3 Questions to Prepare Your Clinic for the Cures Act

By Katie Messner, DO

The 21st Century Cures Act is live, and it impacts the entire healthcare industry—including your dermatology clinic. 

Amendments to the Clinical Laboratory Improvement Amendments (CLIA) and the HIPAA Privacy Rule of 2014 allow for the release of real-time laboratory and imaging results to patients. It’s only recently that the law came to include pathology reports. 

The Cures Act drives interoperability within the healthcare industry and expands patients’ access to their medical information via electronic devices or smartphones. This initiative will encourage better care and outcomes for patients and dermatologists. 

“In a future where data flows freely and securely between payers, providers, and patients, we can achieve truly coordinated care, improved health outcomes, and reduced costs,” CMS reports. But what does this drive to interoperability and digital technology mean for your dermatology clinic? 

In addition to implementing EMR technology, these federal changes will require some adjustments in your clinical workflow. Addressing three questions about the impact digital innovation will have on the availability of patient information, transparency, and reporting will reinforce safe and effective practices for efficient care and elevate the patient experience.

When will lab results be available to patients?

Although medical information should be available electronically per a patient’s request, access to pathology test results via a patient portal, for example, shouldn’t supersede the doctor’s opportunity to review the test results before the information is available to the patient.

The good news is that eight exceptions can prevent doctors’ actions from being construed as information blocking. In this case, the infeasibility exception states that it’s not information-blocking if the request can’t easily be granted due to issues with the type of information requested and available resources.

Communicating to your patient during the exam that their test results will be available after being reviewed by the doctor should help minimize confusion. Although the test results are accessible digitally, emphasize that you’d like to meet with them either in person or via a telehealth visit to discuss those results. It would help if you also consider working with a digital lab like PathologyWatch, which offers quick turnaround times on lab results to allow more time to review them.

How will you control transparency?

Per the 21st Century Cures Act, patients can request their whole record. That means patients can see the names of the lab that processed results, the name of the dermatopathologist, and other contact information that may blur boundaries between the patient, your clinic, and the lab testing review process. 

A healthy physician/patient relationship rests on clear communication and trust. Without it, patient care will feel fragmented and confusing. Be proactive in explaining what your patient can expect following their exam. Make it clear that your office is their point of contact for fielding questions about their care. Then adjust your staff’s responsibilities and office processes to ensure those inquiries are handled promptly. 

Who is your audience for reporting? 

To put it simply, it’s no longer a mystery to patients what doctors say about them in their medical files. For instance, if the patient is noncompliant or appears morbidly obese, they can read all about it in their medical file. 

But this newly expanded access to patient information also spurs a debate about the language used in patient files. Should a doctor use more commonly understood terminology and avoid medical jargon for the sake of catering to the patient reading it? 

The primary purpose of recording a patient’s medical information is to create a medical record for you to monitor your patient’s history and bill payers and to communicate with medical colleagues who also treat your patients. Although your patient has access to this information, some dermatologists argue that they are not your audience.

“The psychology of this process seems to detract from the goal of smooth and effective care and the privilege of methodical clinical documentation and discussion without the possible paranoia of wondering who’s reading it,” asserts Lorraine Rosemilia, MD, FAAD

Warren R. Heymann, MD, FAAD, agrees: “While I appreciate the advantages of transparency and disclosure of all medical data, we went to medical school for a reason—to provide compassionate care, enveloped in providing information in the right context.”

The goals for the expansion of data availability are to deliver quick access to care, reduce costs, and improve the quality of care. But this technology evolution requires buy-in from providers committed to adapting their workflow processes to support interoperability.

While this initiative will likely face numerous changes in the coming years, the future of healthcare will undoubtedly continue on the path to better processes that engage patients, providers, and payers with thoughtful digital transformation.

TDS Hosts 2021 Annual Fall Meeting Virtually, and We Can’t Wait

The Texas Dermatological Society (TDS) is getting ready to roll out the red carpet—Texas-style—for their 2021 Annual Fall Meeting

In preparation for this event, we sat down with Laura Madole, executive director at the TDS, to talk about the upcoming 2021 Annual Fall Meeting to be held virtually on September 24–25, 2021. In the past, the in-person TDS event welcomed almost 400 attendees to their annual spring and fall meetings. This time, TDS looks forward to hosting hundreds in a virtual setting. 

