Webware

Content intelligence searches entire sentences, not just key words, for meaning.

(Credit: NetBase)

It all started with Content Intelligence--focusing on understanding the actual meanings of sentences independent of grammar, lexicon, etc., and creating structured semantic indexes from massive volumes of content to power search experiences.

It wasn't until after the Mountain View, Calif.-based NetBase Solutions developed its content intelligence platform that the company decided to test it out in the world of medicine. Their just-unveiled HealthBase is to medicine what Kayak.com is to travel--the mother search engine of not just content, but other search engines.

Culling through 10 million health articles and sorting search results on two types of data, "conditions" and "treatments," into manageable subsets, HealthBase includes "causes of," "treatments for," "complications of," and "pros and cons of treatment." Content sources are also provided and ranked. And Jens Tellefsen vice president of marketing and product strategy, said it might include user collaboration akin to Digg's voting articles up or down in the near future.

The search engine has some kinks to work out--when I tried to research garlic, HealthBase treated it not merely as a treatment but also as a complication, showing "causes of garlic" and "treatments for garlic."

HealthBase seems to have a few kinks to work out, like treating the search term garlic as a condition instead of treatment.

(Credit: Screenshot by Elizabeth Armstrong Moore/CNET)

But Tellefsen acknowledged by telephone Tuesday that I am not, as a layperson, the target market:

"We see a lot of applications, but this is really a showcase of what is possible to do with our technology. We picked health because it is such an incredible information-overload space; 8 million people per day use the Internet to search on health information. It's something that is very important for people.... But our end customers today are really health publishers and portal providers we'd like to provide information to."

NetBase already boasts several Fortune 500 clients, not to mention the federal government. Having built HealthBase in just two weeks (which is somewhat self-evident), and with plans to quadruple the amount of information it mines, I see tremendous potential here. It already has an edge on Google, although for how long remains to be seen.

Meanwhile, anyone looking for additional information after a doctor's visit, or perhaps in lieu of one (who really wants to see the doc about erectile dysfunction, as Tellefsen points out), HealthBase is your oyster--a search term, by the way, that is neither a condition nor a treatment, at least as of yet.

If you regularly find yourself on WebMD or Wikipedia in an attempt to diagnose an itchy spot, chronic cough, or other mystery ailment, a new medical reference app for the iPhone and iPod Touch could save you some steps.

iTriage ($0.99) lets you search and browse hundreds of symptoms, diseases, and procedures in a logically, possibly overly designed app, that's intuitive to navigate. In addition to useful descriptions of the condition, treatments, and medical tests, the app also offers a plethora of support links to your insurer's advice line, medical Web sites like WebMD, and in-app Google Web searches with results that include images and further information about the condition. In addition, iTriage can use the iPhone's GPS to help you find nearby pharmacies, hospitals, and other treatment centers.

For all its strengths, iTriage also suffers a few avoidable and mostly minor weaknesses. For instance, its information-rich setup requires more navigational tapping than we think necessary. Also, some information is missing, like the phone numbers to pharmacies in our area, and a medical sketch of each ailment in the disease and symptom overview. Still, the application is a promising hub for basic information, and not just for hypochondriacs--though most of this introductory information is also available for free from other Internet sources, like Medpedia.

iTriage covers only the U.S. for now, though it may incorporate other cities and countries worldwide in later versions. Check out our screenshots for a more in-depth look.

iTriage: Diagnosing iPhone hypochondriacs

Genetic analysis start-up 23andMe, known for its star-studded "spit parties" and a controversial investment from Google, announced Thursday the debut of a new initiative to bring together women who have been affected by breast cancer or who may be genetically at risk.

October is the 23rd annual National Breast Cancer Awareness Month.

Using its Web-based social network, 23andMe hopes to "reach out to, and build a community around, women who have encountered breast cancer, thereby increasing the scientific understanding of the inherited aspects of a disease that affects 200,000 newly diagnosed individuals per year." Women who purchase the $399 testing kits will have the option to participate in surveys, and the start-up's research arm, called "23andWe," will build a community for the swapping of knowledge, advice, and support.

Representatives from 23andMe said that the project does not yet have any external research organizations as partners, and remains "primarily a social-networking community" at the time. The genetics community has been reluctant to embrace consumer DNA-analysis companies, and the state of California asked 23andMe, along with other companies in the same field, to stop selling tests until they could be fully compliant with health regulations.

