Study Shows that Smart Phones Can Help Skin Docs Consult on Patients in the Hospital

One of the things I’m learning is how to best describe scientific research in simple terms. Below is piece I wrote about a new study from some of my Penn Derm mentors that was just published in JAMA Dermatology:

Doctors consulting using a smartphone “app” might be just as good as an in person visit from a doctor, according to a new study from the University of Pennsylvania. Many patients in the hospital end up with skin problems but most hospitals don’t have dermatologists to evaluate them.  A possible solution may lie in a an “app” that lets doctors look at pictures of the skin problems and tell hospital staff whether or not the patient merits an in person visit.

 The study, published Wednesday in JAMA Dermatology, took 50 patients from the Hospital of the University of Pennsylvania who needed to be seen by a dermatologist. Researchers took a picture of the skin problem using a smartphone and sent it virtually to dermatologists (“teledermatologists”) who provided an opinion. Another dermatologist saw each of the patients in person and recorded his decision: did the patient really need to be seen that day, the next day, sometime during their hospital stay or could it wait for an outpatient visit? He also wrote down whether the patient needed to have a biopsy (skin sample).

When the in person dermatologists decided a patient be seen the same day, the teledermatologists agreed in 90 percent of cases. And they agreed in 95 percent of cases where the in-person dermatologist had recommended a biopsy. The doctors completely agreed on a diagnosis 82 percent of the time, and partially agreed in 88 percent of cases, which is the standard variation expected between doctors.

This is encouraging news in a time when many areas of the United States have very little access to dermatologists. “In addition to addressing physician shortages from a clinical standpoint, teledermatology programs are very important for vulnerable citizens in the United States and abroad,” said Dr. William James, author in the study and past president of the American Academy of Dermatology. “It is wonderful that the impact of these teledermatology consultations continues to expand.”

Tropical Medicine and Twitter

ImageI was invited to travel to DC to attend the American Society of Tropical Medicine and Hygeine’s annual conference in Washington DC. I was delighted because my clinical interest is skin disease and global health/tropical medicine. So I left sunny Palo Alto and flew across the country to re-immerse myself in some good old fashioned medical learnin’.

The conference so far has been incredibly exciting. I gleefully texted friends that I was psyched to see several sessions solely dedicated to helminths (parasitic worms). Only I would be that big of a nerd but, hey, as Popeye would say “I yam what I yam.”

To be honest, this conference is very technical in many ways: lots of really cool basic science and research about malaria, dengue fever and other global health issues. I understand bits and pieces from the clinical side but a lot of the science goes straight over my head. It was admittedly fun listening to clinical content- I didn’t realize that I would long for the days of hearing “thrombocytopenia” casually dropped in a conversation.

What has been new and excited for me is approaching this from the angle of a reporter. I walked into the press room with a bit of trepidation. But, to my shock, I am a reporter now and people do take me seriously- partially because of the title of my fellowship. I loved reading the press releases and seeing what the conference organizers felt would be newsworthy: everything from a study comparing dengue fever in two parts of the country to new vaccines for malaria.

The other fun thing has been engaging in social media. I am fairly new to twitter but am really starting to appreciate how it keeps me connected to people in journalism and health care who curate and amass content that keeps me interested and on top of the news.

During MedicineX (a medicine and technology conference I reported from in September) it seemed like everyone was on twitter. (Here’s a clip from a video interview I did about this subject:

Here the “twitterverse” has been markedly more limited. Less than 10 people seem to be regularly tweeting about the conference. For those who don’t know- it’s possible to have a conversation on twitter by including a hashtag (denoted by the # sign) in your tweet. Then, when you click on the hashtag- you see everyone who is talking about that subject. In this case the hashtag was #TropMed2013 so a sample tweet might be “Now we can protect kids from Japanese Encephalitis. This year a JE vaccine safe for children was rolled out #TropMed2013”

I ended up meeting a bunch of like minded people during these conversations and we got to meet in person and talk about global health and science and reporting.

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The other highlight was a panel entitled “Global Health and the Media: From Shoe-Leather Reporting to Television to Twitter” that was moderated by the amazing Dr. Michele Barry– one of the heads of my fellowship and an amazing mentor. On the panel were Donald McNeil (NYT global health reporter), Michaeleen Doucleff (NPR global health producer/reporter), Emily Judum (from Global Post) and Penny Duckham (from Kaiser Family Foundation).

The whole panel was fantastic. I won’t rehash everything but there were a few key highlights:  McNeil started off talking about his experience reporting on polio in Pakistan and how he did a story regarding how vaccinators were being killed. His experience reflected deep, old fashioned  investigative reporting and it was riveting. Ducleff spoke mostly about social media and she was incredibly optimistic (not something you get a lot of in the journalism world): “it’s easier than ever for scientists to be published” she told the crowd. Clearly there are no excuses why scientists (including doctors) shouldn’t be communicating their work to the public.

The night ended with a real treat for me: dinner with the whole panel. I got to hear about McNeil’s experience with the CIA, the work that the Kaiser Foundation is doing with the ACA, what it’s like to work at NPR. We talked about pay structure for journalism and what journalists owe their sources in terms of anonymity. I was honored and happy to be included in the conversation.

Not only that- but tomorrow there is a panel on tropical dermatology. Pretty sure they designed this conference just for me. In the meantime, text me if you want live updates on parasitic worms!