Comments for MyMedLab: Are You Qualified to Interpret Your Lab Tests?

MyMedLab: Are You Qualified to Interpret Your Lab Tests?

2008-11-26T23:00:54Z

On Monday we reviewed the state of health 2.0 and it was also the topic of this week's RWW Live, our live podcast show. At the end of the podcast, I asked all the panelists to list their favorite health 2.0 app (about the 58:30 mark if you want to listen to it). I've listed all the apps the panelists chose at the end of this post, but I wanted to highlight my own choice in this post. I selected MyMedLab, an online lab testing service - despite it being only available in the U.S. There appear to be two key benefits to MyMedLab, and similar services such as MedLabUSA. One is that a doctor's prescription isn't required because the test requests are approved by in-house physicians. The second is that tests can be completely confidential to the user. Both of these benefits have drawbacks though, which we'll discuss below.

]]> But first let's look at the process, which is largely electronic:

There are privacy agreements to check as part of the sign-up process, and also the site has a straight forward but comprehensive privacy and security section that promises not to allow "any third party access to your personal health information."

When it comes to getting a lab test done via MyMedLab, there is a fairly long list of lab tests that you can request through the site - although some of them aren't available online and require you to call a phone number (e.g. DNA tests). MyMedLab has partnered with reference laboratories in the U.S. and their services are available at nearly 2000 Patient Service Centers (PSC). Users are given a secure area of the site for their "Personal Health Record (PHR)", essentially their account history at MyMedLab.

Pros and Cons

A recent Wall St Journal article outlined some of the potential concerns about MyMedLab. While not needing a doctor's prescription will save consumers time and money, it's important to note that MyMedLab tests won't necessarily be covered by a consumer's health insurance. Also the money savings of not seeing a doctor may be offset by the cost of using MyMedLab - WSJ reported that a blood test on MyMedLab.com costs $45.

Also WSJ raised concerns about the ability of consumers to interpret their lab test results. MyMedLab says that results are interpreted by one of the company's doctors and put in the user's PHR. While MyMedLab encourages its users to share their test results with their own doctors, it isn't a requirement. David Clymer, CEO of MyMedLab, commented on ReadWriteWeb earlier this week that "once you know your numbers you can begin to make informed decisions, formulate a plan, and track your progress over time." Ultimately, as John Sharp of the eHealth blog wryly noted, this argument against MyMedLab and similar consumer-focused health services may be "one of the last hold outs of paternalistic medicine". We at ReadWriteWeb like the fact that MyMedLab is consumer-centered, although I personally would want to run my lab tests by my doctor or specialist.

Favorite Health 2.0 Apps of the RWW Live Panelists

Here were the choices of each of the RWW Live guests this week, along with Sean the host. Let us know your own favorite in the comments, and we will take a note to explore some of them in upcoming posts.

Sramana Mitra: Maria Health (currently in stealth mode)
Steven Krein, OrganizedWisdom: 23andMe (online genetics)
Abe Lederman, Deep Web Technologies: PatientsLikeMe (patient community)
Robert Shelton, Private Access: Sermo (physicians collaboration site)
Malcolm Costello, Kryptiq: no one choice, but likes "sites that encourage sites to take personal responsibility for their healthcare"
Scott Shreeve, MD: ChangeHealthcare (will become "the Mint.com of healthcare")
Sean: Yelp (not health 2.0 per se, but it helped him find a yoga studio while traveling)

Comment from Char James-Tanny on 2008-11-26

2008-11-26T23:24:31Z

Lab work done through a hospital (or doctor's office) produces a report that shows your current results and the valid range of levels for each test. Does MyMedLab?

If so, what you want to look for are those values that are out of range.

If MyMedLab doesn't provide the ranges, use Google to find out what they are.

Comment from Matthew Theobald on 2008-11-26

2008-11-27T07:03:20Z

You may find some interest in ISEN.org which is a way of identifying, describing, classifying and authenticating database in the deep or as we call them "search environments". (beyond just databases) If you'd like to do a Q+A for blog don't hesitate to contact me about ISEN. We are very transparent as part of our sharing model.

