Last week I wrote the Dentist Office Software Story and the top comment on that post was this from LIAD:

….along comes Sevin Kystrom, he only cares about looking at photos of teeth. he unbundles photos from by creating a standalone app called teethagram. users love it. he sells it back to for $1bn

I kind of flipped out when I saw that comment because it describes our most recent investment, Figure1, which my partner Andy blogged about at yesterday. We had closed but had not yet announced the Figure1 investment when LIAD made that comment.

Figure1 is “instagram for doctors.” It’s not for dentists, as LIAD’s fictional company teethagram is, but other than that, and the sale for $1bn, the story is pretty much the same.

We have believed that simple, easy to use, photo centric apps on mobile have the potential to become very large businesses for a host of reasons. First and foremost, as Brian Watson taught me, photos are the atomic unit of mobile. It’s easier to snap a photo and post it/send it, than it is to do anything else, including write something. And, as the old adage explains, a picture tells a thousand words.

A doctor can say “I’ve got a patient with a very rapid A-fib” or she can send this to her colleagues:


There’s a hell of a lot more info in that EKG than a doctor could type into a text message or email.

But the even better thing is the conversations that instantly develop around these images, like this one:

I think it’s rapid a-fib. I think the ischemic changes are due to the rate. Give them some #Amiodarone and see what happens when the rate sloes down.

Instagram is a powerful product. And most people know how to use it and the value of the interactions around photos that it produces. Like our portfolio company Edmodo, which took the Facebook UI and applied it to teachers and students in K-12 education, Figure1 takes a popular and effective UI and applies it to an industry in desperate need of change.

I’m super excited about the value Figure1 provides to doctors and their patients and I am really pleased that the Figure1 team agreed to work with USV as they build their business.

#hacking healthcare

Comments (Archived):

  1. awaldstein

    Instagram is a monster community tool. I know companies that use only that for community and marketing.I also know that doctors could make leap as i email with all of my doctors and text with one of them.Time (doctors are crazy busy) and behavioral change to use this medium rather than picking up a phone are the kickers over time.I think Figure 1 has a shot. How far beyond the curve they are, of course I don’t know.

    1. Richard

      Spoke with my gf about this app, she is a intern at a major teaching hospital. So far at least, no much time or risk tolerance for signal to noise issues.

      1. LE

        Not to mention the fact that any doctor that I have ever been in contact with isn’t really spending their off time on medicine they are totally spent and literally are watching stupid light TV shows after the shift or office hours. And they aren’t interested in (typically) helping people on the side they already have enough smoke being blow up their butt to feel all satisfied and important already. (Re-read that because it’s important).This is quite different than, for example, me and business. Business and people are fascinating to me and I can’t get enough of it. I’m on 24×7 everywhere every place. It goes way beyond a hobby because even a hobby you wouldn’t do 24×7.

  2. pointsnfigures

    similar to the company hard to navigate the FDA, HIPPA and all the regs.

    1. fredwilson

      the Gotham Gal is an investor in Capture Proof.Capture Proof is more of an “enterprise” play where Figure1 is more of a “consumer” playFigure1 is free for anyone to use but only doctors can commentFigure1 uses Doximity, another really awesome healthcare company that we like a lot, to authenticate that doctors are actually doctors

      1. JimHirshfield

        But what about privacy concerns?And medical liability, as in “some doctor on the internet, who didn’t even see me, said I needed to take this medication…and now I’m sicker”

        1. fredwilson

          the company has answers to all of these questions. they are good and valid questions and we asked them too. i am not going to try to do justice to answering them. maybe the company will weigh in here. we will see.

          1. JimHirshfield

            LMFTFY (Let Me Find That For You)Because our images do not have identifying details about patients and are not attached to any patient information, such as names or addresses, they do not fall under regulations such as HIPAA’s Privacy Rule in the United States, privacy legislation in Canada (such as PHIPA in Ontario), or similar legislation in other jurisdictions around the world.

        2. Gregory Levey

          Hi Jim-We’ve spent a ton of time and effort (and legal bills) on the various legal and privacy issues that emerge. I can’t get into our whole legal strategy here, but the short answer on the privacy stuff is that as long as all identifying details are removed from images, the images are not considered Personal Health Information (PHI). We go way beyond the minimum in protecting patients’ privacy.UPDATE: We were posting at the same time, it seems. But yes, that’s the essence of it.

          1. JimHirshfield

            Thanks Gregory. Great stuff you’re up to! Congrats.

