Jared Heyman is the Founder and CEO of CrowdMed, a site that harnesses the wisdom of the crowd to solve difficult medical cases online. I caught up with him at the 2015 Personalized Medicine World Conference in Mountain View, CA in January. In this video interview, Jared explains how the site works. [You can view the video here: https://www.youtube.com/watch?v=Lx2mSPXi19E]

In brief, patients who have conditions that have not been able to be diagnosed via traditional medical office visits despite seeing multiple doctors, having multiple tests, and costing many thousands of dollars, pay a small fee to post their case on the CrowdMed site. Medical Detectives (practicing and retired docs, medical students, nurses, medical researchers, scientists, and interested others) review the information, ask the patient questions, and do literature searches in an attempt to solve the case. Case-solving thought processes are shared online and the detectives learn from each other as well—just like what happens in resident’s report when docs are in training.

Medical Detectives are not practicing medicine and nor are they meant in any way as a substitute for the patient’s regular physician(s). Rather they are a source of new ideas, new possibilities for the patient’s doctor(s) to consider and confirm—or rule out. As the medical literature continues to grow exponentially, and new diagnostics, such as genomics & proteomics, metabolomics, etc., are added to the equation, it is becoming more and more important to have many minds—with different backgrounds and perspectives—applying their knowledge and energy to tough cases.

 

So, why do the medical detectives do it?

Detectives with the best diagnoses can earn a small amount of money, but for the most part, the real motivation is helping patients, enjoying the intellectual challenge, and honing diagnostic skills. I have been a medical detective for about a year now and I can tell you that these are extraordinarily challenging cases, the kinds of cases that would be overwhelming to try to deal with in the standard 10-15 minute office visit that characterizes much of outpatient medicine today. But they are the kinds of cases that many of us were trained to diagnose whether we chose to practice primary or specialty care. We just need time to ponder the details, review the literature, consult with colleagues, and work through the complexities.

Because CrowdMed keeps the cases on the site for about 2 months on average, the Medical Detectives do have the time to think about the case, discuss it online with other detectives, and do research on potential diagnoses. What they don’t have is the physical presence of the patient or a formal physician-patient relationship.

Another benefit is expanding your medical knowledge. I have learned about some pretty unusual illnesses by working the cases, including systemic mastocytosis (without rash), burning mouth syndrome, and Bickerstaff encephalitis while working my cases. I have also had some good “conversations” with patients. If you are interested in becoming a Medical Detective, sign up at www.crowdmed.com. It’s easy. It’s fun. And, the big bonus: It helps people who really really want an answer to their medical mystery.

 

What does success look like?

When I asked Jared how he defines success he said, “it’s when patients come back and tell us that there was some insight in the discussions/suggested diagnoses & solutions that brought them closer to either a correct diagnosis or a cure.” By that metric, he said, “we have almost a 70% success rate right now.” Although this metric is pretty soft, hopefully as CrowdMed grows, they will consider working with some academic researchers to do a more rigorous evaluation of their outcomes.

 

What’s next?

Jared says they have

“solved hundred of medical cases to date but we want to take it from hundreds to millions. We have about 500 active medical detectives, but we want 500,ooo. We want it to be the first things people think to use around the world when they have an unsolved medical mystery…that’s our goal.”

I say, go for it!


You can read my prior post about CrowdMed here: http://thedoctorweighsin.com/tough-case-now-can-crowdsource-your-medical-diagnosis/.

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