Dermatologists establish ‘instant online practices’ with remote diagnosis network

After hearing about how long a co-worker’s wife had to wait to see a dermatologist after being misdiagnosed by a primary care physician, Victor Gane had an idea.

He teamed up with Jamison Feramisco, and together they brought life to, a nationwide network of dermatologists who establish what Gane calls “instant online practices” that allow them to diagnose skin conditions remotely, connecting them with patients who need them but are faced with long waiting times or are misdiagnosis by general practice physicians.

To do that, DermLink has portals for three different populations: patients, dermatologists and general practice physicians. A patient can organically initiate an online consultation with a DermLink dermatologist, and the system will match the patient with the closest one who accepts his insurance.  By matching the patients with someone nearby, DermLink hopes to enable easy travel if the condition can’t be diagnosed remotely, and to avoid issues with licensure across state lines.


DermLink – which is available online and in an iPhone app – also opens its platform to primary care physicians, who can refer a patient using the system. “There’s still a pretty high degree of misdiagnosis from the primary care physicians when it comes to diagnosing skin-related conditions,” Gane said. In a study of nearly 1,500 patients published in Archives of Dermatology earlier this year, 98 percent of the patients’ disease management plans were changed during a teledermatology consultantation following diagnosis by a referring physician.

Finally, dermatologists can also reach out to their existing patients using the DermLink software and accept new patients via the program.

To use the HIPAA-compliant platform, patients provide their contact information, preferred pharmacy, medical history and answers to a few key questions (which were developed by working with physicians at Stanford, UCSF and Northwestern, Gane said), and then upload photos of their skin condition. DermLink’s software does a quality check of the images – a critical process, Gane said, because blurry photos that can’t be used for diagnosis mean extra time wasted by the dermatologist. The selected dermatologist is the only one who can see this information, and a diagnosis and treatment plan is delivered to the patient within 24 hours, according to Gane.

For dermatologists, the value proposition is that they can diagnose more patients while also being able to customize the program to fit their needs. “Dermatology is an interesting field of medicine – it’s a very small group, a very tight community,” Gane said. “They are generally paid very well, and they value their time, so it’s not easy to incentivize them.” DermLink attempts to do so by allowing dermatologists to decide how they want to be contacted and how much they want to charge per case.

Currently DermLink takes a piece of what dermatologists charge patients for the consultation, but the vision is to look into insurance reimbursement in the future, Gane said.

Teledermatology (PDF) has been studied with somewhat mixed results but has spurred a number of programs and startups, including Iagnosis, DermatologistOnCall, Skin of Mine and Novi Medicine.

Started at Stanford University, DermLink was part of the inaugural Healthbox class in Chicago, ran pilots in California and Illinois, and is now at the Stanford accelerator StartX Med. The network has already launched in 16 states, Gane said, and the portals will soon be available in the form of an Android app. The next big goal for the founders is to have dermatologists in every state, he said, so the services can reach patients across the country.

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