Physicians

Prescribing Physician Information

Learn about Clarify

Targeted, precision, narrow-band UVB therapy is now available at home with improved physician oversight. Your prescription and authorization controls dosage, frequency and duration, linked to the Clarify Home Light Therapy system through the patient’s smartphone.

The Physician determines prescription protocol, incorporating your input on the patient’s skin condition and Fitzpatrick skin type. You may also create customized protocols. A CarePartner team remotely educates patients and monitors ongoing therapy, keeping you in the loop with contacts determined by your notification preferences.

A lightweight, handheld device linked to your patient’s smartphone delivers targeted light therapy ideal for patients with scattered lesions—and also provides treatment guidance and reminders for physician follow-up appointments. Patients can deliver their own treatments wherever and whenever is most convenient for them, so therapy adherence is easy.

Physicians find targeted home light therapy useful for many patients, including psoriasis patients on other therapies who have not achieved clearance or are experiencing new flares and vitiligo patients who may wish to determine if they will respond to phototherapy. Clarify Home Therapy also provides a new option for pediatric patients. The handheld is an easy way for parents to deliver phototherapy, which they may prefer over oral or topical drug treatment.

The system maintains complete treatment and progress records, including photos of skin condition, and issues succinct physician reports as needed.

Download Physician Brochure

Enroll to prescribe

Complete the one-time Physician Enrollment Form in addition to the Physician Agreement/Business Associate Agreement. You and staff members you designate will gain access to the Clarify Patient Management System. Here, you can prescribe, specify reporting preferences, monitor patient progress as needed, create new protocols and communicate securely with your Clarify CarePartner team.

Evaluate for the right fit

Home-based, self-administered care is not for every patient. The greatest success is achieved by motivated individuals who are willing to dedicate daily time to self care. They are comfortable using smartphones. Patience and realistic expectations of therapy are key to high patient satisfaction.

Write prescription

Once you become an enrolled prescriber, you or your designee enters your patient’s identifying information in our secure system. You identify the Fitzpatrick skin color type and skin condition, then select an established phototherapy protocol. You also have the option to create your own unique protocols.

Select notifications

Practice styles and preferences differ. You select how and when you want us to notify you of issues such as patient burns, missed treatments, worsening and poor satisfaction with treatment.

Enjoy long distance control

We’re here to be your partner in providing high-quality, convenient care that adjusts to meet different patient and practice needs. Your prescription and authorization controls treatment dosage, frequency and duration. CarePartner team educates and monitors for optimal home-based care, keeping you in the loop based on your notification preferences and reminding patients of follow-up appointments. We’ll track treatment records and patients’ reported outcomes—available to your patient at all times—and available to you to access when clinically relevant. On-demand summary reports are available to review during follow-up visits. After light therapy treatments end, our smartphone-based patient support continues during remission.

Frequently Asked Questions

The Clarify System

What are the Clarify Patient Management System software requirements?

The physician’s portal is designed for the following browsers: Chrome: Version 30+, Safari: Version 8+, Firefox: Version 45+, Edge: Version 12+, Internet Explorer: Version 9+

How do I use the Clarify Patient Management System?

Simply complete the prescriber enrollment form. You’ll gain access to your system and enroll staff member designees. Here, you are able to write prescriptions, monitor patient progress as needed and communicate securely with your Clarify CarePartner team.

How long will it take to prescribe?

For enrolled physicians, entering a new prescription only takes minutes.

How do I engage with the Clarify Patient Management System?

We’re here to be your partner in providing high-quality, convenient care that adjusts to meet different patient and practice needs. We’ll track treatment records and patients’ reported outcomes—available to your patient at all times—and available to you to access when clinically relevant. On-demand summary reports are available to review during follow-up visits. After light therapy treatments end, our smartphone-based patient support continues during remission.

What are my responsibilities?

