Everyone, here is a link to the comments attached to the BMJ article, Googling for a diagnosis:

http://www.bmj.com/cgi/eletters/bmj.39003.640567.AEv1#148937

Google was not even doing the “diagnosing”, despite the extremely misleading headlines that appeared at the time the study was released; the study was really testing Google’s efficacy as a clinical decision support system. Hence the subtitle of the article: “use of Google as a diagnostic aid”.

Human physicians (fortunately) were doing the diagnosing. If human physicians did as badly as a 58% accuracy rate, that would be cause for a whole lot more studies…

I am a medical librarian and teach other librarians classes about evaluating health resources for the public. One easy thing to remember is the ABCs: Accuracy, Authority, Bias, Currency & Coverage. See http://nnlm.gov/outreach/consumer/evalsite.html for details, it’s pretty similar to identifying quality sources for journalists to report stories. :)

Another good resource to help people learn how to identify quality health information online is the MedlinePlus Guide to Healthy Web Surfing at http://www.nlm.nih.gov/medlineplus/healthywebsurfing.html

Speaking of wishes, have you all been following the #blankcheck for health care discussion on Twitter? The Robert Wood Johnson Foundation’s Pioneer Fund is asking people what they would do for health care if money was no object. You can post your idea on Twitter and they are also posting videos on YouTube:

http://www.youtube.com/user/pioneerrwjf

I’m seeing some #blankcheck ideas here:
1) A medical librarian on call, 24×7, to help people with online health research.
2) A magical platform that takes any legacy data/system/whatever and makes it work with whatever is the latest, greatest technology. A consumer never has to re-enter a single piece of their health history and it’s all available to them 24×7.
3) A #blankcheck for evaluation research to provide the evidence base for online health interventions.
4) A prevention specialist/health coach on every block to help people read food labels, design fitness programs, etc. etc.

Thanks – and please keep the comments & critiques coming.

Where is prevention in this debate?

Others have offered insight; I’ll offer some questions. In no particular order:

1. Interoperability of platforms – is this going to be an issue down the road? EMR compatibility is already an issue, as each vendor hopes to be the one that sets the standard, and there are many vendors (see here for one version of a list: http://www.emrexperts.com/emr-ebook/emr.php). In the interim, the platforms generally don’t talk to one another and patients switching from one system to another (say, if they switch providers) don’t have their records easily carried over. I have a telling pic that my wife took, of a 5.5″ stack of paper on her desk. The paper is a printout of a patient’s medical record from Logician, because her practice uses Epic. Unacceptable, and inefficient.

I recognize that this is being addressed; one report on this topic recently came out from AHRQ (http://healthit.ahrq.gov/portal/server.pt/gateway/PTARGS_0_1248_907504_0_0_18/09%2810%29-0091-1-EF.pdf). There’s a mention of interoperability, although the major focus is on common frameworks for usability and evaluation purposes.

EMRs/EHRs are one thing – I’m also thinking about the growing world of consumer health informatics. If several tools are adopted by a single individual, with each tool focusing on a different aspect of health, will any of this information be able to join together to create a more complete picture of the individual? I imagine an end user would find that to be useful.

2. Insured v. uninsured individuals: do people with health insurance search for and utilize health information and social media tools differently than those without insurance? I am sure there is overlap, but I am not sure if uninsured people are more likely to use it as a substitute for seeking in person care.

3. In general, evaluation and outcomes research. There is a *huge* gap here. Anyone out there looking at the impact of these tools on people’s health outcomes? Or on health care quality? Anyone have any projects to throw at a doctoral student who is interested in this work? ;)

I look forward to hearing what others are thinking about on this topic!

http://www.idc-hi.com/index.jsp

Any pointers to something you’re esp. excited about?