That amounts to more than 30,000 doctors, or twice as many on LinkedIn. The reason doctors shy away from LinkedIn and other mainstream social networks is, unlike Doximity, there are no privacy protections in place that will keep physicians on the right side of patient privacy laws. Previous attempts at a doctor-only social network required physician anonymity, which made it all but useless when it came to make referrals or conferring on a diagnosis.

On Monday, Doximity launched ExpertFinder, a new service the company says will make it easier for doctors to find experts and opt-in to research interviews. The announcement seems to position Doximity as an early leader in the mobile health care device market, which could quadruple to $400 million in annual revenues by 2016.

"Harvard Medical School has two teaching hospitals - Beth Israel Deaconess and Brigham & Women's - that are right across the street from one another," he said. But because they're on different systems and compete with one another, "the big joke is that the fastest way to get a lab report from one hospital to another is by paper airplane."

The first telephone switch was developed for use in hospitals in 1876 and the first pagers were developed for doctors in 1950s. More recently, however, med tech has been "stuck in the 1970's," Tangney said, with doctors still relying on faxes and those pagers that are no longer cutting edge. Much of that is due to HIPAA regulations aimed at insuring patient confidentiality, but they also have hospitals and doctors reluctant to try new ways of communicating and collaborating in both their professional and personal lives.

"For a lot of these guys, Facebook is the F-Word," Tangney said.

Analysts also say that these apps are increasing in price during a period of rising healthcare costs and a significant rise in the number of professional-aged people without health insurance.

These are items that are billed as being for the health and wellbeing of the sick and suffering but are really no more than gimmicks that play into fears about our health and our bodies.

We reported a few weeks ago about the FTC levying fines against two app makers that claimed users could erase their acne using colored lights from the iPHone.

This predication comes on the day of the F8 conference in San Francisco, where many Facebook developers are being encouraged to make "meaningful" apps for the rollout of Timeline on September 29.

With a victory that was certainly commendable but not really all that surprising, IBM's supercomputer Watson successfully finished the three-day Jeopardy tournament last night by beating its human competitors by a whopping $50,000. A victory for artificial intelligence and computer science. Scrawled at the bottom of his final Jeopardy response, Jennings quipped "I for one welcome our new computer overlords."

Today, IBM announced its post-Jeopardy plans for our new overlords: healthcare.

IBM has announced a partnership with Nuance Communications to utilize Watson's technology in healthcare. The partnership will involve research combining IBM's Deep Question Answering, natural language processing, and machine learning capabilities with Nuance's speech recognition and Clinical Language Understanding solutions. The goal is to help improve diagnosis and treatment of patients.

According to Dr. John Kelly, senior VP and director of IBM Research, "Combining our analytics expertise with the experience and technology of Nuance, we can transform the way that healthcare professionals accomplish everyday tasks by enabling them to work smarter and more efficiently." This will allow, for example, a doctor to consider diagnosis and treatment options using Watson's analytics and Nuance's clinical language processing technologies in order to quickly process the latest information from research journals.

"Watson has the potential to help doctors reduce the time needed to evaluate and determine the correct diagnosis for a patient," said Dr. Herbert Chase, professor of Clinical Medicine at Columbia University College of Physicians and Surgeons.

At least our new overlords care about medicine, right?

When I was diagnosed with diabetes, I spent two weeks in the hospital learning how to give injections to defenseless oranges. After those two weeks were up, my parents and I were given prescriptions for insulin, test strips, a glucose meter, and a book about meal planning. And we were then thrust into the world of managing type 1 diabetes all on our own.

Where Are People With Diabetes Clicking Around?

Individual diabetes bloggers are a popular destination for both the newly diagnosed and the veteran diabetics. I've been writing my diabetes blog, Six Until Me, since 2005; it's where I chronicle what a "real life" with diabetes has been like for the past 24 years.