We appreciate your help in selecting patients who are likely to succeed with home phototherapy. Home-based, self-administered care is not for every patient. The greatest success is achieved by motivated individuals who are willing to dedicate daily time to self care. They are comfortable using smartphones. Patience and realistic expectations of therapy are key to high patient satisfaction.

Although there are few absolute contraindications to phototherapy, such as history of light sensitivity and genetic skin cancer conditions, relative contraindications include history of skin malignancy, photo-aggravating condition and prior poor response to phototherapy. Please consider the risks in treating those with lighter skin, taking light-sensitizing medications, and/or taking immunosuppressive agents (such as azathioprine and cyclosporine) with markedly increased risk of UV-induced skin cancers.

We’ll ask for you to provide us with your notification and communication preferences—we’ll be sure to get in touch with you only when and how you prefer.

How will this affect my bottom line?

Great care that is more convenient for patients is excellent for your practice’s reputation in the community—and its bottom line.

What is the reimbursement for my care during home phototherapy?

Prescribing Clarify Home Light Therapy is similar to prescribing a medication. No Current Procedural Terminology (CPT) code would be indicated.

Will patients be reimbursed for the cost of the equipment?

Many insurers offer reimbursement for home phototherapy equipment, depending on diagnosis, medical history, and individual coverage policies. Since the Clarify System is new, no specific coverage policies have been established for our technology, and there is no history of acceptance or rejection of submitted claims.

We believe strongly in the clinical and economic benefits of our technology, and UVB treatment is universally accepted as effective in treating many chronic skin diseases. We will certainly make our case for coverage with public and private health care plans, but at this early stage we can’t predict whether or when the Clarify System will be covered. We will keep you posted on reimbursement progress through our website.

What role does the CarePartner play and how does this service help me?

Our goal is optimum service to your patients and to you, which will lead to optimum outcomes. The CarePartner support team educates patients about home phototherapy, fostering optimal and effective home treatment and monitors for adherence and early signs of non-response or worsening. You select how and when you want us to notify you of issues such as burns, missed treatments, worsening and poor satisfaction with treatment. We remind patients of follow-up appointments with you and need for skin cancer screening surveillance.

Device

Why were LED bulbs chosen over traditional mercury halogen bulbs?

LEDs are smaller and lighter than traditional bulbs, allowing for a compact, battery-operated device. Additionally, LEDs have performance improvements over traditional bulbs including elimination of warm-up times, output degradation and replacement parts. LEDs are also environmentally-friendly as they don’t contain mercury which is present in fluorescent bulbs.

How are you able to provide Narrow Band UVB output using LED bulbs?

Both our LED technology and mercury halogen bulbs produce light across the therapeutic spectrum of 300-320 nm. Mercury halogen bulbs produce a series of peaks with the largest at 311 nm whereas our LEDs produce a single peak around 310nm with a broader spectrum. Although there are slight differences in the spectrum, our devices have been calibrated using a NB-UVB scale, so that customary NB-UVB protocols can be used.

How does treatment with the Clarify System compare to in-office treatment?

The Clarify System is targeted phototherapy; only the affected areas are treated. The Clarify device delivers a high intensity dose, so treatment times may be shorter.

How long are treatment times?

Treatments may require from seconds to minutes to deliver depending on skin color, diagnosis and the stage of therapy. As treatment progresses, dosage is often increased to speed healing, which adds to overall treatment time. Those with relatively small, scattered areas of involvement or who want additional control for problem areas when taking combination therapies are ideally suited to Clarify Home Light Therapy.

Why is the device the size that it is?

The device size was designed based on patient input and studies reporting high prevalence of small, scattered lesions in patients with psoriasis and to support early treatment during onset for patients with vitiligo. When possible, most patients favor a targeted approach that spares unaffected skin.

Why does the device enable treatment of different body locations with different doses?

There is a large variability between the optimal dose for different body locations. Body locations that have thicker skin or are darker will tend to have optimal treatment at higher doses. The Clarify System allows the patient to optimize the treatment doses in targeted locations.

