Selfie telemedicine (2021 List)

Hey, doc, about this rash…

A medical revolution

This year, the doctor-patient relationship changed almost entirely. At the height of the COVID-19 pandemic, over 50% of medical appointments were conducted via telemedicine. Before that, it was just 1%.

Telemedicine – in which you have a live visit with your doctor via the Internet – has a lot of advantages, first among them convenience.

But the drawbacks include unequal access to healthcare among those without Internet access, untreated illnesses for those with conditions not conducive to telehealth, and clinician fatigue.

Selfie telemedicine

Interacting with our physicians via our smartphones and other devices has opened a whole new can of worms as well.

Patient selfies (no, not the kind where you’re flashing the peace sign) allow physicians to collect more data and even allow for conditions (such as skin flushing) that don’t constantly occur to be recorded.

Selfie telehealth has been in use for a few years with apps that diagnose skin conditions. Patients can often pay to have a rash or mole or other blemish diagnosed from afar, even by a physician they have no prior relationship with. Other times, an AI algorithm sorts through similar photos to suggest diagnoses.

But there are dozens of issues to consider (as is often the case when it comes to medicine).

The problems

Are our phone cameras good enough to produce useful photos?

How do we keep those photos private and who is in charge of making sure they’re secure? Currently, there are no real rules dictating how a texted photo should be treated.

Should selfie telemedicine be relegated to dermatology and wound assessment? Or do we need to perfect the system so it can be broadened?

Can doctors trust patients to share photos of themselves? Or, could patients theoretically use someone else’s photo in order to procure medication?

If separate apps are used outside of the primary doctor-patient relationship, who keeps track of long-term issues and medications?

Will insurance companies start to demand the use of this relatively cheap and easy way of diagnosing certain conditions to save resources?

Is a simple selfie diagnosis really quality medical care?

Further reading:

Kaiser Permanente, “How to Take and Send Photos to Your Doctor”

Lisa S. Rotenstein and Lawrence S. Friedman “The Pitfalls of Telehealth — and How to Avoid Them” (Harvard Business Review, 2020)

Geoffrey A. Fowler and Laurie McGinley, “The Webcam Will See You Now: Doctors Urge Patients To Replace In-Person Visits With Apps” (Washington Post, 2020)

Amanda Holpuch, “Sexting For Your Health: Patients Send Genitalia Photos, Raising Legal Concerns” (The Guardian, 2016)

(Paywalled) Maurice Mars, Christopher Morris, and Richard E Scott, “Selfie Telemedicine – What Are the Legal and Regulatory Issues?” (Studies in Health Technology and Informatics, 2018)