COVID-19 has made telehealth an essential component of dermatological care. The sudden shift to virtual care has left many dermatology practices scrambling to figure out the best way to handle their Accutane patients online.
Other practices have turned to HealthLens for help.
HealthLens is the only store-and-forward telemedicine platform with an integrated Accutane workflow for managing isotretinoin patients with telehealth. The entire workflow is simplified down to a four-step process that is easy for both female and male patients to follow.
How It Works
The patient submits an online visit with acne photos and history of present illness (HPI).
The dermatologist recommends isotretinoin and uses HealthLens’ file-sharing tool to send the patient the required iPledge guide & consent forms. Male patients also receive a lab slip at this point.
The patient submits a second online visit with the completed forms & other information required by their doctor. Female patients submit a photo of their home pregnancy test.
The dermatologist registers the patient with iPledge.
If the patient is female, the dermatologist again uses HealthLens’ file-sharing tool to send them a lab slip for the required blood work due in 30 days.
For male patients, the doctor prescribes isotretinoin with instructions for starting the medication through Healthlens’ integrated eRx tool.
Female patients submit a third online visit with a statement acknowledging they have completed the required lab work and iPledge questions 30 days after the second online visit.
The dermatologist uses HealthLens’ eRx tool to prescribe isotretinoin to the female patient with instructions for starting the medication.
Every 30 days, the patient submits an online follow-up visit so their dermatologist can update their iPledge status and issue a refill. Female patients include a photo of their home pregnancy test with their clinical photos.
HealthLens’ Automated Follow-Up feature allows the physician to schedule an online follow-up with just a click.
HealthLens’ integrated Accutane workflow eliminates the stress of managing your isotretinoin patients online. In fact, many dermatologists report that it is easier to manage their isotretinoin patients on HealthLens than in their office.
Virtual care is exhausting. Here are 3 things doctors should do before every online visit to practice telehealth more efficiently:
1. Get photos of the condition Tell the patient to take a few photos of their condition and send them to you beforehand. Most skin conditions can be immediately diagnosed from a photo.
2. Obtain medical history Ask the patient to provide details about their symptoms and any previously tried & failed treatments ahead of time. This way you can spend the time with the patient reviewing their diagnosis and treatment plan instead of documenting the complaint.
3. Collect a visit fee Have the patient pay for their share of the visit with a credit card before you evaluate the condition. No more chasing patients for uncollected fees.
Obtaining this information prior to a telehealth visit requires substantial legwork by your staff. HealthLens does it automatically.
The short answer is your dermatologist’s office. Buying skincare products from your doctor guarantees you are getting the products you need for your skin and those products are authentic.
With the ubiquity of online shopping, you can now find almost any skincare product on dozens of websites. Many of these websites are legitimate businesses with professional standards. Many are not. These sites may offer free shipping or a money-back guarantee to trick you into thinking they are legitimate but the products they ship can be counterfeit, stolen, or expired.
A quick Google search will yield hundreds of horror stories of patients duped into buying and using illegitimate products they thought were real. The consequences range from mild burning to lasting injuries.
Buying products from your doctor’s office used to be very inconvenient. The good news is the inconvenience of buying skincare products from your doctor is a thing of the past.
If your doctor uses HealthLens, you can now buy all the products they carry in their office on HealthLens. Every order comes with free shipping and sales tax is included in the product’s price. It’s the convenience of online shopping but with the personalization of a 1-on-1 consult with your skincare specialist.
Go to HealthLens.com today to visit your doctor online and buy the products you need.
As the days get shorter and colder, your skin is very susceptible to the changes in the environment and can damage easily. Here are 6 easy skin care tips that should help you and your skin survive this winter.
6. Moisturize More
As the seasons change, your skin care products may need to change as well. Your skin dries out very easily in cold weather. Consider upgrading from a moisturizing lotion to an oil-based ointment. The ointment will help seal in more moisture than a lotion.
