A health care app to keep doctor’s trip at bay

If you have young children, you’ve most likely endured caring for an ear infection or two. Or, children aside, perhaps you’ve experienced a mysterious rash. Those situations generally mean a trip to the doctor’s office and time away from your job, if you work outside the home.

But what if you could snap a photo of your rash, or your child’s ear canal, and send it to your doctor for analysis? That’s the idea behind a new breed of apps and devices that increasingly put medical tools in the hands of consumers.

CellScope Oto, for instance, combines an app with an attachment that lets you turn your iPhone into an otoscope — the tool physicians often use to examine the inside of your ear. Various apps and online services now let you communicate with your dermatologist by snapping a photo of a rash or mole and transmitting it electronically. And with an app-and-attachment combination called AliveCor, you can turn your smartphone into a heart monitor, record an electrocardiogram and send it to your doctor.

The trend of do-it-yourself examinations and tests is part of a shift in health care toward consumer participation that began with online health information sites and is accelerating with advances in mobile technology. Consumers are increasingly comfortable using walk-in medical clinics for minor ailments, and they see at-home digital tools as yet another level of convenience, said Ceci Connolly, managing director of the Health Research Institute, an arm of the consulting firm PricewaterhouseCoopers.

“We know from our research that consumers are very interested in these conveniences, as opposed to going to sit in a doctor’s office,” she said.

Erik Douglas, co-founder and chief executive of CellScope, said ear infections were a top reason for visits to pediatricians, so the Oto device might help eliminate unnecessary trips.

Robert L. Quillin, a paediatrician in Webster, Texas, has used CellScope’s Oto for several months during the device’s testing period. Shaped like a traditional otoscope, it fits over the phone’s camera, has a plastic tip that is inserted in the patient’s ear, and uses the phone’s camera to take photos or video of the ear canal and eardrum. Quillin can show the image on the phone directly to the patient — or to medical students — to educate them about ear infections and help them understand his diagnosis. Ultimately, he said, a physician or nurse practitioner must interpret the image, make a diagnosis and prescribe any necessary treatment. “It’s a great tool for teaching parents and young doctors,” he said.

Joseph C. Kvedar, founder of the Centre for Connected Health, part of the Partners HealthCare system in Boston, said that in these relatively early stages of mobile health tools, doctors might be most comfortable using them to expedite follow-up care, or to treat conditions with a relatively low level of risk. For instance, a patient who is doing well under a treatment plan for acne may be able to send photos and answer a few questions for the dermatologist to feel comfortable advising the patient to continue a treatment plan without an in-person examination. “For something like acne,” he said, “probably the time has come.”

Right now, he said, these new digital tools help expedite evaluation and diagnosis by a doctor. But in the long term, he said, they may become more disruptive and controversial as they begin to use algorithms and large databases to diagnose conditions and recommend treatment, without a doctor being directly involved.

It can take a little practice to learn to use the tools properly. And patients should understand that while becoming more involved in their health care is a good thing, they are in effect shouldering more responsibility by using do-it-yourself tools, Kvedar said. Sending an image of one mole to your doctor electronically, for instance, means the physician isn’t examining the rest of your body for other, potentially more serious, moles. “You, as the patient, own more of the execution,” he said.