Another diabetes blog is The B.A.D. Blog (aka "Born Again Diabetic), which is written by a man who has been living with diabetes for twenty years and calls himself the Ninjabetic. Other bloggers, like Scott Johnson of Scott's Diabetes Journal and Karen G. of Bitter-Sweet Diabetes are sharing their personal experiences with diabetes, and giving slice-of-life advice as only a fellow person with diabetes can.

Ed: I'd like to add Amy Tenderich's Diabetes Mine blog, a long-standing diabetes blog which I subscribe to and enjoy. (Richard)

Social networks specific to diabetes are also a huge haunt, like TuDiabetes, a site developed by Manny Hernandez. TuDiabetes, which is comprised of over 15,000 people with diabetes, gives its users free reign to post photos, write blogs, and to participate in awareness initiatives like The Big Blue Test and Making Sense of Diabetes. Another popular diabetes social network is Diabetes Daily, where thousands of members are chatting daily in the forum and featured diabetes bloggers write weekly, in addition to the individual blogs being written by members.

Even the previously brick-and-mortar-only diabetes organizations are getting their webpages together. Now, even if you can't attend your local JDRF meetings, you can access their resources online - like the Type 1 Toolkit for adults with diabetes or the fundraising pages for local JDRF walks. The American Diabetes Association is expanding their online presence, with online versions of their Diabetes Forecast magazine and even their own public-facing blog.

Even my own diabetes care facility, the Joslin Clinic in Boston, MA, has a website that provides educational resources and support group information. And with these reputable organizations fleshing out their online homes, more and more patients are being referred to the Web for their basic disease education and support networking.

Why Are Diabetes Patients Clamoring For Care Online?

What's the big draw? I've attended a lot of healthcare conferences that all ask the same question: Why are diabetes patients the loudest and most engaged voices in the social space?

Answer: Because diabetes is every day. It's not a disease that you can manage by simply popping a pill and seeing your doctor once or twice a year. This disease, as a whole, requires thought and care every day. And for people who are living with type 1 diabetes, like me, the impact of diabetes hits at every morning, every meal time, every bed time, and just about every moment in between.

Diabetes is pervasive disease that gets into the nooks and crannies of our lives, and the Internet has become an unparalleled and powerful tool in dealing with the emotional and physical factors of this disease.

Photo by Jill A. Brown

The app allows patients to enter their diagnosis information, with the goal of providing patients with a mobile version of their pathology report so that when they visit other doctors they will have accurate information.

The app also includes illustrations and definitions of common pathology report terms.

Healthcare Goes Mobile

A decade ago, Susannah Fox, who directs the healthcare work at the Pew Internet and American Life Project, wrote about a "revolution" in online healthcare. "Ten years later, I am ready to declare the access revolution over, at least in the United States. It's time to change our frame of reference," Fox said at a talk at the Mayo Clinic earlier this month.

Fox argues that the new realm to focus on will be mobile technologies, something she sees as "portable, personalized, and participatory." She contends that mobile technologies will impact how we think about healthcare - how we gather and share medical information.

The iPhone app released by Breastcancer.org is certainly a step in that direction, helping patients have access to records and research, which hopefully in turn will help provide better care and support.

We've embedded the infographic below in Microsoft's new web page viewer Zoom.it.

The data mining part of this story is one of the most interesting to me. As one online resource has explained:

Medical (or clinical) databases have accumulated large amounts of data on patients and their medical conditions. This kind of information, stored along with that of other patients, make up an ideal place to look for new analysis and patterns, or to validate proposed hypotheses. To exploit such large volumes of medical data, numerous inductive data analysis techniques derived from Machine Learning (ML) study have been successfully applied to medical data to discover useful and new knowledge. However, medical data mining is considered by many machine learning communities as the most complex and problematic domain yet to be overcome.

Where there is data, there is opportunity for analysis and building added value. The increasing instrumentation of the healthcare experience could become a major platform for innovation and improved service for consumers.

