Medicine 2.0 Blog Carnival

Welcome to the Medicine 2.0 Blog Carnival ! The purpose of a carnival is to celebrate, and that’s what I hope to do with this carnival. My theme is - How can Medicine 2.0 contribute to healing the healthcare system ?

I feel the healthcare system today is sick because it is doctor-centric. Healthcare is fragmented and disorganized and there are too many specialists , most of whom have tunnel vision. In order to reform the healthcare ecosystem , we need to put patients back where they belong - at the center. We believe that patients are the largest untapped healthcare resource ! Patients ( or their relatives and friends) are : intelligent and capable; and because they have a lot at stake , they are motivated to get good health care and will be willing to invest time and energy if given the right tools to ensure a good outcome. We need to provide the tools directly to patients.

The good news is that what the medical profession has not been able to do for so many years, is now gradually becoming possible because of Web 2.0 ! As Clemanceau said, " War is too important to be left upto the Generals. " This is equally true of medical care – it’s too important to leave upto the doctors !

It’s good idea to start with students first. Most practicing doctors will find it hard to change their habits – but medical nursing students are much more flexible – and if they can use Web 2.0 tools for their own training, they are much more likely to use these for improving the care their provide to their patients ! Dan Weberg has a good list on the Potential Uses for health 2.0 in nursing education at Lets Upgrade Health Care Innovation. Here is another excellent overview of the 6 axes of medical education in Web 2.0 style.

Phil for Humanity presents The Controversy over Stem Cell Research posted at Phil for Humanity. Here’s a good example of what well-informed patients can find out on their own Not only is there a wealth of information , but because it is being shared with others, it becomes much more useful and powerful !

One of the good things about the Web is that it allows doctors to look at things from the patient’s lens ! Doctors who blog are much more patient-centric – and blog about things which are likely to be of interest to their patients ( rather than stuff which is only of interest to them and their colleagues). This kind of blogging is bound to help a doctor become more empathetic – and improve his bedside manner too ! Ed Odom, MD presents Top Ten Ways to Survive 'til You're 35 posted at thehonestdoctor.com.

Lots of doctors are using Web 2.0 innovations very cleverly. One of the most high profile doctors is Dr Jay Parkinson who announced hello health at the Health 2.0 conference in San Diego. What a great idea ! It's a very good example of how technology can be used cleverly to cut out all the "middle-men" between the doctor and patient, so doctors can focus on doing what they do best - providing high quality medical care - one-on-one ! Over!my!med!body! has some concerns about this style of practise , because it selects for the healthier patients, and it's going to be interesting to see how this model evolves.

Mic Agbayani presents Take Your Reading With You With ReadTheWords posted at geekydoc.This is a very clever application – and it’s free. Doctors are very busy – but they can use ReadtheWords to listen to journal articles or abstracts while driving or commuting ! Now someone needs to make similar applications for Indian languages too !

He also offers an alternative viewpoint on Twitter at Rants: Too Much Twitter. I’d agree ! Sometimes, less is more !

Jose DeJesus MD presents Lowering Prescription Drug Costs posted at Physician Entrepreneur. The private sector has used some innovative tactics to encourage the use of generics, and the public sector would do well to learn from the trails they have blazed. After all, the private sector puts its own money on the line and unlike the public sector, will not throw good money after bad in some failed social experiment.

Dr Bill Crounse has a thought-provoking entry on how Unified Communications can provide better tools to manage caregiver communication and collaboration in healthcare. Clever use of these tools can help to improve the doctor-patient relationship by providing more opportunities for interaction, without either the doctor or the patient having to actually travel to the clinic !

David Rothman, the medical library geek, has an entry on some clever alternatives ( with some exotic names ) to PubMed , which allow for much more focussed searches. No more sorting through hundreds of papers you don’t care about to find the handful you were looking for–our search engine does it for you.

Vince Kuraitis has a very thoughtful comment on Search Engines Using Your Personal Health Information: Creepy or Cutting Edge? posted at e-CareManagement. Like all advances, this can be used for good or evil. I guess it’s going to be up to patients to decide whom they want to trust – and whom they don’t !

