Grant Program Targets Telehealth Access in Underserved Neighborhoods

A teledermatology clinic that was launched in a church is the model for a program aimed at creating new channels for underserved residents to access healthcare.

A DC-based health system has launched a grant program aimed at using telehealth to expand access to dermatology services in underserved neighborhoods.

The George Washington University School of Medicine and Health Sciences is partnering with Pfizer Global Medical Grants on the program, which expands on a successful GW Teledermatology Help Desk Clinic that was located at the Temple of Praise Church in Washington DC.

The clinic offers access to care for treatment of inflammatory dermatoses, such as Atopic Dermatitis, which affects more than 30 million children and adults in the US.

“During the pandemic, the healthcare divide became even more apparent across many underserved areas,” Adam Friedman, MD, chair of dermatology and residency program director at the GW School of Medicine and Health Sciences, said in a press release. “However, as telemedicine enhanced access to dermatologic medical care for many, we also noticed that the divide itself was widened not just because there was a health desert, but now there’s also a technology desert.”

“Specific populations are at greatest risk for physical, emotional, and financial losses associated with inflammatory dermatoses," he added. "And it is well established that there are significant racial disparities in healthcare and disease burden. For example, those who identify as Black tend to have more Atopic Dermatitis [and] have more severe disease, but make up fewer of the appointments seen by a dermatologist for this condition. While finally receiving the attention it deserves, this disparity has been long-lived and pervasive in all areas of medicine.”

Friedman's program is one of many across the country aiming to address lack of access to healthcare by putting clinics and/or telehealth stations in areas where communities tend to gather, like churches, malls, pharmacies, salons, community centers, homeless clinics, and libraries.

"I appreciated that utilizing and partnering with a community lighthouse, so to speak, would engender a sense of trust and comfort for those potential patients in the area," Friedman said in an e-mail exchange with HealthLeaders. "Using a familiar location demystifies an unknown and unfamiliar program."

The grant program, offering grants of up to $250,000, aims to identify healthcare organizations that can take this model and expand to other underserved areas and communities. Applications are due by August 24, with programs expected to start by January 2024 and continue for as long as 18 months.

"First and foremost, I want applicants who are just as excited as I am to explore new ways and approaches to improving healthcare outcomes to those who need it most," Friedman told HealthLeaders. "I want to not only see how the applicant and their team will employ our telehealth help desk model within their community, but how they plan to sustain beyond the period of the grant. The funds can be used to support medical students interested in pursuing dermatology to dedicate, coordinate, and oversee the execution of the clinics; to compensate community partners for their time and investment in the project's success; [and] to purchase supplies and tools needed for a successful series of clinics and marketing/advertising to ensure a steady stream of patients."

The telehealth help desk, established in a church with more than 15,000 members, offers resources and education on how to access and use telehealth and specific dermatologic diseases like Atopic Dermatitis and Alopecia Areata, and can link a visit to a specialist for a free virtual visit. Patients are registered through GW's EHR platform and can be scheduled for follow-up visits.

“The number of dermatologists/dermatology clinics in this area of the district is disproportionately low to serve the health needs of this large population," Friedman said in the press release. "In fact, there is not a single dermatologist practicing in this area of DC. Though the reasons for underutilizing telemedicine can vary from patient to patient, we believe that improving access to technology and increasing awareness of teledermatology will lead to more patients using this type of healthcare to seek diagnosis and treatment before symptoms become too severe.”

Friedman told HealthLeaders the process of finding partners to establish clinics and good locations for those clinics isn't easy. Good programs need high traffic and visibility and a steady base of volunteers.

He hopes to expand this model not only to other locations, but to address other chronic conditions.

"This grant program, even the telehealth help desk we established and can now continue thanks to [support from organizations like (Pfizer and Lilly] is an amazing example of how academic and pharmaceutical partnerships can be meaningful [and] productive and achieve the shared goal of improving patients’ lives," he said. "I am very grateful we have the opportunity to take the learnings and experience from our free clinic and support those we fund to launch this model in other cities to ensure success."