Newport Beach, CA (April 1, 2012) — Just two weeks after a private showing to reporters and bloggers at the South by Southwest (SXSW) conference, a new app called XrayGram is stirring up controversy.
We all know the popular Apple motto, “There’s an app for that.” But few dreamed when the iPhone launched in 2007 that soon modern diagnostic medical care would be coming to the iTunes App Store.
A start-up called XrayGram, with support from GE Health Systems and the founders of the popular photo app Instagram, is set to launch later this week on the AppStore.
The founder of the startup, Dr. Manual Ossa, asserts that the App can take x-rays of the human body that “are medically comparable to traditional radiographic equipment in most hospitals.” His goal is to bring fast diagnostic tools to the family backyard, and to remote parts of the world where it can be hard to reach a fully equipped hospital.
The breakthrough came when Ossa began playing with Square, the fast-growing service that turns any iPhone or iPad into a credit card terminal to accept payments. The founder of Square, twitter inventor Jack Dorsey, created a small plastic attachment that plugged into iOS hardware via the standard 3.5mm headphone jack. Similarly, XrayGram developed a plastic X-shaped attachment that is mailed to users who sign up, and pay shipping and handling costs.
Dr. Ossa, who had spent the early part of his career at GE Health working on radiology equipment, realized that thanks to the chip advances and the advances in silicon compute power known as Moore’s Law, it was now possible to shrink a cathode ray tube and tungsten anode to fit inside a 3-inch-wide unit that could fit into a shirt pocket, and plug in to an iPhone when needed.
Dr. Ossa presented the idea in April 2011 to Kevin Systrom, the founder of Instagram. Systrom instantly recognized the connection to Instagram’s digital image software, which lets consumers snap a picture, and then “stylize” the image to a flavor of their choice, from 1960s Instamatic to 1970s Polaroid.
Systrom’s team invested in XrayGram, and agreed to develop formatting software. After several months of experimentation, the app now features the ability for users to snap an x-ray, and while the image develops, choose between styles from “Vietnam-Era Black & White Film” to “3D Pixar Color Max.”
After the user snaps an x-ray of an injured area, for example a child’s wrist after a fall, the user has three options. For free, users can self-diagnose. If signed up for the Premium service ($8 a month), users can upload the images to XrayGram and their Facebook pages, and encourage other community users to help the diagnosis, in a “crowdsourcing” approach. Lastly, for the Gold Service (at $16 a month), the x-ray is uploaded to a medical “offshoring” facility in Bangalore, India, where an Indian board-certified radiologist will make a reading, and email the user a private diagnosis.
All of which has some US medical organizations up in arms.
“This XrayGram represents a dangerous trend, begun with WebMD, towards amateurs practicing medicine on themselves and their families,” said Dr. Ian Avarus, president of the American Medical Association. “There is no substitute for a licensed, trained physician, nor can Americans expect good care on the cheap, from an Indian call center.”
Other concerns go deeper.
“I am afraid that over-exposure to radiation will follow inevitably,” wrote Chase Vix, editor of the Journal of American Medicine (JAMA), in a recent blog post. “If kids x-ray themselves as often as my 7-year-old plays ‘Angry Birds,’ they will glow in the dark before leaving elementary school.”
Vix called on the app developer to cap XrayGram to no more than three exposures per month, and to add warnings not to point the device at women who are or may be pregnant.
The offices of XrayGram, in Mountain View, CA, would not comment on the issues raised by Vix, except to note that the unit is mailed with a lead iPhone case, which the developers recommend the user remove and place over their “private parts” before clicking the x-ray button.
What will modern technology bring us next?
I find this an electrifying possibility, but at the same time I am revolted by the abuse that may follow.
I suggest we all write Tim Cook at Apple and ask him to de-list this app from iTunes until further research on its safety can be completed, probably by next April 1.
Michael Arnold Glueck IV, M.D., of Newport Beach, has written extensively on medical and legal issues locally, nationally and internationally.
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