Whether you’re a solo practitioner in a rural area, or a patient who’s bounced from doctor to doctor with a difficult–to-diagnose condition, there are many reasons why you might seek out expert medical advice from a larger group. Fortunately, in 2016, seeking feedback from other physicians or getting a second opinion is as easy as going online.
“Medical crowdsourcing” sites and apps are gathering steam, from provider-only forums like SERMOsolves and Figure 1, to patient-focused sites like CrowdMed. They share the same mission of empowering doctors and patients, reducing misdiagnosis, and improving medicine. Is crowdsourcing the future of medicine? Read on to find out more.
Fixing misdiagnosis
An estimated 10 percent to 20 percent of medical cases are misdiagnosed, even more than drug errors and surgery on the wrong patient or body part, according to the National Center for Policy Analysis. And diagnostic errors are the leading cause of malpractice litigation. Doctors often report that with many of their patient cases, they would benefit from the support and advice of their peers.
The photo-sharing app for health professionals, Figure 1, is filling that need. Since we reported on it last year, the app has reached 1 million users and added a direct-messaging feature. The app is geared towards verified medical professionals, and goes to great lengths to protect patient privacy in keeping with HIPAA laws. According to co-founder and CEO Gregory Levey, an average of 10,000 unique users check in to Figure 1 every hour, and medical professionals and students in 190 countries currently use the app.
Using Figure 1 to crowdsource advice from the medical community has saved at least one life. Emily Nayar, a physician assistant in rural Oklahoma and a self-proclaimed “Figure 1 addict,” told Wired magazine that because of photos she’d seen on the app, she was able to correctly diagnose a patient with shingles meningitis. Another doctor had misdiagnosed him previously, and the wrong medication could have killed him.
Collective knowledge at zero cost
In addition to serving as “virtual colleagues” for isolated medical providers, crowdsourcing forums can pool knowledge from an unprecedented number of doctors in different specialties and even countries, and can do so very quickly.
When we first reported on SERMO, the company billed itself as a “virtual doctors’ lounge.” Now, the global social network with 600,000 verified, credentialed physician members has pivoted to medical crowdsourcing with SERMOsolves, one of its most popular features, according to CEO Peter Kirk.
“Crowdsourcing patient cases through SERMOsolves is an ideal way for physicians to gain valuable information from the collective knowledge of hundreds of physicians instantly,” he said in a press release. According to SERMO, 3,500 challenging patient cases were posted in 2014, viewed 700,000 times, and received 50,000 comments. Most posted cases received responses within 1.5 hours and were resolved within a day. “We have physicians from more than 96 specialties and subspecialties posting on the platform, working together to share their valuable insights at zero cost to the healthcare system.”
While one early user of SERMO wrote on KevinMD.com that he felt the site’s potential was overshadowed by the anonymous rants and complaining, other users have noted that the medical crowdsourcing site has, like Figure 1, directly benefitted patients.
In an article on PhysiciansPractice.com, Richard Armstrong, M.D., cites the example of a family physician in Canada who posted a case of a young girl with an E. coli infection. “Physicians from around the world immediately began to comment and the recommendations resulted in a positive outcome for the patient. This instance offered cross-border learning experiences for the participating doctors, not only regarding the specific medical issue but also about how things are managed in different health systems,” wrote Dr. Armstrong.
Patients get proactive
While patients have long turned to social media to (questionably) crowdsource their medical queries, there are now more reputable sources than Facebook.
Tech entrepreneur Jared Heyman launched the health startup CrowdMed in 2013 after his sister endured a “terrible, undiagnosed medical condition that could have killed her,” he told the Wall Street Journal. She saw about 20 doctors over three years, racking up six-figure medical bills. The NIH Undiagnosed Disease Program finally gave her a diagnosis: fragile X-associated primary ovarian insufficiency, a rare disease that affects just 1 in 15,000 women. A hormone patch resolved her debilitating symptoms.
Heyman founded CrowdMed to prevent other patients from having to go through similar ordeals. On CrowdMed, patients with an unknown medical problem can, for a fee, fill out a questionnaire and upload photos or videos to receive an unofficial diagnosis from a community of “medical detectives,” which includes physicians, medical students, and even members of the general public. Suggestions are voted up or down by the community, with proven medical experts’ responses more heavily weighted, reports the WSJ.
According to the company’s web site, CrowdMed has resolved over 1,000 real-world medical cases to date, with an over 60 percent success rate, for patients who on average had been sick for seven years, seen eight doctors, and incurred over $70,000 in medical expenses before submitting their case. The average case resolution time is two to three months and the cost is less than $500 per case.
CrowdMed has attracted a great deal of attention and investors, including actor Patrick Dempsey, best known for his role as a doctor on “Grey’s Anatomy.” The site’s results have been evaluated by the Journal of Internet Research, which concluded that some patients with undiagnosed illnesses reported receiving helpful guidance from crowdsourcing their diagnoses, “however, further development and use of crowdsourcing methods to facilitate diagnosis requires long-term evaluation as well as validation to account for patients’ ultimate correct diagnoses.”
Whatever your views about crowdsourcing, “Embracing the medical opportunities afforded by new communications technology is critical to the future of healthcare,” as Dr. Armstrong writes.
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