The algorithm analyses a picture. Is it considered a medical act?

integration of artificial intelligence in dermatology

The algorithm analyses a picture. Is it considered a medical act?

Managers often wonder how to deal with insurance reimbursement when using Legit.Health

Short answer

Yes, every time a patient sends a photo, and it’s processed by the algorithm, this constitutes a medical act, as defined in HL7’s FHIR standard and in most national Medical Code of Ethics.

This rings especially true when you consider that even after the algorithm has processed a picture, a doctor needs to confirm the diagnosis and make a medical decision.  

In short, our tool reduces the amount of work that each medical act takes, without removing it completely.

Long answer

A medical act is any lawful activity, carried out by a legitimately trained medical professional (…) aimed at curing a disease, alleviating a disease (…) by direct and indirect means.”

Código de Deontología Médica (https://www.cgcom.es)

This definition also covers the clinical interaction in which the physician partakes indirectly, as long as it is diagnostic or therapeutic and aimed at curing the diseases.

Thus, the medical act is not defined by the time it takes nor the presence of the doctor and the patient in the same room, but by the applied use of the practitioner’s skills and knowledge towards helping the patient.  

What about sending pictures?

Every time a patient sends a photo, it’s processed by the algorithm. This automatically generates a Diagnostic Report, as defined by the international HL7 organization. This report is a collection of data presented in a clinically relevant way that helps the doctor make a faster, more objective and more accurate diagnosis.

The data outputted by the algorithm triggers a clinical workflow, sends information to the patient and the doctor, and enables care continuity. This constitutes an Encounter, and thus a medical act.

There are two points we want to stress regarding this topic. First and most importantly, Legit.Health is a clinical support tool that doctors use to care for patients (as opposed to being used by patients without a doctor’s intervention). Therefore, the very nature of the tool is to help doctors carry out the diagnostic or therapeutic process.

The use of applications for telematic follow-up allows the flow of information between doctor and patient without the need for face-to-face consultations, adjusting it to a more real time and allowing changes in the therapeutic attitude more quickly and effectively.

Dr. Elena Sánchez-Largo, Torrejón Hospital

Additionally, the algorithm has been trained using the consensus and combined experience of the top doctors in the field, and therefore it represents the criteria of legitimately trained medical professionals. Thus, the use of the app is often compared to the doctor asking a colleague for a second opinion on a case. The only difference is that, thanks to Legit.Health, they can do it automatically for every patient, taking only seconds to do so.

With Legit.Health

52 medical acts per hour

remote dermatology with AI

Traditional consultation

8 medical acts per hour

In-person consultation dermatology

With all things considered, it is easy to see how Legit.Health changes the paradigm. Allowing to simultaneously increase the number of medical acts a doctor can perform while reducing the work and time each of them takes.

We are aware of the technical, administrative and economical differences between a face to face medical act and a telematic one. We aim to eliminate unnecessary video calls, improve the signal fidelity of the information that reaches the doctor, and turn telemedicine into an efficient, profitable endeavour for both the doctor and the healthcare provider.

integration of artificial intelligence in dermatology

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The algorithm analyses a picture. Is it considered a medical act?