The field of dermatology is evolving rapidly with new technologies and treatments. Experts in visual analysis, dermatologists treat a range of skin problems on a daily basis, from psoriasis to skin cancer. The practice of dermatology requires physicians to focus on communicating effectively with patients. Outsourcing medical transcription takes care of their EHR-documentation tasks. In addition to enhancing quality of care and reducing medical errors, a reliable dermatology medical transcription service provider helps physicians to get the most out of the EHR with the least interruption to care.
The top trends impacting dermatology in recent times are the transition to a multidisciplinary approach, new technologies and treatments, and the implications of electronic medical records (EMRs) in dermatology.
Multidisciplinary Approach to improve Dermatology Treatment
Recent reports list several trends that are impacting the dermatology landscape in the U.S. and dermatologists need to adapt their practices to these changes. Summing up the results of a 2017 American Academy of Dermatology’s Burden of Skin Disease study, Health Affairs reported that:
- Skin disease is more common than all cardiovascular diseases and diabetes
- In 2013, nearly 50 percent of Americans over age 65 had a skin disease
- Serious skin diseases caused 22,953 deaths in 2013
- In 2013, skin disease cost the U.S. health care system about $75 billion in medical, preventative, and drug costs
- Lost productivity due to skin diseases totaled $11 billion for patients and their caregivers in 2013
- The number of Americans with skin disease is expected to increase as the population ages
- The demand for dermatologists far exceeds supply and is growing
As there are numerous associations between skin diseases and other conditions, treating dermatological conditions now requires a multidisciplinary approach. Dermatologists need to collaborate with other specialists to deliver high quality care. The Health Affairs article cites the example of a patient with eczema who may have difficulty sleeping due to their itchiness. To effectively address this problem, dermatologists would need to work with allergists, neurologists, and sleep specialists.
New Technologies and Treatments
Another important trend is the introduction of new technologies. A recent Dermatology Times article discussed an array of new technologies and treatments that physicians can leverage to enhance services and daily workflow. One of the areas where technology will have the greatest impact is improving care for skin cancer, particularly melanoma. These include:
- Confocal microscopy which provides high-resolution microscopy lesion images at the beside
- Photo-acoustic tomography (PAT) – 3-D technology that shows a lesion’s depth, aiding prognosis or staging
- Raman spectroscopy (RS): identifies chemical and biological compounds in the outermost skin layers
New therapeutics include JAK inhibitors for treating vitiligo, alopecia areata, and psoriasis, and gene and stem cell therapy.
Dermatology Times notes that the future may see physician assistants and nurse practitioners providing more dermatology care. However, experts caution that dermatologists should closely supervise physician extenders.
EMR Systems in Dermatology
MDEdge recommends that dermatologists need to choose an EMR system that is dermatology-compatible. This will make it easier for them to document information such as multiple lesions in different anatomic sites or identify multiple biopsy sites.
Practices need specialty-specific EMR software that will able to receive and integrate laboratory values, dermatopathology and radiology results and consultation notes from other physicians. Such integration can minimize duplicate services, increase patient satisfaction, and meet Meaningful Use (MU) criteria. According to the report, until such an integrated system is developed, dermatology practices should consider adopting an EMR system that is compatible with hospitals, other specialists’ offices, and diagnostic centers in the vicinity, which will maximize interoperability at the local level.
Patient-centered Communication with Documentation Support
In dermatology and other medical fields, EMRs offer the opportunity for care delivery integration, but they have decreased physician job satisfaction and increased physician burnout. Studies found that physicians spend up to 2 hours on EMR-related tasks for every 1 patient-care hour (www.ama-assn.org).
A study published in JAMA Dermatology in 2017 found that using scribes resulted in significant documentation time savings and reduction of physician burnout. Trained scribes shadowed the dermatologists using dedicated laptops, and documented patient-physician interactions and recorded orders, medications, and diagnoses for the physician to approve.
The study, which was conducted by dermatologists at Boston’s Brigham and Women’s Hospital, noted that with scribe support, dermatologists were willing to see additional patients, signaling improved physician efficiency, better patient access, and boost in clinical revenue.The research letter authors also reported that “scribes were well received by patients, with few refusals and unchanged overall patient satisfaction scores.”
The research letter authors also reported that “scribes were well received by patients, with few refusals and unchanged overall patient satisfaction scores.”
The authors also acknowledged that, in addition to scribe services, the EHR documentation support provided by a medical transcription service company is valuable in situations other than face-to face care.
“Other solutions combating physician documentation burdens, such as real-time dictation software or conventional transcription services, have been employed particularly successfully in diagnostic specialties, such as pathology and radiology, which have limited point-of-care patient interaction,” they wrote.
