Teledermatology Improves Access to Care

Teledermatology improves access to care, a new study suggests.

In the study of primary care practices in a large California Medicaid managed care plan, those practices that engaged in teledermatology had a 64 percent increase in the fraction of patients visiting a dermatologist compared with 21 percent in other practices. 

The findings are published online in JAMA Dermatology.

Access to dermatologists is limited in the US due to a shortage of dermatologists and geographic misdistribution.  San Joaquin in California's Central Valley has fewer dermatologists per capita than the national average. For these reasons, rhe Health Plan of San Joaquin (HPSJ), a Medicaid managed care plan, began covering teledermatology services in April 2012.

Lori Uscher-Pines, PhD of RAND Corporation in Arlington, Va., and coauthors analyzed claims data to examine whether introducing teledermatology increased the number of Medicaid enrollees who received dermatology care and which patients were most likely to be referred to teledermatology.

The study included 382,801 enrollees from 2012 to 2014. Of those, 8,614 patients (2.2 percent) had one or more visits with a dermatologist and 48.5 percent of the patients who visited a dermatologist received care through teledermatology. Among newly enrolled Medicaid patients, 75.7 percent (1,474 of 1,947) who visited a dermatologist received care through teledermatology, according to the results.

Teledermatology patients tended to be younger than 17, men and nonwhite. Viral skin lesions and acne were the conditions most likely to be cared for by teledermatology physicians, while in-person dermatologists were more likely to care for psoriasis and skin neoplasms.

The authors note limitations of their study include the generalizability of its results because it describes only the experiences of HPSJ with teledermatology services in California.