Parkland is the first health organization to use EPIC in this way. The function was programmed internally by Parkland Information Technology staff, which helped reduce costs by not using an outside vendor and also ensured increased patient privacy and security. Arturo R. Dominguez, MD, Parkland physician and Assistant Professor of Dermatology at UT Southwestern, said other health organizations have expressed interest in replicating Parkland’s EPIC tele-dermatology system. This fall information about Parkland’s tele-dermatology program will be presented at the national EPIC Users Group Meeting in Verona, WI.
“This telemedicine project has greatly improved the patient’s experience and access to healthcare,” said Esmaeil Porsa, MD, Executive Vice President and Chief Strategy and Integration Officer at Parkland. “And our primary care providers are able to be more fully engaged in the patient’s care, facilitating better communication between the primary care physician, the specialist and the patient.”
The tele-dermatology program has been so successful that Parkland officials are discussing options for expanding into other specialties, such as gastrointestinal, hepatology and cardiology.
Dr. Dominguez said the initial pilot program was initiated because a large percentage of COPC patients were not being seen by dermatology specialists, either because they did not meet clinical referral criteria or missed their appointments.
“That is one of the big issues this program addresses,” Dr. Dominguez said. “By using tele-dermatology, 100 percent of patients referred to Dermatology are evaluated by the specialist.”
Parkland’s tele-dermatology system is not only geared toward providing the best possible care for patients in a timely manner, it also is an effort to make the most efficient use of taxpayer resources.
Dr. Dominguez said that while most of the dermatology patients seen at the COPCs had common skin conditions such as eczema, contact dermatitis or psoriasis, some more serious conditions including skin cancers have been detected and quickly treated.
“I think there are very possibly transformational uses of telemedicine at Parkland, but not necessarily in conventional ways,” he said. For example, Parkland has been a pioneer in the development of shared medical appointments, where a small group of patients is seen by several providers at the same time and are able to share experiences with other patients.
Dr. Porsa said he envisions a possible “virtual clinic” that could make use of telemedicine technology to treat a greater number of patients and provide services more effectively.