Is Google’s Skin App a Hint of What’s to Come?

Medical device manufacturers have been told, “Google is coming.” The tech giant’s interest in healthcare and medical technology has been well documented (my own writings on the subject included). But the ballyhoo has all seemed to be for naught. Sure, Google dipped its toes into the medtech waters, primarily partnering with well-established firms such as J&J, for example (through Verily—Google’s healthcare-focused unit), to form Verb Surgical to develop a robotic surgical system. But after years of few results, J&J bought out the tech giant to continue the venture on its own. And the firm has partnered with a good number of healthcare facilities to aid in efficiency, information, and app development. All worthwhile efforts, but not the big splash expected from such a leading organization.

The doubters might want to pump the breaks for a moment.

Recently, Google announced it was launching an app to help identify concerning marks or rashes on skin. Using the phone’s camera to capture the area in question, artificial intelligence then offers potential conditions that are the most likely matches to the image. The user would then be able to research this list further to help determine the most likely result. In addition, for each identified match, the app will display dermatologist-reviewed information on the condition and also address commonly asked questions.

According to a May 18, 2021, blog posting by Peggy Bui, M.D., product manager, Google Health, and Yuan Liu, Ph.D., technical lead, about the new technology, the offering represents three years of machine learning research and product development. The authors mentioned they’ve published a number of peer-reviewed papers on the app and more are coming. The app is not meant to replace a clinical diagnosis, but provide a good first step for someone worried about a spot on their skin.

On the other hand, some doctors are concerned about possible “overdiagnoses” that could result from use of the app. While there is a global shortage of dermatologists, Dr. Andrew Miller, immediate past president of the Australasian College of Dermatologists, told The Guardian what his preference would be over the app. “What we want is subsidies to be able to work with GPs who will contact [dermatologists] with the patient’s history, and who can take good quality photographs for us and send those through. We can then take our time to analyze those and, with the patient’s consent, work with their GP to come up with a treatment plan.”

Dr. Miller explained there’s more to diagnosis than just an image of the area of concern. “I’d worry that with a computer, people might ignore advice to see a doctor, or the algorithm might miss anything complex. I’d also worry that they might misunderstand questions asked by the app.”

While a skin app may still not be the “big splash” people have been expecting of Google as it moves further into the healthcare space, I found one aspect of the story quite interesting. Google developed the app after finding almost 10 billion searches were happening each year through its search engine related to skin, nail, and hair issues. Further, 2 billion people worldwide suffer from dermatologic issues, according to the blog post. When you look at these elements, you realize Google has unlimited access to determine the most common clinical issues not currently being met by healthcare or its technologies. As such, the “legwork” to find the best possible avenues for new products is practically being done for them. That’s a huge advantage as a starting point in terms of R&D.

Leveraging the inquiries taking place on its search engine and analyzing those results against available products and technologies will certainly reveal a number of other unmet clinical needs. Sure, the start may be dermatology, but the next step may impact heart disease, cancer, diabetes, or any other number of health issues with a huge patient base. Tackling one of these areas would certainly be noteworthy.

As for the aforementioned earlier efforts that didn’t seem to be all that spectacular, one criticism against big tech entering the healthcare space was the organizations didn’t understand the regulatory framework within which they would need to operate. It wasn’t an environment they faced with consumer products. Well, what better way to learn more about regulatory guidelines than to work with the experts who live and breathe it every day? “Dipping your toes in” would be a perfect way to become familiar with the regulations before proceeding with loftier projects.

Perhaps Google shouldn’t be criticized for moving slowly in its healthcare efforts; rather, it should be applauded for realizing how serious the sector is and not entering it too aggressively. 

Sean Fenske, Editor-in-Chief
[email protected]