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McFarland LV, Reiber GE, Raugi GJ. Increasing Access to Dermatology Care for Rural Veterans through VISN 20 Teledermatology Education and Skills Training. Presented at: VA HSR&D / QUERI National Meeting; 2012 Jul 19; National Harbor, MD.
Objectives: To increase access to dermatology care for underserved Veterans living in rural areas of VISN 20 by training and educating rural primary care providers and imagers. Methods: Over a 2-year period, a 5-component educational project was implemented concurrently with a VISN 20-wide teledermatology project. Primary care providers and imagers received the following training: onsite initial training, regular continuing education via VISN-20 wide conference calls with slide presentations and discussions, dermatologist assessment of patient care plans, intermediate dermatologic surgery training, and final competency assessments. The number of providers performing dermatology procedures and educational scores were tracked over two years. Results: By the end of two years, 40 providers and 54 imagers were trained. At onset, 9% of providers were performing shave biopsies and 33% were performing excisions, but by the end, 100% of providers were performing these procedures. Education scores on knowledge of 13 dermatologic conditions and proficiencies for 11 procedures increased by at least one-third for providers. Imager's scores addressing knowledge on conditions and assisting procedures also increased over time. Implications: A continuing educational program delivered in rural sites improved access to dermatology care in underserved Pacific NW clinics by training and monitoring rural primary care providers' competencies with basic dermatology diagnostic and surgical abilities. Impacts: Veterans living in rural areas suffer from a lack of access to specialized medical care, especially dermatology services. Teledermatology provides needed services to these underserved populations.