Mobile App

Why does the Clarify System require a smartphone?

The Clarify System uses the smartphone screen and features such as calendar, camera and secure app messaging to provide value to patients without additional cost for device hardware features.

What are the phone requirements to support the Clarify Medical App and device?

The most recent versions of Android (Version 6+) and iPhone iOS (Version 9+) are supported. Your phone requires 50 MB of available storage.

Why must my patient download the Clarify Medical App?

The Clarify mobile app is the connection between your prescription and the Clarify handheld. It assures that the dosage and frequency you prescribe governs the performance of the system. It also unlocks secure access to personalized phototherapy education, treatment, and CarePartner support services.

Can the Clarify handheld act independently of the mobile app?

No, the Clarify handheld is a part of a treatment management system that requires connection to the mobile app. The connected system provides dose control, schedule management and records that are important to successful treatment with the Clarify system. Smartphone and app locks provide additional safety barriers to unintended treatment.

How will my patient know how and when to adjust the dose?

Your prescription protocol is always available for your patient and CarePartner to view. We’ve taken the protocol and translated it into a user-friendly, smart, personalized treatment plan. We educate patients on the principles of phototherapy and ensure understanding about dose adjustment.

Why does the Clarify Medical app need to access my patient’s calendar?

Patients are able to select treatment days and times that works best for them and based on your prescription protocol. Schedule management includes phone reminders for light therapy, other medications you’ve prescribed, and follow-up visits with you.

Why does the Clarify Medical app need to access the patient’s camera?

Photos are the ideal way to record condition progress. Patients are prompted to regularly document skin lesions, so progress may be viewed easily over time.

How are outcomes measured?

Physicians and patients are the ultimate judges of outcomes both with clinical results and quality of life. Clarify provides a wealth of helpful information about treatment and response including photos of the skin throughout phototherapy and patient satisfaction reports.

Patient Consultation

Who is the ideal patient?

Those who have psoriasis, vitiligo, eczema or other chronic skin condition that respond to light therapy are potential candidates for our service. Those with relatively small, scattered areas of involvement or who want additional control for problem areas when taking combination therapies are ideally suited to Clarify Home Light Therapy.

Our handheld, targeted device is designed to deliver a precise dose to affected areas and minimize treatment of unaffected skin. The total surface area for each treatment is a square with each side measuring about 2 inches. Treatments may require from seconds to minutes to deliver depending on skin color, diagnosis and the stage of therapy.

Tanning and post-inflammatory hyperpigmentation are known treatment side effects, especially with more targeted treatment, and must be considered when weighing risks and benefits in patient and treatment location selection.
Patients must be able to reach treatment areas or have someone who can help. Familiarity with smartphones helps with the initial system set up, but is not necessary. CarePartners are here to help.

How Can I prescribe Clarify Home Light Therapy?

Simply complete the one-time physician enrollment form. It only takes a few minutes to complete. Immediately, you and staff members you designate will gain access to the Clarify Patient Management System. Here, you can prescribe, specify reporting preferences, monitor patient progress as needed, create new protocols and communicate securely with your Clarify CarePartner team.

How do I educate my patient on what to expect?

We recommend you direct your patient to the Support section of our website to learn more about Clarify Home Light Therapy system and determine if this may be the right fit.
Once a prescription has been submitted, we’ll notify the patient and walk them through each step of the way. They will receive a prescription number which enables purchase of the system. A unique Clarify password will be issued, unlocking the unique members-only features.

Your patients will not be alone during the home treatment program. A CarePartner will reach out and begin the education and training program, so treatment may begin a few days later when the device arrives. First treatments are completed with a CarePartner, who is available for general phototherapy and technical support.

Patients are connected to you via your prescription and the Clarify CarePartner helps to ensure safe and proficient home treatments, notifying you should concerns arise. The Clarify System further helps to facilitate treatment adherence with reminders.

