medical collaborative expert (demo)

Demo (2010):

Medical Collaborative Expert™

professionalsand consumersArbitrated Health Decisions for

working name

Founder/Demo Developer

gilronen@revvisionconsulting.com

http://www.linkedin.com/in/gilronen

Our goals

Medical Collaborative Expert was a startup founded in April 2009 by Gil Ronen and Miki Kolko. Our goals were to (1)

promote participatory and shared decision-making between providers and patients by providing concise analysis of

medical information, (2) alleviate expertise bottlenecks by bridging the divide between lay users, prosumers and medical

professionals, (3) provide rigorous medical reputation & trust mechanisms that help discern quality and locate expertise.

The startup was called variously MyPulse and SecondOpinion. For more background see main MCE slide deck (this is

the demo slide deck).

?we were buildingWhat

A service providing personalized step-by-step instructions relating to medical and preventive-health decisions to

consumers, patients and medical professionals; what to do next with regards to treatments, self-tests and lab

procedures, monitoring and follow-up and how to go about them. The service utilizes a new collaboration platform that

addresses quality issues by incorporating proven social arbitration mechanisms and proprietary reputation and trust

algorithms and processes. As a by-product of the service a comprehensive evaluation network is created for content

creators providing help in locating expertise in specific topics and opportunities for professional recognition.

Progressively, the service would have supported multiple delivery methods and cater to varying levels of medical

knowledge with a focus on exploiting the continuum of knowledge from lay users, to prosumers, and to various degrees

of medical specialization.

Where is it now?

Between December 2009 and May 2010 Gil Ronen designed and developed a demo system using Python, Django and

MySQL. The startup was terminated in August 2010 having failed to secure funding alongside well-funded competition.

Synopsis

Mass collaboration, a proven technique,

utilized to generate Q&A sessions on

medical topics. Proprietary accreditation

and reputation algorithms and other social

structures arbitrate between conflicting

elements for state-of-the-art conclusions.

Knowledge authors share ad revenue

based on their effectiveness in high-quality

content production

Domain-specific searches identify more

materials, portals provide more

information, tools targeting professionals

identify articles and ongoing clinical trials

and provide less than cutting-edge

diagnosis,

Envisions personalized step-by-step

instructions relating to medical and

preventive-health decisions for consumers,

patients and medical professionals. Our

solution helps create quality knowledge

and identify where expertise lay

Our Solution Status Quo Solutions

Professionalsand ConsumersVision: Social Arbitration for

Why knowledge and not content?

Current analysis process: search the web ,

look for similar conditions, analyze articles ,

generalize from anecdotal cases on blogs,

filter biased content, find inconclusive and

contradictory conclusions, get confused,

bring stack of printouts to physician office

visit, request various tests and medications,

experience side-effects, start over

How do we create it?

Content Arbitrated Knowledge

For further background see the Medical Collaborative Expert slides (not the demo).

Demo written in Python with Django and MySQL from December 2009 to May 2010.

Part I: Use Guide to Get Medical Recommendations

Search for a Guide and Select to Start

Visitors search for medical guides

to particular topics. A selected guide

can be invoked to provide

individually tailored

recommendations.

Answer Guide Questions and View Recommendations

A new guide may be invoked if the

user requires assistance in

answering a particular question.

Recommendations (actions).

Users answer guide questions to get

tailored recommendations. Each

additional response changes the

recommendations shown to the users..

Guide questions

Possible responses

Part II: Author Guides Collaboratively

Login includes

locality for guest

users.

Entry point for

Collaborative Medical

Expert (aka

MyPulse.com,

)SecondOpinion.com

Log In as Registered User or Guest

The guides in the repository can be

applied en masse to a user’s online

medical records providing

recommendations that change over time

as guides are updated by the community

or new test results are entered into the

user’s medical record.

gilnyc logged in and

has a reputation score

of 97.4.

Dashboard for User ‘gilnyc’

Find Guide is the main

screen for finding and

applying medical

guides.

Search for topics

related to ‘nursing

problem’.

A single medical

expert (guide) is

found when using

‘nursing problem’ as

the search keyword.

The guide can now

be either started or

edited.

Find Guide to Edit

Guides are built collaboratively by

many users over time.

Edit ‘Nursing Problems’ Guide

A guide consists of questions that

specialize the recommendations

based on the user’s responses.

View ‘Nursing Problems’ Guide Recommendations

Recommendations (Actions)

correspond to a pattern of

responses within the guide – when

a user starts a guide and responds

to questions, the

recommendations that closest

match the pattern of responses

rise to the top of the displayed

recommendations.

