Category Archives: #HCCOSTS

Patients Created Crowdsourcing


Crowdsourcing is a phenomena that was coined in 2005 by Jeff Howe and Mark Robinson, editors at Wired magazine. Their initial definition was specific to how businesses at that time were were leveraging the internet to outsource work to individuals.

3 years later, Daren C. Brabham was the first person to use the term in a scholarly article. He also wrote a book by the same name, Crowdsourcing, in 2013. (Jeff Howe wrote a book by the same title earlier in 2009: find it here)

Daren’s definition in his paper was the following:

Crowdsourcing is a type of participative online activity in which an individual, an institution, a non-profit organization, or company proposes to a group of individuals of varying knowledge, heterogeneity, and number, via a flexible open call, the voluntary undertaking of a task. The undertaking of the task, of variable complexity and modularity, and in which the crowd should participate bringing their work, money, knowledge and/or experience, always entails mutual benefit. The user will receive the satisfaction of a given type of need, be it economic, social recognition, self-esteem, or the development of individual skills, while the crowdsourcer will obtain and utilize to their advantage that which the user has brought to the venture, whose form will depend on the type of activity undertaken.

I believe that healthcare was the original pioneers in “crowdsourcing.”

I can remember being a small boy, and my aunts, uncles, and grandparents always calling my mother, a nurse, and asking her about their symptoms. They would discuss their aches, pains, coughs, phlegm, and number of days with my mother.

After seeing their physician, they again would call my mother and ask her about what the doctor told them. They would ask her questions about the diagnosis, the medications, the doctors recommendations.

As I moved into my own clinical expertise in oncology, I have had several family members, friends, and professional colleagues call and ask me the same types of questions.

I started to think, patients have always done crowdsourcing for their diagnosis. Healthcare just never had a formal name for it. (full disclosure, I give the “hat tip” to Dr. Krishnaraj for planting the thought for this post in my mind)

Screen Shot 2015-01-27 at 10.04.22 AM

In the days before the internet, it took place via a phone call. We would wake up, not feel well, pick up the phone, call our trusted friend, talk about how we are feeling, and they would weigh in with their opinion on your diagnosis.

We would go to the store, buy some medicine, and see what happens. Maybe after a few days we finally go see a physician. As soon as we arrived home, we would pick up the phone and share with the diagnosis and recommendations with our friend.

Original Crowdsourcing.jpg

Today, it is even faster. We have access to more people. Instead of being able to call and talk to one person, we can instantaneously go to Dr. Google, input our symptoms, and come up with a self diagnosis in seconds.

We can now turn to blogs, websites, Facebook, Twitter, Instagram, Pinterest, and many other sites to connect with people and get their opinion. We can connect with medical societies, hospitals, online physicians, and quacks. We can even connect with children posing as medical professionals.

Modern Crowdsourcing.jpg

We can input out our signs and symptoms into a search engine and easily receive a diagnosis.

The diagnosis may not be correct, but we can receive one none the less.

We want an answer to our “What” question. (post here: Diagnosis Is King) Since we have immediate access to the internet, friends, family, and colleagues, we crowdsource their knowledge to alleviate our own anxiety.

To arrive at an answer to the “What” question.

Even though magazines like Wired, Inc, and the cool startup culture of Silicon Valley are known for their crowdsourcing endeavors, patients have always used “crowdsourcing” when it relates to their diagnosis.

Patients created crowdsourcing. Healthcare just never acknowledged it.

As I mentioned during the #JACR discussion, if the “insiders” of healthcare can begin to leverage technology to disseminate and leverage all of the medical knowledge globally, in a crowdsource manner, maybe we will bend the cost curve. Increase access, improve wait time, and decrease patient anxiety.

Maybe, just maybe, healthcare “insiders” will finally learn from what is already happening outside the four walls of their own organizations….

Patients always have, are today, and always will crowdsource their diagnosis.

Don’t ignore the crowd. The crowd is full of your patients. Join the crowd. Listen to understand, not to respond. The crowd will tell you what they need.

As always, you can feel free to contact me at: CANCERGEEK@GMAIL.COM or follow me on twitter @cancergeek



Do Billboards Influence Cancer Decisions?


I was driving to work the other morning and I noticed the following billboards. At first I didn’t pay a lot of attention, but the more I drove, the more I began to think about the messages.

The first billboards, in black, are a set of 3 corresponding ads, that when combined, add up to an overall story for one organization. I began to think about the question and answer.

Since I am an insider, how far would I drive? Well, I think the better question is what cancer diagnosis do I have? If it is breast or prostate, I would definitely travel 7 miles. If I had a glioblastoma, then I would be driving a lot further for treatment. I would travel across the country to make sure I go to a facility that has access to the latest clinical trials, that see many cases, and have more support services to care for my less common diagnosis.

As an outsider, I began to think about what makes their care advanced? Is it the people? Is it the technology? Is it the building? Who measured them? Since they are closer, does it also mean they are faster? Will they get me back to my normal routine faster than another cancer center?

What if I missed the first 2 billboards? Do I care that the cancer center is only 7 miles away?

The next billboard, “Pam is living cancer free” (in blue) makes me happy for Pam. (there is a picture of a young woman and her  dog)

Yet the “cancer free” part is so small that I didn’t notice it until I passed another billboard with the same tag line. At first I was wondering why I should be excited that Pam is living. Is it because she got a new dog? Is the dog named Pam?

In seeing the same billboard again, I realize that I am happy for Pam because she does not have cancer. I guess it is implied that she is cancer free because she went to that specific hospital.

The final billboard, in red, is from an Academic Medical Center that is almost 2 hours away from this region of the state. Their tag line, “Academic Medicine is not so far away” lets me know that if I keep driving, I will finally find Academic Medicine.

However, why do I care? Are you better? Do you have something special that the other 2 hospitals do not have? Why when I am not feeling well do I want to drive 2 hours to see you?

I could go on for a while with the various questions that come to my mind.

In each of the examples, I question how well the marketing teams and advertising agencies they hired actually know their community. Since I live, have worked, and am active in the community I would say that most of the messages miss the mark.

What is the call to action? Where is the so what? Why do I care? Why does it matter?

Although I do think about Pam.

I hope Pam was savvy.

I am hopeful Pam didn’t use any billboards to make her decision on where to go for cancer care.

As always, you can feel free to contact me at: CANCERGEEK@GMAIL.COM or follow me on twitter @cancergeek