Bob Coffield also discusses PHRs and patient privacy when ruminating on HIPAA, privacy rights, who is (should be) the steward of medical information, and the pro/cons of patients (consumers) self treatment.

Larry Ferlazzo highlights a clever example of how web technology can be used to make the hospital a less scary place for children at Hospital Connection | Larry Ferlazzo's Websites of the Day... posted at Larry Ferlazzo's Websites of the Day.... I wish they allowed children to add their own comments to the site – this would make it a truly Web 2.0 application ! Kids can be surprisingly smart – and if children in hospital are given a chance to publish on a website ,I am sure they will come up with all sorts of clever things we can never predict. Wouldn’t this be a simple thing to do ? Why don’t we do it ? In fact, why don’t we allow all patients in a hospital the chance to blog or podcast – so we can learn more about their needs , and how we can meet them ?

Walter Jessen presents The Doctor’s Channel - A Media Snack for Doctors posted at Highlight HEALTH 2.0. In today’s fast-paced, hectic world, everyone is busy, especially doctors. With patient visits, paperwork and meetings, doctors have little time to learn from each other and the healthcare community. The Doctor’s Channel, an internet TV site for doctors, is a time-saving tool that offers doctors an informative media snack, enabling them to learn about the latest news, ideas and information quickly.
I am sure it’s just a matter of time before you will be able to can watch this on your mobile too ! This is the likely to become the newest form of CME ( continuing medical education).

There is an uptodate list of medical wikis at List of Medical Wikis – another great tool to get users to collaborate .

Everyone seems to be beating up on PubMed ( and with good reason, I think). Bertalan Mesko offers a possible solution ! Check out Scienceroll Search which is a personalized medical search engine powered by Polymeta.com. You can choose which databases to search in and which one to exclude from your list. It works with well-known medical search engines and databases and will evolve as more people use it and provide feedback !

Google continues to experiment with new areas and an interesting entry highlights its Predict and Prevent program which plans to use information and technology to “empower communities to predict and prevent emerging threats before they become local, regional, or global crises.”

Most people don't care much about Health 2.0 or 1.0 because they have a much more pressing concern - Can it help me lose weight ? Lots of people would like to know , and there's a great comment on this medical journal article with the heavyweight title, “Comparison of Strategies for Sustaining Weight Loss: The Weight Loss Maintenance Randomized Controlled Trial ” at the health 2.0 Blog. Lots of food for thought here !

How do we extract the signal from all the digital noise we are going to create ? The Digital Pathology Blog reminds us that we end up getting " more numbers and data in the chart to filter through which may be of minimal importance. "

Not everything about Web 2.0 is brand new. One of the interesting trends I have been watching is the proliferation of websites which rank and rate doctors and hospitals. There are many examples, including – While many doctors are uncomfortable with these sites ( and these ratings are full of flaws), in one sense these sites are another type of Web 2.0 technology, because they use the wisdom of the crowds. No one has developed a better system as yet – and while judging a doctor only on his bedside manner may not be the best way to judge his clinical ability, it will have to serve as a surrogate marker until we can come up with something better. Actually, doctors have always depended upon word-of-mouth marketing – and these websites are a highly evolved form of this kind of reputation grading.

Another great example of an old technology which allows effective user-generated content is the Bulletin Board. These have become much better – easier to publish and much easier to use. They are extremely popular amongst infertile patients – and even amongst IVF specialists. I use the one at ivfforum.net frequently , which provides me with a great way of interacting with other IVF specialists.

Finally, how we use some of these tools depends upon the lens with which we perceive the world. Clever entrepreneurs are setting up sites which allow patients to bypass doctors, so that they can take better care of themselves. A good example is Mymedlab which allows patients to order their own medical tests.

To summarise, I feel there are 4 major influences which will help patients to regain control over their healthcare.

1. Patients will keep their own medical records using a PHR ( Personal Health Record)

2. Information Therapy can be prescribed to them, tailored to their needs, based on their medical problems captured in the PHR

3. Web 2.0 technologies will allow them to form social communities to help and support each other

4. We can deliver this information to them 24/7 through their mobile, wherever they maybe, whenever they need it !

The next edition of the Medicine 2.0 Blog Carnival is at Digital Pathology Blog and will be live on 13rd of April. Please send in your entries !