[Micki Korn]

I work as a PNP in a rural primary care office. A large percentage of my patients have Medicaid. We only have one dermatologist in our county that will see Medicaid patients. Many of our Medicaid patients have limited transportation to appointments and the wait time is several months. I would like to implement a telehealth program at our clinic to increase access to dermatology consults for our Medicaid patients.

Telehealth Model: (Store and Forward system/Videoconferencing) This would give more pediatric patients access to specialty care without long waits for appointments and eliminate the problem with access to care. This would allow more pediatric patients to have access to dermatology providers.
Type of Equipment: (Store and Forward system and Videoconferencing.)
Type Population: (Pediatrics/Dermatology)
Role in the Program: I would supervise the program and establish the workflow and a vision for the future. I would train the office nurse to be available to videoconference with the dermatologist and act as the liason for assisting in the examination of our patients. I would also participate in follow up with the dermatologist by traininig providers/office nurse in taking photos of derm conditions alreay treated at a previous telehealth visit and send follow up photos for review via our Store and Forward system.
Evaluation of the Program: I would like to evaluate the effectivemness of the program by : 1. Number of pts who receive Dermatology consults in comparison to number of patients who received Dermatology consults prior to implementation of our telehealth model. 2. Does the pediatric clinic lose clinic revenue by providing this service to established patients. 3. Do pediatric patients feel satisfied with a telehealth dermatology appointment.
Legal Considerations: 1. Establish my state guidelines for Telehealth Consent . 2. Make sure Telehealth visit is HIPAA compliant. 3. Establish a BAA. 4. Educate office billing and coding personel understand Telehealth coding and billing guidelines.
Other Professions to involve: In pediatric office providers would be involved to incude NPs, PAs and MD. May involve other specialty physicians in the future.
Protocols to develop: Protocols to include – pt consent; Telehealth format for dermatology consult and follow up visit; specific protocol for office nurse vs provider participation in derm consult.
Consent of patient to participate in Telehealth: Pt or parent would sign written consent to participate in telehealth yearly.

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