5. Stay Hydrated
Just because it’s not 85 degrees out anymore does not mean you should cut back on your water intake. When it’s cold outside, it’s easy to forget to stay hydrated. Dehydration affects your whole body, not just your skin so your whole body will benefit from maintaining adequate hydration.
4. No Super Hot Showers
Nothing feels more soothing than a long hot shower on a cold winter morning. While this may feel great, the prolonged exposure to hot water depletes your skin of essential lipids and oils that maintain your skin’s moisture naturally. In lieu of a long, hot shower, consider a quick, warm one.
Bundling up in your coziest sweats and spending the day on the couch under a blanket is a fantastic way to spend a cold winter day, but don’t forget your exercise. Exercise is not only a great way to stay in shape, but sweating clears your pores and improves blood circulation, which helps deliver essential nutrients to your skin.
2. Don’t Forget Your Sunscreen
Like staying hydrated, using sunscreen is not just a summer sport. Sunscreen is one of the best ways to protect your skin. Most moisturizers already have sunscreen in them so make sure to choose one with a high SPF rating and apply it before you head out in the sun. Furthermore, ski slopes are a hotbed for sunburns. When you’re hitting the slopes this season, make sure to be wearing more protection on your head than just a helmet.
1. Visit a Dermatologist
Nobody has better skin care tips than your skin care specialist. Make sure to visit your dermatologist this winter for the latest recommendations. If you’re too busy to make into their office, try visiting your dermatologist online with HealthLens and create the perfect treatment plan for the winter.
As a dermatologist, the possibilities of telemedicine were evident early in my career. You did not need a patient to make a diagnosis. You just needed a good picture.
Telemedicine was initially promoted as a benefit to patients. It would increase their access to specialty care and surmount geographic barriers. Unfortunately, the only reimbursed format at the time was live interactive video, which was too impractical for widespread use. Patients also had limited access to the technology. Telemedicine languished.
During this dark time, I was involved with a few unsuccessful start-up telemedicine platforms that focused on direct patient access to specialists. There was a lot learned from the experience but there were no compelling reasons for physicians to adopt the practice.
That changed 2012 when California’s own telehealth law (AB 415) went into effect. Now physicians of all specialties would be beneficiaries of telemedicine. The new law authorized physicians to collect for all forms of electronic interaction. This means you could now be reimbursed for all the free care that you normally give out via the phone or email by using store and forward telemedicine.
The largest benefit, however, is the savings that will occur when physicians no longer have to shoulder the burden of rent, staff, and other expenses when providing care that can be done outside the boundaries of an office. As a result, physicians should explore what aspects of patient care can be responsibly provided online and then try to move patients in that direction. Any progress physicians make in moving portions of their practice online will be protected by the parity law. It requires that online visits be reimbursed at the same full level as an office visit. Telemedicine is now very practical.
Physicians should be wary of many of the telemedicine sites that are out there. Most of the ones you read about in the headlines do not meet the California Medical Association’s (CMA) Principles of Telemedicine. These are the anonymous doctor banks, prescription mills, and sites that use physicians in foreign countries.
Fortunately, there are telemedicine sites that closely adhere to the CMA’s telemedicine standards. Store and forward platforms like HealthLens (Author is a founder), Azova, and SkyMD enable physicians to practice online in a medically sound and ethical manner.
The primary standard is allowing patients to receive online care from their established physician. This enables follow up with that particular physician and a physical location if an office visit is necessary. Another CMA principle is that the patient’s medical insurance should be used to cover the visit. The CMA adherent platforms also provide secure messaging between patient and physician so the visits can be interactive.
Most commercial insurance companies including Blue Cross, Blue Shield, Cigna and United Healthcare cover store and forward telemedicine. Medicare only covers it in Alaska and Hawaii but there is legislation in progress to expand to all 50 states. To get reimbursed for store-and-forward telemedicine visits, just attach the GQ modifier to your CPT code; e.g. 99203 GQ.
