Image via WikipediaThe first "Medicine 2.0" Congress happened on September 4 - 5 in Toronto, Canada. You're justified in being confused by — or even skeptical of — any concept released under the version number "2.0" (or, even God help us, "3.0"). But the people who gathered under the flag of Medicine 2.0 early this month are actually doing interesting work. What does Medicine 2.0 mean? Via the conference website:
Medicine 2.0 applications, services and tools are Web-based services for health care consumers, caregivers, patients, health professionals, and biomedical researchers, that use Web 2.0 technologies as well as semantic web and virtual reality tools, to enable and facilitate specifically social networking, participation, apomediation, collaboration, and openness within and between these user groups.
(If you're qualified to expand on the differences between "Medicine 2.0" and "Health 2.0," please feel free to comment.)
To give you a flavor of the work the Medicine 2.0 folks are doing, here's a selection of abstract titles from the freely-available proceedings:
Social uses of personal health information within PatientsLikeMe™, an online patient community: What can happen when patients have access to one another’s data
Inside the Health Blogosphere: Governance, Quality and the New Opinion Leaders
The Construction of Expertise in the Age of the Internet: Psychotropic Drug Knowledge in Consumer-Constructed Online Spaces
BioTIFF: Articulating Self-Documenting Personal Health Digital Information Artefacts
Patient Problem-Solving on the Web: How do Patients Use Web Forums to Cope with Chronic Disease?
Versatile, Immersive, Creative and Dynamic Virtual 3-D Healthcare Learning
Many of the Medicine 2.0 presentations have also been posted to Slideshare. Here's Bertalan Meskó's talk on "Medicine 2.0 with the Eyes of a Medical Student Blogger:"
Sandeep Jauhar writes about the "night float" system — in which interns are required to care for patients during the night shift — in Slate. (FWIW, my personal experience with night float was terrifying but invaluable.)
Wikipedia, which was never a particularly authoritative resource for medical information, now has plenty of competition. Google just released Knol ("a unit of knowledge"), which allows anyone to author authoritative articles about any topic. Many of the topics on the home page, interestingly enough, are related to health and medicine. Clinical Cases and Images has a review.
And finally, Nick Genes writes that he's passed on the stewardship of the medical blogosphere's Grand Rounds to Dr. Val Jones and Colin Son. Thanks for all your good work, Nick.
The New 3G iPhone, Doctors, The App Store, and Medicine
Saturday, June 21, 2008
Joshua Schwimmer, MD, FACP, FASN
I've taken a long break from writing about the iPhone, and you might be sick of hearing about it. But be prepared — in less than a month, things are about to get very interesting.
Why? Not only will the new faster & cheaper 3G iPhone be released, but more importantly, the iPhone will now be open to third party software — that is, programs created by developers other than Apple. And why is this important? In the words of David Pogue, technology columnist for the New York Times, this means there will now be three major operating systems: the Mac, Windows, and the iPhone. (My apologies to Linux.)
This is only a small exaggeration. The iPhone has huge potential as a mobile computing platform, especially for physicians.
Sure, other mobile platforms exist — the Treo, Windows Mobile devices, tablet computers — but none have the graphics capability, the memory, the computing power, the form factor, and the ease of use of the iPhone.
What follows is the result of a brief brainstorming session about potential applications of the iPhone for doctors. Some have already been announced for the iPhone, are available on other platforms, or are currently in development. Let's see how many of these applications are eventually released and sold in the App store. My guess? All of them.
Drug database
Anatomical atlas
Medical calculator
Interface for electronic health record
Viewer of radiologic images
Interface for laboratory results
An expert system to help with differential diagnoses
Messaging system for laboratory alerts and hospital pages
Interface for medical devices (like ultrasounds and EKG machines)
Dictation recorder
Device for electronic prescribing
Device for directly receiving and reading medical journals and podcasts
Medical book reader
Reminder system for patient visits and meetings synced remotely with the office through Mobile Me
Display for patient education videos
Medical simulator (ACLS, for example)
Telemedicine device (pending the eventual release of iChat and a videoconferencing system)
Interface for medical literature searches (Pubmed, Google Scholar)
Word processing device for papers (I'm still waiting for a bluetooth keyboard)
Communication device for hospital teams (Using Twitter or another system)
Secure system for messaging/emailing patients
CME course viewer (with text and/or video)
What other application ideas can you come up with?
Triggers happy, from Running a Hospital, about a rapid response team at Beth Israel Deaconess Medical Center. Fascinating reading. The mortality rate of a nurse expressing "marked concern" is twice that of showing up in the ED with a heart attack. Literally. Google Health: A View from the Inside, from Wachter's World. Dr. Wachter is one of Google's advisers, and he provides an interesting insider's perspective on Google Health.
In part 1, I talked about barriers to patient-physician email. In this section, I'll discuss the many potential benefits of email communication between physicians and patients.
The time for the typical office visit has shrunk. Due to many factors including declining reimbursement and the need to see more patients per day, most office visits are now scheduled for 15 minutes or less. Neither physicians or patients are happy about this. Fifteen minutes is hardly enough time for adequate patient education or for forming a bond with your physician.