Despite the changes prompted by COVID-19, which forced TDS to cancel their spring 2020 event, Laura is confident that attendees, sponsors, and exhibitors will enjoy the unique features of this virtual meeting. 

“We were a little nervous,” admits Laura, concerning their switch to virtual meetings. “So while we hope we can open doors in the spring of 2022, the virtual event has been the next-best option.” In fact, the fall 2020 and spring 2021 TDS events attracted almost 500 attendees. 

The unexpected benefits of hosting a virtual event focus mainly on the accessibility of the event. “It opened up opportunities for us to connect with members living in rural areas or other members who are residents at Texas Tech, for example, who can’t easily get to these events,” she says.

Experience a Unique, Interactive Virtual Event

TDS is using a company called vFairs, which invites attendees to visit customizable virtual exhibit halls, rooms, and vendor booths. Attendees can reach out directly to exhibitors and sponsors via video chat or direct text messaging. Plus, all of the attendees are listed, so face-to-face chat is easy. 

Laura says that many of these attendees have known each other for years; it’s a fun and fantastic way to earn CME credits. But if this is a member’s first time attending the event, she has some tips for a successful virtual experience. 

“I recommend just going in and looking around within the platform: click around and get familiar with the layout. There’s an auditorium, a virtual lobby, a lounge, and several other rooms. I’d definitely utilize the chat feature at a meeting, so it feels like you’re surrounded by your friends and colleagues. It’s more fun when people can interact on the platform.”

The virtual element definitely encourages participation among residents who often have difficulty attending in-person events. Laura says that TDS usually hosts around seven podium presenters for the resident competition. But with virtual, they are delighted to offer 19 podium presenters this fall. 

Take Exhibitor Information with You

This is not a typical Zoom meeting. The vFairs platform provides a hotel lobby feel that engulfs attendees in a rich, virtual world filled with uniquely designed exhibits and booths. Guests can virtually stroll amid custom-designed booths, or they can move directly to a booth of their choice from a directory.

“While we enjoy meeting people face to face at events like this, virtually connecting with people who are genuinely interested in learning more about our technology is a fantastic opportunity,” says Rachel Reeg, senior sales director at PathologyWatch. “At in-person events, you compete with high-volume activity that can be distracting, and people often limit the time they spend at your booth. With the virtual briefcase, we can provide valuable information through video, downloadable case studies, ebooks, product information, and other resources that guests can look through when it’s convenient for them and reach out if they want to know more.”

After the conference, attendees will receive all of the information they saved in their virtual briefcase via email. This is a great feature for attendees to keep track of exhibitor information without the risk of losing papers or accidentally leaving them behind. Since the materials are digital, exhibitors can promote products and services through expanded forms of media; a feature that isn’t possible at in-person events. 

Host a Social Scene, Just on a Screen

For Laura, the conference is an ideal opportunity to interact with members. “There are many components of my job with the TDS. There are meetings, but there are also membership duties. There’s a financial side and boardwork, and grants, and grant-writing,” she says. “With all of those duties, it’s always a good refresher to be surrounded by our members and make personal connections. That interaction reminds me why I do the job that I do. I love it. I do it for my members, and I hope these meetings are a benefit to them.”

The event offers attendees required CME credits as well as the one-hour ethics credit required for those practicing in Texas. But the platform also hosts a background gamification. A visit to the leaderboard shows attendees how to accumulate points from participating in sessions, visiting exhibit booths, and more. 

“For those who are present, and based on the leaderboard points, I will be doing raffles throughout the conference,” says Laura, who promises some amazing prizes for the winners. 

Although hosting virtual events may be a temporary condition for TDS, Laura is partial to the idea of maintaining a virtual component to future events. “I would love to offer a virtual component to our events because it’s a member benefit,” she says. “Members being able to attend from anywhere in Texas if they can’t attend a physical event is huge.” 

She believes that incorporating virtual sessions or activities in conjunction with in-person events is a great offering for members. But the upcoming fall event is the main focus, and it’s shaping up to be “virtually” one of the most engaging, must-attend dermatology events of the season. 

