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Who hasn’t watched the latest Grey’s Anatomy as medical residents fight tooth and nail to have a glimpse of cardiovascular surgeon Erica Hahn performing a double valve replacement on the father of medicine, Wiiliam Tapley? So little space in the operating room, so little opportunity for future surgeons to improve their cutting operating skills.

SurgyTec is an initiative develped by plastic surgeon Stevens MD, PhD to solve that. The site’s goal is to improve and share surgery techniques in order to improve one another’s skills. Physicians can now watch videos from ACL reconstruction to performing a midface lift.

So if you need a last minute refresher course on the use of robotic total mesorectal excision for the treatment of rectal cancer, SurgyTec is the place to visit!

Benefits Check-Up
Free, useful service that lists federal and state assistance programs for older Americans. It was the answer to address the problem of older adults being eligible for benefits and yet not utilizing them. Millions of older Americans may benefit from public programs that offer such things as health coverage,  supplemental income and utility bill assistance.

PhRMA
Provides updated lists of patient assistance program directory

Needy Meds
Similar format to RXAssist in that the site provides a catalog of available programs listed according to drug name and manufacturer

We have covered Health 2.0 in regards to websites and games but there’s a small uprising in another area of medicine, call it Doctor Visit 2.0, a word HippocraTech KF reader termed.

Jay Parkinson, MD/MPH

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Jay Parkinson, MD/MPH can probably be called the ultimate Dr. Geek, or rather, Dr. “House” (as in house calls). This 31-year-old physician began his New York medical practice in September, shorty after finishing his residencies in pediatrics from St. Vincent Hospital and Preventive Medicine from Johns Hopkins. Because of his unconventional approach to medicine, he already has a TV series planned for next season, a book deal and he was recently interviewed on the Colbert Report.

Dr. Parkinson’s approach has been termed by the media as “Medicine 2.0.” He incorporates the use of video chat, e-mail, and IM into his medical practice. Patients can see “open-slots” on his website where he uses Google Calendar then text him for an appointment.

After receiving the text, Dr. Parkinson would then personally go see the patient even if it is within the next hour. Patients spend 10-15 minutes filling out their health information on the website before the visit so that Dr. Parkinson has a snapshot of the situation, saving both him and the patient time.

During the housecall, he performs physical exams, explains his services, and assesses the patient’s medical status. Visits usually last about half an hour. His electronic medical record is ran on his iPhone and he uses a Mac computer.

The cost of his medical startup: less than $1500 (HisTalk)

Other coverage: NY Post, Gothamist, GeekSugar, Wired, WSJ

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While most patients are familiar with using Google, Yahoo or MSN to search for medical information, many are unaware of other available search engines, and some even specifically designed for health information. In no particular order, here are some engines:

Healiahealia.png
Healia is a health search engine that lets users “filter” information based on “checked boxes”. Information is neatly organized into tabs (Prevention, Causes/Risks, Symptoms, Treatments). Each result has “Attributes” such as “Advanced reading, Privacy Policy, HONCode etc. Which would make more sense to an everyday user: “Attributes” which lists such characteristics as “Fast loading, Advanced Reading” or Healthline’s “Trust Mark” that displays sites which are “Doctor-Reviewed”? Initial glances at the “Attributes” area of Healia, slightly confused me as I did not know if it was a technical error or part of the search as the area blends into the search results and there was no explanation as to what “Attributes” meant.

healianandhealthline222.jpg

MedStorymedstory.png
Medstory was acquired by Microsoft for an undisclosed sum. The site was developed by Alain Rappaport, MD. While search results are neatly organized at the top into categories such as “Drugs & Substances” or “People” the link results do not indicate any sort of Trust-Marks i.e. HONCode, reviewed by physician etc. There isn’t a way for users to differentiate legit sites from the gibberish background noise.

HealthVaulthealthvault.png
My review on HealthVault can be found here

Healthlinehealthline.jpg
My review on Healthline can be found here

RevolutionHealthrevolutionhealth.png
RevolutionHealth was started by AOL founder Steve Case. It uses Kosmix’s engine as a part of its search algorithm in addition to its own engine that searches within the site itself. Results are neatly organized on the left: Articles, News, Clinical Trials etc. RevlutionHealth offers doctor reviews, health communities, and expert bloggers as well as a way to organize your health records online.

