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How a Stanford dermatologist is using telemedicine to reach underserved populations in California

Physicians in rural areas in California are in short supply, and some fear the scarcity could grow more severe. But telemedicine might prove beneficial in these parts: Research has shown increased use could help reduce health disparities between rural and non-rural areas.

David J. Wong, MD, PhD, a Stanford dermatologist and cofounder and CEO of Direct Dermatology, stands among health-care providers working to increase the reach of telemedicine. His company brings medical dermatology expertise to poor and underserved populations in California to treat serious and even life-threatening conditions including melanoma, psoriasis and problems of the skin, hair, and nails.

A panelist at last week's Healthcare Innovation Summit at Stanford, Wong believes a social mission driving a for-profit company can deliver healthy results. He discusses his company's work and how it fits into broader efforts to improve rural medicine in a Stanford Graduate School of Business Q&A.

On explaining how Direct Dermatology visits work, he says:

The interaction is asynchronous. It's not a live interactive visit over Web cams. A patient takes a picture of their skin problem, then sends in that picture along with their medical history. And then a dermatologist will review it, and send back a report and any prescriptions that are needed. We have a two-day turnaround. Dermatology is such a visually based specialty that dermatology consultation works well through images.

Later in the interview, he talks about how his work is relevant to other medical specialties:

While some specialties will always require some live interaction, nearly every specialty can provide better access, higher quality care and lower cost by integrating telemedicine in some fashion. Dermatology is a great one to start with as a proof of concept, because it is so visually based. But we believe similar concepts can be spread to other specialties.

In ophthalmology, for example, much of the exam is based on images of the retina. Cardiologists are looking at EKGs and echocardiograms. A lot of those types of images you'd have to first acquire at a lab or clinic, and then send them in. That being said, there is a growing number of home consumer appliances that will take your EKG, for example. And consumers will be soon able to send those in directly to their physicians.

A 2010 study showed that online dermatology visits, similar to those described by Wong, can be as effective as office visits and can save patients time.

Previously: Ask Stanford Med: Stefanos Zenios taking questions on health-care innovation and entrepreneurship, Phoning in your specialized medical tests and Can telemedicine work for dermatology patients?
Photo by mysiana

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