          2. Josh Gordon

            First off, great idea with Figure 1. I’m curious: Privacy was first thing that crossed my mind too. I get that you’re removing identifiable info, that resolves HIPAA etc. But can one take a photo of another person in a private setting and share that? In other words, if you’re in public space, anything goes, and the person who takes the photo owns rights to it (I think; a lawyer told me that even if you stopped someone on the street to take a photo of yourself with your own camera, the person who snapped the photo actually owns the artistic license to it; not sure if that’s true). But can one take a photo of another person in a non-public space, especially of very private parts and conditions, and share that freely?

          3. Josh Gordon

            Glanced over terms & conditions, Interesting. Lots of legalese pushing responsibility to the docs etc to make sure their consent forms allow it etc. I’ll venture to guess that regardless of what patients sign, no patient would ever assume they are granting rights for their body parts to be posted on the web for all to see, identifiable info or not. I foresee legal challenges one day a la napster etc. Much less though – there is a very strong public good done by sharing the info. But a legal challenges nonetheless.

  3. JimHirshfield

    But does it do filters? I want pictures of rashes with the Toaster filter.

    1. fredwilson

      there are certainly many images on figure1 where i want the “don’t show me that” filter!

      1. JimHirshfield

        Yes, I can see a Tinder version of this emerging.

        1. sbmiller5

          Swipe right if you know what the fuck this is?

        2. Richard

          What we won’t see is a Secret Medical app.

          1. JimHirshfield

            Oh, ye of little faith! The copy-cat economy is already hard at work on that. 😉

      2. Richard

        You were kind to the avc community with the choice of picture. There are definitely some grueling and heart breaking pics on the site.

  4. JimHirshfield

    This…”…but other than that, and the sale for $1bn, the story is pretty much the same.”…in time, in time.So, at scale, is the model that doctors would pay? Pharma ads to patients? Ads to doctors?

    1. fredwilson

      i don’t know and i don’t really care. we will figure it outwe said that when we invested in delicious and we said it when we invested in twitter…we’ve said it many times over the years and have never regretted saying it

      1. JimHirshfield

        How did I know you’d say that?#softball

      2. Jim Peterson

        Love it. Build something amazing and let answer show up.

      3. Brandon G. Donnelly

        Hardest part is building the community in the first place, not monetizing it. Is that the viewpoint?

      4. LE

        i don’t know and i don’t really care. we will figure it outI think when engineers get together for some mega project (like your dad and the Army Corps) they have some idea that something is possible and they will just figure it out on the way. [1] I wonder if that is part of what allows you to think that way.I was raised differently from the school of “now I have to clean up the mess” so I definitely don’t trust the future the same way.[1] Man on the moon or Boeing 747. I mean before doing the project or going down the road they most certainly knew that by the law of physics something as big as a 747 would fly and something like man on the moon could be done by some method that they had more than napkined out. They just had to engineer their way around the various issues.

      5. Charlene Ngamwajasat MD

        It’s refreshing to see a NYC-based VC say that. I think that the value & use case scenarios will develop over time as # of users & mass effect take place as the community builds. How people use something & why will tell you where to go. I agree w the comments though about it leaning towards being a learner tool.Doximity & other sites that list MD’s are interesting. You can be a doc & be on a site without u even knowing. I’m interested in why ppl go to these sites, how often they go, & for what purpose? Also what is the profile of the most active users.Comments on govt oversight are important. Seems like a lot of people making the rules don’t have tech or medical backgrounds. We really need a HIPAA for the digital age that is clear and above all has practical use in the real world & its workflow.

  5. mikenolan99

    I’ve already used the dentist story (with proper credit, of course…) and plan to use it – with the new footnote – as part of my regular schtick.Today’s installment is a great example of so many things – wisdom of the crowd, unbundling features to build new markets and the vision of great investors and entrepreneurs.I deal mostly in “brick and mortar” entrepreneurs – store fronts, service industry, light manufacturing in established markets, etc. I’m really intrigued at how unbundling could apply to this area of entrepreneurship.For example, I’ve seen a great (20M) generator company pop up in the shadow of a huge multi-national generator company – all by niching in the custom market. I wonder how many more great “little” companies can be created by specializing in just one part of the established leaders market?

  6. Jorge M. Torres

    I see that Figure 1 has roots in Turkey and a team in Toronto. I think Turkey is super interesting right now for startups and VCs. Good stuff.

