Grant Program Accepting Applications, Seeks to Bridge Care Gap in Inflammatory Dermatoses

Adam Friedman, MD, FAAD, is the chair of Dermatology and residency program director at the George Washington (GW) School of Medicine and Health Sciences (SMHS). Friedman was the recipient of a quality improvement project grant, wherein he took part in developing and supporting a teledermatology initiative in underserved communities within the Washington, DC, area.

The successful project has since expanded into a collaborative grant program led by the GW SMHS and Pfizer Global Medical Grants, wherein both organizations seek to broadly implement Friedman and GW's Teledermatology Help Desk Clinic model throughout underserved communities in the United States. According to a press release from the GW SMHS, the grant "is designed to expand access to quality-based care for Inflammatory Dermatoses including atopic dermatitis and other inflammatory dermatologic conditions."

Friedman spoke with Dermatology Times® to discuss the grant program and encourage organizations to submit an application. Applications are open until August 24, 2023. Interested parties can view the full request for proposals here.

Transcript

Adam Friedman, MD, FAAD: Hi, I'm Dr. Adam Friedman, professor and chair of Dermatology at GW School of Medicine and Health Sciences.

So I now at this point can say I am intimately experienced with the Pfizer grant program, being a recipient of a quality improvement project to support a innovative telemedicine-based approach to enhancing access to care in underserved areas. I personally have served as a grant reviewer for their ASPIRE program and had the opportunity to review some incredible grant applications and award grants to both established and junior investigators. I have also had the opportunity and a unique opportunity to interview past recipients of said grants through a podcast series that was sponsored by Pfizer that is hosted on the Journal of Drugs in Dermatology website. And now, I am running a call for applications and grant program in collaboration with Pfizer here at GW. So I would challenge anyone out there to say that they've had more interactions with a grant program than I have at this point.

Dermatology Times: What was your own experience receiving the grant and implementing your teledermatology help desk project?

Friedman: So I think the original pilot grant that we were awarded at the height of the pandemic is very relatable and translatable to the recent call for applications. So at that time, the RFP, request for proposals, from Pfizer was around utilizing telemedicine to improve access to care, especially given the timeframe we were in where many places were shut down, or were only open to urgent or immediate in-person care. Yet the populace still needed dermatologic care.

Now taking that aside, even pre-pandemic, we knew, and now even more now, that there are disparities with respect to access in terms of certain populations, their ability, whether it be the availability of dermatologist, the ability of those individuals to get to a dermatologist, or even individuals having the wherewithal to know they need to see a dermatologist; pick your poison, there were significant issues when it came to access to care. Now throw in a global pandemic, and even when thinking about utilizing telemedicine as a conduit for care, there are still going to be populations that have those same disparities, but now, it's even widened further because of not just a health disparity, but a technology disparity as well.

And so that was the kind of premise behind this grant was: How can we use telemedicine to overcome both past and present challenges? And that was where this kind of all started. I think very often when it comes to science, right place, right time, right observation, making sense of it. Here at GW, we have a wonderful telemedicine program that is run through the emergency department. Dr. Neal Sikka has actually not only established a telemedicine program that is actually integrated with the state department. He even has a fellowship program to train fellows to be experts in telemedicine, and he had established what he coined as the Telehealth Help Desk where he would go into the community to educate community residents about telemedicine. So I'm like, 'That's a really cool idea.' What about going into the community, really demystifying this technology, making it simpler and making it accessible? But let's take it one step further and actually have a telehealth visit. And so it's a mock visit, but actually real visit, because these patients are interfacing with a physician, they have a treatment plan, they get prescriptions and follow up. So this was just evolving and established a really brilliant idea that came from outside of dermatology, and this grant program when it was announced, right time, it really allowed for us to actualize this evolved concept, married to the Rodham Institute, which is with GW's community-facing advocacy institute formely run by Dr. Gigi El-Bayoumi. Her ability to forge networks with community stakeholders is unparalleled, and I really relied heavily on her to connect me with Bishop Webb at Temple of Praise Church in Ward 8, where we actually have been holding this clinic for now several years. So it was a right place, right time, but really connecting those dots to then create this help desk 2.0 where we created almost a mini health fair inside the church where someone would come in, register in our electronic medical records. They would then undergo training on best practices for telemedicine. We had our little booth with a poster and videos and telehealth-trained experts. Number 3 would be the educational booth on initially atopic dermatitis, this is from the original Pfizer grant-funded program, now we have our continuation, which is funded by both Pfizer and Lilly, and we're focusing on alopecia areata and atopic dermatitis.