See also: How Location Services Could Impact Healthcare

The promise of improved clinical information systems, based on real-time information updates across patient touchpoints could be a workflow game changer. If the tablet becomes the tool that is carried with a nurse or doctor on their travels from patient to patient, it will save time, money and lives by enabling the first "always updated" system.

Considering the massive expense of implementing an electronic health record (EHR) system - for example the $4 billion spent by Kaiser Permanente - data synchronization is a huge investment for the healthcare system. At the national level, the Office of National Coordinator (ONC) is administering billions of dollars of stimulus dollars to help systems move forward into the electronic realm.

But early today, the ONC's Charles Friedman told a FDA interoperability meeting that in 2008, a mere 4% of systems in the United States qualify as "fully functional" electronic health record systems. With all the fantastic and innovative work that has gone into creating a healthcare specific devices, such as Panasonic's series of tablet PCs, it's not the mainstream yet.

A big part of this reason is usability of the software. Clearly, vendors have been building creative and durable machines. But in a similar way that earlier smartphones now seem clumsy compared to the iPhone, we haven't yet seen a product that is amazing. Something like what we think the Apple tablet could be would change this landscape overnight and may be priced at a point that's much less than other medical devices on the market.

Mobile Health Momentum

The iPhone has already changed the face of healthcare. Apple shared this fact at last year's iPhone OS 3.0 release and within the keynote at WWDC. The momentum that started with consumer applications has moved to forward-looking doctors and health providers. We know that it is becoming common practice for some doctors and nurses to carry both their company-issued Blackberry and their personally purchased iPhone.

There are already amazing applications in the market. AirStrip allows doctors to monitor patient vital signs and receive alerts from afar. There are now personal health records that can be carried and updated from anywhere.

Additionally, there are information-rich applications that allow nurses, doctors and patients to look up health information in real time. Last week during the Haiti tragedy, an injured individual was able to use an iPhone to treat himself using an first aid application on the iPhone.

Clinician Ready

Apple and EPIC systems have been collaborating to release the first version of MyChartManager on the iPhone. EPIC is a leading provider of EHR in the United States, and powers systems such as Kaiser Permanente and Palo Alto Medical Foundation in the Bay Area, to name a few. The application, named Haiku was released on Jan. 13, 2010, and several health systems are in the process of testing it. It's a clear contender for the "killer app" in the hospital setting. Looking at the screenshots, it's clear that more screen real estate would be ideal - which means it may be just the right time for an iTablet-like device to emerge on the market.

It's the Apps

It is nearly certain that iPhone OS 4.0 will create a path for existing applications to "upsize" to a tablet device, and this includes size. The medical category today is already the highest-aggregate-priced category on the App Store today, and with the promise of applications inside the clinical walls, the opportunity gets much larger.

The iPhone-to-tablet combination may be the biggest reason that a tablet is successful in the market, since the entire iPhone developer community will be able to deliver on this new platform. With Apple's success in having an integrated OS that shares core libraries across both the Mac and iPhone, it is likely that a table device will also connect with apps from both the iPhone and the Mac.

Workflow Wish List

Having had the opportunity to observe clinical workflow and talk with several healthcare providers - including Kaiser Permanente and the Lucille Packard Children's Hospital - we've compiled a list of device capabilities that would change healthcare. Our wishlist includes:

• Real-time observations, including vitals signs: It is amazing that many systems still require doctors or nurses to take down vitals on pencil and paper, even when an EHR is in place.


• Shift changes: Shift transitions between nurses can be greatly improved by having a device that is mobile and moves freely with each part of the staff, so that the shift exchange is a workflow generated process that isn't tied to a physical location. Nurses move, the system should too.


• Rich content delivery: The ability to share with a patient what is going to happen in rich detail, including video, can be a major force in improving readiness of the patient.


