WebLib, a small international technology startup of experts in information retrieval, natural language processing and medical informatics, recently released NLMplus, a semantic search and knowledge discovery application that utilizes a variety of semantic resources and natural language processing tools to produce improved search results from the vast collection of biomedical data and services of the National Library of Medicine (NLM).
Earlier this year, About.com conducted a research study on health, revealing that significantly more people find online health advertisements helpful in coping with diseases and learning about the side effects and safety of medication . The study confirms that people are turning to the Internet to take charge of their health and to better educate themselves about conditions and treatment options.
Launched in 2002, the Hospital Quality Alliance (HQA) is a national public-private initiative that includes hospitals, physicians, nurses, federal agencies, quality experts, and consumer and business groups. HQA members collaborate to make meaningful, relevant and easy-to-understand information about hospital performance accessible to the public and to inform and encourage efforts to improve quality.
Last year, members of the HQA together with the Centers for Medicare & Medicaid Services and the Department of Health and Human Services created a consumer-oriented hospital comparison website called Hospital Compare. Hospital Compare provides information on how well hospitals care for patients with specific medical conditions or surgical procedures, as well as results from a survey of patients about the quality of care they received during a recent hospital stay.
Yesterday, new quality data on hospital readmission rates was made available on the Hospital Compare website. The data includes hospital readmission rates for Medicare patients with heart attack, heart failure and pneumonia. This is especially relevant in today’s healthcare reform environment because the issue of hospital readmissions has been cited by policy makers and the Obama administration as a potential opportunity for improving healthcare quality and reducing unnecessary healthcare spending . Indeed, a recent New England Journal of Medicine study found that almost one-fifth of Medicare beneficiaries discharged from the hospital were readmitted within 30 days; one-third were rehospitalized within 90 days .
Until now, hospitals have had only information on those patients who return to their own hospital, but not about patients who were readmitted to a different hospital. Using Medicare billing records from July 2005 to June 2008, the information on Hospital Compare shows how often a Medicare patient with one of these conditions returns to the same hospital or a different hospital within 30 days following their initial stay. Hospitals are placed in one of three categories based on their readmission rate in relation to a national readmission rate – “no different than the U.S. national rate”, “better than the U.S. national rate” or “worse than the U.S. national rate”. Each hospital’s readmission rate for the specific condition also can be compared to its state’s average. Additionally, each rate is shown as a single number, along with a confidence interval that indicates the range of certainty in which the hospital’s true performance falls.
The new quality data on hospital readmission rates is being added to existing information on how often hospitals take the right steps to provide care for their patients, as well as updated information on mortality rates. Available information includes statistics on a variety of quality measures such as:
- Percent of surgery patients who were given an antibiotic at the right time (within one hour before surgery) to help prevent infection
- Percent of surgery patients whose doctors ordered treatments to prevent blood clots after certain types of surgeries
- Percent of heart attack patients given aspirin at arrival
- Percent of pneumonia patients given the most appropriate initial antibiotic(s)
- Percent of heart failure patients given discharge instructions
- Percent of children who received reliever medication while hospitalized for asthma
In addition, Hospital Compare includes statistics on answers to a survey of patients’ hospital experiences, such as:
- Percent of patients who reported that their doctors “Always” communicated well
- Percent of patients who reported that staff “Always” explained about medicines before giving it to them.
- Percent of patients at each hospital who reported that YES, they were given information about what to do during their recovery at home.
You can search for hospital information in your area using either a general search or a specific medical condition or surgical procedure search. The general search provides information on Hospital Process of Care Measures, Hospital Outcome of Care Measures, and Survey of Patients’ Hospital Experiences. The specific medical condition or surgical procedure search provides information on Hospital Process of Care Measures and Hospital Outcome of Care Measures (where applicable), Survey of Patients’ Hospital Experiences, and Medicare Payment and Volume. The Hospital Compare database is updated on a quarterly basis.
Interested in how your hospital stacks up to others in the area? Find and Compare Hospitals
- Vital New Quality Data on Hospital Readmission Rates Available on Hospital Compare Website. Hospital Quality Alliance press release. 2009 July 9.
- Health Reform’s Benefits for Middle Class Under Scrutiny. Kaiser Health News. 2009 Jun 25.
Jencks et al. Rehospitalizations among patients in the Medicare fee-for-service program. N Engl J Med. 2009 Apr 2;360(14):1418-28.
This article was written by Hope Leman.
Consumer health sites are all over the Web and more and more of the content they are producing is working its way into search engine results on health-related topics. Some of this material is solid enough, but much is simply banter or commiseration of one heathcare consumer to another. Knowing ahead of time about these sites can save power searchers in health matters time and prevent ill-considered clicking on what is almost certainly likely to be fluff or outright rubbish.
