Mobile phone app: Dermatologist diagnosed using a mobile phone

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Can cell phone app save a visit to the dermatologist?

Patients usually have to put up with long waiting times to get an appointment with a dermatologist. A new cell phone app should remedy the situation in the future. A photo of the skin problems taken with the cell phone is then forwarded to a dermatologist via the app. The expert will also give a recommendation for action via the app after two days at the latest. However, the offer is controversial among medical professionals. Many consider the cell phone app to be a thing of the past, because patients have to pay for their inquiries.

Mobile phone app is supposed to give recommendations for action in the case of skin problems. If the skin suddenly starts to itch and a red rash becomes noticeable, the only option left is to go to the dermatologist. Then you have to wait in the crowded waiting room. In many practices, the waiting time for an appointment is often several months. Simon Bolz and Simon Lorenz believe they have found a solution to the problem. The social scientist and the health manager, together with specialist Johannes Ring from the Technical University of Munich, have developed a mobile phone app that is intended to provide faster access to recommendations for dermatological action. With "Goderma" Patients can take pictures of their skin problems and send them to a dermatologist. The latter examines the photo and sends back a response with a recommendation for action within two days. For this, the person seeking advice has to pay 29 euros.

Many doctors are skeptical of the cell phone app for inquiries to the dermatologist. The technical implementation is unproblematic. In Germany, however, telemedicine is not so easily enforceable. Professional associations and medical associations are very skeptical. "This is not permitted under professional law, because there is a ban on remote treatment for doctors," Sascha Rudat, spokesman for the Berlin Medical Association, told the news agency "dpa". The quality of the photos and data security could lead to problems. The expert also sees hardly any benefits for the patient through the cell phone app. "If the advice is: go to a dermatologist - what does that do?" It should now be checked which doctors in Berlin work with the company. "We'll pat them on the fingers," warns Rudat.

Other experts are also skeptical. "This is a courageous project, but new medical and legal territory," Klaus Strömer, President of the Professional Association of German Dermatologists, told the news agency. The colleagues who have been involved in the project so far are serious colleagues, but the specialist society remains critical The participating doctors still have a statement before the professional association. Strömer hopes that they will "hopefully be legally well advised". In addition, the expert has a hard time imagining how diagnoses are made using photos. "I cannot ask a patient about the history," said Strömer. He also did not want to leave patients alone with a suspected diagnosis, for example, of a malignant skin disease.

Health apps are already established in many countries. The two company founders still want to implement the mobile phone app. They indicate numerous advantages for the patient. This would avoid long waiting times at the dermatologist and slight complaints could be distinguished from more serious ailments. "If you have athlete's foot, you don't have to go to a dermatologist," Bolz explains to the news agency. The situation is different in the case of shingles, which needs urgent treatment. The app is not an alternative to an examination at the dermatologist. It only provides initial guidance for those seeking advice .

The German Society for Telemedicine faces the cell phone app of the Berlin open. "We see many health apps critically because there is no medical expertise behind them," spokesman Wolfgang Loos told the news agency. "But as long as doctors are involved, there is no contesting this." However, these services would always have to be paid for yourself. Loos would probably answer "No" whether the German ban on remote treatment in the model professional code for doctors is still up to date. Even the health insurance companies would eventually offer emergency telephone services. E-heath strategies have long been part of everyday life in Scandinavia, the USA and France.

In Germany, telemedicine is limited to a few areas of application Many doctors and health experts in Germany shy away from expanding telemedicine. Clinics are currently using the technology to better monitor heart patients and diabetics. Telemedicine has been used in southern Brandenburg since 2010. Bernd Richter, dermatologist in Bad Liebenwerda, is contacted by general practitioners via a secure network, for example, if they need an assessment from the specialist. A photo of the skin problem is often included. If Richter comes to the conclusion that it may be skin cancer, the patient concerned immediately gets an appointment in his practice. "Otherwise there is a waiting period of up to six months," Richter explains to the news agency. The dermatologist would not support the "Goderma" mobile app. "I need my magnifying glass. And I have to touch the skin. For everything else, I would have Stomach pain."

Nevertheless, he would welcome a sensible expansion of telemedicine. Doctors could skype with colleagues and patients. Clinicians, surgeons and other specialists could also be involved. That would also be possible in nursing homes. “We have so long ways for patients here. That could make their lives a lot easier, "says Richter.

In Germany, however, there are other difficulties in addition to the legal problems of remote diagnosis. In many places in Germany there is no fast internet connection, which is a basic requirement for telemedicine. Especially in rural areas, the speed is too slow to be able to make diagnoses consistently and reliably. (ag)

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