Edit Recommendation (Action) Triggers for ‘Nursing Problems’ Guide

A recommendation is associated

with a set of responses to the

guide’s questions. A question can

be skipped if its response is not

relevant to the recommendation.

Edit Supports for ‘See an Osteopath’ Recommendation

A recommendation is supported by

links to support materials such as

articles or documented anecdotal

evidence.

Phonetic Search

Phonetic search on ‘slip apiya’

results in two guides being

presented.

Logout user ‘gilnyc’ and login as

‘DrBob’. Notice lower reputation

score of 26.5.

Edit ‘Obstructive Sleep Apnea’ Guide

User DrBob with low reputation

score wishes to edit the question

‘Are you sleepy during the day’?

Edit Question ‘Are you sleepy during the day?’

The question belongs to the

‘Obstructive Sleep Apnea’ guide

and consists of 3 possible

responses.

The question also has three

recommendations (actions), two of

which suggest performing additional

tests.

Adding New Possible Answer

Adding a new possible answer (‘In

the afternoon’) to the question.

Position of New Answer

Answer is added as last response

option.

Part III: Collaborative Process

Proposed Deletion of Response Option

Dr Bob tries to delete an answer

option for one of the guide

questions but because of a low

user reputation score the

proposal requires additional

support from other users. In

essence, DrBob needs to pool

reputation with other users to

affect the proposed change and

make it available to others. Dr

Bob can vote on the proposal and

provide support and the proposal

will be pending other votes.

Crux of Collaboration: Providing Support for Content Proposal

Based on Argumentation Theory, supporting

an argument, or objecting to an argument, fall

under one of several pre-defined categories.

The user votes not only by applying their

reputation score to their support or objection

but are required to do so within a selected

category. Users are encouraged, but not

required, to provide additional materials for

the benefit of other prospective voters on the

proposal at hand.

Dr Bob selects to support his

proposal by choosing the ‘expert’

support category: DrBob wrote ‘the

book’ on Sleep Apnea and claims

to be an expert in the field. Of

course, citations and links are

needed to support this claim.

Recording Support for Proposal

Dr Bob’s vote is counted and the

current support and threshold for

acceptance of the proposal are

displayed:

An Arbitration Action is Required on the ‘Obstructive Sleep Apnea’ Guide

A different user logs in. Despite the

name, user ‘baba’ has a high

reputation score and therefore will

have more impact on proposals

than DrBob.

The user selects to work on the

guide ‘Obstructive Sleep Apnea’

and sees that there is a question

that has a proposal pending. In the

parlance of the Collaborative

Medical Expert, it requires Social

Arbitration.

The user may have been

subscribed to this guide and

therefore received a notification that

arbitration is needed.

Social Arbitration of Proposal

User votes in support of proposal

using the Standard Procedure

support category.

Clicking on ‘what?’ for a category

will bring up an explanation, in this

case for the Research support

category.

Proposal Accepted

Vote is sufficient to cross the

Acceptance Threshold and so the

proposal to delete a response option

from the question is accepted.

The same process is followed for other changes

to a guide. Depending on the Acceptance

Threshold of the proposal, the reputation of the

content and the reputation of the users involved,

the process may be immediate or more involved:

simple changes to low reputation content by

high reputation users would go into affect

without additional arbitration. For other content

it may be prudent to have a more involved

process of deliberation between knowledgeable

users through the Argumentation mechanisms

provided.

Part IV: Publish Guide Changes

Publish Guide on Obstructive Sleep Apnea

Click Publish to make guide changes

visible to guide users.

Part V: User Reputation and Content Reputation

User Reputation Enhancement

Logging in again as user ‘DrBob’

we see that the reputation score

was enhanced by acceptance of

the proposal authored by this user.

The increase is small reflecting the

value of the change. Note that the

user reputation score is not simply

cumulative but is in relation to the

scores of other users.

Reputation mechanism highlights:

1. A user whose proposal is accepted sees an

increase in reputation.

2. A guide that is created by high reputation

authors will itself have a high reputation that

manifests as higher Acceptance Threshold

values for future proposed changes.

3. Positive ratings for a guide will reflect on

the reputation of its authors in correlation to

their contribution.

Appendix: Collaborative Medical Expert Server Log Snapshot

medical collaborative expert (demo)

reputation

social arbitration

medical professionals

lay users

find guide

medical

reputation

user

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