  7. Mac

    An app a day keeps the doctor away.

    1. JimHirshfield

      Stick out your tongue and say aaaaaap.

      1. Mac

        Take an app and call me in the morning.

        1. Ryan Frew

          It’s still recommended to schedule an occasional doctor’s app for the routine checkup, though.

          1. Mac

            An app in time saves nine.

          2. pointsnfigures

            Bend over, let me check your app.

          3. Mac

            Would that be an app-endectomy?

      2. LE

        Definitely (9/10th on the Hirshfield scale) sitcom grade humor. Or should it be humour.

        1. JimHirshfield

          I appreciate you spelling my name correctly. Really makes a difference.

  8. William Mougayar

    And the best part of this (but I’m biased) is that Figure1 is based in Toronto. This is good for Canada’s startup ecosystem which now boasts 3 strong USV-backed companies: Kik, Wattpad and Figure1.

    1. jason wright

      that’s quite impressive. what do you think accounts for it?

      1. JimHirshfield

        I think people like @wmoug:disqus account for it. Smart, innovative, go-getters. Great edu system in Canada. I used to work for a Canadian startup, so I’m an expert…not 😉

        1. Brandon G. Donnelly

          Ecosystem on the rise! 🙂

          1. JimHirshfield

            For real, eh?

          2. Brandon G. Donnelly

            You should see how much free poutine and maple syrup they give out to employees

          3. JimHirshfield

            Eat too much poutine and you’ll be uploading some gross images to Figure 1 in no time.

        2. William Mougayar

          Thanks @JimHirshfield:disqus 🙂 Being underdogs, we try harder. USV’s antennas are quite good, and also with help from @bwertz

          1. JimHirshfield

            Oh yeah, @bwertz is awesomest.

          2. PhilipSugar

            I don’t know if “you” are underdogs. I get to Canada so often I might be part of the team.

          3. William Mougayar

            I meant in the tech startup world, we’re still up and coming, comparatively speaking. Let me know next time you’re in Toronto.

          4. JamesHRH

            I think we do OK, per capita.

          5. awaldstein

            Canada’s best Michael Ondaatje!

        3. LE

          When I think of Canada the following things come to mind:HockeyComedyNice

          1. JLM


          2. JimHirshfield


          3. LE

            I love it when I learn something new on this blog.…Problem with that word is that it’s not cool sounding enough to become common place in, um, the states.I will return the favor with this clearly cool sounding competitor:

          4. JimHirshfield

            Nice counter punch.”Hoser” is only funny in the USA if you’re old enough to remember the Bob & Doug MacKenzie skits. Otherwise, you just sound like a douchebag.

          5. pointsnfigures

            How bout a Molson?

          6. JimHirshfield

            Yes, @JLM:disqus mentioned that.

      2. William Mougayar

        Well, Toronto is the 4th largest city in North America (after NY, LA, Chicago). The tech startup scene is getting better and better, especially when you add Waterloo to that region’s cluster, a bit similar to San Jose-SF or Boulder-Denver situations.

        1. JLM

          .Time for serious merger talks between the US and Canada. We’ll be willing to be ruled by a Canadian for a few years as part of the deal.If not, we intend to start lobbing rockets into Toronto.JLM.

          1. William Mougayar

            Ha. I know it’s been on your To-Do list for a while 🙂

          2. pointsnfigures

            Better to lob them in the direction of Quebec or Montreal-more french and the Maple Leafs aren’t any good at hockey anymore.

          3. JamesHRH

            In the words of Jonathan Winters, “I hope we take you over, quietly, one day.’No chance of that – gun laws.

          4. LE

            Israel made a key error in not putting out more PR as far as why they had to do what they had to do. They assumed that it made sense but in retrospect I’m sure they now realize that you can’t take things for granted. Nightly news (which I watch) totally showed all the suffering in Gaza with only light mention of why it was happening. (On NBC Richard Engel fell 17 notches in my ranking system).This is a mistake that happens time and time again with people when they think things are obvious and don’t realize that you have to fight battles (PR and/or legal battles) as if you are the underdog. Don’t assume the monster is dead. Don’t assume a job is easy.Exhibit A:…Imagine how much better things would be for us if our country wasn’t so fucking worried about occasional civilian casulties and was backed up by our citizens (who had to serve in the armed forces). Bibi grew up in the US during Vietnam which at least allowed him to understand how not to wage a war. (You’re the military guy so perhaps your take is more informed or different than my take..)

