Maine has the sixth highest rate of melanoma in the country and a severe shortage of dermatologists, leading to months-long waits for dermatologic referrals. For a patient with melanoma, a wait that long is more than inconvenient. It can decrease their chances of survival. What can be done, then, to provide them with timely melanoma screening and care? With some help from the ACO, dermatologist Elizabeth Seiverling, MD, and her colleagues at Maine Medical Partners Dermatology have developed a promising solution.
Dr. Seiverling’s approach relies on close collaboration with primary care. It began in 2018 with an initiative that gave 200 primary care providers dermatoscopes and offered them training on using the instrument to complement skin examination of potentially malignant growths. In trained hands, dermoscopy reduces unnecessary biopsies and improves melanoma detection. In 2019, Dr. Seiverling enhanced the training by adding Project ECHO follow up sessions. This increased dermoscopy use among participants to 96 percent.
…replacing face-to-face visits with e-consults saved nearly $170,000 in health care costs.Recognizing the promise of the initiative, the ACO provided funding in 2020 to help expand the trainings and Project ECHO sessions. It also provided support for an e–consult component to increase primary care providers’ access to dermatologic consultations. Dr. Seiverling quickly stood up a platform within the electronic medical record for primary care physicians to securely share patient information and dermoscopy images with their practice partners. Over 600 e-consults were completed, 84 percent within 72 hours of being submitted. Only about 25 percent required a face-to-face follow-up visit. The resulting decrease in face-to-face visit volume reduced wait times for patients with growths worrisome for melanoma to under 14 days. Overall access to general dermatology care for face-to-face visits also improved. And, replacing face-to-face visits with e-consults saved nearly $170,000 in health care costs.
The initiative will continue to analyze data to determine the impact of dermoscopy on melanoma stage at diagnosis and cost of treatment. In addition, Dr. Seiverling and colleagues plan to use geo-spatial analysis to identify geographic hotspots in Maine in need of dermatology training and access to care.
Hear an interview with Dr. Seiverling.
In the summer of 2019, Chief Medical Officer Matt Dunn, DO, of North Conway, New Hampshire’s Memorial Hospital was hearing from both patients and staff that accessing primary care was a challenge for many in the community. Data backed up what Dr. Dunn was hearing and he quickly launched an effort to assess and address the access challenge.
“We began by looking at our practice schedule, and we realized that, in our low unemployment population, many patients would need to take time off from work to make an appointment,” he said. “In response, we expanded from 35 to 53 open clinic hours per week, with several 10-hour weekday shifts and new 4-hour weekend shifts. In addition to an expanded schedule, we developed a Patient Outreach Center, giving providers and staff even more time for direct patient contact and communication.”
In 2020, Memorial grew its primary care panel by 20 percent. Since then, it has added primary care providers to help meet the welcome increase in demand.Community members responded by immediately filling all the slots made available on the first weekend. Since then, the expanded schedule has continued to be popular, both with patients and care team members.
“Community members are thrilled to come in for appointments after their workday rather than having them disrupt their usual schedules. These new expanded hours are not only great for our patients, but allow our providers and staff the flexibility to build a schedule that works for them,” said Dr. Dunn.
In 2020, Memorial grew its primary care panel by 20 percent. Since then, it has added primary care providers to help meet the welcome increase in demand.
“The practice continues to see tremendous growth and that’s a good problem to have,” said Dr. Dunn.
Hear an interview with Dr. Dunn.
Maine has the sixth highest rate of melanoma in the country and a severe shortage of dermatologists, leading to months-long waits for dermatologic referrals. For a patient with melanoma, a wait that long is more than inconvenient. It can decrease their chances of survival. What can be done, then, to provide them with timely melanoma screening and care? With some help from the ACO, dermatologist Elizabeth Seiverling, MD, and her colleagues at Maine Medical Partners Dermatology have developed a promising solution.
Dr. Seiverling’s approach relies on close collaboration with primary care. It began in 2018 with an initiative that gave 200 primary care providers dermatoscopes and offered them training on using the instrument to complement skin examination of potentially malignant growths. In trained hands, dermoscopy reduces unnecessary biopsies and improves melanoma detection. In 2019, Dr. Seiverling enhanced the training by adding Project ECHO follow up sessions. This increased dermoscopy use among participants to 96 percent.
…replacing face-to-face visits with e-consults saved nearly $170,000 in health care costs.
Recognizing the promise of the initiative, the ACO provided funding in 2020 to help expand the trainings and Project ECHO sessions. It also provided support for an e–consult component to increase primary care providers’ access to dermatologic consultations. Dr. Seiverling quickly stood up a platform within the electronic medical record for primary care physicians to securely share patient information and dermoscopy images with their practice partners. Over 600 e-consults were completed, 84 percent within 72 hours of being submitted. Only about 25 percent required a face-to-face follow-up visit. The resulting decrease in face-to-face visit volume reduced wait times for patients with growths worrisome for melanoma to under 14 days. Overall access to general dermatology care for face-to-face visits also improved. And, replacing face-to-face visits with e-consults saved nearly $170,000 in health care costs.
The initiative will continue to analyze data to determine the impact of dermoscopy on melanoma stage at diagnosis and cost of treatment. In addition, Dr. Seiverling and colleagues plan to use geo-spatial analysis to identify geographic hotspots in Maine in need of dermatology training and access to care.
In the summer of 2019, Chief Medical Officer Matt Dunn, DO, of North Conway, New Hampshire’s Memorial Hospital was hearing from both patients and staff that accessing primary care was a challenge for many in the community. Data backed up what Dr. Dunn was hearing and he quickly launched an effort to assess and address the access challenge.
“We began by looking at our practice schedule, and we realized that, in our low unemployment population, many patients would need to take time off from work to make an appointment,” he said. “In response, we expanded from 35 to 53 open clinic hours per week, with several 10-hour weekday shifts and new 4-hour weekend shifts. In addition to an expanded schedule, we developed a Patient Outreach Center, giving providers and staff even more time for direct patient contact and communication.”
In 2020, Memorial grew its primary care panel by 20 percent. Since then, it has added primary care providers to help meet the welcome increase in demand.
Community members responded by immediately filling all the slots made available on the first weekend. Since then, the expanded schedule has continued to be popular, both with patients and care team members.
“Community members are thrilled to come in for appointments after their workday rather than having them disrupt their usual schedules. These new expanded hours are not only great for our patients, but allow our providers and staff the flexibility to build a schedule that works for them,” said Dr. Dunn.
In 2020, Memorial grew its primary care panel by 20 percent. Since then, it has added primary care providers to help meet the welcome increase in demand.
“The practice continues to see tremendous growth and that’s a good problem to have,” said Dr. Dunn.
Hear an interview with Dr. Dunn.