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4/18/2014
11:05 AM
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Can Crowdsourcing Beat Dr. House?

Startup CrowdMed uses a mix of prediction market software, crowdsourcing, and gamification to help patients gain insight from hundreds of medical detectives.

Crowdfunding The Next Healthcare Hit
Crowdfunding The Next Healthcare Hit
(Click image for larger view and slideshow.)

Watching his sister visit doctor after doctor, in fruitless pursuit of a diagnosis and treatment, frustrated and inspired entrepreneur Jared Heyman.

After three years, countless physician appointments, and many unnecessary medications, Heyman's younger sister finally received the correct diagnosis: a rare disease with a straightforward treatment plan.

She is hardly alone.

It takes an average of more than two years for people with fibromyalgia to get the right diagnosis. Lyme disease is frequently misdiagnosed as everything from Crohn's disease, Lupus, and early Alzheimer's to Raynaud's disease and multiple sclerosis. In fact, diagnoses that are wrong, delayed, or overlooked are thought to affect 10% to 20% of all cases, according to a 2012 report by the Journal of the American Medical Association.

[Appointment with Dr. Video? Read Telehealth Gains Momentum In Obamacare Era.]

Rather than visiting one physician at a time, Heyman envisioned a system that uses the power of the crowd to recommend suggestions to patients who, in turn, can share that information with their primary healthcare providers. Already well versed in crowdsourcing and a developer of market prediction software, Heyman moved to Silicon Valley and founded CrowdMed.com.

The website combines the wisdom of the crowd with gamification, prediction software, and analytics to deliver the most appropriate advice to patients, Heyman tells us. Like an online stock market, CrowdMed's prediction market analytics software -- adapted for medical diagnostics -- allows people to choose future outcomes and win a reward if they're correct. The software aggregates respondents' knowledge to generate suggestions.

(Source: CrowdMed)

(Source: CrowdMed)

Patients pose their questions, along with symptoms, test results, lifestyle information, and images. The site's "medical detectives" respond. Although "several thousand" people have signed up as advisers, CrowdMed currently has about 200 active medical detectives. Since its beta went live in April 2013, CrowdMed has resolved approximately 200 cases, says Heyman, and now that the company is actively promoting the service, CrowdMed can handle up to 10 or 20 times this volume with its existing infrastructure and technology.

Detectives include a diverse array of medical professionals such as doctors, nutritionists, acupuncturists, and homeopaths, as well as people without formal health training who may have personal experience with a disease, he said.

"I think the expert-driven model is broken in healthcare. I saw it in my sister's case. They were all very biased and saw things through their own very narrow lens," says Heyman. "At the end of her struggle she ended up knowing more about her disease than most doctors because she ended up living it. I didn't want to bar patients who had deep knowledge about an illness."

Patients have two options, according to CrowdMed: They can submit a question for free, although they must provide a $50 deposit, which CrowdMed returns once the patient notifies CrowdMed which detective provided the

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Alison Diana is an experienced technology, business and broadband editor and reporter. She has covered topics from artificial intelligence and smart homes to satellites and fiber optic cable, diversity and bullying in the workplace to measuring ROI and customer experience. An ... View Full Bio

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Susan Fourtané
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Susan Fourtané,
User Rank: Author
5/5/2014 | 3:24:40 PM
Re: Wisdom of the Crowd
Ariella, 

Yeah, let's put all the patients in the same box. They are all same. Most likely you have read some of my comments about my uncle. He was a doctor. A kind that doesn't exist any more. He used to say that illness doesn't know about times, or days of the week. For that, a doctor should always be ready to respond to a call of his patients ay day at any time, he used to say.

And that's what he did until he could. He was a pediatrician. His patients loved him so much they kept on going to see him for consultation when they were teenagers. Then, taken their own children. 

-Susan 
Ariella
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Ariella,
User Rank: Author
5/5/2014 | 3:09:27 PM
Re: Wisdom of the Crowd
@Susan yes, I've grown a bit cynical about the schedules set by doctors. They like to induce or to begin surgery early in the morning. I'm sure there are practical reasons on the hospital's end for this, but it does push a one-size-fits-all mold on patients who are all individuals. 
Susan Fourtané
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Susan Fourtané,
User Rank: Author
5/5/2014 | 2:58:16 PM
Re: Wisdom of the Crowd
Gee, Ariella! What a story. :( Being overwhelmed is no excuse. They are dealing with human lives. It's not a business where you can choose the best time that suits you to receive a baby. It seems they do, though. They like to induce early in the morning so they don't have to be called in the middle of the night, or any other inconvenient hour that some babies dare to choose, you see.

