Dermtest: empowering primary care with early detection software

The objective of Dermtest is to improve early detection of severe and complicated diseases. The solution connects primary  care and specialist doctors and puts tools in the hands of general practitioners for providing fast access to care according to guidelines.

Dermtest offers a full-scale solution that combines applied software, support ser-vices and digital dermatoscopy, helping GPs to detect and prevent skin cancer at an early stage. If someone is worried about a mole, they can approach the nearest clinic that uses Dermtest. The GP will take images of the mole using a special camera called a dermatoscope and sends the images to a dermatologist for evaluation. Compared to bare-eye observation, dermatoscopy results in a 30% improvement in diagnosis accuracy and allows doctors to provide a high qua-lity evaluation of whether there are suspicious changes pointing to cancer.

The dermatologist evaluates the data remotely and provides instructions for subsequent treatment. The patient recei-ves from the GP a personal summary regarding the results of the examination, including prevention tips. “At the primary care level, we offer services backed with specialist opinion so that GPs can offer more to patients and diagnose melanoma at an early stage,” says Priit Kruus, CEO of Dermtest.

An idea that emerged from a specific a problem

The idea for Dermtest started at Dr. Niin’s skin clinic, with the aim to make specialist care available to patients with no derma-tologist in their local district. Dermtest was launched as a project but then evolved into an independent start-up that is currently operational in Estonia, Lithuania, Germany and Moldova.

Since the establishment of Dermtest, about 100 early-stage skin tumours have been detected – lives saved.

In Estonia, 60 people die of melanoma every year. Since the establishment of Dermtest, about 100 early-stage skin tumours have been detected – lives saved. Dermtest is in use across Estonia and Europe in a total of 35 clinics. Partner clinics can provide patients an opportunity to quickly get a medical opinion for any suspicious skin lesions. Today the service is locally available for 1.5 million people in Europe.

“Detecting skin cancer early means that the cost of treatment is many tens of times cheaper than in a later stage. If melanoma is detected in stage 0, the sur-vival rate is nearly 100% as opposed to 20-40% in stage four,” says Kruus.

Dermtest significantly improves the availability of dermatologists, which is an acute problem because the waiting lists to see a specialist are long and availability varies greatly from one region to another. In addition, Dermtest has brought added value to care quality. Dermatoscopes have not been previously used at the primary level, and personal and preventive instructions for the patient – which Dermtest soft-ware helps to automatically generate – provide added value.

A comprehensive approach to tackle diseases

Germany is one of the important markets for Dermtest, as melanoma mortality is high in that country – 3,000 people per year. The costs of skin cancer are more than half a billion euros per year – equi-valent to half of the budget of the Estonian Health Insurance Fund. Kruus says Dermtest can offer significant added value for the German health system, because the solution improves the availability of specialist medical care and reduces expensive oncological treatment costs and melanoma mortality. “To this point, with melanoma mortality high, the problem is unresolved. These deaths would be 100% preventable if melanoma were detected in an early stage,” says Kruus.

The service has recently expanded to Moldova, where there is no analogous solutions in the field of dermatology. “We have managed to cover most of Estonia with Dermtest. When entering other markets, our goal is to resolve problems with early detection of melanoma in a single country or the entire region. The aim is to make early diagnostics of melanoma into reality by involving the whole system and all stake-holders – dermatologists, GPs, hospitals, government, insurance providers and patient organizations,” says Kruus.

Dermtest has used a similar approach on new markets, promoting cooperation between networks of physicians, insurance companies and state agencies. The solution offers tools that help to make dermatologists’ work easier while guaran-teeing that no matter where the person lives or goes to see a doctor, they will have access to specialist opinions and their dermatological treatment history.

In future, Dermtest plans to expand to other countries in Eastern and Northern Europe, and also to the US market. The team is keeping a close eye on developments in the field of artificial intelligence so as to offer quality decision support and support the physician’s diagnostic process with image analysis.

Integrative components along the patient pathway

Besides expansion plans, Dermtest has been actively dealing with new services because the app itself is powerful and many GPs have taken an interest in using the functional platform for consultation on other problems, whether dermatological or not.

Dermtest is now offering acne diagnostics and treatment plan solutions as well. People with acne problems can visit a partner clinic near them to provide an overview of their problematic skin; the information gathered from the patient is then sent to the dermatologist. The dermatologist provides a remote evaluation of skin problems and conveys personal instructions for acne care. Based on the dermatologist’s evaluation, a special treatment plan is generated for the patient, including further instructions.

Dermtest has several necessary components to offer a systemic approach for the management of a specific disease. There is a general risk questionnaire and digital case history module, views for the GP, nurse and specialist, a powerful integration module for interfacing with other information systems and a patient notification module. All these components can be put to work in the interest of a comprehensive approach to medical care for a patient with a specific problem and to promote cooperation between different healthcare levels to solve the problem.

The components of the Dermtest technology also support early diagnosis for people with chronic obstructive pulmonary disease. In this case, a spirograph is employed instead of a dermatoscope, the latter of which can be used at the GP level for the initial diagnosis. Again, the link to the specialist is key here, as they can provide consultation remotely. Today, thanks to Dermtest, several hundred patients with possible COPD have received a questionnaire based risk assessment. “Our philosophy is to take a disease-specific approach. We make sure that the approach to a specific illness is high in quality, according to guidelines and covers the patient’s entire treatment journey,” says Kruus.