Enter email, a service which allows more time for physician patient-communication and helps people feel closer to their doctor. A few potential uses for email include:
Asking about lab results
Reporting potential side effects of medications
Clarifying whether it's safe to take a certain medication
Reporting home blood pressure readings
Reporting blood sugar readings
Giving positive feedback
Giving negative feedback
Asking for prescription renewals
Reporting new minor (but important) symptoms
Communication new medical issues when out of the country
And many others
Of course, any of these communications could also be made with a phone call -- but with a lot more hassle for everyone involved.
Take this example. Let's say a patient on a cholesterol lowering medication (Lipitor) has a twinge of pain in his left arm. He's heard that Lipitor can cause muscle problems, and is concerned that the twinge might be caused by the medication. One option is to schedule an office visit, but he's reluctant to do this for such a minor problem. Another option is to call the doctor's office, speak with a secretary (who would then take time deciding about the severity of the problem), have a note left for the doctor, who would then call him back later in the day to reassure him that this twinge doesn't represent a problem with Lipitor. Or the patient might not even ask the question, figuring that the pain is nothing significant, but still remain worried that it's a side effect of his medication and might even stop taking the Lipitor out of concern.
Alternatively, he could write an email describing the problem and receive a reply reassuring him that the pain is not consistent with a side effect from the Lipitor and he should make an appointment to be seen if it continues. Simple, almost effortless, and everyone is satisfied.
In part 3, I'll talk about ways of implementing patient-physician email.
I'm back. I was away on vacation in the North woods of Minnesota, in a cabin by a lake, without Internet or mobile phone service. Very different from life in New York City, and a quiet place to read, write, and think.
Dr. Salvatore Volpe writes the iPhone Medicine Blog. Medical Marketing and Media wonders whether physicians will get their continuing medical education credits on the iPhone. (As an aside, I routinely email myself articles from UpToDate and read them later on the iPhone.)
Unbound Medicine offers access to multiple reference materials formatted for the iPhone.
In the future, I'll be writing more about the iPhone and medicine. If you're aware of any medical resources for the iPhone, or if you have ideas for potential applications, please feel free to comment.
In part 1, I introduced ways of searching for health information online and discussed Healthline's approach and its innovative use of HealthMaps. In this post I'll discuss MedlinePlus.
MedlinePlus.gov is a service of the National Library of Medicine, part of the National Institutes of Health. From the website:
MedlinePlus will direct you to information to help answer health questions. MedlinePlus brings together authoritative information from NLM, the National Institutes of Health (NIH), and other government agencies and health-related organizations. Preformulated MEDLINE [medical literature] searches are included in MedlinePlus and give easy access to medical journal articles. MedlinePlus also has extensive information about drugs, an illustrated medical encyclopedia, interactive patient tutorials, and latest health news.
To use an example, having returned from the emergency department after having a kidney stone, our hypothetical patient from part 1 would see the following after searching for "kidney stones" on MedlinePlus: The search results are divided into topics, including kidney stones, bladder diseases, and other diseases of the kidney. The section on "kidney stones" has a large amount of information (which some patients might find overwhelming). Links include patient information from the National Institutes of Diabetes & Digestive & Kidney Diseases, the American Medical Association, the American Urological Association, and many other sources.
Also included is a link to Clinicaltrials.gov -- this site, created by the National Library of Medicine, is a search engine for federally and privately supported clinical trials, and is the best place to go to answer the question, "What research trials are being done on this particular disease?" (At some time in the future, I'll write a post on Clinicaltrials.gov; it's a useful and underutilized resource.)
Finally, another possible source for medical information is the web pages of individual physicians. Services like Google Page Creator now make it easy for health care providers (or anyone, for that matter) to create simple websites inexpensively or for free, no programming knowledge required. For example, on my website, I've created a page linking to information on kidney disease. This links to another page which lists types of kidney diseases, which includes information on kidney stones and this link that I've chosen from the National Institutes of Health. Dr. Ves Dimov talks further about using Google Page Creator on the Clinical Cases and Images blog.
Part 3 will look at more useful sources of health information online.
The Healthline Site, its content, such as text, graphics, images, search
results, HealthMaps, Trust Marks, and other material contained on the
Healthline Site ("Content"), its services, and any information or material
posted on the Healthline Site by third parties are provided for informational
purposes only. None of the foregoing is a substitute for professional medical
advice, examination, diagnosis, or treatment. Always seek the advice of a
physician or other qualified healthcare provider with any questions you may
have regarding a medical condition. Never disregard professional medical advice
or delay in seeking it because of something you have read on the Healthline
Site. If you think you may have a medical emergency, call your doctor or 911
immediately. Please read the Terms of Service for more information regarding
use of the Healthline Site.
Image via Wikipedia The first "Medicine 2.0" Congress happened on September 4 - 5 in Toronto, Canada. You're justified in being confused by — or even skeptical of — any concept released under the version number "2.0" (or, even God help us, "3.0"). But the people who gathered under the flag of Medicine 2.0 early this month are actually doing interesting work. What does Medicine 2.0 mean? Via the conference website:![Reblog this post [with Zemanta]](http://img.zemanta.com/reblog_b.png?x-id=be768aea-5bdc-4ce8-a48a-90f683bcd8ac)