Articles/Resources

Narrowband ultraviolet B (NBUVB) phototherapy in children with moderate to severe eczema: a comparative cohort study.

Darne S, Leech SN, Taylor AEM.
Br J Dermatol. 2014;170(1):150-6.

Atopic dermatitis can usually be controlled with appropriate skin care and topical steroids or topical calcineurin inhibitors. However, more severe disease can disrupt the life of a child and his or her family. All too often, parents receive repeated courses of systemic steroids, which can cause HPA axis suppression and growth retardation. Systemic immunosuppressives also have undesirable side effects. This study shows that NB-UVB is a useful alternative for childhood atopic dermatitis, with few side effects. Compared with alternatives, it is cost effective and well tolerated, and, most likely, underutilized.

Management of atopic dermatitis: safety and efficacy of phototherapy

Patrizi A, Raone B, Ravaiolo GM.
Clin Cosmet Investig Dermatol. 2015;8:511-520.

Atopic dermatitis (AD) is a common chronic inflammatory skin disease that can affect all age groups. Phototherapy represents a valid second-line intervention in those cases where non-pharmacological and topical measures have failed. This review illustrates the main trials comparing the efficacy and safety of the different forms of phototherapy. Clinicians mainly refer to the indications included in the American Academy of Dermatology psoriasis guidelines devised by Menter et al in 2010. The efficacy of phototherapy (considering all forms) in AD has been established in adults and children, as well as for acute (UVA1) and chronic (NB-UVB) cases. Phototherapy is generally considered to be safe and well tolerated, with a low but established percentage of short-term and long-term adverse effects, with the most common being photodamage, xerosis, erythema, actinic keratosis, sunburn, and tenderness. A carcinogenic risk related to UV radiation has not been excluded. Phototherapy also has some limitations related to costs, availability, and patient compliance. In conclusion, phototherapy is an optimal second-line treatment for AD. It can be used as monotherapy or in combination with systemic drugs, in particular corticosteroids.

Guidelines of care for the management of atopic dermatitis. Section 3. Management and treatment with phototherapy and systemic agents

Sidbury R, Davis DM, Cohen DE, et al.
J Am Acad Dermatol 2014;71:327-49.

Atopic dermatitis is a chronic, pruritic inflammatory dermatosis that affects up to 25% of children and 2% to 3% of adults. This guideline addresses important clinical questions that arise in atopic dermatitis management and care, providing recommendations based on the available evidence. In this third of 4 sections, treatment of atopic dermatitis with phototherapy and systemic immunomodulators, antimicrobials, and antihistamines is reviewed, including indications for use and the risk-benefit profile of each treatment option.

Twenty-year follow-up using a postal survey of childhood vitiligo treated with narrowband ultraviolet-B phototherapy.

Lommerts JE, Njoo MD, de Rie MA, et al.
Br J Dermatol. 2017 Jan 24.

Vitiligo is a depigmenting skin disorder with an estimated prevalence of 1%. Childhood-onset vitiligo occurs in approximately a third of all cases. Early-onset childhood vitiligo tends to be a more extensive and progressive type of vitiligo. Narrowband ultraviolet-B (NB-UVB) phototherapy is an effective treatment option in active vitiligo and leads to >75% repigmentation in 14-75% of childhood cases. Although the European guidelines on vitiligo state that prolonged maintenance with NB-UVB treatment is not recommended because there is a potential risk of photodamage, none of the patients in this study reported melanoma or non-melanoma skin cancer. This study suggests NB-UVB phototherapy may be a safe and effective treatment option in childhood vitiligo and may change the natural course of the disease. More long-term observational and controlled studies are needed to address these important issues.

Randomized, parallel group trial comparing home-based phototherapy with institution-based 308 excimer lamp for the treatment of focal vitiligo vulgaris.

Guan STT, Theng C, Chang A.
J Am Acad Dermatol. 2015;27(4):733-735.

