Crowdsourcing your healthcare
Crowdsourcing, unlike crowdsurfing (see featured photo), involves the use of social media to survey people in order to collect opinions, votes, or in the case of this podcast episode, diagnoses and treatment options.
Let’s start this entry with a basic question: You have a cough and chest discomfort, and your primary care physician can’t figure out why. A cardiology referral is made. And they also can’t solve the puzzle. What do you do next?
A. Get a second opinion (another cardiologist)
B. Phone a friend
C. Post your symptoms on the internet and see if someone reaches out to you with a better idea
D. None of the above. You’re fine, it’s just a little GERD.
There is no correct answer here. But there is another option I did not mention, option E. Find a DIY web-based application that helps you assemble a differential diagnosis given your particular symptoms. Dr. David Do’s app seems to work just fine (Symcat), and it was even proven to be the best out of over a dozen similar apps and websites according to one Harvard study. Just type in your symptoms, and you will be given a list of diagnostic considerations. With one caveat, you are still recommended to seek medical attention from a physician.
Medical care is no longer about the private patient-provider experience. Applications like Symcat and sites like WebMD have existed for a decade or more by now, and have digitized the basic data overlying your health. Which is really spectacular actually. For patients, these automated programs and webpages have now empowered you to learn about your symptoms—maybe you’ve got a touch of the flu—and these services have now given you the tools to act on them without wasting time in line for a doctor’s visit. “Drink plenty of fluids and take some Tylenol,” your app says. Because of this quick and easy fix to a likely benign problem, who would want to drop a $50 copay at your primary care physician’s office when you could lose 5 minutes of your life on the world wide web? But even this digital environment has its own limitations. For a moment, we actually derail into the example of “Chronic Lyme” as a sensationalized epidemic. Here are just a few of the comments Dr. Do sees all the time about the latest treatments for this fictitious infirmity:
Because of these and many other shortcomings to automated data and diagnosis, there has been a movement to integrate more providers into a patient’s care. Dr. Adam Rodman, who joins me in today’s episode from Botswana, describes how patients frequently arrive at clinic with an entourage of family and friends. By the time they get to see the MD, the patient has already received a half dozen potential diagnoses or home remedies for whatever ails them. And all these attempts have failed. So now, they get to see Dr. Rodman.
The question then becomes what if Dr. Rodman doesn’t have the right answer? Or the answer the patient is looking for? What if Dr. Rodman is the only physician in that small town in Botswana who can care for the patient, but he has limited resources or lacks specialization in other medical disciplines like surgery or infectious disease? Where else can the patient turn to? And this, my friend, is what the bulk of today’s episode hopes to address.
But for those disinclined to the audio version of BrainWaves, we’ll cut to the chase here. Crowdmed.com is perhaps your best bet if you wish to solicit opinions from medical professionals. There is at least an internal peer-review process that is run by volunteer (paid) physicians who approve or disapprove of diagnostic and therapeutic suggestions for patients. It shouldn’t take a randomized controlled clinical trial to prove that using a site like crowdmed is easily more credible than posting your symptoms on Twitter.
And we didn’t even get into it, but crowdsourcing also has a utilization in collecting data for research purposes, for sharing information about the utility of medicines, and it’s got numerous other clinical applications. If used appropriately, it can prove to be a life-altering advantage in this open data movement. Or if used carelessly, it can devastate you. In a world of digital doctors, I think patient-centered care can thrive so long as patients and providers continue to respect each other and engage in a collaborative effort to solve problems.
BrainWaves podcasts and online content are intended for medical education only and should not be used to guide medical decision making in routine clinical practice. Given the absence of available data, BrainWaves can neither endorse nor condemn crowdsourcing in healthcare. Pursue at your own risk!
- Dunford E, Trevena H, Goodsell C, Ng KH, Webster J, Millis A, et al. Foodswitch: A mobile phone app to enable consumers to make healthier food choices and crowdsourcing of national food composition data. JMIR Mhealth Uhealth. 2014;2:e37
- Ranard BL, Ha YP, Meisel ZF, Asch DA, Hill SS, Becker LB, et al. Crowdsourcing–harnessing the masses to advance health and medicine, a systematic review. Journal of general internal medicine. 2014;29:187-203