Digitized Medicine

by Anjana Murali

Snap and send! Follow these two steps and you don’t even have to go to a physician for your next medical appointment. 

UPMC recently launched an eDermatology platform, which allows patients to answer questionnaires about their symptoms and upload pictures of skin conditions such as rashes, moles, acne and bug bites in order to get a quick diagnosis and treatment plan. Patients are guaranteed a response from dermatologists within three business days. 

According to Dr. Sandra Mitchell, Chair of the University of Pittsburgh’s Department of History and Philosophy of Science, technology gives us tools for communicating and sharing information at a much faster speed. “Because of the immediacy and the breadth of context space, now you can reap more benefits from [receiving diagnoses electronically], and it doesn’t cost very much,” Mitchell said.  

A similar electronic medical tool, called Figure 1, is already widely available and has been dubbed the new Instagram for healthcare students and professionals. Medical personnel are now able to upload pictures of unusual or interesting cases in order to ask questions and get advice about proper diagnoses and care. 

For Mitchell, the idea of crowdsourcing diagnoses is an interesting concept. “The technology itself gives us the opportunity to take advantage of the expertise that’s shared across a larger population to benefit patients who only go to see that one doctor or that one clinical group,” Mitchell said. “The more physicians that look at [a case], the more likely you are to find somebody who has seen it before.” 

Darvé Robinson, a second year medical student at the University of Pittsburgh School of Medicine, already sees Figure 1 as an effective learning tool. “I was fairly impressed with the sheer quantity of pathology slides and diagrams available demonstrating disease,” Robinson said. “I believe that this could provide additional examples of presenting signs and tissue abnormalities for studying diseases.” 

Robinson believes medicine is part art and part science. “The art of medicine is tied closed to pattern recognition, identifying unique disease pathologies, and responding in a quick and effective manner to treat,” Robinson said. “I believe Figure 1 seeks to provide critical examples to training physicians to solidify the base for our pattern recognition knowledge.” 

While technological tools such as eDermatology and Figure 1 offer faster, digitized medical services, there is always the question of what consequences the technologies will have on the care and privacy of the patient. 

One of the main concerns with digitizing medicine is that the physician-patient relationship will deteriorate. Dr. Abraham Verghese, a renowned physician and writer, sheds light on the duality of technology in the hospital setting in his TED Talk “A Doctor’s Touch.” He believes that with technology, the patient in the bed is replaced by their own medical charts in the computer and becomes what he refers to as the i-patient. Verghese said that the i-patient is the one who gets the best care while the real patient is often left wondering where everyone is and when everything will be explained. 

With medical tools such as eDermatology, there isn’t even a patient in the bed anymore. Patients have become i-patients. Mitchell believes that having a “personal touch” in medicine is more important than a static picture when it comes to obtaining a patient’s history in-person. After all, only a medical history can supply the information that could discriminate against alternative diagnoses. 

However, Mitchell argues that with technology, you gain this incredible speed of response. “If I have to wait four months and what I have is a fast growing cancer, that’s going to be a really high cost to pay to have the personal touch,” Mitchell said. Under those conditions, she believes that an initial, electronic diagnosis would be worth the sacrifice of the “personal touch.” 

Another major concern with technological advances in medicine is patient privacy. With more people having access to patient cases, there is an increased probability that somebody might hack the system. This could bring potential harm in terms of identity theft. It could also result in discrimination against people for hiring, retention or insurance purposes, according to Mitchell. 

The second privacy issue that must be addressed deals with what parts of a patient’s body can be made available to the public. This is especially important as people have differing views on how they value their own self-image. “Given that, one would hope there would be ways of respecting those differences through consent,” Mitchell said. 

According to Mitchell, any technology can be abused, but many technologies can really do a lot of good. “The fact that they could be abused shouldn’t be something that makes us not be able to get that good,” Mitchell said. 

Robinson believes that there has always been a medium similar to eDermatology in the medical profession. However, to him, digitized medicine is the way of the future.  

“This might be the next iteration in the continuum,” Robinson said.