Skin monitoring app closes care gaps and fights burnout

The Miiskin app (Miiskin) helps nearly 800,000 patients monitor the progress of moles and quickly access skin care when needed. For dermatologists, it provides a time-saving asynchronous teledermatology solution to serve the digital patient based on images recorded by the patient. This approach allows dermatologists to increase their productivity by 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 in his wife’s skin. “My wife is at high risk of developing skin cancer. She’s blonde, blue-eyed and probably tanned too much when she was young. As an adult, she had already had 12 moles removed, including a precancerous mole.

“We know we need to be mindful of changes on her skin. That’s why I created the first version of the technology and app, so people can become more self-aware and self-monitor over time to see if anything changed.”

Miiskin is meant to be used between doctor visits, not to replace 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.

“It’s about follow-up and monitoring combined with teledermatology visits. Our technology does not claim any clinical results, so we do not do any screening. We do not detect. But we give patients and users the ability to structure their skin monitoring process, compare and identify with objective images whether something has grown or there is a new spot on your skin. And if they find anything to worry about, we always recommend everyone seek medical attention.

Miiskin allows patients to easily document changes in parameters such as lesion size, shape or color for their healthcare providers. “You can measure lesions directly in the app using a reference object such as a coin,” Friis said. “You can do a 3D scan of your face or a full body photograph without help.”

US clinics that purchase Miiskin PRO subscriptions offer the technology free to patients so they can track their skin and, if needed, access emergency 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 press a button, download the app, take the images and answer a few clinical questions, then send it to the provider for immediate review,” he said.

Miiskin offers state-of-the-art measures to ensure image quality. In addition to excluding certain older phones from the platform, “we have unique technology to calibrate and stabilize and ensure that these images are of good quality. We use machine learning (augmented reality by computer vision) to stabilize and standardize this process, so that the image quality is the best it can be. And we keep improving that all the time.

An interface provided by Miiskin allows providers to review and respond to patient inquiries during a dedicated telehealth visit that is reimbursed at the same rate as an in-person consultation. “The provider can actually start delivering care immediately on our platform and respond very quickly to suspected injuries with 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 manage patient visits during downtime, cancellations, or whenever it suits them. This capability can increase supplier capacity by 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, Friis said, although the fact that 20,000 US patients have purchased Miiskin subscriptions reflects its success with consumers. The basic patient application is free; premium patient subscriptions cost around $30 per year.

Melanoma overdiagnosis isn’t a problem for Miiskin, Friis said, because providers don’t diagnose skin cancers directly from images alone. Instead, the app lets providers prioritize a case if they suspect melanoma or another skin cancer. “If the problem looks like a lesion on the skin that the doctor would like to see face-to-face, it 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 simpler concerns. When you have all the information before you meet the patient, it’s quite unique to be able to prioritize care delivery.” In addition, Miiskin supports documentation for electronic medical records and reimbursement.

Friis predicted that in the future, mobile apps for skin and healthcare will increasingly rely on patients as a resource, to the point that this strategy will become an integral part of healthcare delivery. “There are so many things, especially when it comes to the skin, that patients can do before they meet the providers.” Examples include documentation of lesions, location of lesions, and specific patient concerns.

“All downstream processes after that will be optimized if a provider has access to this information before seeing it in person. I believe we are in the next phase where technologies, including patient technology, should be integrated into the health systems. This is the opportunity of the next 5-6 years, especially since the patient is the only resource that we do not really use to the maximum. Everyone knows that all providers in dermatology are already working at 130%”.

Disclosures:

Friis is founder and CEO of Miiskin.

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