Medical Futures Lab

Guest posting by David Lam

Click here to view video post

Guest posting by Jesal Shah

How is crowdsourcing’s role in medical care different from the ePatient community, which similarly leverages the internet population to provide services, information and support? Personally, crowdsourcing and its medical applications inspired strong connections to the ePatient movement currently shaping the health care delivery system. However, delving into each more closely, I realized subtle, but significant departures in their overall mission and function.

Crowdsourcing Medical Diagnoses

Jared Heyman, founder of CrowdMed, an online platform that crowdsources medical diagnoses, highlights the value of the “wisdom of crowds” and believes “large groups of non-experts can collectively be much wiser than individual experts.” This platform has two primary members: patients and medical detectives. It creates an incentivized system empowering the “crowd” to research and provide suggestions for the medical condition to the patient.

Patient Process: ²

Medical Detective Process: ²

ePatient Community^1.3

The ePatient community places strong emphasis on patient empowerment. It promotes greater patient/caregiver involvement in medical information dissemination and reception as well as clinical care decision-making and treatment process. There are many online list-servs that push the patient to take action, plan ahead, be informed and shape the definition of quality in medicine. (ACOR.org, a ePatient portal for patients with cancer, is shown below.)

Mission and Function: Similarities and Differences

Both movements have been enabled by the online community and heightened by involvement of lay individuals in their own health as well as the medical system. The medical detectives who work to provide diagnoses are not required to possess medical education nor is their formal training, outside of personal experience, for e-patients providing insights on care and treatment. Neither movement is anti-doctor. Moreover, both instead envision themselves as supplementary tools; nonetheless, crowdsourcing more directly plays the role of doctor. Its platform somewhat resembles an online virtual doctor game where each person can play physician, with the best receiving the prize. This is illustrated through the following image of a medical detective’s web page.

The primary objective of crowdsourcing medical diagnoses is very technical; in contrast, while the ePatient movement provides information on expert topics, it also plays an emotional support role. In most cases, a physician is inherently limited by not directly experiencing the challenges of a particular illness; thus, by allowing a patient to share his experiences as well as hear of others undergoing similar trials, a patient can improve his or her psychological and social wellbeing. Not to mention, the ePatient movement is rethinking quality in healthcare delivery and patient-doctor experiences in terms of a patient-centric vision with direct patient input. It clearly extends beyond an interaction with medical knowledge and other technical matters. Overall, both movements are clearly reshaping the medical field in similar and unique ways; it will be interesting to see how these two fields converge or diverge going forward.

References:
1. DeBronkart, Dave. “How the E-patient Community Helped save My Life: An Essay by Dave DeBronkart.” British Medical Journal (2013): n. pag. Web.
2. https://www.crowdmed.com/
3. http://radar.oreilly.com/2012/01/epatients-empowered-patients.html

Guest posting by Rachel Marren

Guest posting by Pooja Kapadia

Click on video games to view blog.

Guest posting by Emile Gleeson

Throughout the semester, this course has focused on our changing healthcare system and the way that new technologies are changing the way we practice medicine. While this class touched on both the positive and negative aspects of integrating technology with medicine, I got the overall impression that, while there may be a bit of a learning curve, eventually these new technologies will improve our healthcare system. This got me thinking a lot about the general direction that our healthcare system is heading and whether the overall changes happening are more positive or more negative. Although this class seemed to focus more heavily on the positive changes, my recent experiences with the healthcare system made me more interested in some of the negative changes, especially when it comes to the insurance company’s role in patient care.

Recently, I went through a very frustrating process in which my insurance company would not approve a medical test that three different doctors deemed necessary for me to get until I tried 8 weeks of my insurance company’s own alternative treatment plan. Personally, I found this experience to be ridiculous, so I searched the web to try to see if other patients had been experiencing similar situations. While I couldn’t seem to find any patient stories similar to mine, I did find multiple posts by doctors discussing the modern-day medical insurance system and the way in which insurance companies more and more are overstepping their bounds and making medical decisions for the patient. Combining the thoughts of these doctors with my own recent experience has led me to conclude that the role of insurance companies in our healthcare system is not going in a good direction.

http://likesuccess.com/423378

Doctors go through years of medical school and residency for a reason: making sound medical decisions requires a lot of in depth knowledge and training experience. Insurance companies, while still educated about healthcare, simply do not have this necessary knowledge base. When insurance companies approve or deny their patients’ treatment plans, they do so based on what treatment would cost the least for them to provide to the average patient. Insurance companies are focused on money, not patients’ health. We trust out doctors for a reason. Our doctors meet with us and see us an individual people. They evaluate our medical problems on an individual basis and figure out what the best treatment plan is for us, not for the average patient. Insurance companies don’t do this. If multiple doctors agree on a single treatment plan for a patient, insurance companies should not have the ability to override this treatment plan because they simply don’t have the knowledge or experience to see the patient’s medical needs in the same way that a doctor does. In our modern-day healthcare system, insurance companies are gaining more and more power to overstep their boundaries and make their patients’ medical decisions. This power needs to be checked before someone gets hurt.

Sources:

http://www.kevinmd.com/blog/2014/03/insurers-dictate-medical-decisions.html

http://www.kevinmd.com/blog/2014/06/whos-making-decisions-health-care.html

http://thinkprogress.org/politics/2009/07/17/51365/gop-rep-health-insurance/