        2. Brandon G. Donnelly

          Mexico City is the biggest in North America. And technically, the city proper of Toronto has a greater population than that of Chicago. But Chicago’s CMA is still bigger and that’s what really matters.

          1. William Mougayar

            I wasn’t counting Mexico City. Was more focused on USA/Canada.

    2. JimHirshfield

      Fess up…Did you source this deal for USV? Playing northern scout for the USV franchise?

      1. LE

        As your PR expert I suggest you do something similar to this as a hook for your next gig:…An all-female Hasidic rock band will play Arlene’s Grocery on Thursday night — and the Lower East Side music venue has agreed to shut its doors to men.Much safer than what the Russian Pussy band had to do to get on the map.

      2. William Mougayar

        I didn’t.

    3. Guest

      This is great news. So USV has how many investments in Toronto/Waterloo, 3?

      1. William Mougayar


    4. Brandon G. Donnelly

      This is great news. And they’re all in the Toronto/Waterloo region.

    5. Elia Freedman

      How many of these companies have people that came out of RIM?

      1. William Mougayar

        Ted Livingston (Kik) has worked at RIM prior to founding Kik, but not for a long time. He didn’t make a fortune there, then founded Kik based on that.Sadly, RIM is largely irrelevant to the current Canadian tech startup scene.

        1. Elia Freedman

          That’s too bad. My theory was that RIM dying would spawn lots of start-ups, similar to how a nurse log spawns growth in the forest. Apparently not.

    6. LE

      You might have missed the other day that Brandon thought I was part of the Canadian mafia on AVC. He thought I was in Vancouver.

      1. William Mougayar

        Ha. I missed that. Well, by the powers bestowed to me by Her Majesty the Queen of England, I hereby grant you an honorary Canadian citizenship.

      2. JamesHRH

        You are 2x too street smart to be CDN!

  9. Gregory Levey

    Thanks for the kind words, Fred! We’re thrilled to be working with USV.

    1. Richard

      MDs comments on some of pics range from serious to comedic to combative. I also see a lot of medical students commenting. Will the comments remain the open and unfiltered?

      1. Stephanie Norris

        I was just hired as the Community Manager (starting next week), and it will be my job to address these issues. Would love to hear suggestions!

        1. LE

          One suggestion would be you need to anoint others to help you do your job and police the community. You won’t be able to do it all by yourself.

        2. Richard

          Here is the problem…the field of medicine really doesn’t have a common personality.. Orthopedic surgeons are competitive, oncologists more analytical, primary care more herd like ….

          1. LE

            Exactly. (To add a few more radiologists and anesthesiologists would tend to be less social and not like patient interaction.) Orthos tend to be physically large and like sports (at least from what I’ve heard. ) DO’s are sometimes looked down on by MD’s. Psychiatrists tend to go into that because of family history or they couldn’t make it in another part of medicine. All stereotypes for sure but definitely a basis for those.In any case it’s certainly not a problem that can’t be solved with some labor and ingenuity.

        3. William Mougayar

          Stephanie,- Wattpad has a lot of experience with managing millions of comments to keep the community clean and pristine. I suggest steal some best practices from them. I can intro, but so can USV.

        4. Andy Ellis

          I wanted to give the app a couple of weeks before weighing in. Why in the world is there a “mouth” category but not a non-surgical dental one? Weird organization aside, the premise of Figure1 is excellent and could be really useful to help docs figure out unusual cases. The signal to noise ratio seems problematic at this point with a lot of insane comments with weak foundations. Figuring out a user rating system (which I assume is in the works) will be helpful but then could unintentionally downplay a newly arrived expert. Perhaps fleshing out profiles and degree designations would be helpful as a starting point for authority.I like the idea of hopping on and opining on puzzling cases. As an individual I will realistically not contribute often but hopefully leveraging the network will keep well intentioned providers available (on average). The idea is a good one and I think the biggest obstacle to keeping folks interested is separating the wheat from the chaff.

  10. LIAD

    Healthcare clearly archetypal industry where this would work.Industry characteristics which would bode well for this type of app?1. High propensity to share information. Knowledge not seen as zero-sum.- healthcare yes. – technician financial analysis. No (stocktwits?)2. Ever changing and growing corpus of information.- meteorology. Yes. – archeology. No.3. Need for real-time info.- macro-biology. Yes. (Ebola!!). – astrology. No.4. Ability to achieve actionable outcomes.- horticulture. Yes. – ancient history. No.#2Cents.

