The "Digital Patient" & Dermatology: Providing Virtual Care

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, such as MiiSkin, to communicate and monitor patients’ skin lesions remotely. 

In this video, Dr Margareth Pierre-Louis discusses the "Digital Patient" and how to provide dermatologic care virtually. 

TRANSCRIPT-

Dr. Margareth Pierre-Louis:  The digital patient wants convenient care. They want on-demand care. If there's a worrisome lesion, the first thing they want is to see if someone could give them an answer to what the problem is. They want their problem solved.

For me, it is no different than us wanting our package from Amazon Prime overnight. There is a certain on-demand that is happening in all the industries, and it's not leaving healthcare behind. Again, the pandemic made this even more so that we have to be part of this digital revolution. What we do in our clinic and what other dermatologists can do, one, engage with patients digitally.

You have to, and you can do that with a tool like Miiskin. That's what our clinic has chosen to do. Make sure that you can meet their on-demand digital needs because if you can't, they're going to go elsewhere. What I find is when patients go elsewhere, then it undermines what we have as special training in our specialty.

Patients are now being seen by nurse practitioners and PAs and even urgent care for problems that we could easily solve for them. We are utilizing digital health because we must and if we don't, we're going to find that we're going to be undervalued as dermatologists. What we do, we first offer virtual visits. We get to the point of virtual visits by first triaging.

The first and foremost -- I guess I'll back up -- before we can even provide a virtual visit, you must triage who qualifies for a virtual visit. Dermatology is a procedural specialty. Not everything can be done digitally and that's one of the things we have to remind ourselves. It can be a short fall if we try to too much apply digital health into our practice.

First, you must triage that patient, you must determine if their need can be treated or addressed through telemedicine. I've always been a proponent of virtual visits. Again, we've been applying that type of visit structure since 2018. What we were missing was a triage tool.

For me, every dermatology clinic -- if you're going to engage patients, the digital patient -- you must have a triage tool. What that means, you must be able to say, "Hey, this visit qualifies for a virtual visit."

Meaning it is simple, straightforward, and I can deliver care or you need to be able to say, "Hey, this is urgent. This person should not just sit at home and wait. This is potentially a melanoma. They need to get in right away." You could use that triage tool to say, "I think this is fine. I'm reassured by what I'm seeing. Just keep your appointment because there's no need to come in now."

I never realized, until I had to implement these virtual visits, that you need a triage tool and that's what, again, Miiskin does for us. It's a triage tool where we determine the level of need, and then we can effectively deliver because we know exactly what we're getting into.

Just to rephrase, how can dermatologists utilize technology? One, they can use it to better triage patient cases and patient needs, especially since the digital patient, the digital consumer wants on-demand care. You can now use a tool, a digital HIPAA-compliant platform to determine that need.

Then you can either turn it into a virtual visit, or you can turn it into an office visit, or you can provide reassurance. The triage tool I'm talking about is not diagnostics. I'm not talking about using this platform to determine what the lesion is, or what the problem is.

It is a way that you can then truly walk a digital patient through the process, so that you have an effective outcome. I want to make that disclaimer. Miiskin, for instance, it is not a diagnostic platform. I'm not using it to make decisions on patient care or to give medical advice.

What I'm doing is, I'm giving the patient a better and more effective, efficient care experience because I know exactly how to triage and manage their problem. Yes, so have a triage tool, offer virtual visits because if you don't, they're going to go elsewhere. The triage tool, have virtual-visits capability in place then. Again, I can always tell you how to do that.

A lot of dermatologists don't know about the GQ modifier. There are two different types of virtual visits. Again, that's another question I'll go into. I'm sorry, I'm talking a lot because I'm really excited about this whole concept. Have a triage tool, have a way to then be able to deliver virtual visits, whether it's going to be through teleconferencing or Store & Forward.

Again, Store & Forward is better or superior for time management for a dermatologist. Then third, have a way to engage the patient, make sure they can connect with you through this tool. What better way to do it by having them privately be able to use the tool, like Miiskin, because there is a self-monitoring, self-tracking app as part of the tool.

[pause]

Dr. Pierre-Louis:  The world of Curology is taking over our practice. How many patients come to us having used Curology? Well, all the ones who want convenient care and they want to start their acne care, but Curology is not enough. Using lower than prescription-strength topicals is not enough. Our patients need more than that. We've got to be available.

We've got to be available online because they've made it convenient. They've embraced the digital consumer, and there's nothing wrong with it. If we want to make sure that our expertise does not become undervalued because Curology can't meet everyone's needs.

There are people who have more crazy acne and scarring. I think it's a great start. Curology is the most amazing idea ever. That person should win a Nobel Prize because this is what people want. People want to have their needs met. We have to keep up with it. They're driving what happens in the digital revolution because they're armed with a smartphone.

Then they're going to decide who they want to treat them, how they want to be treated, and how fast they can get their care. It's got to be convenient to them. I'm not saying we have to cater everything to the digital revolution.

We're smart, educated specialists who have invaluable training, but if we cannot offer it to the people who need us, then I'm not sure that value isn’t going to be starting to be eroded.