The Pros & Cons of Monitoring Skin Health with Technology

Margareth Pierre-Louis, MD, a dermatologist at Twin Cities Dermatology in Minneapolis, has made it her mission to provide skin care for patients, regardless of their race, skin tone, and background. Oftentimes, the ability for patients to use digital tools can be frustrating to providers - as it can lead to self-diagnosis and unnecessary fear (think WebMD). However, Dr Pierre-Louis is embracing the shift to digital tools, using skin tracking apps and secure platforms to communicate and monitor patients’ skin lesions remotely. 

In this video, Dr Margareth Pierre-Louis discusses the pros and cons of monitoring skin health with technology.

TRANSCRIPT-

Dr Margareth Pierre-Louis:  What are the successes that we've seen with this platform? It's been pretty transformative. To give you some of our numbers because what I'm doing, I'm studying this tool and saying, "Hey, is there a return on investment here?" Yes, there is. The subscription for this platform, for Miiskin, again, is offered through the dermatologist.

You pay about $150 a month, and then all your patients have access to this tool. It's per provider. I would argue that 150, I don't know if that even does it justice because what we've gotten back in return over the first three months of using it has been amazing.

For instance, since using Miiskin over the last three months, 75 percent of our patients' submissions have resulted in scheduled appointments. Private practice is tough because you can have a schedule of 50 patients, but only 30 come. There's the loss in potential revenue from no-shows and cancels, and you never know what any day will be like.

Having this platform be available to that on-demand patient who is clamoring to get in is helpful. We've seen that 75 percent of those submissions were then turned into an office appointment or a virtual visit. All the virtual visits got completed because, obviously, it's just about them submitting it.

A few of those patients who came in did cancel, but you can see how you're generating a path here for care delivery by just offering this triage tool to patients. 62 percent of our Miiskin submissions converted to a completed medical visit.

Once they said, "Hey, I need your help," and we said, "Well, yes. Come in, or submit a virtual visit," 62 percent of those encounters that were patient-initiated turned into completed medical visits.

The average revenue from each visit was about $229. If we weren't providing this platform and engaging patients in this way, we wouldn't have been able to do this. It's important that we understand that the digital patient is driving health care now and we either have to embrace it or we are going to be losing out.

Again, it's a better way to deliver care because we can effectively triage before we get a sense of what the patient's in there for and not waste their time, and also not waste ours or even potentially end up with a canceled or no-show appointment.

Other numbers again, like I said, most of these visits would not have been possible if we didn't have this tool out there. We are growing our practice by engaging patients through a digital platform.

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Dr Pierre-Louis:  This is a very new platform. Little things like there were a few patients we couldn't first connect with because they had put in their cell phone number wrong. There was no field to see their email. The patient had reached out to us, but we couldn't get back to them because our technology wasn't robust enough. Miiskin has worked to fix that.

It's those little things of how good is this triage tool that it can hopefully help you reach out to a patient? You don't want a patient who submits an image of a lesion worrisome for melanoma, and you can't get back to them. That's why I stress this is not a medical diagnostic tool because there's not a patient-doctor relationship yet.

Once that patient is trying to engage you, it's important that you be able to follow up with them and engage them. We had a few patients who lost a follow-up because we couldn't somehow connect with them, or they never picked up their phone.

That is what's tough about telehealth. You are dealing with people, but it's being done through technology. One of the shortfalls is if the two don't sync, then there could be a miss.

You have to even be more aware and hyper-vigilant out there to make sure that you're meeting that patient's needs and that no one falls through the cracks. The tool is only going to be as good as you engaging with that digital patient and them obviously receiving your recommendations and your response to then engage you, so you can deliver care.

The shortfall is technology, and technology is happening remotely. We don't have control sometimes about how we can make that transaction happen. It might take multiple attempts.

My physician assistants sometimes had to call a patient three or four times until they got them on the phone or could reach them to say, "Hey, this is a worrisome lesion. You need to come into clinic today." When we were able to do that, how amazing. It was transformative for that patient. They were so thankful we could get them in right away.

Number one shortfall, technology has its limitations. It is not always direct communication working through a telehealth platform, so you have to make sure that you're engaging patients in a way that will convince them to reach back out to you especially if there is something you can do to help deliver care to them.

The other shortfall, not everything can be treated or managed through telehealth. As I said, first you triage, but then what if someone has a lesion that is obviously a blatant cancer and they need to have an excision? You still need to somehow get them into a place where they can deliver care. Say, they're reaching out to you from two, three hours away.

There's limitations to telehealth and telemedicine because not everything can be managed or triaged through such virtual or digital platforms. That can also be challenging because just giving someone access to care, providing access, doesn't mean that you're going to be able to deliver care. It's trying to make sure that you have a plan in place.

It might mean that if that patient is two hours away, you find a dermatologist out there to help them, but it probably would take a little bit more maneuvering than you would think than if the patient just calls up and says, "I want an appointment."

That's a shortfall, too, is that you're dealing with people who are not in the same space or vicinity. You're going to have to find a way to make sure that care can happen.