Diagnostic decision support vendor Isabel Healthcare wants to end the confrontation between doctors and patients who bring their own health research into the office. It's doing this by offering those patients access to targeted searches, based on symptoms, with results that might actually be useful to health professionals.

Isabel's recently introduced symptom checker is a consumer-friendly version of the U.K.-based company's core diagnostic decision support engine. The latest tool is meant to engage patients in decision making.

"We are trying to make a vice into a virtue" by giving physicians a good starting point for discussing potential diagnoses with patients, Isabel CEO and co-founder Jason Maude told InformationWeek Healthcare. He cited a British study of patient attitudes in 13 countries around the world that suggested 31% of patients were not confident challenging their doctors.

That study, from health services provider Bupa, also found that only 47% of those who search the Internet for health information always check to see if the source is credible. These findings were in line with a survey Isabel conducted in the U.K., Maude said.

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The symptom checker comes as a free version on Isabel's website, with a daily usage limit to combat abuse by healthcare organizations, and as an application programming interface (API) for embedding into institutional websites and patient portals. "Hospitals and institutions can use it as a patient engagement tool," Maude explained, and can also map the symptom checker to a doctor finder. It also is available as an Apple iOS app through iTunes.

In any format, Isabel is trying to make clinical decision support more accessible to patients and support what Maude called the "democratization" of healthcare.

"It's like the Bible being in Latin," he said. Before it was translated into English, "we needed priests to tell us what it meant."

With computerized tools like Isabel, there is no longer an excuse for physicians not to create a differential diagnosis whenever a nonstandard case presents itself, said Maude, especially considering the fact that the original database for professionals can be integrated into electronic health records. "The root cause of diagnostic error is not thinking about what some of the possibilities might be," Maude said. "The differential forces you to start thinking about it."

He said the consumer symptom checker allows patients to put together their own differentials, print out the results and compare their findings with the doctor's. "I hope this may be a radical change," Maude said.

Maude noted that The New York Times last week reported on Dr. Gurpreet Dhaliwal, a superstar diagnostician at the University of California, San Francisco. Though Dhaliwal has proven his chops in weeding through symptoms and test results to make proper diagnoses, he often consults Isabel to confirm his work.

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