All that information dermatologists are plugging into their electronic medical records (EMRs) might seem tedious, unnecessary and irrelevant, but there’s an important flip side that could mean better medicine and reimbursement down the road.
“A dermatologist could ask, why should I record what specific medications my patients are currently taking if I am only treating their basal cell cancer?” said Kavita Yang Sarin, M.D., Ph.D., clinical assistant professor of dermatology, Stanford University Medical Center, Stanford, Calif. “However, a researcher can use this data over millions of patients to find a new association with a specific medication and increased risk of skin cancer. In this way, the individual patient and physician contributes more broadly to improving human health.”
Big data can be used to fine-tune interventions to manage increasing numbers of patients at a lower cost, according to Mark Seraly, M.D., dermatologist in McMurray, Penn. In addition to in-office patients, Dr. Seraly has more than 1,200 online patients each year, through a business he founded, DermatologistOnCall, which is used by more than 150 U.S. dermatologists.
“In an office setting, [an] EMR platform, for example, is used to track melanoma patients to ensure compliance with follow-up visits, coordination of care with the patient’s other healthcare providers and lab testing,” Dr. Seraly says. “In teledermatology … studying big data can help us better understand consumer behaviors as [they relate] to virtual health — how data can help us deliver a ‘personal’ connection in an often impersonal online setting. It can also help us optimize workflows and processes, such as predicting what percent of online patients will need to be referred to an in-office consultation; predicting what percent of online patients will need prescription care; and measuring time-to-complete for online cases.”
Big data figures prominently in healthcare’s new value-based payment system, called the Merit-based Incentive Payment System, which goes into effect in 2019, said Michael Sherling, M.D., dermatologist, cofounder and chief medical officer of Boca Raton, Fla.-based Modernizing Medicine, and co-developer of EMA, a cloud-based, iPad native EMR system, which powers 35% of the U.S. dermatology market.
“What we do in 2017 depends on that 2019 reimbursement,” Dr. Sherling says.
With the Merit-based Incentive Payment System, dermatologists will get paid based on the data they put in and how it measures their quality of care; cost compared to other physicians; as well as something called practice improvement, which is the ability for physicians to use their own data to manage population health, Dr. Sherling says.