    1. aweissman

      next time I am going to ask you to write the USV blog post for an announcement, ok?

      1. LIAD

        Next time, I wanna be the founder of the company the announcement is about!

        1. Tom Labus


        2. William Mougayar

          you don’t miss a beat 🙂

    2. LE

      Otoh a typical Physician is used to operating independently and making their own decisions on the fly for the vast majority of decisions that they have to make. They aren’t consulting with other docs they are executing on their own knowledge gained over the years. By the nature of corner cases they (corner cases) are corner cases. Not the day to day stuff. So you have the problem of something not being needed frequently enough to become a habit. (Which is why this app is more relevant to the learning phase of things). Like I check the weather app every day. Other apps, I’ve forgotten about although I’m sure they are useful if I remembered they were there.Also, Docs are not geeks in the sense that they aren’t wasting their time mentally masturbating (that’s a real term that they use btw) over what if’s and what could be and cool things that peak their interest (not the majority anyway). [1] They are single function machines who do their jobs day in and day out and tend to be tunneled in a particular area. That’s why they are docs to begin with sometimes (ability to focus and not give a shit about stuff that doesn’t matter). (And why I’m not I’m all over the place in what I can do and what I find interesting (the signature flaw).)[1] So if they are reading medical journals while they might read an article here and there that they find interesting they are more likely to read a journal article that relates to what they do day to day. Anyone who reads HN knows that geeks are just interested in stuff because nearly anything can pique their interest if “it satisfies one’s intellectual curiosity” (as PG says iirc). “Why Plants grow better in clay pots”.

  11. jason wright

    i once worked in a medical bookshop attached to a university medical school. some of the ‘anatomy of…..’ medical books displayed the most shocking medical photography you can’t imagine. the suffering some patients endure is almost beyond consideration. if Figure 1 and the stampede of other startups in the medical sector can take web tech to spot problems at the earliest possible stage then that’s fantastic. it still requires competent doctors who know what they’re doing, and a profession willing to embrace’s project ara modular smartphone concept could work very well here. modules designed for a range of medical requirements, for remote data gathering et.c. could revolutionise the health sector and patient pre care.

  12. Dave Pinsen

    Nice to see you guys find a health care investment that ties in with your broader thesis.

  13. sbmiller5

    I love it. My father works in orthopedics and I know the text images back and forth all day. My wife is an Infectious Disease doctor – I’ll have to ask her if this would be useful.

  14. Chris S

    I dunno. I get the wonderful benefit that might arise from tapping into the collective brain of my colleagues. Or in other words, I get. But who’s giving? The source of benefit (physicians + their knowledge) are not the average web users. In other words, this isn’t Wikipedia. What’s the hook to engage them to monitor and post real-time feedback? For example, posting that rapid a-fib EKG is useless unless one can get almost immediate treatment recommendation. (Posting a query on what to do if a patient isn’t breathing is a more extreme and perhaps a bit facetious example, but you get the point.) My time is pretty tight, as is the case for many other physicians and business professionals. Has that free contribution, and when it might occur, been considered in the model?

    1. aweissman

      the short answer is this is not a diagnostic tool for medical professionals. it is a collaboration and community service

      1. Richard

        I do see Diagnosis and Treatment opinions taking place on the site.

        1. aweissman

          and they most certainly do because those users have decided that’s what they want it for. That’s a user driven choice.

      2. LE

        Might want to have the team update the site to take into account the immediate impression of the parent commenter (apparently a Physician as I read the comment).I guess the point is they have to figure out the niche that this is useful to and focus on that specifically in the marketing copy.My snap judgement is that this tool would do well for those learning (med students, interns) or in the third world rather than established Physicians.

    2. SubstrateUndertow

      At some point don’t new technical-extention-tools start to rewrite the old workflow habits and the attitudes behind them ?Maybe its another chicken or egg affair ?

      1. Chris S

        Maybe. It’s not so much a re-think of workflow, though. And it’s not an issue of technology. Doctors are much more amenable to answering text messages, emailing, etc. since now they can get reimbursed for their time. As a physician, if I post an item seeking information, I get something out of that submission. But what about the other side? Will doctors be likely to “hang around” to answer questions or comment on their own time? If it’s “work”, then they won’t be interested in doing more of the same but without reimbursement. If it’s “fun” or for a higher purpose, perhaps they will. So my question, perhaps to the ceiling or just myself, would be: what’s the reason to participate if not seeking an answer? Not saying there is no answer. I’m just not sure what it is.

