More and more patients these days are seeing their physician pull out an iPhone or iPad to look up drug dosing information, review lab and radiology data, or help teach them more about their medical condition. And as developers, and the increasing number of physician-developers, continue to find more creative ways to bring medical resources to the point of care, we can certainly expect smartphone platforms and medical apps to become pervasive at the bedside. However, just as healthcare providers and patients are noticing this trend, there are number of others who are paying attention as well – for WebMD, one of the largest companies in this industry, it is the lawyers who may be watching that are worrisome.

As they put it in their annual statement to the SEC,

If our content, or content we obtain from third parties, contains inaccuracies, it is possible that consumers, employees, health plan members or others may sue us for various causes of action.

We’ve talked in the past about potential liability issues for healthcare providers using medical apps and the developers who produce them, as well as similar issues related to electronic health records. The fact that WebMD found the issue significant enough to report it to the SEC and their investors clearly indicates the issue is still unresolved and the remainder of their statement adds some further interesting perspective.

If you’ve used a medical app, you’ve seen the disclaimers that go along with them – its a bit like trying to read the Magna Carta in its original Latin. To most of us, it seems as though something that complex and detailed should be pretty protective. But as WebMD notes,

Although our Websites and mobile applications contain terms and conditions, including disclaimers of liability, that are intended to reduce or eliminate our liability, the law governing the validity and enforceability of online agreements and other electronic transactions is evolving. We could be subject to claims by third parties that our online agreements with consumers and physicians that provide the terms and conditions for use of our public or private portals or mobile applications are unenforceable.

In short, these disclaimers could be determined to be meaningless and thus expose app developers to liability for inaccuracy in their products. Now as we’ve noted in the past, it would be hard to imagine the publisher of Harrison’s being held liable for harm that occurred as a result of an error in a new edition. Similarly, it’s hard to imagine that Medscape would be held liable for an error in its app that resulted in harm. However, we’re not nearly as imaginative as our friends in the legal world. And in any case, as the folks at WebMD point out,

Even if potential claims do not result in liability to us, investigating and defending against these claims could be expensive and time consuming and could divert management’s attention away from our operations. In addition, our business is based on establishing the reputation of our portals as trustworthy and dependable sources of healthcare information. Allegations of impropriety or inaccuracy, even if unfounded, could harm our reputation and business.

There are clearly a lot of unanswered questions in the area of medical apps, as often happens in an emerging industry. As we reported earlier this week, the FDA has now announced plans to review regulation of medical apps. So at least hopefully some answers to these questions are on their way.

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.

WebMD has launched a new app directed towards health care providers. Medscape is a free app and was launched a few days ago. I like this app because of it’s speed. It’s great for looking up med dosages (adult vs. peds, etc), interactions, and pricing. If you’d rather not wait a few extra seconds for Epocrates to load in order to look up a simple drug dosage, then you should try this app. I found the user interface to be nice and quick.

Medscape has a CME section and a medical news section, which I didn’t find as useful. There is also a section where you can look up nearby hospitals, physicians, and pharmacies. The only downside I could find for this app is they ask for you name, email address, etc before you can use it. I fudged most of that information though and it took me just a few minutes to set up. Medscape has a nice interactive website set up here.