Medical diagnosis based on a cell phone picture

Cell phone and digital camera pictures are being tested as diagnostic tools. Some physicians see using them not only as a means to save costs and time but also as a way to improve existing diagnostic and management practices, such as those used by 24-hour nursing call services. Advocates of employing these technologies in medical practice, however, say many issues must be addressed before cell phone pictures become a standard tool, including those related to security, privacy, liability, ethics, technical quality of the images, and parameters for what types of conditions are appropriate for this approach.

Meanwhile, Neal Sikka, MD, is conducting a research project in the emergency department of George Washington University Hospital in Washington, DC, to explore the possibility of using cell phone pictures in triage to diagnose and treat minor problems such as wounds and skin ailments. Patients presenting at the emergency department who do not have life-threatening or urgent conditions are asked to volunteer for the study. Participating patients with minor cuts or wounds or those who are seeking follow-up care for a skin rash send a completed questionnaire and cell phone photo to a designated physician, who uses that information to make a diagnosis or treatment determination. The same physician then examines the patient in person and compares his or her diagnosis with the diagnosis made on the basis of the photo. To date, a large proportion of the diagnoses based on photos have matched the in-person diagnoses, according to Sikka.

One drawback to the immediate use of cell phone images for medical consults is the lack of supporting infrastructure for this application. For example, use of cell phone images for triage would require a dedicated Web site to which images could be sent. In addition, because most health plans do not cover online consultations, a payment structure would have to be devised. Finally, parameters must be established to define which cases would be appropriate for this type of diagnostic process and also for image quality.