OrganizedWisdom is one such consumer health site and indeed if you go by its notable presence at conferences such as Health 2.0, it is a market leader in this space. It certainly excels at parlaying a bargain basement marketing gimmick, its WisdomCards, into a reputation for business savvy.
On its home page, the peel away top right corner reveals that WisdomCards are “Your guide to the best health resources” and touts “We do the Searching for you!”
Now, I don’t really get the appeal of the whole WisdomCard thing. Basically, each WisdomCard is simply a page of results organized in much the same way as you might find on MedlinePlus, say, or RightHealth.
Moreover, the “hand-crafted by experts” part doesn’t really inspire confidence. Take the WisdomCard for ALS, for instance. Clicking on “About this WisdomCard” reveals that the card was contributed by Tonya J. and reviewed by Pat. However, there is no information about who Tonya J. or Pat are. I was able to find information about the composition of the OrganizedWisdom Physician Review Team. Consisting of four medical doctors, OrganizedWisdom’s Physician Review Board is “responsible for training, educating and guiding all our Guides. In addition, we take great care in hiring people who have extensive health backgrounds, personal experience with health issues, or who may have served as caregivers, health advocates or health professionals.”
Nevertheless, given that credibility is a fairly basic component of consumer health searching on the Web, it is fairly amazing that OrganizedWisdom has received such positive coverage in the business press (the rah-rah, go team buzz it generates in such venues as the Health 2.0 conference is less surprising).
For instance, on the basics of cross-referencing OrganizedWisdom falls flat. Case in point: You can call up a WisdomCard on ALS provided that you call it ALS and not Amyotrophic Lateral Sclerosis and we are told once at the ALS WisdomCard to, “Try also: Muscular Dystrophy; Myasthenia Gravis; and …” (trails off there) but not Lou Gehrig’s Disease, which does not have a WisdomCard of its own, and not Motor Neuron Diseases, which is a topic allocated to a WisdomCard. And on that card you do at least get the last names of the contributor and the reviewer. The Motor Neuron Disease WisdomCard was contributed by Elisa Carter. According to her (self-listed?) health experience, she has spent 15 years working in the medical field as a Supervisor in a Hospital Admissions Department and has managed administrative staff for a large multi-physician office that included pediatricians, a cardiologist and an internist. The Motor Neuron Disease WisdomCard was approved by TaraS. According to her (self-listed?) health experience, “Her medical knowledge comes from years as a medical secretary and in administration for physicians’ offices specializing in internal/pulmonary medicine, orthodontics and pediatrics. She has also served as a health advocate and caregiver for people with disabilities, a role that brought her to a nuanced understanding of Web health search and online research.”
I am not against consumer health sites. Indeed, I get rather impatient with the persnickety attitude some in the medical library community take towards them. But it is unnerving to think that the “serial entrepreneurs” (as founders Steven Krein and Unity Stoakes style themselves) can generate such hype on the basis of some quite sloppy, not ready for prime time stuff as is on OrganizedWisdom. Call in a librarian, guys, to inject some order into the currently messy state of affairs in your WisdomCard world.
I decided to try to determine what qualifications guides (the term appears to cover both contributors and reviewers) must meet. The page Become a Guide outlines a three-step process to apply to become an OrganizedWisdom Guide. First you register with the site, then you fill out a Guide Application, providing as much information as possible about “any related experience, whether in paid or volunteer work, that will contribute to your success. OrganizedWisdom Guides need to be self-motivated, well organized, able to discriminate between good and bad information, and able to check their own work. And yes, spelling and attention to detail counts.” Applicants then take an open book test. At the bottom of the page is a list of reasons OrganizedWisdom rejects Guide applications:
- No relevant experience.
- Misspellings or poor grammar on application.
- Incorrect answers on Open Book Test.
- Applicant did not check “I am over 13 years old.”
- Applicant did not check “I agree to the Guide Terms of Service.”
- Applicant did not provide full name, address and telephone information which we need for payment verification.
- Applicant does not live in the United States (sorry, we can only accept U.S. applicants).
Although the results on the WisdomCards are acceptable, they are not noticeably better in terms of links or richness of multimedia content than you would find on RightHealth and certainly lack the authoritativeness of MedlinePlus. Additionally, the web site has has navigation problems. For instance, it not always clear when you are in a WisdomCard nor how to get to one, except by browsing through an alphabetical list, and even that is not reliable as there seemed to be a WisdomCard for the man Lou Gehrig but not for the disease named after him, but the biographical entry does not appear to be in the alphabetical list and so on.
All in all, much ado about very little in the case of OrganizedWisdom.
Additional health search resources are listed in the Highlight HEALTH Web Directory.
About the author: Hope Leman writes about Health 2.0 and the e-patient movement at Significant Science. She is also a writer for AltSearchEngines, which covers hundreds of alternative / niche search engines. Hope is a research information technologist for a health network in Oregon and is also Web administrator of the grants and scholarship listing service ScanGrants.