December 02, 2008

Physician's Reference Tool Idea

After reading the book "Wikinomics", I've been on a big kick thinking about the future possibilities for mass collaboration. Here's my idea for a medical device. I'd love your thoughts.

This tool, designed to help physicians and healthcare professionals better diagnosis their patients, is a portable tablet that practitioners can use whether they’re seeing a patient in their office, at the patient’s home, or in an emergency situation.

As one evaluates their patient, they mark the symptoms, vitals and relevant medical history on the tablet within a universalized analysis chart.

When they submit the evaluation notes through a satellite connection, it travels to a wiki database of other physician analyses’ and conclusions, omitting patient names for privacy purposes, and through statistical correlations, offers the physician a list of possible and probable outcomes.

Let’s say a physical therapist completes an evaluation, and the database confirms the therapist’s original diagnosis that these are common symptoms for one who has recently undergone shoulder surgery. The therapist is then directed to the treatment section of the user-created database, where a host of peer-submitted exercise and treatment plans are available for use. These treatments can include in-depth medical illustration charts, audio advice, and video tutorials that can be shown to the patient immediately, as well as e-mailed directly to the patient for reference if being assigned take-home exercises.

These treatment plans can also be rated by the community, so that the highest quality and most informative diagnosis treatments will be featured.

This collaborative reference tool will help apply group-think to each and every patient, making sure that the physician makes their diagnosis with the best possible information. This tool will prevent misdiagnoses, and most importantly, will serve as a great research tool that will help practitioner’s to better understand the possible treatment options for their patients.


Unknown said...

While I agree that this a novel concept (one which could save zillions of dollars) doesn't it devalue the medical degree earned by the doctor? Theoreticaly you could train someone to only look for the symptoms and then upload them into the database.

Also, you know that there are people who (even though they could get the most comprehensive and spot-on diagnosis) will want a second opinion. Would this eliminate their chance to get it, if they are only going to get the same answer that they got in the first place?

Eric Olsen said...

my wife helped me think through this one, and she had the same concern that you did, Tim. She thinks it would be important to market this as a research device, not as a final verdict.

But, as a patient, I'm absolutely going to want my doctor using it every time. Even if I respect their judgment. Maybe there's some odd-ball scenario they've never seen, but several other doctors have.

I feel like the consumer demand for it would be greater than any initial doctor push back.

Unknown said...

Maybe you use this as a second opinion... Then the doctors get to keep their status as the purveyors of the initial diagnosis and, if you are not satisfied, you can consult the research with someone trained to study your symptoms who has an intricate knowledge of the database.

what would happen if you had some rare scenario where there was one out of a thousand treatments returned by the database that was 180 degrees the opposite of the others? Would we want the system to weed out the unconventional (i.e. holistic, voodoo, etc...) and only include the consensus treatment?

Very cool discussion though. If our country does go the way of universal healthcare, would this not be a way to streamline the system and cut the cost? I could see a clinic of "research physicians" being a lot cheaper than a team of doctors or P.T.s

Freeing up doctors from treating common things like an ear infection or strep throat might allow them to concentrate on people who really need their help. Plus this could also be a useful tool in either preventing/cutting down medical malpractice by providing the patient with more knowledge about their ailments and treamtment. If a doctor knows that the there is a legitimate way for a medical lay-person to scrutinize his/her dianosis and treatment, then maybe he/she will concentrate on getting it right the first time (I am not trying to impugn or stereotype doctors or P.T.s as a whole here, I am just trying to make a point about the cases where malpractice occurs).

Eric Olsen said...

You're hitting on a few things here, Tim.

1) The point of this device is that every patient contributes to the research automatically, so that we create an ever-growing pool of information to make the best possible statistical correlations from.

So, while some doctors might be ready to diagnose with a "it's probably just a cold", after submitting the patient's report he sees a 2% correlation with a weird blood virus, that can be tested quickly and inexpensively.

2) WebMD is a horrible idea. This new tool should not be a patient device. All my doctor friends say that WebMD turns sane people into paranoid people with pycho-somatic symptoms.

3) You're getting into in a whole different idea as to whether or not doctors actually need to be seeing the patients themselves, or if they can be off-site and evaluate many more patients a day through the help of PA's getting the vitals and a video feed. It's very intriguing, but a different idea.

Anonymous said...

I think it is are assuming many doctors are suffering from a "God complex" also, the good doctors should be on top of the research and be able to find out what the possible diseases are without a pool of physicians telling them.

and as far physician submitted exercise treatments...what? most physicians don't really have a clue on what PTs can do or treat and they really do dictate too much and limit what PTs can do often.

Treatments may work medically but individualization of treatments is needed for exercises for the most part. not just protocols.

Eric Olsen said...

what i'm assuming is that most physicians do not have an unlimited fount of knowledge from which to base their medical decisions.

Good doctors WOULD use this tool as a resource to stay on top of the latest research findings.

By physician-submitted, I used physician in a broad sense to cover all practitioners. As a PT, you would see PT-submitted treatments and results.

Anonymous said...

so this will be better than peer reviewed journals?

Anonymous said...

Basically, I see it as a great way to collect massive amounts of data readily accessible for research purposes. It would be better than the average peer-reviewed journal articles we read now because the pool of subjects would be much less limited. In some cases, i can see it being helpful in diagnosing rarer/less common problems, but for the most part, I see it as a tool for the professional who knows the treatment possibilities, but wants real data on which treatments are statistically most effective. I do think this should be limited to medical professionals due to the fact that the data entered will not simply be "my back hurts", but would include special orthopedic tests performed, imaging results, and other subjective/objective information typically collected by the clinician.

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