The next time you head into the doctor’s office with a weird “I have no idea what this could possibly be” health issue, get ready—your M.D. could very well whip out her cell phone, take a photo, and upload it for the world to see.
A new smartphone health app called Figure 1 allows doctors, nurses, and other health professionals to snap, upload, and share photos with others. Basically, it’s set up like an Instagram for M.D.s. Users can browse images based on body part (eye, nose, stomach, upper limb, back, etc.), mark photos to review later, and comment on them.
The photos, which are as gnarly as you might imagine, are sure to churn most people’s stomachs. But for health care professionals, especially those who are new to their field or in an area with limited support, they could be vital to helping them make accurate diagnoses and treatment decisions.
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“Medicine is a profession in which we are all constantly learning, says Sachin H. Jain, M.D., chief medical officer of CareMore Health System. “One way we learn is by consulting other physicians and medical professionals. Tools like Figure 1 that help facilitate conversations with other clinicians about clinical care will help us take better care of patients and augment our learning and understanding of medical conditions and their treatments.”
But is sharing patients’ images (there’s even an entire image feed for reproductive organs), even if it’s for the patient’s good, above board? Federal Health Insurance Portability and Accountability Act (HIPAA) privacy regulations, which are intended to prohibit doctors from sharing personal information about their patients, don’t extend to photos in which the patients are not identifiable. For that reason, Figure 1’s website states that users must remove any identifying details related to the patient (like faces or tattoos) prior to uploading. The app even contains an automatic face-blocking tool and manual block tool for any other features a doctor needs to hide from view. And before an image goes live on the app, moderators check to make sure the patient is in no way identifiable.
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But is that enough? “While the photos themselves may fall outside of the HIPAA privacy regulations, the subsequent discussion between physicians about the particulars of a patient’s malady may inadvertently disclose personal health information,” says N. Hausfeld, M.D., a fellow of the American College of Surgeons and founder of The Society of Physician Entrepreneurs. “I would therefore make it mandatory to receive the patient’s permission to disclose their photographs and other pertinent information about their history on a platform like this.”
Figure 1 does contain an in-app consent form for those users who want to get their patients’ consent as well as those that have to due to jurisdiction or medical facility requirements. “Patient privacy must always remain at the forefront of our considerations and it will be up to apps like Figure 1 to build in appropriate safeguards to ensure that patient privacy is always protected—and it will be up to healthcare professionals to continually exercise common sense when using these tools,” says Jain.
The one safeguard it doesn’t have, though, is a way to verify that everyone commenting on photos and giving diagnoses are actually doctors. And even if the commenter is a physician, users need to know that he or she has the appropriate background and expertise to offer up opinions, says Hausfeld.
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Currently, anyone can join the app, look at images, and even comment on them. (Seriously, you’ve got to take a look!) However, only medical staff can become “verified.” Just like Twitter’s blue tick verifies a user is legit, the app puts a check mark by users’ names if Figure 1 staff members have verified that the users are, in fact, who they say they are. They do this by contacting the user’s medical facility or searching authoritative databases. Fellow users have no information about the health care professional apart from their username and specialty.
It’s an iffy area, and getting a second, third, or thousandth opinion—especially online—has both serious pros and cons. In the end, it’s up to the doctor and patient to figure out what’s best for them...right?
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