At the end of August, 23andMe announced that California authorities had granted it a license to continue selling its tests. In a blog post, 23andMe's founders described the agreement as "only the start of the dialogue between regulators and genomics companies that offer direct-to-consumer services."

This post was updated at 1:04 p.m. PT to clarify the state of 23andMe's negotiations with the state of California.

If you want more proof that software as a service and ad-supported business models are shaking things up, check out Practice Fusion. This week the small company announced the availability of its free, on-demand suite for physician practices.

Practice Fusion CEO Ryan Howard touts the software suite as Google Apps for physicians. It's a radical departure from the established and costly software packages used by physicians to manage their offices and patients records.

Practice Fusion includes practice management, scheduling, patient management (electronic medical records) and e-mail applications. The Web interface takes advantage of Flex 3, Adobe's rich Internet application platform.

Howard is betting that he can make money on free software by connecting advertisers with doctors while they are working via ads. So far Practice Fusion has about 1,000 physicians signed up for the service and about 20 advertisers, including Johnson & Johnson, AstraZeneca LP and Ortho-McNeil-Janssen Pharmaceuticals, Inc.

"The campaigns range between a $50 and $150 CPM, and we are starting to do a significant amount of lead generation, where there is typically an ongoing revenue sharing component," Howard said. Given how difficult it is for a drug salesperson to get a doctor's attention, Howard may have tapped into a rich vein.

Update at 12:19 PM PT: This story was updated to reflect the World Privacy Forum's position on PHRs in general.

Google is set to announce on Thursday that it will be using the Cleveland Clinic hospital in Cleveland, Ohio as the pilot site for its new personal health records initiative.

The Cole Eye Institute (foreground) and the taller Crile Building, which is the flagship facility of the Cleveland Clinic.

(Credit: Cleveland Clinic)

Between 1,500 and 10,000 patients at the Cleveland, Ohio, facility will participate in the project's test run, volunteering to have their medical records transferred to their Google accounts. The hospital already keeps electronic records for over 100,000 patients in an internal system called MyChart, but when those personal health records, or PHRs, are shared with Google, patients will be able to use them outside of the Cleveland Clinic. Included in the data will be prescription information, medical histories, and details about conditions and allergies.

"Patients are more proactively managing their own healthcare information," Dr. C. Martin Harris, the Cleveland Clinic's chief information officer, said in a statement. "At Cleveland Clinic, we strive to participate in and help to advance the national dialogue around a more efficient and effective national healthcare system."

"We believe patients should be able to easily access and manage their own health information," Marissa Mayer, Google's vice president of search projects and user experience, said in the same statement. "We chose Cleveland Clinic as one of the first partners to pilot our new health offering because as a provider, they already empower their patients by giving them online tools that help them manage their medical records online and coordinate care with their doctors." Additionally, Cleveland Clinic president and CEO Delos M. Cosgrove is a member of Google's Health Advisory Council.

Google isn't the only tech titan looking to change the healthcare industry. AOL founder Steve Case has launched a new company, Revolution Health; InterActiveCorp has invested in several health-related start-ups; and Microsoft has been working on a medical record service.

But all these "health 2.0" initiatives will inevitably raise privacy concerns, and critics of such projects have already begun to make themselves heard. The World Privacy Forum, which has highlighted concerns about medical identity theft in the past, has already issued a report voicing concerns about third-party PHR systems that aren't covered by the Health Insurance Portability and Accountability Act (HIPPA), which has been in effect since 1996 and requires individuals to be notified when a party other than a patient's doctor wants to access confidential medical data.

Not only is security an issue, the nonprofit has said, so is the likelilhood that marketers and other corporate entities will be able to exploit otherwise confidential data. The World Privacy Forum has not taken a specific stance on Google's new project or on others like Microsoft's.

Google is of particular concern to some privacy advocates because the company already has so much data about its users.

"While PHRs may have some laudable goals," the report by privacy consultant Robert Gellman read, "they are also a tempting target for companies or others that want to evade whatever privacy protections remain in the health care system in order to make a profit."