        1. Chris S

          Forgot to add: it’s hard not to measure or at least view something that’s so close to what’s done in the course of a normal work day as just more of that work. And when that happens, it’s inevitable that this time gets measured in (foregone) dollar values. Not an insurmountable issue, but reframing that perception could present a challenge.

        2. SubstrateUndertow

          I see your point but I’m thinking that those new technical-extention-tools must inherently include new reimbursement workflows as reimbursement is fundamental to any workflow old or new ?

  15. LE

    This is a great investment. Definitely has possibilities if executed right more likely with younger docs and those starting out for sure. Med students, interns, docs in small towns. Third world docs and so on.That said a few things about the site need to be updated quickly. Some thoughts and suggestions. (I’m sure some of these must be in the pipeline.)1) There is no “about” page indicating who the team is and why anyone should trust them. No way I would refer anyone to this site w/o that info.2) There is no contact information at all on the website, no address, no phone, no names, nothing. Additonally, the whois info is private, and it shouldn’t be. (Forget 97% of what you read as far as private whois info being good for legitimate companies, what you read is wrong.)3) Pictures should have watermarks on them.4) The Press page needs more medical related press mentions. Physicians don’t care about Tech Crunch and Pando Daily. The press mentions should link to the actual press mention or at least a page with a summary.

    1. JimHirshfield

      Looks cool…and much more enterprisey full-featured diagnostic cooperative tool, yes?

  16. Aaron Klein

    Venture capitalists now roaming the streets of New York, trying to find @liad:disqus and get him on retainer. “He predicted the Instagram of SOMETHING!”

    1. LE

      Also possible that he figured it out by hacking into something at USV though. Either way, shows potential.

    2. jason wright

      swarming. run LIAD, run!

  17. zackmansfield

    Forwarded this to a friend who is a practicing pediatric cardiologist. He responded “this is great, I do this all the time via text from the ER or clinic”Taking an existing (imperfect) behavior and skinning it for the audience to make it better (while also adding value via the network). Love it. To quote my friend, “This will be huge, we ALL do this”

  18. blv

    Ideally actual data can be observed by all parties? I.e., if cannot be transmitted then have some post-processing of photo(s) to lessen chance for misintreptation. Are the units of measurement always consistent (etc)?

  19. JamesHRH

    What a spectacular idea.How do they get around legal hurdles?

  20. LE

    Note to the figure1 team, this magazine is a great resource and you should contact them:…They publish pictures (see image database) like this on the cover of the print mag which comes bagged in plastic. And idea would be a postcard insert in the bag highlighting your app (in addition to editorial mention obviously).

    1. JimHirshfield

      Do you buy lots of picture magazines bagged in plastic?

      1. LE

        10/10 Hirshfield scale on that one. We can do improv together.By the way if you haven’t watched it yet the CNN Series “The Sixties” is excellent. You would especially like episode 1, “TV Comes of Age”. [1]…[1] In a clip from the MTM show a cop says to Dick Van Dyke “unfortunately there aren’t laws against bad TV shows…….so you’re safe for now”.

        1. JimHirshfield

          Thankfully there are no laws against bad comments…so you’re safe for now.

          1. LE

            The scale only goes up to 10 or I would have given that a 12.

  21. ShanaC

    There are so many times I wish my doctor had that.

  22. JimHirshfield

    Figure1 is “instagram for doctors.”How did I not catch this earlier? You dropped a “this for that” on us?!!!!

