Skin monitoring app bridges care gap, battles burnout

The Miiskin app (Miiskin) helps nearly 800,000 patients monitor changing moles and access dermatologic care quickly when needed. For dermatologists, it provides a time-saving asynchronous teledermatology solution to serve the digital patient based on patient-recorded images. This approach enables dermatologists to boost productivity up to 20%, according to the company.

Miiskin provides a first line of defense against melanoma and other skin cancers, said founder and CEO Jon Friis, who developed the original version in 2015 to track changes on his wife’s skin. “My wife is at high risk of developing skin cancer. She’s blonde, blue-eyed, and has probably done too much tanning when she was young.” As an adult, she had already had 12 moles, including a premalignant mole, removed.

“We know we need to be observant of changes on her skin. That was why I created the first version of the technology and the app—so people could become more self-aware and monitor themselves over time to see if anything was changing.”

Miiskin is intended for use between doctor visits, not as a replacement for them. Many other apps on the market make bold claims about screening or technical capabilities, he said. But these claims create legal and ethical complexities such as how to handle false positives and negatives, Friis added.

“This is tracking and monitoring combined with teledermatology visits. Our technology doesn’t claim any clinical outcomes, so we do not screen. We do not detect. But we give patients and users the ability to structure their skin monitoring process, to compare and identify with objective images if anything has grown or there’s a new spot on your skin. And if they find anything concerning, we always recommend everyone consult a doctor.”

Miiskin makes it easy for patients to document changes in parameters such as lesion size, shape, or color for their healthcare providers. “You can measure lesions directly within the app by using a reference object such as a coin,” said Friis. “You can do 3D scanning of your face, or full-body photography without a helper.”

US clinics that purchase Miiskin PRO subscriptions are giving the technology freely to patients so they can track their skin and, if needed, access urgent care in days rather than months. Instead of phoning a provider’s office, scheduling an appointment, and traveling, Miiskin initiates access to care through a widget on the clinic’s website. “You can push a button, download the app, take the images, and answer a few clinical questions, then send it in to the provider to review immediately,” he said.

Miiskin features leading-edge measures to ensure image quality. Along with excluding some older phones from the platform, “we have some unique technology to calibrate and stabilize and make sure that these images are good quality. We use machine learning—computer vision-augmented reality—to stabilize and standardize that process, so that the image quality comes out the best way possible. And we keep improving that all the time.”

An interface supplied by Miiskin allows providers to review and respond to patient requests in a dedicated telehealth visit which is reimbursed at the same rate as a physical consultation. “The provider can actually start delivering care immediately on our platform and respond to suspicions lesions very fast due to the high-quality image documentation. Response time is critical when it comes to skin cancer, and melanoma in particular.”

Using an asynchronous store-and-forward model allows providers to handle patient visits during downtime, cancellations, or whenever works for them. This capability can increase provider capacity up to 20%, Friis said. Providers can use this breathing room to serve more patients, he added, or as a buttress against burnout.

Measuring Miiskin’s impact is difficult, said Friis, although the fact that 20,000 US patients have purchased Miiskin subscriptions reflects its success among consumers. The basic patient app is free; premium patient subscriptions cost around $30 annually.

Melanoma overdiagnosis not a concern with Miiskin, Friis said, because providers do not diagnose skin cancers directly from images only. Rather, the app lets providers prioritize a case if they suspect melanoma or another skin cancer. “If the concern seems like a lesion on the skin that the doctor would like to see face-to-face, that can happen extremely quickly on our platform because the provider has all the information in front of them to be able to prioritize that patient ahead of more simple concerns. When you have all the information prior to meeting the patient, being able to prioritize care delivery is pretty unique.” Additionally, Miiskin supports documentation for electronic medical records and reimbursement.

Friis predicted that going forward, mobile skin and healthcare apps will rely increasingly on patients as a resource, to the point where this strategy becomes a seamless part of healthcare delivery. “There’s so much, especially with respect to skin, that patients can do prior to meeting the providers.” Examples include documenting lesions, lesion locations, and patients’ specific concerns.

“All downstream processes after that will be optimized if a provider has access to that information before seeing them in person. I believe that we are in the next phase where technologies including patient technology should be integrated into health systems. That’s the opportunity of the next 5 to 6 years—especially since the patient is the only resource we are not really using to the full extent. Everybody knows that all providers in dermatology are already working at 130%.”

Disclosures:

Friis is founder and CEO of Miiskin.