Dr. Carrie Kovarik, who invented the AccessDerm app, examines the foot of a one-year-old from Uganda.Mary Brophy Marcus
Sayre Health Center is one such clinic. Dr. Kent Bream, an assistant professor of Clinical Family Medicine and Community Health at the University of Pennsylvania, founded Sayre eight years ago and is the medical director there. He has used teledermatology for four years now.
The wait for specialty appointments at Sayre, he said, is about three months – that is, if you can get one.
"But for a rash — a burning, itching, sore rash — you really need care right away,'' he said. "And if it's cancerous, you really don't want to wait three months.”
Bream said they've evolved from taking photos and uploading them to a computer and emailing them to Kovarik to now where Sayre clinicians just download the AccessDerm app onto their smart phones.
One Sayre patient, Trena Medford, from West Philadelphia, said she's thankful for telemedicine. Medford was suffering from a serious rash in April when she visited Dr. Katherine Mahon, a family physician at Sayre.
"The doctor whipped out her phone and said, 'Mind if I take a picture?'" said Medford, 37, whose face and arms still show scars from the rash.
She said it didn't cross her mind to call a dermatologist at nearby Penn. "I prefer to stay in my neighborhood for my medical care."
But when Dr. Mahon told Medford that a dermatologist at Penn who'd viewed her telederm photo wanted to see her as soon as possible, Medford made the four mile trip and received steroids for what turned out to be a serious allergic reaction to an antibiotic.
"That wouldn't have happened five years ago," said Sayre family physician Mahon. "To get a derm consult that fast, I would have had to have had a friend who was a dermatologist do me a favor."
Since launching a new version of the app this past January, Kovarik said AccessDerm users have performed almost 200 consults, more than they were able to log altogether in the first couple of years of the teledermatology program. The American Academy of Dermatology has helped spread the word as well.
Teledermatology will likely continue to grow in the U.S., said McKoy at Harvard. However, she cautioned, "Issues of reimbursement, confidentiality and liability remain."