• Video: Bringing remote feeds right into the emergency room, outpatient setting or other environment should be easier than ever before.


• Family and friends: Offering a feature for family and friends to directly communicate with the patient is a huge opportunity. A tablet may be the perfect device to enable more personal discussion and check-ins with family members in the hospital, near or far.

Prediction

If Apple does in fact show a tablet device at the Jan. 27 event, hospitals around the country will react with pilot programs, and we will see tablets and Macs join the iPhone in helping deliver healthcare with a new era of style and grace. It is also true that Apple will have an uphill battle getting past corporate IT; getting support in the enterprise as a new class of device is a daunting challenge. But the "iTablet" will give visionary IT leaders more opportunity to change the status quo and look to the future.

We can hear the doctor already: "Take two moments to fire up your iTablet, and teleconference me in the morning."

What do you think, could a tablet be the product that brings Apple inside the hospital walls and improve the system?

Photo credit: Balazs Gal.

The American and Australian scientists at STAR have received a $100,000 grant from the Gates Foundation to develop the cough-analyzing software for developing countries where access to health care is more limited than in first world nations. Despite the poor economic conditions of these under-developed countries, there are a plethora of mobile phones which are being used for everything from early warning systems to mobile payments to health alerts. An mobile app that diagnoses disease would fit right in.

The way the diagnostic software works is by comparing the sounds of the mobile user's cough to a database of coughs associated with all the different types of respiratory diseases. There would also be multiple coughs per disease stored in the database to take into account variations by age, gender, weight, and other factors.

While to our untrained ears, many coughs sound just alike, a tuned-in doctor - or in this case, a mobile app - can listen to the entire structure of a cough from the initial intake of air to the final 100-150 milliseconds of a cough that contains the distinctive "wet" or "dry" and "productive" or "unproductive" sounds that help to classify the cough's seriousness, explains an article on Discovery News. Even the loudness of a cough is taken into account - healthy people have coughs that are 2% louder than a sick person's.

At the moment, the software exists as a computer application but the scientists plan to have it re-written, when complete, as an application for mobile phones.

There's no word on when the mobile application will be released, but the scientists will need to collect around 1000 cough samples before the database is ready. If they're able to then design a successful analytical tool for mobile phones, the impacts to people's health would be far-reaching - and not just in developing countries, but everywhere in the world.

The quiz asks a number of questions including, "Have you or others in your family been seriously ill?" and "Do you think premiums are rising too fast?" From here, the application creates a personalized statement of benefits and users can choose to publish these statements to their Facebook wall. For the most part, this is a well built outreach tool. However, the quiz could be more informative if the "Read the Plan" link actually linked to passages relevant to each user's quiz results. This would ensure that netizens understood the actual plan rather than the messaged benefit statements.

The Obama administration has always had a strong Facebook presence. An average of 4000 status updates per minute were being broadcast alongside a live Facebook video feed during the inauguration. The first White House Live Facebook App was simply a continuation of that service. The quiz app is the group's first issues-based application.

In addition to the Facebook applications and activities, the Reality Check Health Care Reform campaign also posts regular updates to the White House Twitter feed, MySpace page and YouTube channel. To take the quiz visit apps.facebook.com/healthreformquiz.

DiabetesMine founder Amy Tenderich noted that they had "many iPhone-based entries, but what these two students have designed goes beyond a single logging, data calculation or learning application." She listed the following reasons this concept stood out (edited version):

• The LifeCase & LifeApp solution is a glimpse of the future; they've taken the integration of diabetes devices to its fullest conclusion.
• The phone acts as a glucose meter, controller for your pump, and data logging application all in one, with built-in capability to share the data across platforms. The case even houses a lancet and test strip storage for a complete, all-in-one solution.
• The system could easily be expanded to include continuous glucose monitoring (CGM).
• This system is not limited to the iPhone models, but could be implemented on any smartphone.
• The technology to make this system happen is all here and functional. It just needs some visionaries to push for implementation.

