Leveraging Telehealth in Your Direct Care Practice

Integrating Telehealth Into Your Practice

Telehealth is a natural extension of the direct care model. Without insurance billing complexities, direct care dermatologists can seamlessly incorporate virtual visits into their practice. Here is how to do it effectively.

Choosing Your Technology

Select platforms that prioritize both usability and compliance:

• Video platform: Choose a HIPAA-compliant solution with reliable connectivity and screen-sharing capabilities for reviewing images together with patients
• Asynchronous tools: Consider a store-and-forward solution that allows patients to submit photos and clinical information for your review
• Integration: Ideally, your telehealth tools should integrate with your EHR and scheduling system
• Patient experience: The technology should be easy for patients to use without downloading specialized software

Clinical Workflows for Virtual Visits

Establish clear protocols for telehealth encounters:

• Appropriate conditions: Define which conditions and visit types are suitable for virtual care. Follow-ups, medication management, and established skin condition monitoring work well.
• Photo guidelines: Provide patients with instructions for capturing high-quality images, including lighting, distance, and angle recommendations.
• Documentation: Use standardized templates for telehealth visits that capture the unique elements of a virtual encounter.
• Escalation protocol: Establish clear criteria for when a virtual visit needs to be converted to an in-person appointment.

Incorporating Telehealth Into Your Membership

Direct care memberships should explicitly address telehealth:

• Include virtual visits as a core membership benefit, not an add-on
• Set expectations about when telehealth is appropriate versus when an in-person visit is needed
• Define response times for asynchronous consultations, typically within 24 to 48 hours
• Communicate availability for synchronous video visits during regular office hours

Best Practices for Virtual Dermatology

Maximize the effectiveness of your telehealth encounters:

• Lighting matters: Coach patients on using natural or bright, even lighting for skin photographs
• Consistency: For monitoring conditions over time, ask patients to photograph the same area in the same way each time
• Documentation: Save patient-submitted photos in the medical record for longitudinal comparison
• Follow up: Schedule in-person visits at appropriate intervals even when telehealth is working well

Regulatory Considerations

Stay informed about telehealth regulations in your state:

• Licensure: You must be licensed in the state where the patient is located during the visit
• Prescribing rules: Understand your state regulations around prescribing via telehealth
• Documentation standards: Telehealth encounters should be documented with the same rigor as in-person visits

Telehealth enhances the direct care model by extending your reach and improving patient convenience. Implemented thoughtfully, it strengthens the doctor-patient relationship rather than replacing it.