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.”

Donate Your Caller Tune for Public Health

ImageAs many of you know, I love telemedicine and have done some research in this area. I am always interested, therefore, in novel applications of telemedicine- especially to public health.

ImageSo I was excited when I learned that I would be attending the launch of the “Donate your caller tune” initiative. This program, created by the WHO Indian country office, allows users to transform their caller tune into a public health message of their choosing. Caller tunes are less popular in the US but they are essentially “ringbacks”- a song (typically a Bollywood song here in India) that someone hears instead of a ringtone when they are calling you. Participants in this program sign up through the internet or by scanning a QR code (made out of a celebrity’s face) with their smart phone. They choose a cause (cervical cancer, diabetes, fitness, high blood pressure, breast cancer etc) and anyone who calls them will hear a message from a celeb related to that cause. For example, the caller tune for obesity is recorded by John Abraham, a popular Bollywood actor/model: 

“Hi this is John Abraham and I think that obesity can be beat. Say no to smoking, drinking, junk food. Say yes to walking, running, dancing. And remember, this won’t happen overnight- so be patient, don’t give up. For more information visit donateyourcallertune.in”

Nata Menabde, WHO’s ambassador to India explained the rationale behind the initiative: 

Image“The idea is to reach out with creative messages for adopting healthy lifestyles. India has one of the largest mobile users in this world and on an average, a person receives around 15 calls a day, making the space of caller tune an untapped area for promoting health causes.”

Always a cynic, I wondered if simply listening to a pre-recorded celebrity message could effect change in thorny public health issues such as obesity or smoking cessation. But the more I thought about it, the more I liked it. As far as I am concerned, this program could serve several functions beyond just broadcasting of the messages:

The use of popular Indian celebrities, mobile phones and current technology such as QR codes gives this public health initiative a youthful, slick feel and reinforces the idea that these issues are relevant.

ImageMost importantly, it creates stakeholders. A young person who changes their caller tune will not hear it themselves, but the very act of doing something related to public health is important. To feeling like an agent of change as opposed to a passive recipient of public health messages. Hopefully it keeps them active in promoting and normalizing these messages and becoming stewards of the health of themselves and their peers.