Pediatric Dermatology E-Consults with CHOP Providers
Getting an appointment with a pediatric dermatologist can involve long wait times. In an effort to provide care sooner in a way that is both safe and convenient, CHOP Dermatology is introducing a new provider-to-provider dermatology E-consult service.
This dermatology E-consult service allows primary care providers within the CHOP network to send photographs and information about a patient’s skin condition directly to a board-certified CHOP pediatric dermatologist for non-urgent review. The doctor will carefully review the information and provide a response, including the most likely diagnosis, advice and recommendations on management and treatment. This service does not include a video interaction with the dermatologist or primary care provider.
The goal of this service is to provide children with skin problems easier and faster access to our expert pediatric dermatologists and get families directed to appropriate care.
What can an E-consult be used for?
Common reasons to seek a consultation with a pediatric dermatologist include complicated eczema and acne, as well as some skin infections, infestations, birthmarks, hair loss, nail changes, excessive sweating and a variety of other skin conditions.
What should not be submitted for an E-consult?
Providers should not use this service for any medical emergencies, including swelling of the lips, tongue or throat; blistering in or around the eyes; severe rash with fever; difficulty breathing or anything causing severe pain.
How to request a dermatology E-consult
To request this service, providers will search for “Econsult to Dermatology” in the electronic medical record (EPIC) orders tab and fill the order out completely. Note to first-time users: The order may not be in the preference list so search the entire order database to find the order.
- All information and photos are sent securely within the existing medical record
- Photos must be taken during the PCP encounter using EPIC Haiku or Canto to be attached to the order.
- At this time, patient-submitted MyCHOP messages and photos cannot be submitted for an E-consult. However, during the E-consult submission there will be a way for the PCP to indicate if there are other relevant photos in EPIC for review.
- A CHOP pediatric dermatologist will review the case and send recommendations via an EPIC E-consult note to the PCP.
- The PCP is responsible for communicating recommendations to the families and prescribing any needed treatments much like after obtaining lab or radiology results.
The MyCHOP patient portal can be an efficient way for the PCP to relay information to families if the patient/family agrees to that method of communication upfront.
We may contact participating families for follow up surveys and/or consent to use photos for educational purposes in the weeks following the E-consult.
We thank you for your participation and hope this service is helpful to CHOP providers, patients and their families.
Questions and technical support
For technical support, please call CHOP IS at 215-590-HELP (215-590-4357).
For assistance coordinating follow-up care for patients and all other issues please use the CHOP teledermatology hotline at 267-426-8342.
Frequently asked questions
When should we expect a response from the dermatologist?
In many cases, the PCP may receive a response within one business day. All cases will be answered within five business days. The PCP will relay information to the family as soon as possible.
Who can use this service?
This service is available for patients aged 4 weeks-17 years old. Currently, it is available to CHOP Primary Care Network patients only. If a patient has already seen CHOP pediatric dermatology they are still eligible to receive care via an E-consult. However, keep in mind that if a patient was seen within the last three years by CHOP Dermatology, an in-person clinic visit will be considered a “follow up” and wait times for in-person appointments will be shorter than for a new dermatology consultation.
How much does the service cost?
This service is at no cost to patients at this time.
Can a skin condition be diagnosed using a photograph taken on a smartphone?
The quality of the photographs taken by smartphones has dramatically improved over the past several years. Medical studies have shown that using photographs to diagnose and treat skin conditions is reliable.* It is important, however, to try to take the best possible photograph of the skin condition and to include several images. Please refer to these instructions on how best to take photographs of skin conditions with a smartphone.
- Choose a well-lit area
- Keep the child still
- Include one photograph of the entire affected region of the body AND several close-up photos of the condition
- Make sure the image is in focus – tap the screen of the phone when taking a photo to help the camera focus on the skin condition
*Daniel M. O’Connor et al. Diagnostic Accuracy of Pediatric Teledermatology using Parent-Submitted Photographs, JAMA Dermatology, Nov. 15, 2017.
What happens if the patient needs to be seen in person?
As part of the E-consult, the specialist will provide advice on whether follow-up management is needed and, if so, what kind of follow up care is recommended.
If urgent (within four weeks) in-person follow up with CHOP Dermatology is recommended, our pediatric dermatology staff will call the family directly to arrange care.
If non-urgent (can wait longer than four weeks) dermatology follow up is recommended, then patient families should be instructed to call 215-590-2169 to make an appointment to see CHOP Dermatology at a CHOP Care Network location that is convenient for them.
When a patient family calls to schedule an appointment, they should indicate that their PCP completed a dermatology E-consult so the Dermatology schedulers know how best to schedule them. Other options for follow-up care may include:
- Continuing to see their PCP
- Using MyDerm E-Visits through MyCHOP
- A standard video visit (also facilitated through MyCHOP)
- Potentially seeing another CHOP pediatric specialist
Families are encouraged to talk to their child’s provider about the right type of care for their individual situation.