Surely by now you have heard of Microsoft’s Bing search engine.  Microsoft has been heavily advertising Bing through TV commercials, content deals, and even offering cash back deals via major vendors such as Best Buy, Walmart, and others. A few days ago Microsoft announced an upgrade to its Bing Health experience that medical professionals should definitely take note of – it could change the current landscape of how medical content is accessed and shared with patients.

What makes Bing Health’s experience so valuable is they aggregate data, much like Wikipedia does, but only from legitimate medical sources.  Later in this article I’ll go through an example using sarcoidosis as the search term and compare it to Wikipedia and WebMD – then explain how the data can be used with patients.

Bing Health’s newest content partners include trusted medical sources: Harvard Health Publications, the CDC, and the Natural Standard.  Bing Health already uses content from the Mayo Clinic, and the National Institutes of Health’s MedlinePlus.  The search engine is also adding integration with social media, such as Twitter – but will only allow tweets from authoritative medical content providers, such as the National Psoriasis Foundation.

So lets go through a test search using Sarcoidosis and compare with WebMD and Wikipeda.

If you search Sarcoidosis with Bing, you get the following result:

If you click on the Sarcoidosis link, you get the following page (there is more information, but the following is a one page screen shot)

As you can see, Bing clearly tells you the source of the information.  The above content is from the Mayo Clinic, a trusted source of medical content.

Now lets compare the search result to WebMD:

And the search result to Wikipedia:

As you can see, WebMD does not yield  the same level of patient oriented content that Bing does when entering a simple search of sarcoidosis.  Plus, there is no ability to email out, or share with social media tools.  Wikipedia on the other hand, provides entirely too much information.  You would almost never want to show your patient a Wikipedia page of their pathology – it could easily confuse them and give them way too much information to digest.  Plus, with Wikipedia you can never trust the content 100 percent, and never want to use the information when advising patients or for patient care.

With that said, Wikipedia is a great tool for medical research.  We’ve highlighted before how it’s fantastic for looking up research studies.  Bing Health even provides a tab where you can look up the same content in Wikipedia – but again, the utility of Bing Health is you are able to avoid sources that are not 100% verified – so don’t use the Wikipedia tab.

How can health care providers use Bing Health for patients?

Bing Health’s new search focus now allows health care providers to have access to vast databases of medical content made for patients, all aggregated into one medium, and most importantly, derived from trusted sources.

Providers can use Bing Health to share information with patients.  The e-mail out functionality is key for this, or you could even print the information in your office and hand it to you patient on their way out.

This one click access to trusted data is key for providers who are short on time, don’t want to read through a full Wikipedia entry to make sure the information is legitimate, or feel the content could overwhelm a patient.  Providing this type of content to patients is a proactive way of dealing with the flood of medical data available on the web – and lets them know you aren’t afraid of the web either

You can even use Bing Health for patient information when prescribing new medications, such as a statin.  Below is a sample screen shot that appears when you search for Levostatin:

When you click through the link, you are still within Bing Health, but you see the full Gold Standard article, again, a trusted source of medical content.

However, there are definitely some improvements that could be made with Bing health. Two things we want to see are more images, and an integration with the Bing iPhone app. If you provide e-mail service to your patients, it would be great to have the ability to use the iPhone app to look up a pathology or medication, and then e-mail out the information while talking to the patient.

As Bing adds more trusted medical content providers its utility will only grow. But as it is, medical providers should definitely take notice, and consider using the search engine’s Health section when educating patients.

This clever and  disruptive web service – and the perfect companion to an electronic health record that includes practice management tools – started in September 2007. Unfortunately I have met very few doctors who have heard of it. This company started by connecting New York dentists with open appointments to unattached patients trying to schedule a checkup, but has since expanded to include primary care, pediatrics dermatology, ophthalmology, ENT, orthopedics and several other specialties in New York City, Washington DC and San Francisco. In this sense, they have followed the model of Yelp, a recommendation provider for local commerce, by building the service one city at a time, instead of launching widely and taking a bigger risk of failing. But as more sophisticated electronic health records proliferate, physicians will definitely want to keep an eye on this service.

The value of the site is easily understood, especially if you have an electronic health record/practice management system. You, the patient, need to see a pediatrician or an orthopedic surgeon. If you search for doctors on-line or in the Yellow Pages (do they still print those?), you will be assaulted with dozens of names and offices in every specialty. After that, you still need to telephone each doctor’s office and request an appointment, preferably at a time that is convenient for you. And then, you get put on hold. ZocDoc changes all of that and for the better.

Now, this seems like a perfect job for the internet which, if nothing else, excels at connecting sellers and buyers, especially those with very particular needs. And indeed, this is what Zocdoc does. Right on the home page, you enter your zip code or city, the type of doctor you are looking for and your insurer. You will then quickly see a list of doctors and their available appointment times. You can click on a doctor to see their education, hospital affiliations, insurance accepted and patient reviews. If you are a patient (and we are all patients), it seems too good to be true at first.

