Navigating medical apps and technology

LONG WAITS, HIGH COSTS AND PACKED PEDIATRIC EMERGENCY ROOMS can be a nightmare for parents and physicians alike. 

Therese Canares, M.D., MBA, saw both sides as a pediatric emergency physician and mother of two young children at the height of the pandemic. 

She saw that critical health care was being slowed by a glut of minor maladies “that didn’t belong in the emergency room in the first place.” But she also understood why parents brought in their children: ailments occur 24/7, not just during office hours. And when a child sobs from pain they cannot explain, parents can become anxious. 

“It’s a struggle for families,” says Canares, who also was an assistant professor of pediatric emergency medicine at Johns Hopkins University School of Medicine. “But if you’re in the ER, you or your child could spread or catch a contagious disease.” 

How could families stay home instead? “The missing piece,” she says, “is knowing why someone is sick.” 

Elevating telemedicine 

Already the inventor of several devices to improve pediatric care—including using AI, machine learning and pictures of the ear drum to predict ear infections—she envisioned kicking telemedicine up a notch. 

Work on what would become CurieDx began in 2021, resulting in an AI predictor of strep throat and a mobile app which would enable patients to take close-up photos of a throat to send to their physician for a remote diagnosis. 

Though she had the medical knowledge to know what visual information was needed, she turned to a collaborator for help with the artificial intelligence component. 

Enter Mathias Unberath, Ph.D., John C. Malone associate professor of computer science at Whiting School of Engineering at Johns Hopkins. His work was supported by colleagues including Catalina Gomez Caballero, M.S., and a Ph.D. candidate in computer science at Johns Hopkins. Chief technology officer Rashmi Sachan, based in San Jose, also contributed. 

“It takes a village to bring something like this to life,” Canares says. 

Ultimately, Microsoft, TEDCO, Johns Hopkins Technology Ventures and Accelerator Hexcite, National Science Foundation and others helped fund, develop and commercialize CurieDx, of which Canares is CEOand cofounder, with Sachan. 

The CurieDx mobile app enables at-home screening through a smartphone camera and AI. It provides instant analysis of strep throat and other conditions and allows parents and patients to check in with a telehealth clinician remotely.

CurieDx empowers physicians to detect subtle differences which would indicate whether a patient simply has a sore throat due to a cold, or if it’s due to strep. 

Mind the gap 

Before CurieDx, long-distance diagnosis for strep had been lacking. Without a throat swab, clinicians who were contacted remotely were accurate in their diagnosis only 60 percent of the time. 

“Strep doesn’t always look the same in every patient,” Unberath says. Tonsils may be red, enlarged or spotted—but not always. And throats that are simply sore may share some symptoms with strep. “But we’ve been able to train computer models to be more likely than a human eye to see subtle patterns.” 

By using the CurieDx platform, accurate remote diagnoses have risen, with nearly 90 percent accuracy, Canares says. 

Despite that improvement, physicians often have asked patients to follow up with in-person tests. 

“Doctors are the ultimate decision makers for prescriptions and antibiotics,” Unberath says. 

More research is needed to determine how that confidence can be improved. 

The future of CurieDx 

Researchers plan to submit an updated version to the FDA soon. Researchers intend to add other common conditions to the mobile app, including skin rashes, urinary tract infections and pink eye. 

“Parents need to know whether their kids can go to school, which may mean a family member must stay home from work,” Canares says. 

“CurieDx’s use of unconventional data, like smartphone-acquired images, could transform telehealth,” Canares says. “We want to arm patients and families with reassurance—and with digital lab tests in their pockets thanks to smartphones.” •