e-medicine, toward the end of doctors

http://www.melasciences.com/

http://www.nytimes.com/2013/07/21/business/dissent-over-a-device-to-help-find-melanoma.html?nl=todaysheadlines&emc=edit_th_20130721

"In late 2011, the F.D.A. approved MelaFind for sale in the United States. But, given the concerns that general physicians not trained as skin experts might miss a skin cancer, the agency restricted the use of the device to dermatologists — and then only after the doctors had successfully completed a MelaFind training program. So far, Ms. Beqaj says, the company had sold about 150 of the devices, which cost about $10,000, in the United States and Germany.

Since health insurance does not currently cover the service, patients are paying $25 to $175 for the first mole evaluation and around $25 for subsequent moles, doctors say.

WHETHER or not MelaFind eventually gains traction among dermatologists, the device is nevertheless significant, said Dr. Hensin Tsao, the director of the melanoma and pigmented lesion center at Massachusetts General Hospital in Boston, because it introduces the idea of artificial intelligence in dermatology.

Unlike an X-ray or mammography device that requires a medical professional to read the images and identify abnormalities, Dr. Tsao said, MelaFind both captures images and analyzes the likelihood of melanoma. That extra intelligence, its accuracy notwithstanding, is bound to change doctors’ interactions with patients.

Dr. Tsao’s clinic is participating in a post-marketing study of MelaFind, financed by Mela Sciences. And he said he and his colleagues were thinking hard about how to develop a role for such new devices in informing physicians and patients.

“Until now, you trusted the doctor to make the decision,” Dr.  Tsao said. “Now you’ve got a three-way interaction. It’s a brand new paradigm.”"