  23. Charlene Ngamwajasat MD

    Heard about Figure 1 a while back in an HIT publication & it is something that is needed in the space and something students & HCP’s would say yes to.Likes 1. As an education tool for students & as part of cme.2. As a case study repository. Sometimes you write a case study & it disappears into the ether, when it could benefit others. 3. Aid in rare disease or skin rash findings (City doc sees case of prairie dog bite or second opinion by a derm on a rash)4. Helps docs in areas that lack specialists or even lone docs in private practice (in medicine, u learn every day)5. Face blocking aspect to keep pt identity private 6. Real time feedback. Only some institutions allow remote access to pt radiology films/EMR. This looks like a more kosher way of sending a pic to someone who isn’t in the hospital.Considerations 1. See it more helpful in some areas. Radiology of course, derm, internal. Psych not so much.2. Picture quality/resolution is key. That EKG pic above is readable because I can make out the boxes. But EKG reading has a lot of subtlety to it in regards to rate, rhythm & waveform morphology. Also context of the clinical scenario is impt because some drugs or maneuvers are contraindicated in certain scenarios or a decision is based on pt’s vital signs. Like a hypotensive pt w afib tx differently than a more stable one. 3. If use is in real time, how fast would the replies be? ICU, seconds to minutes to make decisions. In office, pt visit might be 15-30 min. 4. Competition. Seen some all derm online tools, have books of just rads pics on my shelf. 5. Pt ok to have pic taken? Would that require a form? There is a paper that most teaching hospitals have ppl in the ER sign that says something about cases/info & use for didactics. 6. Hopkins already has primary care & hospitalist learning modules for residents & students that I believe they license out to a majority of the US IM residency programs. I went through them as a resident. Didn’t have a lot of pics though. 7. A lot of ppl focus on us docs but there are other types of care providers/allied health too who might benefit. Glad dentists brought up. Also, going into the non-human realm, vets.

  24. sigmaalgebra

    I’m trying to understand:(1) Okay, smartphones are good at taking pictures and at sending them. Good. And an app can have a user interface that makes such work easy.But, what’s wrong with just simple mail transport protocol (SMTP) e-mail with pictures sent via multi-media internet mail extensions (MIME)?Indeed, likely about the easiest way to send a picture would be just via SMTP, and this approach gets to use the large e-mail infrastructure. Part of this infrastructure is e-mail servers, security, encryption, as I recall, some cases of trusted third party authentication, software for searching for e-mail, ‘e-mail address books’, ability to send also audio and video, and, of course, text, Gmail, etc.So, the app would want to try to redo and replace much of this infrastructure?So, one way, maybe a good way, to write the app would be just to make it another way to send SMTP e-mail.(2) Is the ‘secret’ of the app, that is, its approach to a “large network of engaged users” and a ‘network effect’ is that the receiver of the message also has to have the app?(3) Is the app also to permit audio, that is, voice?I would wonder: From what medical attention I’ve received recently, obviously now there is a lot of software for medicine. E.g., at the last clinic I went to, essentially everyone carried a laptop computer, and essentially all questions asked, all answers received, all prescriptions written, all appointments, all the medical records, etc. were via the laptops. Thus, I have to guess that if there is strong interest in sending picture, say, of EKGs, then that already is or soon will be programmed and integrated with the rest of the ‘information system’. E.g., I would suspect that eventually such a system would send not just a picture of an EKG printed on paper but the original, digital version of the EKG, and similarly for a lot of other medical imaging.Where am I going wrong here? What the heck am I not seeing or understanding?

  25. John

    The biggest risk here is that the FDA will want to regulate these images. There’s a good case to be made for it too and there are other mobile solutions that have gotten FDA clearance that will be happy to push the case that the FDA should regulate the images as well. Your example is a perfect one for them to use. The EKG image is ok, but has nuances that can’t always be seen in a picture. At least that’s the case they’ll make.Of course, you probably thought I was going to mention HIPAA, which is an issue that has to be dealt with, but can be done. The FDA regulation is much more of a concern in this case.

  26. William Mougayar

    Here’s a quick 6 min interview with Gregory Levey on the Canadian Business News Network.

  27. Dasher

    TBH when I think of Instagram for business – Healthcare would not be the first one to come to my mind – because of HIPAA and privacy issues of sharing.

    1. Dasher

      I see that the data is anonymized – so HIPAA may not apply here.

  28. Red Top Rep

    This is great, but what about HIPAA regulations? I’ve read news articles about doctors and nurses sued for posting picture of an operating room after working on someone, where the person wasn’t even in the picture. Widely distributing pics of people’s anatomy without their explicit consent in every case seems like it would run afoul of HIPAA in a bad way.

  29. awaldstein

    Great point.At its core Instagram is a community building tool.Looking to build an inclusive community of people who are supportive with a subset of people that purchase your bread products, this is potentially perfect.Point–if the dynamics of community are there, Instagram sorts them well. True for doctors potentially as well.

  30. aweissman

    its a public community, HIPAA compliant, geared toward medical pros. Not meant for private communications, per se

  31. JimHirshfield

    1) super busy and 2) super lazyCan I get a Venn Diagram on this?…’cause the only thing I can think of at the intersection of these two things is sleeping.