OrganizedWisdomorganizedwisdom.png
OrganizedWisdom lists its search results in a very uncluttered manner. It boasts to be the “the first human-powered, doctor-guided search service for health.” The results are neatly divided in areas showing results such as: What is Diabetes, What are the symptoms, Support Groups etc. However, I would not have guessed that the site had physicians guiding it because there is no clear designation (as compared to Healthline which has their physicians and healthcare experts on the front page).

Kosmix
Kosmix is a multi-purpose engine that does not solely focus upon health. That was probably why RightHealth was launched (See next link). The one correct strategy that Kosmix implemented that Microsoft HealthVault has not, is alerting the users of their “RightHealth” service. Any results pertaining to health found on Kosmix is linked to the “RightHealth” engine.

RightHealthkosmix.png
RightHealth was developed by Kosmix. The engine splits the information into several sections such as web results, trusted sources, advanced reading, among others. What confuses me about this health site is the organization of the material. In health, trusted information is important because wrong information may be deadly. The “Trusted Resource” should be at the very top area of the site, not “Web Results” that display links to erroneous sites. In addition, RightHealth does not define what is a “Trusted Resource.” Is it a resource verified by a physician? Applies the HON code? etc.

HealthFinderhealthfinder.png
HealthFinder was developed by US Department of Health and Human Services

OmniMedicalSearch
OmniMedicalSearch searches up to 12 different medical search engines at once and brings back search results from at least 30 different sources. But quantity, does not equate quality.

GoogleHealth Co-Op
Company Description: “Topics are specific search areas that Google is developing with the help of expert contributors. Contributors to topics annotate websites that they think are especially useful, relevant, or authoritative to a topic with pre-defined category labels. These labels appear as links at the top of search results pages when users search for something related to the topic. Users can click these labels to refine their search results, giving priority to sites that have been labeled by topic contributors.”

Womens Health Search Enginewomenshealth.png
This search engine focuses upon then needs of women users. The engine was developed by the Office on Women’s Health in the U.S. Department of Health and Human Services.

GirlsHealth.govgirlshealth.png
GirlsHealth is not a search engine but it is a useful resource just launched by the Office on Women’s Health in the U.S. Department of Health and Human Services. It is an interesting site because it targets younger girls who are learning about their changing body. For parents who have a difficulty time explaining the changes that go on during puberty, GirlsHealth is a useful resource to read and to share with your daughter.

WebMDwebmd.png
One stop medical site filled with quizzes, forum, interactive calculators and other things to assist patients in learning more about their condition. They are now offering a way to store your personal health record online as well as blogs written by healthcare experts, Q&A involving doctors, as well as a message board.

MerckMedicusmerckmedicus.png
MerckMedicus is one of the most comprehensive medical resources on the internet. While the site was originally geared towards medical professionals, it does have a “Patient Education” area that provides patient handouts, medical news, and clinical trials. Of most interest to patients may be an illustrated guides to surgeries and procedures as well as a list of patient support groups. For healthcare professionals, the site offers clinical references, images of infectious diseases, and disease modules among the other various tools available for free.

There is no form of advertisement on this site which was developed by Merck& Co.

