The term anamnesis comes from the Greek anámnēsis and means memory. In the field of medicine, anamnesis refers to a patient’s medical history, which doctors or other medical professionals find out by asking patients specific questions about important medical and social aspects related to their health. Currently, a patient’s medical history can be collected in two ways: either the doctor talks with the patient when the latter visits the surgery, or the patient fills out a paper questionnaire in the waiting room. Many doctors have developed their own questionnaires. ”These questionnaires are neither standardised nor disease-specific,” says Dr. Lucas Spohn, CEO of Tomes GmbH. “Paper is not suitable for obtaining a comprehensive individual anamnesis.”

Doctors use a patient’s anamnesis to gather information that is useful for formulating a diagnosis, particularly in cases that involve complex diseases. Lucas Spohn, a medical doctor from Freiburg, knows from experience that doctors often lack the time for in-depth conversations with their patients. When he did his internship during his medical studies, Spohn found in many cases that too little information was available about a patient. “The reason we lacked information was because we did not have the time for in-depth conversations with our patients,” says Spohn who therefore set about looking for a useful technological tool to improve doctor-patient communication.

With the foundation of a company called Tomes GmbH in October 2016, Spohn achieved his first goal. Tomes stands for “Tomorrow’s medical software”. The company focuses on the development and will later be involved in the sales of the Idana (intelligent digital anamnesis) anamnesis software. “It is a software tool that doctors can use to obtain precise information about their patients’ condition, even in cases when they do not have time for an in-depth conversation,” says Spohn. Idana is an anamnesis software that asks a patient specific questions related to the patients’ symptoms before they actually see the doctor. “We are developing the questionnaires ourselves; they take into account the medical discipline for which they are developed, diseases, disease symptoms and the type of visit, i.e. whether it is the first time a patient is seeing the doctor, or whether it is a follow-up examination,” explains Lucas Spohn, who also did a bachelor’s degree in embedded systems engineering.

The team’s first place in the regional Elevator Pitch Baden-Württemberg in Freiburg in November 2016 demonstrates the huge potential of Spohn’s idea. Two months earlier, in September 2016, the German Ministry of Economics and Energy awarded an EXIST start-up grant for Spohn’s “ITAS-med” (intelligent tablet anamnesis system). Meanwhile, Lucas Spohn, Jerome Meinke (developer) and Lilian Rettegi (medical doctor) have moved into rooms at the University of Freiburg to further develop the software. “Our offices are in the Department of Healthcare Research in the Healthcare and Rehabilitation Research department led by Prof. Dr. Erik Farin-Glattacker,” says Spohn.

Unlike traditional anamnesis questionnaires, Tomes GmbH’s software tailors questionnaires to an individual patient’s specific situation, which the patients fill out prior to seeing a doctor. In practice, it looks like this: Software versions that will be used by GPs will come with a symptom-based questionnaire. The questionnaires will be designed such that a patient will be able to answer the questions in 15 to 30 minutes on a tablet in the waiting room. The patient will be guided through a question tree that simultaneously adapts to the patient’s responses. In specialist medical practices, a medical assistant will be able to select appropriate questionnaires based on GPs' tentative diagnoses. “We create questionnaires based on evidence-based guidelines and in cooperation with medical specialists. So we hope that our questionnaires will be of a high scientific standard,” says Spohn. Before talking with the patient, the doctor will go through the questions and answers and the software will point out critical issues. Tomes GmbH has the advantage over other anamnesis software developers that two of the team members are medical doctors. “Our software is a product developed by medical doctors and used by medical doctors; this is a huge advantage,” says Spohn. 

The field of cardiology is the first discipline for which a questionnaire package is being developed. "We hope that the software will be ready for practical testing in the first quarter of 2017,” says Spohn. Questionnaires for other disciplines will follow. Another objective is to use the software for telemedical anamneses so that patients can stay at home rather than having to visit their doctors. The advantage of telemedicine is that the questionnaire can also be used for follow-up monitoring of patients. Doctors do not need to visit their patients at home, which is especially important in rural areas where there are few medical specialists and it would take too long to visit patients. The software will also be evaluated in clinical studies carried out at the Freiburg University Medical Centre. Prof. Erik Farin-Glattacker will focus on the scientific aspects of using digital anamneses for disease diagnosis and monitoring.

In the future, the company is hoping to set up a cloud-based version of the software. “This is still a very sensitive issue in Germany,” says Spohn. “But other countries think differently.” If this happens, doctors would be able to use the software without having it to store on a computer, and software installation and maintenance could be kept to a minimum. The protection of data is technically feasible. “The data protection model needs to be implemented correctly in order to guarantee maximum security for all parties involved,” says Spohn.