Web search is a whole lot easier than thumbing through a household copy of The Merck Manual when you're trying to find out what you're sick with. A simple search based on symptoms might steer you the right way, but several medical Web services have gone the route of attempting to emulate the kinds of questions you'd get when visiting a doctor's office. One of them, called MEDgle has quietly been offering up a symptom-based medical search tool for the last year.

The crux of MEDgle is the search tool, which either lets users type in what's wrong with them, or pick it out piece by piece by clicking on affected body parts or general symptoms. There are also tabs to hone down your search by drugs, procedures, and health care providers. The goal is to give you a list of conditions, along with pointing you the right way to places to get them checked out. What makes it interesting is that some of the results you get are actually hand-picked by physicians working with the service. Similar to the idea behind Mahalo, the hope is that you can get some guided search recommendations alongside the standard Web hits that have been tailored to the information you've provided on sex, age, and body type.

What makes MEDgle worth checking out is the results system. It'll first break down possible afflictions or conditions, then let you mouse over to get a quick overview of what it is. Each one is also rated on a five-star scale, which is tied in to the symptoms you've listed; the higher number of symptoms that match up to that condition, the higher the star count. You can then drill down by clicking on the condition, which will pull up the Web results, along with Snap-powered previews of each site.

While MEDgle lacks some of the polish and visual flair of WebMD, it's dead simple to use, and does a fair amount of hand-holding along the way, which I think novice users will enjoy. Until Google rolls out its own health search service and records platform, sites like these are a great place to bookmark for the next time you feel like doing a little research on what ails you without having to phone or visit your medical provider.

See also: Outlook healthy for health care Web sites, but use caution

Not for the faint of heart, MEDgle's symptom checker lets you pick out what's wrong with you visually.

(Credit: CNET Networks)

Microsoft is giving a booster shot to its Health Solutions Group, announcing on Monday plans to acquire clinical workflow software developer Global Care Solutions.

The acquisition of Global Care Solutions, based in Bangkok, Thailand, is designed to enhance the management of clinical workflow, medical records, billing and regulatory compliance at hospitals and other medical facilities. Terms of the deal were not disclosed.

Global Care worked with Thailand's Bumrungrad International Hospital to design its system, which serves more than 1.2 million patients a year from nearly 200 countries. The hospital uses Global Care's system to manage scheduling and medical records in multiple languages.

Peter Neupert, vice president of Microsoft's Health Solutions Group, noted in a statement that Global Care's "state-of-the-art health information system" allows patients to see a doctor within roughly 17 minutes after arriving at Bumrungrad.

Is Thailand gearing up to be the next India for tech resources? Get those passports ready.

WebMD's symptom analysis is nice.

Although you can't singlehandedly fix the woes of national health care that are spotlighted in the movie Sicko, many free Web sites at least put a bit more power in your hands to manage personal wellness or a medical crisis. Just share your data wisely.

WebMD (a Webware 100 winner) offers videos, virtual support groups, quizzes, blogs, doctor lookups, and a spiffy symptom checker. Look up drugs by a pill's color, imprint or shape. WebMD won't spam you, but as with its competitors, if you subscribe to e-mail updates about some unappetizing ailment, then prepare for related tidbits in your in-box. It's too bad that some ads, like those for toothpaste, are hard to distinguish from the rest of WebMD.

Although WebMD offers more activities, HealthAtoZ is also helpful, letting you chat with nurses and create a personal health record with feeds from your insurance claims. But community features, blogs, and videos are lacking.

RevolutionHealth pivots around a treatment portfolio you create in addition to blogging and rating doctors and hospitals. You can pose questions anonymously to the community. Talking to experts about care and insurance costs $129 annually, or is free for a month.

A newer site, TauMed (also here), enables you to create a medical library of clips from the Web, as well as a Health Space profile to add doctors and collect "friends." The question-and-answer service is novel--although it lacks a stealth mode in case you're curious about something blush-worthy.

The ad-free, clean, and less peppy FamilyDoctor and HealthFinder are excellent and encyclopedic. You can dig deeper into the latest medical studies via the National Library of Medicine's Pub Med and Medline, which also offers drug interaction lookups.

For health care quests, social networking takes on a deeper dimension beyond collecting friends, songs and party plans on MySpace or Twitter and the like. Ill people from around the world can compare symptoms anonymously online, share suffering or healing tales, and tip off each other about treatments.

PatientsLikeMe hosts support communities for people dealing with ALS, Parkinson's disease, or multiple sclerosis. You can create quick graphs that track prescription regimens and symptoms. Hopefully similar tools are in the works for a wider array of conditions. I like PatientsLikeMe's Answer Network, a Q&A service that delivers data in novel ways. For instance, bar charts display other members' top reasons for discontinuing specific drugs.

Patients Like Me helps you track complex drug dosages and symptoms.

In addition to linking you with strangers, the Internet provides gathering spaces for family and friends. I've used theStatus, which partners with hospitals, to see from San Francisco how a dear family friend in Ohio fared after heart surgery. TheStatus feels like it sounds--a no-nonsense check-in service for the straight dope on an urgent medical situation. You can leave well wishes, too. BabyStatus is new.

I have another close family friend whose ongoing medical care requires regular attention from people in far-flung places. We tried to set up a Web-based spreadsheet to track our visits via Google Docs & Spreadsheets (more here), but only the few geeks among us could get past the awkward document-sharing steps.

We turned next to CarePages, which was built for our purpose. But its colorful design somehow didn't feel appropriate for tracking the care of a retired mathematics professor who would kick back with paperbacks about string theory in his free time. But CarePages seems a good fit for the million families, particularly those with young children, it has served. Opening a page is uncomplicated. There are sections for pediatric cancer, brain injury, and much more. CarePages is now part of RevolutionHealth.

Similarly, CaringBridge steps you through selecting one of several age-appropriate designs for a patient. You can share photo galleries, a guest book and a journal. But while I picked privacy options, CaringBridge displayed my password in clear type on its site. At least nobody was looking over my shoulder. Security sin aside, I can see why the nonprofit site's ease of use has led to success for more than a decade with some 64,000 patient sites.

With any highly personalized service dealing with sensitive topics, security should be paramount. It's hard to peek inside these sites without registering. You might want to set up a separate e-mail account for medical matters first, and never use your real name as a user ID.

The Truste seal marking WebMD, FamilyDoctor, HealthAtoZ, and CarePages shows that they use the same encryption as bank sites (so does theStatus). I like WebMD's privacy policy best for telling you how you can ask to yank your data from its servers.

All of these Web sites pledge not to send all of your data with third parties--except for John Law. No patient-client privilege here. If you are hiding a medical condition that you don't want unearthed by a search warrant, then you have the nearly impossible option of accessing these sites with a PC and IP address separate from anything else you do in life, also while using strong security software. That's still no guarantee that you won't leave personal cookie crumbs.

On that note, wouldn't it be nice if you could find what's inside all of your medical files from over the years, lickety-split, just like Googling yourself? What if you could connect that information to your genetic code? Such dreams of convenience would trigger obvious privacy nightmares. As Web-based health care tools become easier and richer to use, striking the balance between approachability and security will become trickier.

The president of CEO of TauMed.com, Tauseef Bashir, attributes this extra depth to a proprietary search engine, which finds articles by theme, not just those with matching keyword tags. When I tried the phrase "birth control," I found that related articles from different parts of the site (news, health tips, blogs) appeared. Nothing irrelevant was placed on the first page of search results, whereas on Google-powered WebMD, the second item listed was only loosely connected to the search term.

Several other features of TauMed are promising. One of the newly added features is "My Health Space." This function lets members create a personal Web site containing links to articles, TauMed support groups and doctors. "My Health Share" is a blog-style forum where users can sound off on a host of health topics. Both functions are aimed at building a solid community of users and medical professionals.

I found that most of the blog-style forum's posts are answered by other TauMed members. This may be good for light issues ("Does pulling my hair in a ponytail too tight cause headaches?"), but less useful or even dangerous for serious medical concerns. While I would like to see the editorial board step in as experts and not just hidden moderators, Bashir's intention with the blog community is to create a comfortable environment for discussion, not necessarily diagnosis.

The site could be helpful for patients researching ongoing conditions because of the bookmarking capabilities on "My Health Space." If I want to research diabetes, for example, I could easily create a full library with credible resources and connect to a community around the topic. While TauMed is off to a good start, I'm uncertain of how comfortable users will be sharing their medical woes in a social-networking setting, without the promise of receiving a doctor's expert advice.