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Smart Diagnosis Now Possible with Smartphones

TeledermThanks to a new smartphone app to diagnose skin conditions, Penn dermatologists are providing special care in Jonathan Lax Center, Sayre Health Center, and the nine city health centers operated by Philadelphia’s Department of Public Health. Not only are they treating patients who may not otherwise receive this care, but each case is an educational opportunity for dermatology residents. 

How Does It Work?

When patients enter the health clinic, their primary care provider photographs the skin condition and sends that, along with relevant clinical information, to a team of resident and attending dermatologists at Penn Medicine. After a resident evaluates the case, the diagnosis and treatment recommendations are reviewed by an attending and sent to the primary care provider. Residents can also view the attending’s response and receive immediate feedback on their recommendations. Because the technology uses cloud servers, everything is synced automatically and nothing is saved on the user’s phone.

Now a Penn Medicine CAREs grant helps ensure those using the app are using it most effectively, supporting hour-long training sessions for providers at each clinic, during which Caroline Nelson, a fourth-year Perelman School of Medicine student, demonstrates how to use the program’s software. She also explains the proper way to consent patients for an active research study evaluating teledermatology’s impact on patient care and access to Philadelphia dermatologists. Penn Medicine dermatologists see all patients who exhibit more complex cases and require an on-site visit.

The grant also provides digital cameras (for the web-based version) for clinics that do not have cell phones available. 

How Did it Begin?

Carrie Kovarik, MD, of Dermatology and Dermatopathology, began her journey with this technology in 2007, partnering with a dermatologist from Austria to create africa.telederm.org. The website is still a valuable resource, enhancing access to dermatology services in African countries that have few dermatologists available.

That program started the loop of sending clinical information and photos via phone to clinicians and receiving the answer back through the phone, without a physical Internet connection. “Now you can send encrypted messages through your phone and securely transmit data,” Kovarik said. After success in other countries, the group brought the technology to the United States.

Last year, a company contracted by the American Academy of Dermatology developed a HIPAA-compliant and secure iPhone, iPad, and Internet system for use on personal phones. The company is also rolling out an Android version. This platform, implemented in Philadelphia health centers in December 2012, is enjoying growing popularity.

“This program allows patients without access to specialty care to receive consultations in an effective manner,” said Kovarik. “Primary physicians are able to quickly and easily send consults using their personal phones, and most patients are able to be managed with their primary care team. This technology has the potential to revolutionize the way we provide care.”

Photo caption: (L. to r) Carrie Kovarik, MD; William James, MD, vice chair of Dermatology; and Caroline Nelson show the evolution of tools used in Telederm’s success.

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