Comments

  • Fragmented Team. Any health engine/site needs to make sure that they cover the basis and areas of all medicine. The team of advisors needs to make up a diverse team. Diagnosis/Disease: Physicians; Drugs/Medicare: Pharmacists; Teeth: Dentists; User-search behavior and organization: Medical Librarians, Daily Patient Care: Nurses. And most importantly…the people who directly use it – the patients. The majority of the search engine team consists of only physicians. You can’t fix the fragmented healthcare system with a fragmented team.
  • Lack of marketing. Of all the new engines/portals on here, I would have to say RevolutionHealth did the best in terms of marketing itself to healthcare providers and making use of their already established AOL database of users.. They were aggressive in presenting at conferences and sending information about their product. The campaign thus far would appear successful, proof of such when I ask patients “Have you heard of Healthline or Medstory?” Their answer was most often “No” but when referenced to “RevolutionHealth,” the answer typically sounded like: “Yes, that AOL guy founded it.”
  • No superior search engine. Of the mix above, none would I consider the “perfect search engine.” Each one of these have strong points and weak points. For instance, Healthline has the “Trust Mark” feature whereas Healia does not. WebMD has a Q&A section supported by physicians whereas some of the others do not. This is probably one of the most important features for any health site – the ability for patients to interact with doctors who may provide them with a second opinion. Everyone needs a “Friend” in healthcare. With that being said, these sites need to analyze and examine their competitors and add to their services what work and phase out what doesn’t.
  • The current health search engines are boring. Information about health does not always have to be boring. If I was searching for “Breast Cancer,” it would be nice to have information in regards to celebrities or interesting event such as the “American Idol Gives Back” special or about Lisa Spodak and Kelly Wold who waited hours after a celebrity event to acquire signatures in order to raise money for breast cancer. One could call them: uplifting news. Fighting a disease doesn’t have to be sad, depressing, or boring. It should be fun, inspirational, and empowering.
  • Don’t hold back on the [tasteful] graphics. When I have a pounding migraine with halos, coupled with nausea/vomiting, the last thing I’d like to see from my search engine is a screen filled with words that is completely overwhelming. Health search engines do not need to be so dry. Provide some more graphics or perhaps a screenshot of what the website looks like. Meaningful graphics could help cut the sea of text and help organize the looks and feel of a result. If I searched for “diabetes”, I’d like to see some pictures relating to diabetes.
  • Attack of the Clones. Most search engines seem to be clones of one another, presenting the information in a different fashion. The engines need to tackle other areas that patients search for, such as finding a doctor who speaks a particular language or accepts a certain health insurance plan.
  • Make health fun. Search engines need to provide a reason for users to come back and not just when they are sick. I know that a lot of intellectuals complain that health information from areas such as FitSugar or information provided by Cosmopolitan are “blonde” information. Health information delivered by health experts do not always have to be dry or focused upon clinical trials. More users will likely return or subscribe to a health expert on a search engine’s site if he/she made reading about health fun, filled with more pictures. For example, a breast cancer patient may get tired of reading about clinical breast cancer trials and just wants to read about what other breast cancer patients are doing to empower themselves or celebrities who are making a difference in healthcare.
  • Be the search engine of health tools while branding yourself.. Being a search engine does not mean merely providing information through search. The notion of a “health search engine” can be applied to other arenas. For example: For a women interested in fitness, the engine may provide her search results of fitness instructors or gyms in the area or a database of healthy recipes. In another example, a diabetic patient who wishes to keep his blood sugar information organized but does not want to keep it online would need customized documents. He needs a place to go where he may search for “useful printable documents” that he may use to monitor his sugar levels. All print outs would have the search engine’s logo on it, thereby building a brand.

Know what users want by talking to them. No one gives more insight and better information than a patient who is sick, complaining about his needs.

Pulse is a virtual-clinical training tool for nursing and medical students. The game’s purpose is to develop skills from time management to quick thinking. Pulse!! is funded by the Office of Naval Research and developed by BreakAway, a developer that has made several simulations for emergency response teams as well as for military purposes.

Students walk through the Pulse!! environment as if playing a first-person shooter, but taking the role of a medical physician in order to talk and interact with patients in order to obtain information to assess his condition. The game’s sound and movements are realistic, which is to be expected since the Breakaway developers work closely with physicians and nurses to ensure accuracy of symptoms, injuries, as well as movements of a real-life medical team during an emergency.

breakaway.png

Perform Open Heart Surgery Online
Assume the role of a surgeon to perform a coronary bypass surgery. There are 3 levels of difficulty (intern, surgeon, specialist) and the game is based upon a real operation.

heartsurgery.png

How well do you know the human body?
Images are provided to the user and he must be experienced enough to match the image to the correct body part on Jerome.

bodyparts.png

Performing Hip Surgery
Become a surgeon and perform a hip surgery.

hipgame.png

Other Related resources
Bringing fitness into games
Games help children escape reality of burn unit
The making of Remission by HopeLabs

Online doctor-rating websites have been emerging left and right on the web and most doctors are not happy about it. Medical Justice, a company led by neurosurgeon Jeff Segal provides physicians with contracts that require a patient to ask for the physician’s permission to grade them online (WSJ Health Blog). Dr. Segal hopes that this initiative would reduce the number of “anonymous” ratings. “About a third of the 1,600 doctors who pay Medical Justice’s annual fee have asked for the online-review contract since the company started offering it earlier this year.” A response to Medical Justice’s proposal:

“I would personally not be likely to even want to be treated by a physician that was so paranoid about what might be said about them by a patient so as to request that such a document be signed by them. For me, that would be a signal to get the hell out of their office asap and never go back.” – JaneQPatient

As if there aren’t enough physician rating systems out there, the Senate Health, Education, Labor and Pensions Committee are revising a health information technology bill regarding the creation of a physician rating system based on federal claims data that would take into account patient risk factors and health condition (Government Executive).