In regards to the last note, this is only a prototype currently. However, we agree with Amy that this is the future of diabetes mobile phone apps - and points the way to how mobile phones and the Internet will improve other health care appliances in the near future.

There are a plethora of medical sites that help you figure out based on symptom what sort of ailment you might be suffering from. Put in your symptoms, browse the results, make a guess. In fact, Healthline has such a search engine as well: SymptomSearch. But how do you get more information if you already know what's causing the symptoms? What if your doctor is suggestion a course of treatment and you want a second opinion? This is where the new search tool TreatmentSearch is handy. Using sematic search technology, TreatmentSearch takes your diagnosis and finds resources such as treatment costs and specialists. According to West Shell III, Chairman and CEO of Healthline Networks:

"When you are diagnosed with a health condition, you want to know your options, find a treatment and a specialist that are right for you, and understand the associated cost implications. Healthline semantic search technology enables us to get inside not just the consumer's health inquiry, but also all the relevant associations."

DocSearch

Also announced today is DocSearch, a comprehensive searchable database of 1.3 million doctors nationwide that can quickly supply useful results starting with a zip code and symptom, or alternatively just by specialty. Searches can be refined by distance, name, hospital affiliation, experience, and even spoken languages. Up to twenty doctors can be compared side-by-side to find the just the right specialist.

Healthline is taking advantage of new technologies such as recent advances in semantic search in order to improve the experience visitors have when using the site to help them with every stage of medical care, from diagnosis, finding a doctor, costs of treatment and pharmaceutical advice. Of course, Healthline is also a business, and to that end it has partnered with quite a few other networks and portal sites to provide search, content and advertising as well.

The app also enables users to email their readings, along with a message, to other people such as your parents or nurse. Plus it has charts and lists - not unlike another iPhone app which this author uses to manage diabetes, called Diamedic.

The new LifeScan iPhone app isn't the only initiative to use Web technology to improve the lives of people with diabetes. DiabetesMine, a website run by Amy Tenderich, is running a competition for an iPod-like device or web app for diabetes management. According to Tenderich, "21m Americans live with diabetes, yet the devices we rely on generally don't hold a candle to the sleek design of consumer electronics (think iPod)." The 2009 DiabetesMine Design Challenge is offering a prize of $10,000. It's sponsored by the California HealthCare Foundation (CHCF), with support from global innovation firm IDEO, and by health blog Medgadget.com.

The Internet in Everyday Objects

We're increasingly seeing the Internet-enabled objects that up till now have been offline experiences. Earlier today we described how a UK company, partnering with Penguin, built 6 web-based book applications - including one that used Google Maps for a 'flyover' experience of storytelling, a Twitter book, and one where real time user keystrokes were tracked as part of the story. The creator of those, Dan Hon, told us that he was excited to see Bluetooth connectivity enabling a vastly improved interface for glucose monitors. He said that developments like this could be the stepping stones toward a future of ubiquitous computing - we're inclined to agree.

The next step of LifeScan's Internet-connected glucose monitor might be to have all that iPhone functionality in the glucose monitor itself, doing away with the need for the iPhone. Right now the cost of that would be prohibitive, but we can imagine a time in the near future when touch screen UIs and Internet connectivity in everyday devices will be commonplace and inexpensive.

InSTEDD has built a product called InSTEDD Geochat, which is a service combining SMS, Twitter and email. However it is SMS-only interaction for users, as most don't have browsers. Driving the system is a "semi-structured" API with an extensible pipeline. However the idea of this system is that the participants don't need to be concerned with all the technology behind it, they can just interact with the system using SMS.

Interoperability is an issue, but this is being addressed with an InSTEDD service called Mesh4x. It syncs data from diverse applications, sources and devices. It works via HTTP, files and SMS. It supports open standards, such as FeedSync - an open protocol that describes data formats and algorithms used to version information in a mesh. Interestingly this is a Semantic Web application, with RDF as the default data representation.