The service is free for both patients and doctors. If you a participating physician, you provide your available times and your front desk is alerted whenever an appointment has been made. The utility of the web application and its strategic placement at the moment of doctor selection leaves the service many options for monetization. Undoubtedly, we physicians will be hearing soon about “premium” placement and rapid reporting of our patients’ reviews. This potential was obvious enough that the company was able to attract a star-studded list of investors including  Vinod Khosla, Jeff Bezos, and Marc Benioff of Salesforce.com – who is also backing Practice Fusion, the free web-based electronic health record .

For physicians, disruption is a challenge and opportunity. We have always been told that the three most important qualities a doctor needs in order to build his or her practice are availability, affability and ability – in that order. This is usually said with a slightly longer look to make sure that the listener heard that ability was last. For physicians in a competitive market or those building their practice, ZocDoc will no doubt become a required competitive asset.

Editors addendum

This service is free for patients, but in order for a physician to be listed they have to pay a fee.

As the debut of the iPad fast approaches, speculation about it is reaching a fevered pitch. Scanning the thousands of articles written about the iPad’s potential, one may walk away thinking that Steve Jobs has just cured cancer, ended global warming, and established peace in the Middle East. Some people are even calling Apple’s latest creation the “Jesus tablet.” While the iPad probably falls somewhere short of some of those lofty projections, it has already done what Apple seems to do best – transformed the way we look at an existing market, in this case mobile computing and the tablet. We’ve talked previously about how the iPhone paved the way for the iPad in healthcare. Again, Apple’s entry into this market has signaled a huge shift in the way users will interact with the tablet and, through it, their environment.  This new user interface has a great deal of potential to change the way physicians deliver care. But perhaps more importantly, it could also have profound impacts on the way patients experience healthcare.

Innovative therapies

Over the past decade, there have been a number of examples of novel technologies being used either therapeutically for sick patients or in preventative care. For example, there have been numerous trials, with more success in the pediatric population, that use text messaging to remind patients to take their medications. When the iPhone transformed the user interface for the smartphone, therapies centered on that platform also emerged – autism and major depression are two conditions with iPhone apps that are therapeutic in nature. Enter the iPad. With a more advanced touchscreen, a high-quality webcam, and perhaps even 3d graphics, the possibilities become far more rich.

Take children with cancer – these kids can be hospitalized for weeks at a time and, due to the chemotherapy, stuck largely in isolation for most of that time. An app that utilizes the webcam to connect kids while playing a fun and interactive game together would provide a far richer interaction than a networked gaming console. Or consider the numerous elderly patients who succumb to delirium while in the hospital largely because, on top of being sick, life in the hospital, void of sunlight and normal sleep-wake patterns, gets so disorienting. Consider an app that, much like the mentally challenging games on the Nintendo DS, helps older patients stay a little more active during the day and perhaps ward of delirium. Will the iPad cure cancer or, for that matter, anything? No. But what it will do is provide some interesting and creative adjuncts to standard therapy that could make the patient’s quality of life a little better.

Improved patient-provider communication

In the ever growing iPhone app store, educational apps are among the most numerous. One of the biggest reasons why is because the interface allows user to interact with the material in a number of different ways. Take the Blausen Human Atlas or Pocket Heart – both of these apps allow the user to interact with anatomy in an incredibly rich way. With much more powerful graphics capabilities, these kinds of apps can certainly be taken to another level.

Consider a patient going into surgery. Today, explanation of the surgery is restricted to some form of charades by the surgeon and 2d radiology images. An app that allows 3d reconstructions of a patient’s scans to be pulled onto the iPad and manipulated would allow for a far better explanation, improving patient-physician communication. Or how about the diabetic patients or the heart failure patients? These poor folks are often subjected to hours of mind-numbing “educational” videos in the hospital – iPad apps could bring an element of interactivity that allows patients to engage with material that is critical to their health. Finally, consider the stroke patient. There are rumors that the iPad’s camera will be sufficiently sensitive to allow facial recognition. Perhaps then it could also be used to detect facial, or for that matter limb and trunk, motion with apps designed for post-stroke rehabilitation therapy. In a “game” format, individual goals outside of professional physical therapy could help empower the patient as they fight to recover.

The key opportunity that the iPad offers here is not just another platform to convey information, but a way to make it fun and engaging. While the iPad won’t replace a good physician taking the time to talk to a patient, it could certainly augment the patient-provider relationship in a fun and engaging way.

These are just a few ways that the iPad could transform the way a patient understands their illness and interacts with their healthcare providers. Among the most elusive goals in medicine is helping patients understand complex diseases and empower them to manage these conditions. Nothing will ever replace a strong patient-provider relationship, a personal support network, and evidence-based therapies based on a thorough scientific foundation. But the iPad could herald the introduction of innovative adjuncts that help patients take control of their own health and improve their quality of life.