- September 21, 2020
Dr. Elizabeth Callahan can learn a lot by looking a patient in the eye.
When the COVID-19 threat closed her SkinSmart Dermatology doors to all except those with urgent needs, such as skin cancer surgeries, that face-to-face interaction seemed impossible.
However, spurred by the relaxation of Health Insurance Portability and Accountability Act (HIPAA) regulations, Callahan has taken SkinSmart online to serve patients.
Easing HIPPA requirements for online appointments has allowed doctors to connect with patients using Skype or FaceTime that previously would not have been allowed. The U.S. Department of Health and Human Services issued a Notification of Enforcement Discretion for Telehealth Remote Communications during the COVID-19 public health emergency.
"We are empowering medical providers to serve patients wherever they are during this national public health emergency," said Roger Severino, the director of the federal government's Office of Civil Rights, in a release. "We are especially concerned about reaching those most at risk, including older persons and persons with disabilities."
Besides HIPPA requirements, Callahan said insurance companies and Medicare had been reluctant to cover online appointments. That has changed, at least temporarily.
Now Callahan and SkinSmart's staff members are working "around the clock" to assure online patients will be served as if they walked through the doors of SkinSmart's Sarasota office.
Callahan said part of her regular, in-office checkups include her using her experience to diagnose a patient.
"I enjoy being an intuitive doctor," Callahan said. "On a screen, it takes longer."
Cristie Weaver, the SkinSmart operations manager, said patients must be asked several additional questions when they are seen online.
"We have to dive in deeper," Weaver said. "We have to ask the same question in a couple of ways."
If a patient isn't comfortable using a computer, he or she can take a photo of a particular spot on their skin to email and have checked out. Those communications between a patient and doctor had to be encrypted.
"It doesn't have to be scary," Weaver said. "People are worried about that spot but they don't feel comfortable online. There is another way."
If the spot has the potential for being serious, then the patient is advised to come into the office.
All reading materials have been removed from the office, patients are forced to social distance and everyone's temperature is taken when they check in.
Closing down the office entirely wasn't a possibility.
"I saw a man in March and he had a stage-4 invasive melanoma," Callahan said. "If I hadn't done (the surgery), it could have been bad for him."
Callahan said even if a spot doesn't need urgent care, the online appointment can alleviate anxiety since the patient doesn't have to worry about it.
If it does, time could be of the essence.
"Even before we see a patient, we get into the patient's history. If B.C. calls and has had eight melanomas, and we see a spot, we probably need to have him come in. At the very least we might need to have a deeper conversation."
SkinSmart has 35 employees, some who have been placed on furloughs. Callahan is hoping the online appointments can keep as many of her employees working as possible.
"This is a horrific time, but we will get through this," she said. "I've gone 110 miles per hour the last 20 years. It's time to reflect on life. We all will change because of this."
For information on SkinSmart Dermatology, go to https://www.sarasotadermatologist.com/