UF Researcher: Future Health Care May Be Modeled After ATM Machines

January 17, 1997

GAINESVILLE — A byte may be better than a touch for some types of health care, says a University of Florida researcher who has shown that cyberspace may soon take the place of personal visits to the doctor.

Images sent by computer networks such as the Internet can bring quicker decisions on how to care for people in rural areas, inner cities, prisons, nursing homes or on the battlefield, said Thomas Bradicich, who did the information systems research to complete his doctoral degree. His study shows such diagnoses can be nearly as accurate as those rendered in the doctor’s office.

“If your family doctor discovers a suspicious mole during a routine check-up and you happen to live in a rural area, it now may mean having to take a day off work, with lost wages, to travel to see a dermatologist,” said Bradicich, who received his doctorate in urban and regional planning. “With this solution, the family doctor may choose to capture a digital image of the mole and transmit it electronically to the specialist for a diagnosis.”

Just as automatic teller machines eliminate face-to-face encounters with bank employees and online shopping replaces shopping mall trips, future health care may allow some diagnostic medical services, such as dermatology and ophthalmology, to be done at more economical or convenient times of the day or night, he said.

“Bradicich’s research has demonstrated that we can use the information superhighway to give many more patients access to world-class medical specialists,” said Dr. John Cuddeback, vice president of health policy at UF’s Shands Hospital, who helped supervise Bradicich’s research. “New imaging and communication technologies provide a real win-win: better quality health care that actually costs less and is more convenient for the patient.”

Using multimedia computer systems and digital cameras, Bradicich captured images of 41 skin lesions on patients and presented them, along with an audio and text report of the patient’s medical background, to dermatologists at UF Shands Skin and Cancer Clinic. The dermatologists were able to match the in-person diagnosis 75 to 85 percent of the time, he said.

Adept use of shadows and multiple angles could increase accuracy, Bradicich said, and would help compensate for the inability to touch the tumor or gauge its height.

“Clearly, the lack of a third dimension accounts for some loss of precision, but experienced specialists are achieving high rates of accuracy and the practice is currently being used in the early stages at several clinical and research facilities,” Bradicich said. “Where there is no other alternative for the patient, it has significant potential.”

Soldiers in combat zones overseas could have images of their wounds transmitted back to the States; bedridden patients in nursing homes could have visiting nurses capture their images; and the inner-city poor with limited transportation options would not have to lose pay by missing work to visit a specialist, he said.

In addition, taxpayers would save money because prison guards and escort services no longer would have to accompany inmates on doctor’s visits, Bradicich said. “There is also the risk of escape, which makes inmates generally unwelcome at doctors’ offices,” he said. “This is a problem that will get worse, as Florida’s inmate population is forecast to grow substantially.”

Although the technology may be applied to medical specialties that are highly visual, dermatology is particularly well-suited because some areas in the United States are hundreds of miles away from a dermatologist, Bradicich said. According to recent statistics from the American Academy of Dermatology, six states have fewer than 20 dermatologists and Alaska and Wyoming have four and seven, respectively.

At the same time, skin cancer has increased during the past decade, Bradicich said. Some deaths from melanoma, a lethal form of skin cancer, happened because patients delayed seeking medical care, he said.

“The big questions is, can we deliver health care in cyberspace without the patient being physically present with the doctor?” Bradicich said. “Eliminating time and place dependencies with health care — just as we’ve done in banking, shopping and other realms of American life — allows us to do that and offers tremendous opportunities to help people.”