Improving Patient Care With EHR

Telemedicine puts dermatologists on the right track to success under MIPS.


Telemedicine, a concept we used to see played out on futuristic TV shows like The Jetsons, is quickly becoming an important part of the health care ecosystem—and for a good reason. We practice in a time of tech-fed instant gratification and health care consumers are no exception. Today’s patients want accessible and convenient quality care, regardless of potential barriers like geographic separation or immobility. 

The rise of telemedicine allows physicians to meet these expectations by virtually providing timely treatment, diagnosis, and professional advice to patients through the convenience of their smartphone or computer. This has proved to be tremendously helpful in the highly visual field of dermatology, where, for example, a contagious skin disease can be treated remotely without the risk of it spreading. 

Synergy With EHR

As telemedicine technology becomes more intuitive and prevalent, it is also becoming more accepted by consumers, providers, and payers. While the interest is there, it has not become a widespread modality just yet. Uncertainty around payment reform programs and reimbursement by federal and commercial carriers may slow down more widespread adoption by practices and the physicians who lead them. Couple this uncertainty with the burden of using an outdated, legacy electronic health record (EHR) system that does not offer built-in telemedicine services, the stress of upgrading their solution, training staff, and incorporating the tool in the safest and most efficient way possible, generates enough cause to dismiss telemedicine all together.

At the same time, value-based health care initiatives present the perfect environment for increasing use of telehealth technology. Modern, EHR-based telemedicine can help physicians score well in the improvement activities component of the Merit-based Incentive Payment System (MIPS). Not only can physicians provide better access to care for their patients, but they are also adhering to newer regulations.

EHR Considerations

When evaluating telemedicine, physicians must find a solution that can accomplish:

• Better patient access, improved patient outcomes: The ability to treat your patients practically anywhere, anytime is important with MIPS. Telemedicine enables dermatologists to treat patients at the time and place that works for them. This can help patients get better, faster and at their convenience. For example, a patient who has a minor skin issue, such as a rash, can share images in real time, allowing doctors to virtually check-in and provide recommendations on how to move forward with treatment. Evidence1 suggests that patients with certain chronic conditions who engage with telemedicine technologies have moderately improved outcomes. And with store-and-forward technology (as opposed to a video conference, for example), the physician and the patient can attend to the situation at a time that is convenient for each of them.

• Improved clinical quality: Physicians can use virtual visits, or remote patient monitoring, to raise their scores in the practice improvement category, which is 15% of the total score used to determine whether they receive a bonus or a financial penalty. Some telehealth tools allow providers to reach out to patients with coaching tips, check-ins, care routine reminders, previsit planning, progress checks, feedback surveys, validated clinical instruments, and other content types. If you use these options in a coordinated way with your in-person practice, many MIPS criteria become easier to fulfill.

• Fewer resources, lower health care costs, and increased health care spending: In most states, payments to physicians for telehealth services may be far lower than for in-person visits. This can put pressure on the provider to illustrate the value of telemedicine services. The added convenience and ease of telemedicine visits also can improve patient satisfaction and lead to better patient compliance, and enable physicians to schedule more virtual visits overall. In states where telemedicine is a noncovered entity, patients may be willing to pay out-of-pocket for the convenience of a timely diagnosis and treatment to avoid missing work hours, child care, or driving expenses.

Telemedicine technology promises to help improve patient outcomes, lessen the burden of visits on patients, increase access to physicians, increase physician efficiency, and decrease costs. Because of this, the technology is on its way to becoming a cornerstone of value-based payment models for dermatologists and physicians alike. The key to physicians being able to offer telemedicine services rests in the ability to achieve good patient care while being reimbursed for their time. EHR-based telemedicine solutions that provide patients and their physicians with real-time access to medical records, have high-quality image capture ability, and provide the means to supply a comprehensive medical history will help further the success of telemedicine. 


Dr. Sherling is the co-founder and Chief Medical and Strategy Officer of Modernizing Medicine. He is responsible for the strategy and medical innovation within the company’s suite of products and services for dermatology, gastroenterology, ophthalmology, orthopedics, plastic surgery, otolaryngology and urology specialties. With Dan Cane, he has developed novel software solutions for EHR, MIPS and ICD-10 automation.

Disclosure: The author reports no relevant financial relationships.



1. Dellifraine JL, Dansky KH. Home-based telehealth: a review and meta-analysis. J Telemed Telecare. 2008;14(2):62-66.