Toronto-based startup Figure 1 enables healthcare professionals to digitally share and discuss medical cases by uploading real-life clinical pictures. The app, which is a free download on the App Store and on the Google Play Store, launched in North America in May 2013 and has since acquired over half a million users in more than 170 countries.
Co-founder and practicing physician Dr. Joshua Landy talked to us about how Figure 1 can support clinical decision-making and improve medical education.
Dr. Joshua Landy
Co-founder and practicing physician
MedicalExpo e-magazine: What is the key idea behind Figure 1?
Dr. Joshua Landy: The way Figure 1 was developed was based on some research I did when I was a visiting scholar at Stanford in 2012. I was studying how young physicians access medical information on their phones.
We found that most physicians were taking pictures of medical cases and asking for feedback from colleagues via text message, email, or social media. This behavior demonstrated a clear need for a tool that lets people do that in a privacy safe way.
ME: How does the app work and ensure patient privacy?
Dr. Joshua Landy: Only licensed healthcare professionals are permitted to comment and upload pictures. When they use the app, a form pops up that shows them how to get patient consent. Following that, there is an automated face-blocking tool built into the app, as well as a number of tools to remove names, numbers, or tattoos.
There is also a list available as users are uploading the picture, showing them which pieces of information have to be removed. Once an image is uploaded, we also review it manually at Figure 1 headquarters before showing it on the app. Privacy is so important in healthcare, and we want to make sure that our privacy tools are as good as our users want them to be. We have a very active legal research team in order to learn and navigate all of the privacy regulations around the world.
ME: Who are your users and what are their key motivations to access Figure 1?
Dr. Joshua Landy: We first launched Figure 1 in Canada and in the U.S., and most of our users are still based in North America. However, our fastest growing populations are for example in India and Brazil, particularly in places where there is a mix of urban and rural healthcare.
As far as specialties are concerned, we initially thought that it would be heavily based on dermatology and radiology, but we actually also see a lot of internal and emergency medicine. We also get specialists who have jobs that are often behind the scenes, such as laboratory or pathology lab doctors and technicians preparing specimens.
I think seeing some of those aspects of medicine is something people really like about the app – getting to learn more about this world of healthcare, that we all live in every day. A lot of the user-feedback we have had is about how Figure 1 has helped them create more curiosity and fulfillment in learning about new cases. Especially students and residents find it helpful because exposure to more cases is what helps you get better as a clinician.
Can you tell us more about cases where the app can have a critical role in patient-care?
Dr. Joshua Landy: We get emails from our users every week, telling us how they used Figure 1 to help a patient. Sometimes it is as simple as a nurse in a nursing home identifying a wound on a patient that needs a particular type of attention. A wound care specialist sees that and can give feedback.
One of the things that we created in order to facilitate that process is a feature that we called Paging. It lets any healthcare professional upload a case and ask for the feedback of a specialist. Figure 1 will use an algorithm to find verified healthcare professionals in that area, who can give fast feedback on the case.
I used Paging in the ICU to ask an ophthalmologist about an unusual eye lesion over the weekend. I had my answer half an hour later instead of waiting till Monday.
ME: Where do you see the long-term relevance of your innovation?
Dr. Joshua Landy: We want to create a system that gives access to the knowledge of medical specialists anywhere there is an Internet connection. What I hope for is that Figure 1 can become healthcare’s central nervous system, where actions occur in the same ways as they do now, but the information connecting people and places comes through this professional network.