Luis Louro - Fotolia
It's been called the Facebook of the medical profession.
But for the 300,000-plus users of SERMO, a social network for doctors, it's much more than that.
SERMO -- formed in 2012 when pharmaceutical market research firm WorldOne bought the social media site and then took the name of the smaller company it acquired -- is a virtual doctor's lounge in which practitioners can vent about the healthcare upheavals and changing roles of providers in recent years. Topics can include meaningful use, healthcare reform, politics, stress or the weather, or just exchanging ideas about new health IT apps.
Another significant function for the online community has been developing quickly, though. It is one with larger implications for patients and healthcare, and a capability that SERMO executives say sets their network apart from other physician social media sites such as Doximity, which is more of a business networking site for doctors.
Osnat Benshoshanvice president of marketing, SERMO
This new, and what SERMO executives and user-evangelists say is a pioneering, application is essentially medical crowdsourcing.
SERMO (Latin for "discussion" or "conversation") members consult each other online about real-world healthcare cases, often uploading photos or X-rays of skin lesions, wounds and other medical problems -- all completely anonymized. More about that aspect later, because with HIPAA privacy concerns paramount these days, overcoming provider system worries about health data privacy could be an issue for SERMO, company executives acknowledge.
SERMO is free for users, but it makes money by selling advertising to pharmaceutical companies and others and making its large pool of doctors available for frequent online polling by SERMO's business wing, SERMO Intelligence. Polls have included such questions as how much medical school debt doctors are carrying and whether obesity is an illness (as a European court recently ruled).
Richard Armstrong, M.D., a northern Michigan surgeon who was an early user of SERMO after it first launched a decade ago and who now serves as medical adviser to the physician social network for a monthly stipend, said the social and medical crowdsourcing aspects of SERMO are equally important.
"I'm an isolated guy in a rural area, and it was a way to connect with doctors all over the country," Armstrong, who has been a practicing physician for three decades, said. "It's also a large physicians' community platform. That's why it's so valuable."
Armstrong and other SERMO members tend to be fiercely independent doctors who chafe under the constraints of medical liability and federal regulation. Instead, they think of themselves as healers for whom medicine is a calling and have a distaste for "defensive medicine."
With conventional consults, doctors who give a medical opinion can be liable if something goes wrong. With the anonymity of SERMO, Armstrong said, that fear is removed.
In fact, anonymity is a cornerstone of SERMO's approach.
Roughly 90% of SERMO members choose to be anonymous online, with screen names that are walled off from doctors' identities. SERMO verifies the true identities of its M.D. and D.O. members with a rigorous three-step process that includes IDology identity verification, confirming with the American Medical Association master file and RelevantID digital fingerprinting.
As for Armstrong, he actually appears as himself online, not anonymously. But he and other SERMO people nonetheless strongly defend the anonymity approach.
Osnat Benshoshan, SERMO's vice president of marketing and a former pharmacist, said, "If you're a CIO and you have security concerns about the sharing of patient information, SERMO doctors are very, very careful about anonymity.
"What's important to CIOs is if you allow doctors to share knowledge, it helps them improve outcomes," Benshoshan added. "Doctors influence other doctors. This is a place where doctors teach other doctors."
For Ayesha Khalid, M.D., a younger doctor who has been practicing for six years as an ear, nose and throat specialist, now at Cambridge (Mass.) Hospital and Massachusetts Eye and Ear Infirmary, SERMO crowdsourcing helped her recently treat a patient whose throat area CT scan also turned up what could be an incipient brain tumor.
Khalid, who also started out as a participant and now consults a few hours a month for SERMO in bringing the service more into hospital settings, posted an image of the tumor and instantly got anonymous advice that this was something to be worried about and to send the patient to a brain tumor specialist.
"We're super psyched to get someone else's diagnosis," Khalid said. "You can't always find the time or the doctors to come in and say 'please eyeball this patient.'"
"Physicians are really worried about being right," she added. "This takes the pressure off. It creates this intrinsic ability to help."
Khalid predicted that online medical crowdsourcing will soon become commonplace. Patients readily agree to this approach when they think it can lead to better results for them, she said, in a dynamic that is similar to patients' widely noted proclivity for waiving HIPAA privacy guarantees in exchange for sharing of their protected health information for the promise of better care.
"Patients love it. Providers want to do it. Now we have to get hospitals to do it," Khalid said.
Doximity, another social network for doctors, includes HIPAA safeguards
Patient engagement possible through social media
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