Hidradenitis Suppurativa

Specialty Referral for Dermatology


Hidradenitis suppurativa

A 26-year-old Caucasian male presents with an 8-year history of hidradenitis suppurativa (HS). He does not have a primary care provider or dermatologist. The patient has made multiple visits to the emergency department (ED) for incisions and drainage but has never been hospitalized. He does not take any routine medications. Cocaine/marijuana use, Ethyl alcohol (EtOH) abuse12pack+1/5daily prior to admission to this facility. He does not smoke cigarettes. Hereportshavingover25incisionsanddrainagesintheEDrelated to his HS.HS affects the bilateral axilla, groin, and lower back. He was started on Bactrim 3 days ago for an acute abscess to the right axilla. Exam: The patient demonstrated a full range of motion in all extremities with no distress. The patient’s vital signs were within normal limits, and he denies any complaint other than the HS.**DERM: There is a 1 cm nodule ”at 2 o’clock” with a small amount of purulent/sanguineous drainage upon manual expression with a 2 cm circumferential area of light erythema and warmth. There are varying degrees of induration/cyst-like features, mostly around the superior lesion, with multiple areas of ropelike scars and pitted skin in the R axilla. Flat lesion at 8 “o” clock with a peri-wound area that is soft, draining a scant amount of purulent fluid.

Currently on Bactrim for acute infection. He needs long-term treatment. Please recommend a plan of care. See attached photos.

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Five Ways eConsults Support Value-based Care and Avoids Specialty Referral

Five Ways eConsults Support Value-based Care and Avoids Specialty Referral

AristaMD offers five ways eConsults support quality patient care that enables a primary care provider, a nurse practitioner, or a PA can submit electronic information to our team of specialists with making a specialty referral. As a result, eConsults beautifully compliment telehealth while the Centers for Medicare and Medicaid Services expand the use of value-based payment models.

#1 Help Patients Avoid Unnecessary Face-to-Face Specialty Referrals

About 70% of eConsults can address what physicians would typically send forward for a face-to-face specialty visit. As a web-based physician-to-physician consultation, there is no need for any particular technology or integration — the PCP orders the referral the same way they would traditionally order one. Or suppose the patient was to go face-to-face for a specialty consult, with the provider using our referral nurse coordination, RNN service, and our nurse navigators. In that case, our nurse will curate the eConsults by grabbing all of the data needed for the patient from the chart. Private health information is then sent to our specialist, who reviews the data and provides an evidence-based response on the best practice and management of that patient. Within four to six hours, the primary care provider receives a notification and can view the eConsult specialist’s recommendations.

The bottom line — for every specialty visit where we serve the patient using an eConsult and address issues through the primary care provider, we can fend off the need for three face-to-face visits. Also, once you gain specific knowledge from a specialist on a particular condition, you have the answer for the same question when it comes up again.