In my practice, I see about 60 online patients per month. Acne, eczema and seborrheic keratoses make up the majority of the conditions I diagnose online. Time sensitive conditions like shingles are not uncommon online diagnoses and it is much easier to get patients on antivirals within that 72-hour window of opportunity when they don’t have to wait for an office visit.
I even see new patients on the internet. According to the Medical Board of California, you can evaluate a new patient online and establish a physician-patient relationship as long as the photo(s) submitted by the patient allows the physician to perform a physical examination that is adequate enough to reasonably make a diagnosis. Established patients, who make up the majority of my online visits, can be evaluated and treated without a photograph. This works out well for prescription renewals.
Medical research will also benefit from the shift to online care because of the data that telemedicine provides. In the short time HealthLens has been in operation, we have amassed a large library of clinical images, corresponding diagnoses, treatments and, most importantly, outcomes. The granularity of the data will allow for unprecedented levels of analysis.
Veering from long practiced norms is a troubling process for the medical community. However, the opportunity to eliminate so much of the expense involved in patient care cannot be ignored. Physicians should be leading the charge in shifting patient care online. We will be among the beneficiaries.
This is a guest post from HealthLens co-founder Christopher Schmidt, MD.
Last year, HealthLens say an array of patients using its platform to connect with their provider remotely. Many of the online visits were for skin checks; however, there were a number of other use cases that presented themselves throughout the year. As more patients use HealthLens, we expect to see even more interesting cases from patients all over the world.
Last year a patient traveling through India was able to connect with his dermatologist in San Jose. HealthLens offered a prompt response to his concern about a newly developed rash.
The oldest patient treated on HealthLens was 81 years old and she used her iPad to submit the visit without the assistance of anyone. HealthLens saw a number of Medicare patients use the service even though Medicare does not cover store and forward telemedicine….yet. These Medicare patients often cited the convenience of not having to travel to the doctor’s office as the main reason for using HealthLens.
The youngest patient treated on HealthLens was 10 years old. This girl, with the help of her mother, was able to submit a virtual office visit to her doctor. HealthLens also connected hundreds of college students with the doctor they grew up visiting.
2016 showed steady growth both HealthLens and for the telemedicine market. Many HealthLens patients are continuing to use the platform over and over again. 2017 promises even more growth as more people are warming up to the idea of visiting their doctor online. HealthLens is excited to help facilitate this connectivity with the providers that patients know and trust.
Many times patients are curious as to why they have to supply a general appearance photo along with their condition photos when submitting a virtual visit on HealthLens. A general appearance photo is essentially a “selfie” and it serves a couple of important functions during the online evaluation.
Foremost, the general appearance gives the doctor an up-to-date look at the patient’s overall health. If the doctor has never seen the patient before in their practice, this picture provides them with a foundation to compare the patient’s overall skin quality to the skin quality in their condition photos. It is a simple way to gauge how much sun damage the person may have. If it is an existing patient but the doctor has not seen him or her in their practice for a substantial period of time, the general appearance photo allows the doctor see if there have been any dramatic changes to the person’s health or skin quality besides normal aging.
A secondary purpose is that the general appearance photo helps the doctor instantly identify which patient they are evaluating. At a busy practice, there are usually a few patients who share the same name. Likewise, many doctors see multiple siblings from the same family in their practices. This photo eliminates the chance of the doctor getting two patients with the same name mixed up.
The general appearance photo is a vital aspect of your virtual visit on HealthLens. The best way to provide your doctor with a quick snapshot of your overall health is to provide the most recent photo possible. A “selfie” taken while completing the visit works great! So the next time you are submitting a virtual visit on HealthLens to your doctor, keep in mind the comically catchy lyrics of The Chainsmokers’s EDM hit song, “#SELFIE,” which go “But first, let me take a selfie.”