Have you ever wondered what that strange rash “down there” was? How about that unsightly bump? We hope not, but these symptoms are unfortunately more common that one would expect. More than 19 million new cases of sexually transmitted diseases (STDs) are reported each year. If you’re worried that you may be one of these millions, a new app released this week on the Apple App Store may be able to help. Released by app maker iDoc24, STD Triage is described as
a [free] iOS app and website that provides discreet assessments of externally visible sexually transmitted disease (STDs) by a licensed dermatologist within 24 hours via photos submitted by the user. Personal identification information such as name or email is not collected and the user is therefore anonymous to the dermatologist. Payment [$9.99/photo] is only required if the user chooses to review the doctor’s assessment. The app also has geo-location capabilities used to display a map showing the nearest STD clinics and pharmacies based on the user’s location.
We caught up with the founder of iDoc24, Dr. Alexander Börve, to learn more about his new app that was released in time for April, which is STD Awareness Month. Unfortunately – scratch that, fortunately – we did not feel the need to do an app review.
Shiv Gaglani, Medgadget: There seem to be a lot of dermatology apps out there. Why did you decide to focus on STD-related skin issues?
Dr. Alexander Börve: I have been building iDoc24, a service that allows anyone to anonymously send in images of any skin problem directly to a dermatologist and get a response within 24 hours. Approximately 30 percent of the cases coming into iDoc24 were of the “intimate embarrassing” variety so we decided to create a niche-branded app focusing on STD/STIs. Approximately 19 million people discover they have an STD/STI every year, so this is a very big market.
Medgadget: What mechanisms will you put in place to avoid abuse of the system?
Börve: We currently offer users to upload their case for free and have the dermatologist review it before paying anything. Although this is a significant risk to us that the user won’t pay to reveal the answer, we believe it is important to establish trust with our users. Abuse can either come from the company abusing it’s users, which we try to prevent by allowing users to only pay when their case is answered, or it can come from users abusing the time of the dermatologists.
The current plan to prevent abuse of our dermatologist’s time is to have a trained medical professional, such as a nurse, “screen” the incoming cases and filter out the ones in which images are of poor quality, the descriptive text is not complete, or if it is not a serious case. Only legitimate cases will be passed onto dermatologists for assessment. We need to maximize the dermatologist’s time as it is the limited resource in this whole equation.
Medgadget: How will privacy of the patient(s) be ensured?
Börve: We do not store any personal or private information such as name, email, health records, etc. The user is anonymous as no personal identification information is given. We do give the user an option to input their email so they will be notified when their case has been answered, but this email is deleted as soon as an answer is ready and notification has been provided. So we don’t store any information, other than the images and descriptive text from the case. Important that the user saves his or her case number received from us, when sent in query.
Medgadget: Have you considered automated image analysis? Why or why not?
Börve: This has been a hotly debated topic in the field of telemedicine and especially in teledermatology, specifically when it comes to skin cancer diagnosis using algorithms. We fundamentally believe that doctors will not be replaced by algorithms, at least not in the short term. A recent study out of the University of Pittsburgh compared the accuracy of skin cancer apps and showed that the ones using algorithms were highly inaccurate, yet the app that sent images directly to a dermatologist was highly accurate.
According to recent coverage, “the best-performing of the computer-driven apps missed 30 percent of the melanoma cases, while the worst-performing missed 93 percent. The app that used actual physicians to diagnose the melanomas worked well, correctly identifying more than 98 percent of the submitted images.” This coverage was great news for us because it validated our hypothesis that algorithms do not beat doctors.
For more information about iDoc24, check out the video below and associated links:
Apple App Store link: Sexually Transmitted Diseases (STD) Triage
Website for iDoc24