While phototherapy is a treatment of choice for vitiligo, it is time consuming and generally carried out in a health institution. This study compared home-based phototherapy with institution-based excimer. The home based phototherapy group had better efficacy with 72% and 50% in the group achieving good and excellent repigmentation, respectively, in contrast to only 54% and 36% in the excimer group. Although, the difference in response was not statistically significant, the observed differences in efficacy could be explained by the difference in compliance. The patients using home-based phototherapy demonstrated 92% adherence compared to 70% adherence in the excimer group.

The Vitiligo Working Group recommendations for narrowband ultraviolet B light phototherapy treatment of vitiligo.

Mohammad TF, Al-Jamal M, Hamzavi IH, et al.
J Am Acad Dermatol. 2017;76(5):879-888.

Narrowband ultraviolet B light (NBUVB) is an important component of the standard of care in vitiligo treatment. However, there are no consistent guidelines regarding the dosing and administration of NBUVB in vitiligo. In this study, experts in vitiligo treatment make broad recommendations to assist dermatologists in the treatment of vitiligo with NBUVB phototherapy.

Combining biologic and phototherapy treatments for psoriasis: safety, efficacy, and patient acceptability.

Farahnik B, Patel V, Beroukhim K, et al.
Psoriasis Targets and Therapy. 2016;6:105-111.

The efficacy and safety of biologic and phototherapy in treating moderate-to-severe psoriasis is well known. However, some patients may not respond well to biologic agents or phototherapy on their own and may require combination therapy. Skillfully combining a biologic agent and phototherapy may provide an additive improvement without much increase in risks. This study summarizes the current state of evidence for the efficacy and safety of combining biologics with phototherapy in the treatment of moderate-to-severe plaque psoriasis. The vast majority of phototherapy was narrowband ultraviolet B (NBUVB) radiation. Most cases reported enhanced improvement with combination therapy. Serious adverse events throughout the study duration were reported in <3% of the patients. Long-term adverse events cannot be excluded.

Incidence of skin cancers in 3867 patients treated with narrow-band ultraviolet B phototherapy.

Hearn RM, Kerr AC, Rahim KF, et al.
Br J Dermatol. 2008;159:931-5.

Narrow-band ultraviolet B (NB-UVB) phototherapy is a widely used treatment. Psoralen-UVA photochemotherapy (PUVA) increases skin cancer risk and some animal studies have raised the possibility of an increased risk with NB-UVB. This study assessed the effect of NB-UVB exposure treatment numbers on the risk of developing skin cancer. No significant association between NB-UVB treatment and BCC, SCC or melanoma. These reassuring results do not demonstrate the early increase in skin cancers that was found associated with PUVA treatment. However, cautious interpretation is required as the cohort contained relatively few patients who had a high treatment number and because the slow evolution of skin cancers may result in a delayed incidence peak. Ongoing risk assessment is therefore essential.

Guidelines of care for the management of psoriasis and psoriatic arthritis. Section 5. Guidelines of care for the treatment of psoriasis with phototherapy and photochemotherapy.

Menter A, Korman NJ, Elmets CA, et al.
J Am Acad Dermatol. 2010;62:114-35.

Psoriasis is a common, chronic, inflammatory, multisystem disease with predominantly skin and joint manifestations affecting approximately 2% of the population. In this fifth of 6 sections of the guidelines of care for psoriasis, we discuss the use of ultraviolet (UV) light therapy for the treatment of patients with psoriasis. Treatment should be tailored to meet individual patients’ needs. We will discuss in detail the efficacy and safety as well as offer recommendations for the use of phototherapy, including narrowband and broadband UVB and photochemotherapy using psoralen plus UVA, alone and in combination with topical and systemic agents. We will also discuss the available data for the use of the excimer laser in the targeted treatment of psoriasis. Finally, where available, we will summarize the available data that compare the safety and efficacy of the different forms of UV light therapy.