Community Health’s Expanding Telemedicine Service Line

When Vermont Senator Bernie Sanders visited Community Health in May this year, he spoke about access to medical care and how during the pandemic telemedicine, live remote consultations with a health care provider, became an accepted and reimbursed form of care.

Community Health described for Senator Sanders how the acute shortage of certain specialty services like dermatology, oral surgery, podiatry and infusion were not generally available for Medicare and Medicaid patients in the Rutland County region. The challenge of traveling several hours for these services limited their access to treatment.

One way to address that problem and bring specialty services to Community Health was through telemedicine. As a result, the Telederm service was created at Community Health.

Telederm gives primary care patients access to a dermatology specialist via remote consultation from Community Health’s Rutland and Castleton practices. A live digital video link connects the patient to a University of Vermont Medical Center specialist located several hours away, bringing the specialized care to the patient.

Community Health patients, families and children can avoid traveling sometimes hours to meet with a provider who specializes in the care and treatment of skin conditions and who accepts Medicaid and Medicare, as well as other, insurance coverage.

When a patient’s primary care provider recommends that a dermatologist review a skin condition, digital photos of the condition are sent to the dermatologist and an appointment is scheduled at the Rutland or Castleton practice. A clinical assistant stays with the patient throughout the live video consultation. The specialist will make a diagnosis, recommend treatment and consult with the patient’s primary care provider if further treatment or monitoring are needed.

If it’s deemed clinically appropriate, certain procedures can be done right there at the Community Health practice, so the patient won’t have to travel to see the specialist in person. In certain cases, additional photos or a pathology report might be needed for the specialist to assess the patient and develop a treatment plan.

Connecting patients and providers throughout Vermont’s rural communities and overcoming the transportation, connectivity and coverage barriers to the community is a goal of Telederm and all of Community Health’s Telehealth services. Community Health is the first facility to offer this type of specialty service in the region, adding to the already robust Telehealth offerings at Community Health.

During the pandemic, all behavioral health services at Community Health were transitioned to the virtual remote appointments, resulting in an improved number of patients keeping their appointments. Last year, Community Health dental providers were some of the only dental offices offering emergency dental services. And Community Health’s school-based telehealth system, on hiatus during the pandemic, is ready to be redeployed this fall in the Slate Valley Unified School District with other nearby school districts expressing interest in the school-based telemedicine protocol.

“Over the past year, the public health emergency has highlighted the disparities in the U.S. health care system, while at the same time demonstrating the positive impact of innovative policies to reduce these disparities,” said Centers for Medicare and Medicaid Services (CMS) Administrator Chiquita Brooks-LaSure in a recent CMS newsletter. “CMS aims to take the lessons learned during this time and move forward toward a system where no patient is left out and everyone has access to comprehensive quality health services.”

CMS is supporting proposed changes “to address the widening gap in health equity highlighted by the COVID-19 Public Health Emergency (PHE) and to expand patient access to comprehensive care, especially in underserved populations.” The July 7, 2021 CMS newsletter also said the agency is supporting the administration’s “commitment to strengthen and build upon Medicare by promoting health equity; expanding access to services furnished via telehealth and other telecommunications technologies for behavioral health care; enhancing diabetes prevention programs; and further improving CMS’s quality programs to ensure quality care for Medicare beneficiaries and to create equal opportunities for physicians in both small and large clinical practices.”

Community Health’s innovative approach to health care provides options like the Telederm service which reduces the barriers to care for patients by providing:

• live access to a specialist in dermatology
• specialist care covered by Medicaid, Medicare and other insurance
• an appointment in a nearby Community Health practice in Rutland or Castleton
• follow up treatment with a Community Health provider
• familiar Community Health professionals to help navigate the process

For more information about Community Health’s Telehealth and Telederm services check our website.

For more information about Community Health and our network of services, check our website at https://www.chcrr.org/.