Best,

Comment from George on 2008-11-27

2008-11-27T08:31:26Z

Thanks for a great post. I really enjoyed reading it as always.

Comment from Robert Banghart on 2008-11-28

2008-11-28T20:55:27Z

I think we should all be more knowledgeable about our physical status and learning how to interpret our own lab tests is a step in the right direction. I am healthy and plan to use MyMedLab for my next series of lab tests. I'll read what their physician has to say and supplement that with my own reading and sharing the results with a doctor I run with. If I still need more input I can take the results my regular physician for his opinion.

Comment from Scott Shreeve, MD on 2008-11-30

2008-12-01T05:45:39Z

Richard,

Thank you for highlighting MyMedLab and the innovative approach of providing direct access by patients to access their personal health information and track their health progress over time.

In full disclosure, I serve as an advisor to the company as well as a participant on the call that was conducted. I became involved with MyMedLab while conducting my own survey of promising Health 2.0 companies, tools, and technology. I was intrigued by their Health 2.0 delivery model of leveraging the internet to remove inefficiencies of time, location, and physician approval for routine wellness laboratory testing.

I became convinced after using the service for myself. Since I hadn't ordered lab test since my medical school entrance physical exam, and I was preparing for an upcoming physical, I ordered the baseline wellness tests I knew my primary care provider would want (conveniently organized by "profiles" - individual tests that are grouped together to provide disease or organ system specific information). I wanted to maximize my time with my doctor and come prepared with as much information to review during our appointment as I could.

MyMedLab helped me accomplish these objectives in a confidential, convenient, and cost-effective, convenient, and confidential way. It was a hassle free ordering process and I had my results within 36 hours. I was able to fax this information to my physician ahead of my appointment and to actually use some of my time with him to review the data as opposed to discuss ordering the test. I immediately saw the opportunity to extend this to other appropriate settings, and other appropriate patient or physician groups who have highly specialized laboratory testing needs (hormone health specialists, bariatric patients, and even diabetic patients).

A persistent question that comes up is the appropriateness of the direct to consumer model. I have to agree with John Sharp about the age of paternalistic medicine going bye-bye. The easiest analogy to understand this point is to review the democratization of the financial services sector. 30 years ago, only qualified financial advisors could provide financial advice, set up accounts, trade stock, transfer funds, or manage a portfolio. Can you imagine that being the case today? Consumers have the ability to read financial information (now abundantly available), set up accounts in minutes, buy/trade stocks with a click of the mouse, move money across the globe between multiple accounts, and manage all their accounts from single portals all without leaving their desks.

Does this obviate the need for financial advisors? For many smaller or DIY investors, it has reduced the need by outsourcing these functions to the consumer. However, the experience and knowledge of a trusted financial advisor is still heavily relied upon for anyone requiring professional assistance, complex trading, or needing higher end service. They haven't gone away, they have just had to adapt what they do, how they provide their services, and who their customers are. In essence, financial advisors have had to move up the value chain.

While this will sound heretical to some old school doctors, most wellness laboratory exams don't need to be interpreted by a physician. In fact, most wellness exams don't need to be performed by a physician. It is pretty straightforward stuff: Cholesterol 250 = get on some cholesterol lowering meds. This isn't rocket science.

However, there clearly is a time and a place to call upon those practiced both in the art and science of medicine. I assert that the trusted physician advisor will be as meaningful, if not more meaningful, to you in the future world of highly personalized medicine. You might interact with her in new and exciting ways - chat, text, videoconference - but she will continue to use her expertise, knowledge, and experience to provide the advice you need on key health issues, disease states, and medical treatment plans. Physicians aren't going away - they will just be practicing at a higher, more meaningful level than they have in the past. Physicians, like other knowledge workers, will have to move up the value chain in order to maintain their relevance in the future.

Most will. Some won't. And for any of those clamoring that they are the only ones authorized to read lab results, send them the this link (Charles Schwab) along with an email saying you are looking for a new physician.