For registration and event information, click here.

Dermatology Practice Trends You Can’t Afford to Miss

 If today’s dermatology practices plan to compete, exploring some of the enduring trends in inpatient care is an excellent place to start.

Just imagine learning the dermatology practice you spent years building must close its doors under the threat of COVID-19. That was the reality for thousands of dermatologists at the onset of the pandemic, with one urban-based academic dermatology practice canceling nearly 11,000 appointments in March 2020.

In a 2021 NIH study, researchers found that “in-person office visits were strictly limited and were reserved for serious, life-threatening dermatologic diseases or those conditions that, if not addressed within 72 hours, would land the patient in the already overwhelmed emergency department.” 

The message was clear: If dermatology clinics hope to reopen, they need to innovate. Even now, as healthcare providers welcome back patients, processes and technology hastily adopted in response to COVID-19 concerns have claimed a permanent foothold in delivering healthcare, particularly dermatology. If today’s dermatology clinics plan to compete, exploring some of the enduring trends in inpatient care is an excellent place to start. 

Here are four trends in dermatological care that are helping clinics not only reopen but redefine the patient experience. 

  1. Outsourced Medical Billing 

As clinics feel added pressure to cut overhead costs, many outsource their billing tasks to streamline office processes and cut expenses. 

Partnering with a medical billing service specializing in EMR, CPT coding, track billing compliance, and other time-saving functions can help scalable strategies. It will streamline your office workflow, offset the expenses associated with hiring and training your staff to handle complicated and often time-consuming billing issues with insurance companies, and help you focus on delivering terrific, personalized patient care. 

  1. Digital Transformation to EMR

The CDC found that 85.9 percent of office-based physicians use an EMR or EHR system for organizing patient files. By comparison, a study conducted by researchers Olivia Katamanin and Alex M. Glazer, MD, found that 86 percent of dermatologists surveyed currently use or have used EHR in the past. 

Although the collective opinions of technology differ among dermatologists polled, continued improvements to the digital technology hope to streamline claims and billing processes while also simplifying access to patient files, reducing errors, updating test results, linking digital imaging files, and acting as a foundation for self-service patient portals. 

  1. Adding Telehealth Services 

Telehealth services were a strategic solution during the pandemic for doctors to follow up with patients who couldn’t meet in person. Now it’s a desired feature for patients. Based on claim lines, which track individual procedures displayed on an insurance claim, US News and World Report showed an 8,336 percent increase nationally from April 2019 to April 2020.

A recent survey found that, of the patients who used telehealth services, 

  • 65 percent liked the convenience,
  • 63 percent appreciated not being exposed to other sick patients,
  • 44 percent favored the ease of scheduling appointments, and 
  • 38 percent noted the simplicity of scheduling follow-up appointments.

Although clinics no longer restrict in-person visits, telehealth technology’s versatility and accessibility increase options for streamlined dermatopathology labs and clinic partnerships.

  1. Shift Treatment Focus to Include Skin Conditions Associated with COVID-19

Although rare, new studies show distinct cutaneous manifestations associated with COVID-19 cases. In a JAMA study, researchers Kanade Shinkai, MD, and Anna L. Bruckner, MD, MSCS, encouraged an understanding of pediatric inflammatory multisystem syndrome temporally associated with SARS-CoV-2 infection among dermatologists.

According to the study, “It will be important for dermatologists to pursue rigorous prospective research to achieve a comprehensive understanding of the true prevalence and natural history of SARS-CoV-2 infection and skin findings, determine whether cutaneous manifestations signal important systemic associations, and identify the best management strategies.” Partnering with a dermlab specializing in identifying signs of these emerging conditions will help you better serve your patients.

The face of dermatology is changing. As clinics explore ways to respond to an evolving industry, a shift to enduring trends like streamlined office processes, digital resources, flexible technology-based patient services, and specialized care is helping move dermatology services toward a more efficient, scalable, and trendy personalized patient experience.

To expand your dermatology practice with the latest trends in medical technology, you need a dermlab that can help you reach your goals to achieve streamlined, digital, innovative, and specialized patient care. To learn more about ways to update your practice with innovative digital dermatopathology lab services and tools, click here.

Dermatology Trends Infographic