Social-Based Medicine: Digital Resources for Clinical Recommendations

While Epocrates and Micromedex may help with most drug information questions, new mobile apps and platforms are leveraging physician membership and online communities to give clinicians an avenue to find out what their colleagues are doing in terms of treatment for diseases and symptoms, and it’s all at their fingertips via their smartphones.

Digital health companies are starting to transition from direct medical information apps to a crowd-sourced information platform where clinicians can share their medical expertise and knowledge with each other. T

hese apps

allow users to create profiles and direct advertisements, and perhaps mine relevant data to pass on.

Nonetheless, there seems to be a slowly growing niche in these types of social-based medical apps, for a couple of reasons:

• Competition. In the beginning, many developers were quick to gravitate towards making drug or disease information apps. In time, however, many trusted resources like Lexicomp and Dynamed slowly but surely managed to transfer their data into an app format with widespread availability and institution integration. This, in turn, has led to individual or small developers being outpaced and backed into a corner. Despite being new to the mobile market, they had no chance of competing against bigger players with a vested name and years of experience.
• Increased social media awareness. The success of widespread social media profiles and use of social media services by clinicians has led them to share clinical experience and expertise with colleagues and patients more frequently. The success of #FOAM (Free Online Access Medical Education) demonstrates this, and developers were quick to create online communities with app integration to capitalize on it. For example, the wildly successful platform PatientsLikeMe just released its own app linked to its browser-based system.

That said, there are several apps that have embraced the social-based medicine format and mechanism for member engagement. This includes SharePractice, an app that purports to be a peer-based clinical support tool that allows members to see what colleagues or other medical providers are using in patient care with specific diseases.

Most of the topics are focused on specific drug or supplement therapies, with users providing specific recommendations on their prescribing preferences and any associated literature to back them up. Other users can comment on these recommendations and either up-vote or down-vote based on their agreement with the users’ suggestions.

SharePractice was developed by an ND, and when I first tested it in the beginning, it was heavily populated by naturopaths. However, the user base has changed dramatically in the past year, and there are an increasing number of other health care professionals present now.

Another great example is the expanding HealthTap platform, which allows physicians and providers to curate clinical answers for patients subscribed to the service. Healthtap is slowly turning into the digital concierge medical services of our time, but a significant addition is the RateRx service. RateRx will allow physicians to review drugs Yelp style and, similar to SharePractice, vote for the recommendations they feel are of clinical significance.

This social-based medicine movement is a recent phenomenon, due to the high usage of mobile systems and devices among US clinicians. While the increased ability to share ideas will push the dichotomy of medicine quickly, it may outpace or put into perspective current practices, including evidence-based medicine (EBM). EBM is a huge topic at a majority of pharmacy schools, and a highly useful knowledge area in the evaluation of treatment, but it is also an area that requires training, knowledge, and the ability to interpret medical literature and keep up with recent changes.

Using social/experience-based apps may be a distillation of EBM, in which those who keep up with EBM literature can then share the information with their colleagues. However, critics may point out that those with less credible knowledge can equally share the stage and purport treatments with little to no research, leading their colleagues astray.

Based on my perspective, pharmacists have made little foray into this area, but could benefit from sharing knowledge on drugs. In light of the movement for provider status and discussions on expanding medication therapy management, it only makes sense for the profession to get involved in these programs and help share insights and clinical expertise.