Medical Design Support is an emerging field in its early stages of technology adoption. This conversation looks at how the field is evolving.
Sramana Mitra: Let’s start by giving our audience a bit of background about yourself as well as VisualDx.
Art Papier: I am a dermatologist. I am also the CEO of VisualDx. It’s a company dedicated to improving health decisions not just in the exam rooms with the professionals but also with the decisions that people make at home.
We have an interesting story. Our company is 21 years old. We founded our company in digital health before Google images existed and only a few years after the internet was founded. We have been making a long-term bet on the complexity of medicine.
We built a foundational knowledge base as well as one of the world’s best digital medical image bases. Unlike other efforts where it is a Wiki model, we believe that medicine requires precision, so we have a very active data set because we have been meticulous in building it. We involve world class physicians from around the world.
Sramana Mitra: Tell me how that works. You have this database of images. What happens to those images?
Art Papier: The images come from experts and institutions that have done medical photography over the last decade. There are physicians, particularly dermatologists as well as infectious disease physicians, emergency physicians, oral disease physicians, and ophthalmologists that either themselves are avid photographers or they have a medical photographer in their clinic that takes these images for patient care, teaching, or research.
There are a select few that take high-quality images. I’m a dermatologist so I understand where the excellence is. We have been meticulously asking these experts to contribute to this effort. They join us as editorial members and case contributors.
The images not only get stored, but they also get cataloged with precise tags that show the diagnosis and also the other factors that are visible in the image.
The image set that we have been dedicated to building spans medicine. It’s not just psoriasis and warts, but it could be skin signs of internal disease or infectious disease. It could also be eye images, oral images, hair images, and images of sexually transmitted diseases.
We have been purposeful in acquiring these images of people of all skin color. When the George Floyd tragedy happened, it put the focus on the horrible problem of racism in America. People in healthcare started asking what they could do.
I published a paper in 2006 about bias in the medical literature where we have books and websites not showing how diseases look on people with color. We have been purposeful about this in the last 20 years.
It’s an important point that diseases that are present on the skin of somebody who has very dark pigmented skin looks different. The inflammation on pigmented skin doesn’t look red or as it does in white skin. You have to train doctors to recognize these key physical exam clues and you do that through imagery.