Mobile Applications

Figure 1: Medical Photo App For Doctors By Doctor

Fewer than 5% of UK physicians find it helpful when patients come with suggestions for what treatment they need. But doctors are finding technology useful for their own needs. Ayesha Salim speaks with Dr Joshua Landy, a Canadian intensive care doctor, about his app which enables healthcare professionals to share photos of symptoms.

“One of the goals that is hardest to meet in medicine is to educate your patient. What you want is for their information and their behaviours to be directed towards conclusions that you help them draw as opposed to ones that they have drawn themselves,” Dr Joshua Landy, a Canadian intensive care doctor tells me over the phone from his practice in Canada.

I am speaking with Landy about the surge in patients ‘googling’ their own symptoms and bringing this information to their doctors. A survey of 330 UK physicians revealed that they find patient self-diagnosis challenging – something Landy experiences himself in Canada: “Once people lock their mind on something it can be hard to dissuade them from a diagnosis that they have reached on their own.”

Landy tells me that his training in medical school consisted of basing diagnostic thinking on Bayesian analysis. This statistical model is an old maths equation founded in a hypothesis that is updated or modified every single time a new piece of information arises. It has been used as the basis for tech innovations today, and even used to help locate the Air France plane in 2011. But I am really surprised to hear that it is used in the medical field.

“You use certain factors to increase or decrease the likelihood of diagnoses. Using a thinking model like that is something you train in and spend 10 years learning,” Landy says.

But according to Landy, patients are not exposed to this type of thinking. This means patients’ conclusions about their own ailments are often flawed. Although Landy himself works in the intensive care unit so his patients are not in any state to be looking things up, he has had several people coming in and claiming to have Ebola.

“These are people who have had no contact, no travel, and no association with any potentially contagious material whatsoever. So they leave and go to a different hospital because they think that their life is at risk and nothing you can say will convince them otherwise. This is despite there not being a chance that they could possibly have it,” Landy tells me.

Patients approaching doctors with their own findings may be problematic, but doctors are embracing technology for their own needs - particularly to share information with colleagues: “One of the things I have experienced many times when I am encountering a patient, is that I often need to get opinions from other specialists and quickly.”

So Landy found himself communicating with his colleagues by taking pictures using his mobile and showing the images to specialists. But he wasn’t the only one: “I talked a bit about this to some of my colleagues and they said were doing the same thing. Later I was able to substantiate this hypothesis; that this is how people [doctors] are communicating.”

Landy decided to look into this deeper by doing some research and found the use of smart-phone based images to communicate about cases was increasingly popular amongst young physicians. It was a great and useful way of sharing information but it had one very important flaw.   

“It occurred to me that these images are being lost to the bottom of the inbox. No one is preserving them or archiving them. Beyond that [a] more substantial a problem is that these images after being transferred by SMS, MMS or email and are not necessarily being treated cautiously when it comes to patient privacy,” Landy says.

This is how his app, Figure 1 came about. Landy wanted to come up with a system that would protect a patient’s privacy but also give the medical community an opportunity to save all these images for comparison, education, and reference: “Our overarching goal is to effectively democratise the knowledge of healthcare. So to me this provides a platform where the knowledge of healthcare and the experience of healthcare professionals resides and where it can be accessed freely by anybody who practices.”

Figure 1 is an iOS and Android app that, once downloaded, can be used by a healthcare professional. They sign-up by indicating what profession they are, then they can surf images and discussions or even search for particular cases. But Landy is hesitant to call it a diagnostic tool: “Occasionally somebody will make a suggestion that could lead to an eventual diagnosis. But that is almost incidental – it is nice to see these emerging behaviours.”

Images that are uploaded on the app get automatically scanned by a face-detection algorithm to detect and block any faces that are in the image. The user still has to manually block identifying features themselves but before they are seen, they also go through a privacy moderation committee to check for any potential privacy violations. Consent forms are customised for the jurisdiction that the patient is in.

Landy tells me that the privacy aspect is built into Figure 1 and not simply layered on top:  “It was such an important part of our identity. And that setup took us a long time. We put a lot of time and research into having the top healthcare lawyers in each country researching privacy regulations and what the necessary requirements were.”

Landy is keen to stress that there are guidelines on which images are deemed acceptable.

“We have a pretty narrow spectrum of what we consider to be acceptable. It has to be interesting to other medical professionals, cannot be sensationalistic, and has to be non-judgemental. The goal is to produce a community of people that would learn about healthcare in medicine. So anything that is not in that spirit is not accepted,” Landy says.

Since its launch in 2013, Figure 1 has had more than 150,000 users. On a busy day, the server can deliver up to a million images to users. So far the app is available in Canada, US, UK, Ireland, Australia and New Zealand. There are plans to expand to the rest of Western Europe by the end of the year.

Figure 1 is gaining steam in other countries too: “We’ve had a lot of interest from Brazil, China and India. Those are the markets where mobile culture has a really heavy opportunity to flourish and make an impact in healthcare.”


Ayesha Salim is E-Content Writer at IDG Connect


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Ayesha Salim

Ayesha Salim is Staff Writer at IDG Connect

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