Conventional diagnostic imaging of the skin involves the use of dermatoscopes. Dermatoscopes use skin surface microscopy to examine dermal and sub-dermal tissues to diagnose skin problems. However, these devices can be costly and provide a limited view of the immediate skin surface. Furthermore, dermatoscopes have to be used in direct contact with the patient's skin. Because of this, they can only be used to image patients in the same physical location as the clinician conducting the examination. Another critical disadvantage is that a steep learning curve is required for clinicians to use the device and interpret the result.
The overall result is that only a tiny portion of the global dermatology patient-base can be reached cost-effectively and efficiently.
In order to facilitate remote skin disease diagnosis, the use of software is required to acquire and share images in real-time and ideally, by the patients themselves. This software enables patients to take their medical sub-skin images with their mobile, tablet or laptop cameras, and securely share it with doctors. Crucially, dermatoscopy images can also be used with the technology to improve diagnostic accuracy.
The technology is available as an embeddable algorithm and as a secured cloud-based service.
The service, RDI (Remote Diagnostic Imaging) is available in two modes: RT (Real-Time) and SAF (Store-and-Forward). RT provides remote real-time examination of the patient’s sub-skin by a clinician. SAF enables the patient to snap and forward the sub-skin images to the clinician for assessment. A non-clinician staff member at a clinic can also help the patient to take the images and forward them to a skin specialist. This remote imaging diagnostics can save significant time and money for both doctors and patients. By providing a more convenient service to their patients, doctors can also boost their practice revenue.
The embeddable version of the technology, AMI (Absorbed Multispectral Imaging) is available in a licence or co-creation form. It can be embedded in OEM devices, equipment and machines.
The RDI service consists of proprietary software that works with any smart camera device such as mobile, tablet or laptop cameras. An individual at any remote location takes photographs of suspicious skin lesions, and then forwards it to the doctor. This is similar to most image-sharing software available. What sets the software apart from other algorithms is the presence of a sophisticated algorithm that acquires sub-skin features of the skin (in normal light) thereby empowering advance notice of skin issues prior to manifestation on the skin surface. Additionally, it derives a wider range of visual factors to better differentiate between otherwise similar looking skin lesions. The potential benefit is better accurate diagnosis and improved patient outcome. The entire system empowers the patient and is effectively a telemedicine platform conveniently connecting patients to their doctors.
Dermatology - With 3rd party software, this skin imaging software platform has the potential to facilitate more accurate diagnosis and management of a range of skin diseases, such as psoriasis, acne, vitiligo and dermatitis, to more serious and potentially fatal conditions of melanoma.
Podiatry (diabetes) – Diabetic patients can suffer from loss of feeling in their feet potentially leading to foot infections which if left untreated may necessitate amputation for example. The RDI and AMI solutions can help podiatrists gain advance notice and clarity of potential issues. The key benefit being a better patient outcome. Additional, revenue is also a potential benefit for the podiatry practice by providing additional and better service for patients.
X-ray (radiology) – X-ray radiation has been and continues to be a major cause for health concern despite its significant benefit in patient diagnostics. It is also not known for being able to render soft tissue visual detail in the way that MRI and ultrasound are for example. Both RDI service and AMI embedded technology enable the use of pre-existing X-ray images to be used to acquire visualisation of more detail. The key benefit is reduced radiation dosage which results in less risk to the health of the patient. Additionally, these solutions make it possible to now gain soft tissue detail from pre-existing X-ray images which lead to reduced costs as X-ray services are less expensive than MRI for example. Also, a historical comparison of a patient’s previous X-ray images and current ones is made possible.
In the near future, it is expected that such a diagnostic platform will become an integral part of a smart diagnostics platform for remote clinical diagnosis. Dermatology clinics and hospitals can use this platform for the remote diagnosis of any type of skin disease, track the progress of a patient condition after treatment, and better engage patients in the treatment process by empowering them to take proper care of their skin health.
According to the World Health Organization, between 2 to 3 million non-melanoma skin cancers and 132,000 cases of melanoma skin cancers occur each year globally. Melanoma skin cancer is the most fatal of all skin cancer. 2016 statistics from the American Cancer Society reveals that every 52 minutes, one person dies of melanoma. Statistics show that between 1982 and 2011, the incidence rate of melanoma has almost doubled. In the US, the National Cancer Institute’s Surveillance, Epidemiology, and End Results (SEER) Program has estimated that the number of deaths due to melanoma in 2017 alone is to be 9,730.
Effective skin cancer therapies can be designed through an early diagnostics platform such as the RDI/AMI remote sub-skin imaging, which may result in reducing the mortality rate and adverse symptoms associated with skin cancers. The detection of this skin cancer at an early stage is extremely crucial to the patient’s survival. This is because if not diagnosed early, the treatment becomes difficult, ineffective, and expensive for a patient in the late stages of melanoma disease. This innovative imaging platform potentially facilitates fast, accurate, cost-effective skin condition diagnosis.
According to UK’s NHS (National Health Service) ‘Diabetes is the most common cause of non-traumatic limb amputation, with diabetic foot ulcers preceding more than 80 per cent of amputations in people with diabetes.
Around 50 per cent of people die within five years of developing a diabetic foot ulcer.’
A major drive to reduce this risk involves early, regular and accurate foot screening. The ability to gain insight into sub-skin issues prior to them becoming visible on the skin surface is therefore vital. This is especially true since the diabetic patient is likely to have lost feeling around their feet and be unaware of the problem. RDI and AMI offer solutions which can have strong positive and cost-effective impact when made central to the foot screen process. The patient is also empowered to image more frequently and forward the images to their doctor for internal foot monitoring thus taking less of the doctor's time while still receiving quality care.
Further, WHO reports that 70% - 80% of medical diagnostic problems can be resolved with basic medical imaging. Yet only 1 in 3 of the world’s population has access to basic medical imaging, some with no access to any kind of medical imaging.
RDI and AMI support telemedicine which has the potential to deliver very low-cost services to low-income and remote communities globally. RDI and AMI can be considered as the de-factor imaging standard for telemedicine.
Some of the advantages of this innovative technology are as follows: