Praxeon Blog

We welcome Parents Helping Parents and United Leukodystrophy Foundation

MyDailyApple.com is delighted to welcome two new partners to its ever-expanding network:

California-based Parents Helping Parents was founded in 1976 to provide lifetime educational guidance, enlightened training support and comprehensive health-care resources to families of children with special needs and to the professionals who assist them.

Since 1982 the United Leukodystrophy Foundation (ULF) has pursued its mission to help and ultimately cure children afflicted with leukodystrophy through treatment, research, newborn screening, patient advocacy and educational programs.  The ULF also provides support services to dedicated family members and to the healthcare professionals who assist them.

MyDailyApple Upgrade : Redesigned and Community-Powered

MyDailyApple has always included the best objective health information on the web. But sometimes news and medical research is not enough. Often, it's a real person's experience that helps you gain that key insight to better understand your health.

So starting today, MyDailyApple will include the discussions from the best on-line health communities. Real patient experiences - relevant to your interests - will be on display in a new "Your Communities" tab. You will have the ability to read, interact and discuss with real people - similar to you.

The community discussions are just the start. You will also be able to recommend or criticize articles to other members of the MyDailyApple community. Reading and commenting on an article is just one of the ways we're making it easier to learn about your health while helping others.

We've also made a few other improvements to make your health exploration easier:

• New site organization making it easier to find and read the information you're looking for.
• A remember topics section to more easily remember your health interests.
• A medical expertise selector that lets you control the type of content displayed by your level of expertise and comfort.
• The ability to view your news just for today, or to catch up on developments over the past week.

There are a few more improvements too - but we'll let you discover them on your own!

Now more than ever, in one place you can find the right health information - whether it's news, research, blogs, discussions, medical reference, or clinical trials - relevant just for you - right when you need it most. And all with the opportunity to learn from and inform other patients like you.

The new MyDailyApple: Learn your Health and Help Others.

Praxeon Provides Medical Research for Kosmix RightHealth

New Service Helps Consumers Find Medical Literature In Their Health Search

Boston, MA – August 11, 2008 – Praxeon, Inc. announced today that its consumer health news and search site, MyDailyApple™ (www.mydailyapple.com), will provide advanced reading content for Kosmix™ RightHealth. RightHealth searches the health Web and categorizes it into useful modules for consumers giving them the relevant information they need to explore and learn about any health topic. The “Advanced Reading” module will now feature medical literature served from MyDailyApple. MyDailyApple’s evidence-based material will give RightHealth users access to the latest literature and research breakthroughs relevant to their query.

“Praxeon's patent-pending semantic fingerprinting, natural language query and profile-based filtering technology is what sets Praxeon apart from other health information and search companies,” said Kevin Cronin, CEO of Praxeon. “Now this technology, combined with some of the most authoritative medical content, will be available on one of the most trafficked health online sites.”

“At Kosmix, we are focused on delivering the most relevant content from a variety of sources – basic facts, advanced reading, expert opinions, forums, videos and images – to users searching for health information online,” said Ravi Raj, vice president of products at Kosmix. “Praxeon’s strong technology gives us the ability to offer millions of RightHealth users with advanced reading material and additional information for their health care needs.”

About Kosmix

Kosmix, headquartered in Mountain View, Calif., takes traditional Web search to the next level by organizing content to let consumers explore, discover and learn about any topic, connecting them to information that makes a difference in their lives. Consumers get a 360 degree view of topics that includes videos, images, reviews, discussions and expert opinions. At the core of Kosmix is a powerful content categorization engine which powers its vertical consumer sites, RightHealth, RightAutos and RightTrips, and the recent alpha of its horizontal platform, Kosmix.com.

About Praxeon

Praxeon’s sophisticated technology is revolutionizing the way people get health care information. Praxeon’s products have been extensively tested and validated by healthcare providers and by more than 20 health advocacy groups. In 2007, Praxeon was voted “Best Health Search Company” at the Health 2.0 Conference in San Francisco, CA.

PHRs - Miracle or Mayhem?

You may have caught some of the recent press around personal health records or PHRs.  Both Microsoft and most recently Google have entered the market of providing individuals the ability to enter their personal health information in an on-line medical record.    And in the case of Google, individuals have the ability to import their medical records from pharmacies, labs, hospitals and insurers.  (Full disclosure – MyDailyApple is a Google Health service).

A lot of commentary on Microsoft HealthVault and Google Health has focused on the advantages of accessibility and patient control.  The PHR allows the patient to take their medical records anywhere and provide access to anyone at anytime – since it’s all on line.  The major disadvantage that has been mentioned revolves around issues of privacy and security.  Do you trust Microsoft or Google to safeguard your medical information?

I agree that accessibility and portability are major advantages of PHRs and that security is a major concern.  But I think most commentaries have missed some of the other major advantages associated with an on-line PHR and some of the major pitfalls.

For instance, from a patient perspective, consider some of the following additional advantages beyond portability and accessibility:

1.       Now you can review your records to see how your doctor thinks.   You can see their decision making, how thorough they are and what other diagnostic possibilities they are considering.

2.       You can see if your physician is compliant with the latest guidelines regarding screening, testing and treatment.

In short, as a patient, you can now get some insight into whether or not you are getting high quality care.

But on the flip side, from a physician perspective, there are some serious concerns with opening up medical records so easily:

1.       Does this expose physicians to additional liability?  What if a patient finds something wrong in their medical record or an omission of care?

2.       Can you imagine a HealthVault or Google Health service provided by lawyers – “We’ll see if there is evidence of negligence in your PHR and get the money you’re entitled to!”  Okay – some of you might think I’m being a paranoid doctor.  But seriously – I saw an ad on the TV asking women who had an emergency c-section to get immediate legal counsel.

Bottom line: Are providers really going to rush to provide easy access to medical records to on-line PHRs if it means they might get sued?

On-line PHRs contain the aura of another miracle for what ails the US healthcare system.  And certainly, greater transparency, portability and accessibility or records and patient empowerment are all important goals – furthered to an extent by the PHR.  But there could be problems – and a great deal of reticence beyond issues of patient privacy – before there is widespread adoption. 

Google Health and HealthVault are not going to be enough to fix the problems in US healthcare.  It’s going to take a couple of additional “mini-revolutions” beyond on-line PHRs – like in areas of medical tort reform and malpractice; easily understood and validated quality measures; financial incentives towards prevention and wellness and not just disease treatment – till this patient starts to get better.

Special thanks to my father – whose conversations with him helped shaped much of my thinking for this current blog.

Praxeon launches Google Health integrated service

New Integrated Service Helps Consumers Find Relevant Health News and Blogs Related to Their Medical Information

Boston, MA – May 20, 2008 – Praxeon, Inc. announced today that its consumer health news and search site, MyDailyApple^TM (www.mydailyapple.com), is now available as an integrated service on the Google Health platform. Google Health is a new product that was launched today at a media event in Mountain View, California that allows users to store, organize, and manage their medical records online. The new Praxeon service gives Google Health users access to health news, blogs, and research information from the most trusted sources along with the ability to personalize that information to individuals’ health profiles.

“Google Health is a personal health service that paves the way towards consumer involvement and accountability,” said Kevin Cronin, CEO of Praxeon. “And MyDailyApple provides Google Health’s users with relevant and personalized health information so that users can be fully engaged in managing their own health.”

MyDailyApple uses data from an individual’s Google Health profile, upon their consent, to provide relevant health content that is personalized to their own health conditions or medications. MyDailyApple gives Google Health users pertinent, current health information from sources that are matched by medical relevance and by measures of community popularity. This combination of sophisticated health search technology and active user input leads to a richer, more informed, personalized health experience, driven by the most trustworthy health news and information.

“Praxeon's patent-pending semantic fingerprinting, natural language query and profile-based filtering technology is what sets Praxeon apart from other health information and search companies,” said Dennis Underwood, Chief Scientific Officer of Praxeon. “That technology powers Praxeon's top-rated health news and search products — MyDailyApple^TM for consumers and Curbside.MD^TM for healthcare providers — and delivers intelligent, organized and personalized answers to health questions.”

Praxeon’s sophisticated technology is revolutionizing the way people get health care information. Praxeon’s products have been extensively tested and validated by healthcare providers and by more than 20 health advocacy groups.  In 2007, Praxeon was voted “Best Health Search Company” at the Health 2.0 Conference in San Francisco, CA.

Google Health is available on the web at www.google.com/health

We welcome the Christopher and Dana Reeve Foundation

We are pleased to welcome The Christopher and Dana Reeve Foundation aboard the MyDailyApple.com network of disease advocacy organizations.  The renowned charitable organization was founded to accelerate curative spinal cord injury research and improve quality of life for those living with paralysis.  Named after Christopher Reeve and his wife Dana, the foundation (formerly the American Paralysis Association) lends its name to fund global initiatives in the areas of embryonic stem cells and innovative research.  Feel free to visit our new partner’s website at www.christopherreeve.org.

Financial Incentives in Medicine

A recent article in the New York Times “Many Doctors, Many Tests, No Rhyme or Reason” reminded me of the distorted financial incentives that permeate the practice of medicine in the United States. In the article, the author, a NY cardiologist states, “In our health care system, where doctors are paid piecework for their services, if you have a slew of physicians and a willing patient, almost any sort of terrible excess can occur.” He then goes on to detail the evidence of excess both at a national level and on an anecdotal basis.

Unfortunately, I have to concur with his bottom line conclusion: “Doctors are doing too much testing and too many procedures, often for the sake of business. And patients, unfortunately, are paying the price.”

This article reminded me of my own early experiences in the hospital. I remember as a third year medical student I commented to one of my classmates that my internal medicine hospital rotation was so easy! All we did was call consults every morning based on all the abnormalities we found on the labs and imaging from the day before. Okay – so I’m being a bit glib and over-exaggerating. But I do remember the conversation and sentiment very distinctly. I felt like we spent a lot of time asking for consults when maybe they weren’t necessary. But then again – I was a naïve third year medical student with no experience. What did I know? 

But I have to say, I’ve had those same nagging feelings through the years  – that utilization of consults and testing is driven by financial incentives; maybe even “throwing a bone” to one of your medical colleagues. Where I did my internship, many of the medicine patients I took care of on the wards were either uninsured, underinsured or within an HMO model. In that situation, where there really wasn’t the willing patient (or matching reimbursement) I felt we were a bit judicious and restrained in our testing and consults. But in other environments where I have practiced, where patients were more generously insured, I definitely have felt a trend towards overutilization and unnecessary testing. 

So what is a patient supposed to do in an environment of distorted incentives for testing and work-up? Some solutions will hopefully come from our site, MyDailyApple. Over the next several weeks, we will be introducing a set of content, features and tools on MyDailyApple to assist patients with understanding the world of medicine and to take action with managing their health.  Some of this is already there and I encourage you to check it out.

 
But even with all the great Health 2.0 technology, it is probably unrealistic to expect a patient to look up information and search on the internet while in the hospital. So how can an individual advocate and maybe to a certain extent – protect themselves within this environment? Probably one of the first steps, in addition to all of the technology out there, is an old-fashioned Health 0.0 solution - engage your provider in an honest discussion. Someone has to start the process. And it is always fair to ask, “Do I really need this? What happens if we find something – then what? What if there is a false positive result? What are the alternatives? Is this all necessary?” Physicians probably aren’t used to such pointed questions. But times are changing – and so should the nature of the interaction between physicians and patients. And perhaps this will start the frank dialogue to understand the distorted incentives that operate in the American health care system. 

I think one of the final quotes from a hospital executive in the New York Times article really sums up my feelings on this one.  “The hospital is a great place to be when you are sick. But I don’t want my mother in here five minutes longer than she needs to be.”

Introducing MyDailyApple

Today Praxeon is proud to introduce MyDailyApple, our personalized health information service for patients and health consumers.

MyDailyApple brings together news, blogs, and discussions from around the web and personalizes them to you based on a simple profile that describes your health interests. You can create this profile right on MyDailyApple, or import it from a personalized health record (PHR) system like Google Health or Microsoft Health Vault.

MyDailyApple delivers you a daily or weekly news bulletin through whichever channel you find the most convenient : email, RSS, a widget-based home page like iGoogle or NetVibes, or right on the MyDailyApple web site. We surround each article with

• Explanatory material and related articles to help you interpret its meaning and judge its quality
• Features to conveniently share it with friends and family
• Links to relevant discussions from trusted patient forums and communities

So if you have specific health interests and you want to stay informed, visit www.mydailyapple.com today and sign up using our simple one-page form.

And if you operate a health-related blog, discussion group, or web site, contact us today at info@praxeon.com to find out we can help you grow your audience through our personalized feeds.

Doctors catch errors in own medical records; experts say patients should check too

How much do we trust our physicians to record our medical histories?  It seems that perhaps we should be checking our medical records as closely as we check out credit history.

Errors can creep into medical charts in various ways. Doctors are often under time pressure and may find themselves taking shortcuts or not fully listening to a patient's problems. Others rely on their memory to update their patients' files at the end of the day. Other mistakes can arise from illegible handwriting or coding problems."  Read more here...

Provided by: The Canadian Press
Written by: Alicia Chang, THE ASSOCIATED PRESS, Nov. 21st, 2007

 

Consider the consequences of recording an inaccurate diagnosis or the wrong medication.  In cases of emergency medical response these errors can be life threatening.  Even in cases of impaired diligence during illness or because of age, the repercussions of taking the wrong medication can be dire. 

"McDonald's has a better record of what they've served all their customers than we have of our patients' medical histories," says Isaac Kohane, a Harvard University medical informatics specialist and endocrinologist ("Paperless Medicine", MIT Technology Review, April 2003). When pondering this, remember the following facts:

•  $17-29B spent each year in medical mistakes in hospitals across the US (Institute of Medicine Report, “To Err is Human”, 2000)
• The WHO estimates that 1 in 10 patients receiving hospital care will experience some form of unintended harm  (PRNewswire, May 21^st, 2007 “American Medical Informatics Association Leaders Shaping the Future of Biomedical and Heath Informatics”
•  About 98.000 people die every year in the hospitals in the USA due to medical errors (1997 statistics)

 

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Semantic Fingerprinting is like Geocoding

Geocoding:

"... is the process of assigning geographic identifiers (e.g., codes or geographic coordinates expressed as latitude-longitude) to map features and other data records, such as street addresses."

- Wikipedia

A geocoder accepts a document written in plain language, and identifies geographic features. Each of these features is converted into latitude and longitude, a unique, canonical representation that is perfectly suited to this kind of data.

Once a document has been geocoded, the computed coordinates can be used to display and manipulate the document as if it were a geographic feature. It can be placed on a map; a collection of documents can be searched by location, with clauses such as 'within 25 miles of Brookline Massachussets'. The value is obvious to anyone who has used a map of real estate listings, or searched for a used car within 25 miles. Imagine having to type in the name of every city within 25 miles of your house, and still not being sure that you didn't miss anything.

Yet, without semantic fingerprinting (or maybe we should call it Healthcoding), this is exactly how people are still searching for documents about health and medicine. Medical documents are full of rich terminology : "malaria", "bupropion", "randomized controlled trial". The semantic fingerprinter recognizes each of these concepts, and translates it into a unique code. Of course medical terms don't map into coordinates, but they do have important natural relationships that, once understood, can be exploited to build powerful and intuitive user interfaces. My favorite example is the concept cloud; you can see two of them (Drugs and Diseases) at the bottom of the MyDailyApple news page. Here, current news is collected and fingerprinted. The medical concepts within the news articles are then aggregated according to their hierarchical relationships, and then ranked by importance. The result is a complete overview of current health news that fits into half a browser screen! Only fingerprinting makes this possible.

Like geocoding, and unlike purely text-based methods, semantic fingerprinting is also very robust to synonyms. Just as a geocoder converts multiple representations of the same place to the same coordinates, the fingerprinter replaces medical synonyms like 'bupropion', 'wellbutrin', and 'zyban' with the same unique identifier. And as in geocoding, the algorithms that operate on the coded document deliver the same query results no matter which synonyms are used in the query and the content.