List of some doctor-rating systems
RateMDs
RateMDs is amongst the most popular physician-rating site available. It boasts theratemd.png largest free online physician rating system based on three factors (knowledge, helpfulness, and punctuality). The recent merger between the Nddb.net database with that of RateMDs further increases their dominance in the physician-rating arena. “The newly, combined database currently consists of over 350,000 ratings for physicians in the U.S. and Canada, and is growing by over 500 ratings per day; over 40,000 U.S. doctors are now rated. Over 10,000 users per day access the website and traffic has at least doubled each year since the site’s founding.”

ZocDoc
ZocDoc provides a multitude of services besides doctor ratings. The site lets patients book dentist and doctor appointments instantly online. No need to spend time on the phone or be kept on hold just tozocdoc.png schedule an appointment. With just a few clicks, the appointment is booked and confirmed within a day. The most useful function that the site offers involves searching for doctors based upon which insurance they accept. The site was founded by Oliver Kharraz, MD and Cyrus Massoumi. This idea is a very useful idea, but unfortunately, the site is currently only available for residents of Manhattan who are interested in booking a dentist. They do have plans on expanding the service to other cities and fields.

CareSeek
CareSeek is similar to RateMDs in concept but the rating criteria is based upon 5 areas: Communication and rapport,careseek.png Competence and experience, Responsive, Likely to recommend to [other] patients, and Treats staff with care. CareSeek also displays personal information about the physician in question (i.e. office address, telephone number, education etc.) The site seems relatively new with few reviews and I do not see any revolutionary features that would make it superior to RateMDs.

Healthgrades
A pay based site where users must pay a fee before they’re allowed a see a “report” on any given doctor.

Wellpoint and Zagat
Wellpoint and Zagat are teaming up to launch an online physician-rating tool, set to launch in January 2008. According to Wellpoint, information about physicians will not include malpractice lawsuits and each doctor will need at least 10 postings before the ratings will be posted publicly. (Source: USA Today)

Comments

  • On an episode of House M.D., a film crew follows House and his team around as they attempt to diagnose Kenny, a new patient of the team. Withhouse.jpg the TV crew documenting their every step, the team shuts down in providing House with theories that would lead to his diagnosis of Kenny. Online doctor rating tools acts as a TV crew watching the doctor’s every step. How could a physician be able to focus upon patient care if their focus is shifted to rankings, points and how the patient “views them” rather than what’s critical, the patient’s health.
  • There will be a shortage of doctors within a few years because insurance companies are raising their premiums higher for certain professions. The big question in regards to these ratings is how it would factor into insurance premiums for doctors and their practices.
  • Could this information be utilized by trial lawyers against a doctor in a court of law?
  • Online physicians rating systems won’t go away anytime soon. To make it a leveled playing field, the very least that these sites could do is to allow doctors to refute any derogative comments made by a user. In the current arena, the physicians are like boxing opponents who have stepped into the ring without the proper equipment to defend themselves against the onslaught of criticism against them.
  • There’s a lot of variability on who rates and comments on a particular physician. For instance, a patient who is known for narcotic abuse may rate a doctor poorly due to his refusal to prescribe a narcotic to him without a proper clinical indication. In similar situations, it would not prove to be a fair evaluation of the doctor and of their performance as a healthcare provider.

