P2P Medicine: How Patients and Doctors can collaborate to improve medicine

The July 2010 issue of Gordon Cook’s Report on Internet Protocol, Technology, Economics, and Policy examines Dr David Zakim’s Clinical Expert Operating System, an internet-based application that could literally change the future of medicine. Dr Zakim’s aim is to bring patients and doctors together in a common effort to arrive at a proper diagnosis so a decision can be made what treatment is needed in each individual case. The system also has another major purpose. Data collected on individual patients can eventually combine to construct an extensive database of facts that would act as an ongoing clinical trial and could bring important new insights to medicine as a whole.

Gordon Cook is the creator and publisher of The COOK Report on Internet Protocol, Technology, Economics and Policy (http://www.cookreport.com/) which is available to a small group of subscribers, people and companies who are serious and “willing to struggle with the future”. Gordon creates his reports based on in-depth interviews with innovators and senior figures at the leading edges of developments in IT. The most recent interview – not available yet – is with Michel Bauwens about his work and the P2P Foundation.

Dr Zakim is a medical doctor and biochemical researcher who, when he retired, got interested in creating a computer assisted system that would make medicine more efficient, improving accuracy of diagnosis and thus quality of care and as a result lowering the cost of medical intervention. The basic premise he started with was that no medical student in this day and age can learn and keep in his head all of the medical knowledge available. Trade-offs must be made and most medical doctors specialize in one narrow field or another.

So what do doctors do when a very important case has to be decided? They form an expert committee, pooling the knowledge of several of the best minds available to decide on diagnosis and treatment. By organizing [important parts of] medical knowledge in the form of “decision trees”, Zakim emulates this pooled knowledge of expert committees and collects the outcome in a program that can directly interact with patients.

It is the patient who knows most of what’s wrong with him and who – naturally – has the greatest interest in being properly treated and brought back to health. By asking the patient the right questions and eliminating unlikely causes, the program arrives at a diagnosis, or at a point where a direct examination or certain laboratory data are needed to proceed. When the doctor sees his patient in person, he already has a complete medical history and a highly accurate diagnosis to work with.

Dr Zakim’s effort is organized in the form of a non-profit, the IDM-Foundation (http://idm-foundation.org/kontakt.htm) and there is a password protected site that has the current version of the program at http://insdm.org/rbk/default.aspx The method was patented in 2008 as a “System and method for obtaining, processing and evaluating patient information for diagnosing disease and selecting treatment” (available at patents.com)

Far from being a complete system, Dr Zakim’s CLEOS or Clinical Expert Operating System is an attempt to show that the digital formalization of medical knowledge is possible, that patients and doctors can work together in collaboration and that important improvements in medical outcomes can be achieved.

Dr Zakim can be contacted via the IDM Foundation. He is looking for help, both from investors and from clinicians who can contribute their expertise to the construction and improvement of the program’s decision trees.

I personally believe that, potentially, Dr Zakim’s CLEOS could be the revolution medicine needs to shake off the dominant and distorting influence of self-interested pharmaceutical giants who have steered the development of medicine towards maximizing their own profits, rather than working to improve the efficiency of diagnosis and treatment or the development of real and effective preventive strategies.

Gordon Cook’s in-depth report and interview with Dr Zakim:

How Dr. David Zakim Is Developing His Clinical Expert Operating System

Introducing a Global Internet and Forth Paradigm Based Digital Framework for the Practice of Medicine and Conduct of Clinical Research

is available on Scribd at

http://www.scribd.com/doc/34842201/The-Cook-Report-on-Internet-Protocol-Technology-Economics-and-Policy-July-2010

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