The Patient Will See You Now: The Future of Medicine is in Your Hands

"The title is, of course, a pun on the doctor will see you now. The thesis is that since you can now have all of your data online, it empowers the patient to be a bigger player in medicine, to take more control of one’s own health. The book talks about your traditional kind of medical records. Traditional meaning the things that are currently used by medical research and by medical doctors. It asks what will happen when everybody’s data is available in a digital form and how this would affect research. So you could contribute your data to a bigger cause, to a bigger data set, to enable us to do far better research. The other part of the thesis is the more personal part of allowing applications or systems that would give very personal advice or treatment, which is something I also discuss in my book. Yes. My colleagues, Ryen White and Eric Horvitz, coined the term ‘cyberchondria’ for this. You start with a very benign symptom and within two or three searches you’re sure you are going to die. This is not a very new phenomenon, it was out there even when there were only public libraries. Three Men in a Boat? I love that book, yes! Information seeking is just one place that we can provide benefit. By looking at how people find information we can make that better. We can inform them of what is, perhaps, the more reliable information. That is just one area where I think data can contribute. “You start with a very benign symptom and within two or three searches you’re sure you are going to die” The other contribution is when people have a very difficult time in reporting what we need in order to do our research, for example, the adverse reactions of drugs and when we want a more sensitive indicator than what we currently have with medical research. The biggest volume of data that we have is search queries. There are several hundreds of millions of queries per day in the US. Then Facebook posts and Twitter messages, again we see between several hundreds of millions and several billions of examples per day. So if you just think about comparing that volume of data to what traditional sources of medical records contain, you see that there are orders of magnitude more internet data. Of course not everything in internet data is connected to health. It’s much noisier than traditional sources of data, but that’s just a challenge that we need to solve. It’s not a barrier to using these data. Let’s begin with the word crowdsourced. That’s a term that was coined a few years ago to capture the notion of people contributing information or contributing work towards a larger goal. Here we are using crowdsourced in a way that is a bit different than what it was originally coined for because the contribution here is not, strictly speaking, voluntary. People are not saying ‘here, use my Twitter feed or my Facebook posts to learn about medicine.’ But we are able to do that, and we’re using the data from many people who have independently provided these data to learn about medicine and health. One example is some work we recently did on evaluating the effectiveness of child vaccinations in the UK. In 2013, Public Health England decided to vaccinate children in a number of cities in order to see if vaccinations against the flu for children would reduce the overall number of flu cases. Everybody who has a child knows that children are very good at transmitting the flu. So they vaccinated in a number of cities and they wanted to compare the number of doctor visits and hospitalisations for influenza in those cities compared to the rest of England. But the flu season wasn’t that serious and so they didn’t have enough people who were hospitalised or saw a doctor in those cities compared to the rest of the country to draw a conclusion. Very few people who have the flu actually see a medical practitioner. Most of them will stay at home for a couple of days, drink tea, and that will be it. But they also do something else, which is they go online and they ask what to do about the flu, what are the symptoms of the flu, things like that, or they might go on Twitter and write about their awful flu, and so internet data provides a much more sensitive way of measuring how many people have flu in the population. Even if you only stay at home and never see a doctor, you are more likely to talk about it. “Internet data provides a much more sensitive way of measuring how many people have flu in the population” So we used search data and we used Twitter data and we showed that actually we get about a 25 to 30 per cent reduction in the number of cases in those cities with vaccination compared to those where children were not vaccinated. We had a much larger number of cases than Public Health England could trace."