The next challenge is using this data for collective action. "Today it takes a lot of coordination to get two organizations working together", said Jezierski. So they have been working on a system called Evolve - described as an RSS Reader for groups by Jezierski. It aims to provide collaborative decision support around streams of information. The service tries to sift through data and identify emerging health-related events. It also has an automatic feature extraction, for data classification and tagging. There is a human input and review module that "allows users to comment, tag, and semantically rank the elements (positive, neutral, or negative)." The overall theme is that it is a mix of machine and human intelligence - the machine can recommend a course of action, but people trigger the actions.

Jezierski has worked in the commercial sector before and he noted that "doing stuff to help people in Cambodia is way harder than running the London Stock Exchange". He said for example that for Twitter to reach wide adoption in these places, much work needs to be done to enable it. In particular he thinks a "better shared language" for technologies is needed for third world work - much in the same way that web 2.0 evolved a specific language in the tech world (tagging, user-generated content, etc).

The InSTEDD Innovation Lab is another project. It's a "socio-technical" lab in Phnom Penh, Cambodia and mixes InSTEDD's own team with various other organizations, to work on technologies that help society.

Overall it's clear that InSTEDD is doing some great work to bring collaborative software and systems into countries that need it the most - for disaster prevention and recovery, healthcare, and other essential needs.

The new alliance wants to guide governments, NGOs, and mobile firms on how mobile technology can be used to help save lives.

Already, mobile technology is providing and augmenting healthcare initiatives throughout the world. In a recent study released by the UN and Vodafone titled, "mHealth for Development: The Opportunity of Mobile Technology for Healthcare in the Developing World," over 50 of these types of initiatives throughout 26 countries were discussed. The biggest adopters of mobile technology were India with 11 projects and South Africa and Uganda with 6 each.

• Sending mobile phone owners updates on diseases via SMS.
• Letting health workers in Uganda log data on mobile devices from the field.
• In South Africa, the SIMpill is a sensor-equipped pill bottle with a SIM card that informs doctors whether patients are taking their tuberculosis medicine.
• In Uganda, a multiple-choice quiz about HIV/AIDS was sent to 15,000 subscribers inviting them to answer questions and seek tests. Those who completed the quiz were given free airtime minutes. At the end of the quiz, a final SMS encouraged participants to go for voluntary testing. The number of people who did so increased from 1000 to 1400 over a 6-week period.
• In the Amazonas state of Brazil, health workers filled in surveys on their phones about the incidences of mosquito-borne dengue fever.
• In Mexico, a medical hotline called MedicallHome lets patients send medical questions via SMS.

The Power of Mobile Technology

But beyond just the altruistic aspects of mobile healthcare, the UN report also demonstrated to mobile operators how programs such as these could provide value to the industry. That, said UN/Vodafone Foundation Partnership head Claire Thwaites, was a crucial step since the industry, like many others today, stands at the edge of a downturn.

Because mobile technology is relatively cheap and easy to spread, it can connect the rural areas that desperately need healthcare with the large populations of doctors who live in the urban centers. For example, "in India," said Dan Warren, director of technology for the GSM Association, the umbrella organization that hosts the MWC, "there are 1m people that die each year purely because they can't get access to basic healthcare. The converse angle to that is that 80% of doctors live in cities, not serving the broader rural communities where 800 million people live."

Some Drawbacks

Using mobile technology is not a panacea for the world's health issues, though. Says Forrester analyst Elizabeth Boehm, one of the biggest issues with mobile healthcare is that "the people who are most in need of healthcare are usually more aged, so they don't use the mobile or they're not comfortable with it." This limits the use of mobile phones in public health information campaigns.

However, as the technology continues to spread throughout the world, it's easy to see how, over the course of time, phones could become a "doctor in your pocket" for the less fortunate citizens of our world.