Pain points — they’re not bad places to start when trying to figure out what’s wrong.
For Joshua Landy, an intensive care physician in Canada, the pain point wasn’t so much a physical thing, but rather the inability to effectively communicate with colleagues and specialists about cases.
During a stint as a visiting scholar at Stanford University, he started researching the workflow habits of young doctors and the way they communicate and reach out to others for medical education.
No surprise, they use smartphones. Trends in personal communication often bleed into the professional world.
Though, there are a few problems with that. Frequently swapping photos digitally means that the photos aren’t preserved in any way, like in a teaching file, and they’re not handled with as much concern for privacy as they should be.
This was, in part, the basis for the creation of Figure 1, an app for iPhone and Android, aimed at medical professionals. The shorthand is “Instagram for doctors,” but it’s a bit more complicated than that.
“The overall theory here is we’re seeing these social type behaviors start to replace less efficient communications practices in professional lives because they way we’re used to communicating outside of our professional lives is very efficient,” Landy said.
With Figure 1, users can upload pictures of interesting cases — this could be anything from a traumatic hand amputation to a classic case of chickenpox — to the app. Other users can see the pictures in a feed and comment.
For SUNY Downstate radiologist Andrew Kesselman, Figure 1 combines two important elements: educational and social. He’s been using the app for about a year and has posted almost 100 pictures.
“Normally, I’d only be able to share with a couple of my colleagues or people at work. But with Figure 1 I’m able to share with people in different specialties, different fields, and all over the world,” he said.
Often times, Kesselman uses Figure 1 as a jumping off point and does more research on the instances he see on there. Not long ago, he had been on the app and was looking at a case that involved a facial deformity associated with a hereditary disease. The next day, a patient came in displaying the deformity.
“I was able to recognize it immediately because I’d just seen the case the other day,” he said. In a way, Figure 1 takes teaching files out of the credenza, and makes them available to those who want to learn.
The other concern Figure 1 works to address is privacy.
In the medical community, privacy is a huge issue. HIPAA compliance means, amongst other things, that there are things doctors can and cannot discuss about patients.
One of the first steps Landy and his co-founders took when creating the app was to talk to a healthcare privacy lawyer. They drafted a consent form for patients that’s now built into an app. According to Landy, working out the privacy protections actually took longer than building Figure 1.
The other safeguard they put into place is a tool set that lets medical professionals delete or mask any identifying information in the picture. The app uses a face detection algorithm and removes the pixels that make up the person’s face.
“We don’t use any image modification like blurring or pixelation because with some tools, those image modifications can be reversed,” Landy said. “This needs to be irreversible. It’s essentially putting a hole in the photo.”
Otherwise, users can draw over details like birthdays, tattoos, names, or any other of the 18 identifiers HIPAA indicates. Figure 1’s team manually reviews posts and approves them. This way, that hand from the traumatic amputation stays anonymous.
Both Landy and Kesselman said that once the patients understand how the app works, they generally don’t have a problem with a doctor posting to Figure 1.
“I find that people find relief in the idea that if they can help somebody else learn about the condition that they have, they’ll make somebody else’s life better who perhaps doesn’t have to suffer they way they have,” Landy said.
He also said he hopes the app brings some relief to medical professionals who might otherwise be limited in sharing their findings and problems with their immediate colleagues, and only during certain times.
“I think any healthcare professional is familiar with the feeling of feeling alone, and seeing something very challenging — it’s four in the morning,” Landy said. “You wish you had more people to share things with because you need answers or because the case is so astonishing that you would like others to learn from it.”
Figure 1 currently has more than 150,000 users, and 20% of medical students in the US now use it.
“Providing tools that mirror the social behaviors in a professional atmosphere or in a professional context, those are tools that are likely to succeed, in the next generation of professional communication,” Landy said.