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Dermatology Online Journal

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What can U.S. dermatology learn from health care systems abroad? An observation of Taiwan’s system of clinical efficiency as a possible model for increased patient access to care and affordability


Background: Difficulty in patient access to care and affordability are major problems faced by our dermatology specialty in the United States.  However, Taiwan provides adequate and affordable dermatologic care for all of its citizens.  Herein we describe our first-hand observations and findings of the outpatient dermatology experience in Taipei, and contrast it to the experience in the United States.

Observation: In Taipei, Taiwan, we observed patient management, electronic documentation, and billing during outpatient dermatology visits in five settings: one academic hospital outpatient dermatology department, one academic hospital Information Technology department, and three private dermatologists’ offices. Through our observations, we found that the dermatology specialty in Taiwan is able to overcome challenges with access to care and affordability through three key system features: (1) short yet frequent patient visits (2) close proximity of ancillary staff, and (3) an integrated and paperless electronic medical record and billing system.

Conclusions: The Taiwan system is attained with some sacrifice, such as shorter time spent with patients and less personalized care. However,  because this system can meet the basic dermatological needs of the entire population, possibly better than our current system, it behooves us to study the Taiwan system with respect and care.

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