NY to begin implementing state-wide medical record sharing
Greater Rochester Regional Health Information Organization will be implementing medical records sharing in 9 New York counties. The sharing will allow physicians and healthcare providers to share patient information such as allergy histories, lab results and medication history. The implementation will begin the week of November 25, 2007 with the goal to allow physicians access to medical records by Dec 2, 2007. (Source: Democrat & Chronicles)

Indiana to use VisualDX to assist with diagnosis in hospitals
Indiana State Department of Health will distribute VisualDX software, a visual diagnosis tool, to 53 facilities statewide. 42 hospitals and 11 local health departments and clinics in Indiana will use the software to cut costs and improve patient diagnosis. VisualDX has over 14,000 images and more than 800 visually identifiable diseases, drug interactions and infections to help physicians with diagnosis. (Source: Health IT News)

Chat Therapy: Patients seek help via Instant Text Messaging
Text messaging is being used to convey patients with health care information. In England, text messages are used to remind women to take their birth control pills while an Austrailia, it is being used as a reminder for patients to take their HIV medication. Studies are being conducted to assess if supportive text messaging may have an impact on bulimics or those going through a smoking cessation program. Source: (Source: Wall Street Journal)

Healthline healthline.jpgis a “taxonomy-driven Medically Guided Search platform.” It seems to be a cross between a search engine and health portal. Results are returned with “Trust-Marks,” showcasing the legitimacy of a link either being “Doctor-Reviewed” or accredited by “HONCode, URAC, etc. Users are allowed to “save” or”e-mail” search results. Upon saving a search result, users can rate, add notes, and tag it.

The left column offers “Top Results,” and Health Maps that suggests other possible search inquiries. Other features include the ability to subscribe to articles written by health experts, firefox plugin, and health news alert based on your indicated area of interest.

Analysis
Healthline is easy on the eyes, the layout is uncluttered, and it’s user-friendly. It reminds me of a “Yahoo” but for health. However, I do not see an option for users to develop “Groups” centered around a disease area on Healthline. I know that when I chit-chat with patients on the sites that they use, a popular response is always “Yahoo Groups.” Group formation may assist in building a relationship with a site through the formation of a user’s sense of herd mentality, turning one-time-users into members. It’s an important feature for any site, especially for a health site where support is the core of healthcare.

Healthline’s option of “saving” links reminds me of HealthVault‘s “Scraps” feature. As mentioned in a previous HealthVault analysis, I wonder if the search engine plans on incorporating a user’s “saved” searches into the engines’ algorithm. Delicious is one of the first sites I go to if I need to search for useful links. Why not allow users to see the number of “saves” that a particular link has and allow users to filter results based on the number of saved links? If a user saves a searched site, it must mean that the site is useful.

The “Health Experts” area contains a multitude of very knowledgeable and smart contributors. However, I am surprised to see that Healthline has not added Health Experts who focus upon some of the most popular health areas and largest disease states: Diabetes, Asthma, Cardiovascular Conditions, Women’s Health, and Drug Management with information on Medicare and Geriatrics.

Businessweek created a slideshow depicting the best countries for healthcare. According to Businessweek:

Among seven nations surveyed, the U.S. ranks lowest in patient satisfaction with overall medical care

30% of U.S. respondents said that they had to pay more than $1000 in out-of-pocket medical costs last year, while 1/3 of those surveyed from the U.S. said that the healthcare system needs to be completely revamped.

Top countries
1. Australia
National spending per capita: $3, 128
Percentage of National GDP: 9.5%
Healthcare System needs to be rebuilt completely: 18% think so

2. Canada
National spending per capita: $3, 326
Percentage of National GDP: 9.8%
Healthcare System needs to be rebuilt completely: 12% think so

3. Germany
National spending per capita: $3, 287
Percentage of National GDP: 10.7%
Healthcare System needs to be rebuilt completely: 27% think so

4. Netherlands
National spending per capita: $3, 094
Percentage of National GDP: 9.2%
Healthcare System needs to be rebuilt completely: 9% think so

5. New Zealand
National spending per capita: $2, 343
Percentage of National GDP: 9.0%
Healthcare System needs to be rebuilt completely: 17% think so

6. England
National spending per capita: $2, 724
Percentage of National GDP: 8.3%
Healthcare System needs to be rebuilt completely: 15% think so

7. United States
National spending per capita: $6,697
Percentage of National GDP: 16%
Healthcare System needs to be rebuilt completely: 34% think so

The constant improvements of technology from biotechnology to web innovation assist in improving healthcare but perhaps a bigger impact on healthcare would be to focus upon improving the policies and procedures.

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[Last modified: 12/08/07]