And one resident for the whole hospital?!  

"I didn't sue, but I refused to pay my doctor the full $5K she demanded b/c no one from her practice attended me for the birth." 

You were too good. Someone who abandon her patients doesn't deserve anything. 

-Susan 

 
Joe Stanganelli
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Joe Stanganelli,
User Rank: Author
4/25/2014 | 10:49:22 AM
As Dr. House would say...
> Lyme disease is frequently misdiagnosed as...Lupus


It's never Lupus.
Alison_Diana
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Alison_Diana,
User Rank: Author
4/24/2014 | 5:42:53 PM
Re: Wisdom of the Crowd
To be in this position, you have to consider that most people coming to this site -- those willing to spend about $250 (because I'd imagine those are the ones who get answers much faster than the ones who don't offer a reward; it's human nature!) -- have probably been to several regular doctors, or even specialists in search of someone who can diagnose and treat them. I know, when I was in that position, I'd have loved this site. The thought of having a name for something would have been wonderful, to posit a potential solution to what ailed me would have been absolutely fantastic, especially with the doctor who told me it was imaginary (although i never returned to him anyway). The ability to potentially reach hundreds of people who have either had the same condition or research it must be extremely liberating and hope-inspiring. 

Once you have a potential diagnosis, you can find a doctor. You may not have even been seeing the right kind of doc! And from there, you may discover an entire world of treatments that allow you to live a full and active life. Of course, that may not happen but at least you've got a much better chance of connecting with someone who understands and knows about what ails you via the Internet and a specialized, crowdsourcing site than by physically traveling from practice to practice. 
Alison_Diana
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Alison_Diana,
User Rank: Author
4/24/2014 | 5:37:12 PM
Re: Wisdom of the Crowd
Some of the people in this particular crowd are medical researchers, doctors, and other healthcare professionals, @Terry. And the way the software works is to determine the "odds," if you will, that some advice is better-suited than others. The more people who recommend an approach, the likelier it is to have an element of truth to it. Or the better-suited the individuals' providing answers are, the likelier it is that their response is correct vs. someone who has no training or personal experience in that particular condition. There's a lot of science in the wisdom of the crowd software at the back of this solution. Now, whether that's going to be correct all the time, who knows! The exec told me their tests and research were very strong -- but i doubt he'd have said otherwise. I'd be really interested in seeing external, unbiased research on the company's software and crowdsourced approach.

Either way, unless the crowd recommends a wait and see attitude or something like hot tea with lemon, most of those posing questions will go to their doctors. Since the site recommends people offer a reward of about $250, I'd think those posing questions are at their wits' end with the traditional approach and have already seen several doctors in search of a diagnosis. 
Ariella
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Ariella,
User Rank: Author
4/24/2014 | 2:39:25 PM
Re: Wisdom of the Crowd
@TerryB true, my husband has to come up with solutions to computer problems for his job. He says he often finds answers on Google. It doesn't slow him down at all; on the contrary, he closes the most tickets on that team.
Ariella
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Ariella,
User Rank: Author
4/24/2014 | 11:51:26 AM
Re: Wisdom of the Crowd
@Susan the problem was that at Columbia Presbyterian Hospital, they get overwhelmed and deal wuith it by adopting a haughty attitude toward their patients. All the birthing rooms were occupied when I arrived on Friday morning, and as they assumed it would be a long time yet until the birth and that they would probably just induce on Saturday morning (all doctors seem to like to induce early in the morning), they could just leave me off in a room until then. They only had caution enough not to send me home b/c the water broke at the beginning of labor. Once we got into Friday night, we were on the weekend, and ther was only a single resident there who felt stretched and exhausted. She didn't want to bother to check on me, and only came with a great huff of resignation. I didn't sue, but I refused to pay my doctor the full $5K she demanded b/c no one from her practice attended me for the birth.
Susan Fourtané
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Susan Fourtané,
User Rank: Author
4/24/2014 | 12:51:38 AM
Re: Wisdom of the Crowd
Alison, 

I love IBM Watson. :)

-Susan
Susan Fourtané
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Susan Fourtané,
User Rank: Author
4/24/2014 | 12:46:11 AM
Re: Wisdom of the Crowd
What an experience, Ariella. :( They all sound very inexperienced, careless, disconsiderate. The worst part is that they didn't listen to you, who was the only one who could really tell when the time was right.

Did you, or your husband make any kind of complain after that? What excuses did they make to justify what happened? :/ 

 

-Susan  
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