They then move on to our little makeshift amphitheater. We have videos on both disease states, and then they're taken back into a private room with to undergo their telehealth visit. As they come out, we kind of locked them down with some patient-based surveys. So we have a whole bunch of PROs, patient-reported outcome-based surveys, that we have them fill out, and then then as a prize, they get a whopping bag of free samples, and they get a follow-up visit, and they make their way out of there.

So we really have created a streamlined process, which has been really effective, and from our patients surveys, really appreciate it has made a very big difference in their ongoing care. Now fast forward to where we are in present day, given that this model seemed to be very effective, not just once it's established, but even the trials and tribulations we went through to figure out: Where do we do it? Who are the committee stakeholders we need to be engaged with? How do we advertise for it? How do we engage the community? Who should be our volunteers? Who should be in the room with the patients? There are so many W's that unless you go through it, and you trip over yourself 1000 times, you're not going to know what is needed to make this effective.

We've now packaged this whole process up and have turned this into a call for applications where other institutions now can apply to receive funding to launch this model in their community, with the added benefit of our experience and our insight, because part of being a grant awardee, you also get some of us along for the ride. So myself and several others who have participated in this program, we're at the ready to provide guidance if you hit a brick wall, like we did so many times throughout this process.

Dermatology Times: How does this grant program help to improve patient access and outcomes?

Friedman: So as a quality improvement grant, the idea here is that this seed funding sets the fire. So in a similar vein, the Pfizer QI grant for us enabled us to figure out: How do we even do this? How do we make this a living, breathing organism? And with that success, and with even generating data, which I think is so hugely important, I was then able to go back to Pfizer, I was able to go to Lilly and say, 'Hey, this is important. Look at the impact of this model in improving access to care.' Over 70% of those who came through our first round had never seen a dermatologist before. So thinking about that, thinking about a cohort of individuals who may not be able to see a dermatologist otherwise, it really sets the stage for looping these individuals in for long-term care.

So I think the idea here would be: Anyone who would receive this grant would learn the ins and outs of setting up a program or a clinic like this, creating the relationships needed to make this effective. But then, and I didn't mention this before, a piece of this puzzle, a piece of this grant application, is we want people already thinking about: How are you going to make this sustainable? What do you need to make this sustainable? And so we actually encourage those applying to engage their development officers, the kind of the parts of the institution that focus on philanthropy and development, to be part of the conversation early. Dean Bass at GW loves talking about the big ideas. What are the next big ideas that we can fundraise around? This could be a big idea for your department, for your institution, that you can fundraise around to make this sustainable. So my hope is that we get a whole lot of applications. Please don't be shy. Send them in so that we have a large and wonderful cohort from whom we can choose. And I realize we can't pick every application, but that the success of round 1 will inspire future years of maintaining this program so we can keep setting up these pilot projects that then get legs under them and can survive and continue onward.

And so if we have these free clinics being maintained through various funding pathways, it enables us to at a minimum, bring someone in to the fold. Maybe all they need is that open door. Maybe this person has every means to see a dermatologist; they don't know the first step, they just don't know how to do that, or they don't even know what telemedicine is. So forget it. It's not something they want to do. We can really open their eyes to what telemedicine is, what dermatology is, change their perception of dermatology, because maybe their perception of derm is not what it needs to be to seek out the necessary care, and now these are lifelong patients. So I think there are innumerable outcomes that can really evolve from even just doing a 1-year program, which I hope will then will be sustained over time through other support.

Dermatology Times: What should organizations consider when applying for this grant?

Friedman: The deadline for applications is August 24. The application submission site is through the Pfizer grant portal, which the website can be found in the writing below, as well as a complete call for applications.

[Application submission site linked here. Call for applications linked here.]

The turnaround is going to be real fast. That's the fun thing. I remember joking years ago about NIH grants, how where sometimes by the time you get your score, you're out of money, and your lab is closed. We are moving fast: deadline is August 24. We're going to announce awards by the before the end of the year; October is my best guess. So there's going to be a fast turnaround. You're going to be supplied with the tools and resources to get this party started by the new year, which I think is extremely exciting and somewhat unique.

Along those lines: The only reason we can do all this is because of a meaningful and purposeful collaboration with industry. I like to say this always, and I'm stealing this line from Rox Anderson, when he gets on stage and says, 'I am proud of my disclosures.' And I'm proud of this partnership with with Pfizer, and I'm proud of the partnerships with other industry partners. As I mentioned before, Lilly and Pfizer are now supporting our current program at Temple of Praise, because we're all in this for the same reason.

We all went into health care, whatever your title is, to at the end of the day, change patient outcomes, change patient care. And so if we acknowledge our shared mission and get around the fluff, we can actually do great work together. I feel very privileged to have the opportunity to work with some really incredible folks on the other side of the aisle to create innovative grant programs like this, that I get to run from my office here at GW, and hopefully support my colleagues out there across the country.

[This transcript has been edited for clarity.]