EMedicine

Last updated

eMedicine.com, Incorporated is an online clinical medical knowledge base founded in 1996 by Scott Plantz MD FAAEM, Jonathan Adler MD MS FACEP FAAEM, a computer engineer Jeffrey Berezin MS. The fundamental concept was to create a large repository of professional level medical content that could be both updated and accessed continuously to assist in clinical care and physician education. The eMedicine website consists of approximately 6,800 medical topic review articles, each of which is associated with one of 62 clinical subspecialty "textbooks". Pediatrics, for example, has 1,050 articles organized into 14 subspecialty "textbooks" (Pediatric endocrinology, genetics, cardiology, pulmonology, etc.); the emergency medicine volume has 630 articles and internal medicine is near 1,400. If the remainder of the specialty textbooks (eg, Neurology, Orthopedics, Ophthalmology, etc.) are added to the total 6800+ articles were created in eMedicine. In addition, the knowledge base includes over 25,000 clinically multimedia files (eg, photographs, imaging studies, audio files, video files). To create this online content over 11,000 board certified healthcare specialists (95%+ physicians, 95%+ US based) were recruited and managed in a first generation, proprietary learning management system (LMS). To provide some perspective on the amount of content that was created it is estimated that, if hard-copy printed out, it would total over 1 million pages.

Contents

Each article is authored by board certified specialists in the subspecialty to which the article belongs and undergoes three levels of physician peer-review, plus review by a Doctor of Pharmacy. The article's authors are identified with their current faculty appointments. Each article is updated yearly, or more frequently as changes in practice occur, and the date is published on the article. [1] eMedicine.com was sold to WebMD in January, 2006 and is available as the Medscape Reference. [2]

Medscape is a website providing access to medical information for clinicians; the organization also provides continuing education for physicians and health professionals. It references medical journal articles, CME, a version of the National Library of Medicine's MEDLINE database, medical news, and drug information. At one time Medscape published seven electronic peer reviewed journals.

History

Dr. Plantz, Dr. Adler and Mr. Berezin evolved the concept for eMedicine.com in 1996 and deployed the initial site via Boston Medical Publishing, Inc., a corporation in which Plantz and Adler were principals. Over a period of 1.5 years the Group Publishing System 1 (GPS 1) was developed that allowed large numbers of contributors to collaborate simultaneously. That system was first used to create a knowledge base in Emergency Medicine with 600 contributing MDs creating over 630 chapters in just over a year. In 1997 eMedicine.com, Inc. was legally spun off from Boston Medical Publishing. With growing traction as a revolutionary online healthcare publishing company eMedicine attracted angel level investment from Tenet Healthcare in 1999 and a significant VC investment in 2000 (Omnicom Group, HIG Capital). All investor companies held seats on the eMedicine Board of Directors.

Several key individuals made early investments in the company. These Co-Founders included Richard Lavely, MD JD who led recruitment and execution for the Internal Medicine volume and Julie Bohlen MBA who ran editorial operations for many years and became a board member. Later Ms. Bohlen, along with the other founders, played a key role in developing eMedicine Health the 600+ article consumer health reference. In 1997 the decision was also made to broaden the scope of eMedicine to effectively all medical and surgical specialties and eventually the aforementioned eMedicine Health initiative. With this gigantic expansion Co-Founders Nicholas Lorenzo MD MHCM CPE DABPN and Anne Bueltel Lorenzo BS invested in and joined the company. Ms. Bueltel Lorenzo ran production operations for many years and with Dr. Lorenzo was stationed in the Omaha eMedicine office. Dr. Lorenzo held multiple senior executive roles in the company including Chief Publishing Officer, was a member of the Board of Directors, Project Editor-in-Chief, Senior Vice President, and was the Founding Editor-in-Chief of eMedicine Neurology.

Several years were spent creating the tables of contents, recruiting expert physicians and in the creation of the additional 6,100+ medical and surgical articles. The majority of operations were based out of the Omaha NE office. However, eMedicine was one of the world's first virtual companies with key staff in multiple offices around the country including Omaha NE (Publishing and later corporate office), St. Petersburg FL (original corporate office), Syracuse NY (technology office), and Boston MA. With increasing web traffic and notoriety eMedicine developed a multi-product sales and marketing strategy. Pharmaceutical sponsorship sales were led by Laz Cabanas BS, Senior Vice President, and healthcare institutional sales were led by Dennis Carson MBA, Senior Vice President. Revenue increased exponentially as a result of the completion of the professional level content, innovative sales and marketing strategies (eg, Laz Cabanas popular web sponsored microsite strategy), and development of the second generation LMS known as GPS 2.

In the early 2000s Drs. Plantz and Lorenzo also spearheaded an alliance with the University of Nebraska Medical Center to accredit eMedicine content for physician, nursing, and pharmacy continuing education. eMedicine also obtained accreditation for optometry and to a lesser extent physical therapy continuing education accreditation. These continuing education accreditations increased eMedicine's visibility and credibility in the healthcare industry and also enhanced revenue generation. eMedicine was also the recipient of dozens of healthcare professional, healthcare consumer, and internet quality awards during this time.

Over the ensuing several years, eMedicine.com and eMedicineHealth.com became widely trafficked and revenues increased markedly. In 2005, eMedicine entered into discussions for acquisition. The board of directors at the time of sale, consisting of Jonathan Adler, Jeffrey Berezin, Craig Burson, Lilian Shackelford Murray and Michael P. Tierney, unanimously recommended approval for sale of the company to WebMD. The sale was completed in January 2006 and the content is available via WebMD's Medscape site and has since been renamed the Medscape Reference.

Content now includes allergy and immunology, cardiology, clinical procedures, critical care, dermatology, emergency medicine, endocrinology, gastroenterology. genomic medicine, hematology, infectious diseases, nephrology, neurology, obstetrics/gynecology, oncology, pathology, perioperative care, physical medicine and rehabilitation, psychiatry, pulmonology, radiology, rheumatology, and sports medicine. Surgical subspecialties include neurosurgery, ophthalmology, orthopedic surgery, (ENT) and facial plastic surgery, plastic surgery, thoracic surgery, transplantation, Trauma, urology, and vascular surgery. [1]

Allergy immune system response to a substance that most people tolerate well

Allergies, also known as allergic diseases, are a number of conditions caused by hypersensitivity of the immune system to typically harmless substances in the environment. These diseases include hay fever, food allergies, atopic dermatitis, allergic asthma, and anaphylaxis. Symptoms may include red eyes, an itchy rash, sneezing, a runny nose, shortness of breath, or swelling. Food intolerances and food poisoning are separate conditions.

Immunology branch of medicine studying the immune system

Immunology is a branch of biology that covers the study of immune systems in all organisms. Immunology charts, measures, and contextualizes the physiological functioning of the immune system in states of both health and diseases; malfunctions of the immune system in immunological disorders ; and the physical, chemical, and physiological characteristics of the components of the immune system in vitro, in situ, and in vivo. Immunology has applications in numerous disciplines of medicine, particularly in the fields of organ transplantation, oncology, rheumatology, virology, bacteriology, parasitology, psychiatry, and dermatology.

Cardiology branch of medicine dealing with disorders of the heart as well as parts of the circulatory system

Cardiology is a branch of medicine dealing with disorders of the heart as well as parts of the circulatory system. The field includes medical diagnosis and treatment of congenital heart defects, coronary artery disease, heart failure, valvular heart disease and electrophysiology. Physicians who specialize in this field of medicine are called cardiologists, a specialty of internal medicine. Pediatric cardiologists are pediatricians who specialize in cardiology. Physicians who specialize in cardiac surgery are called cardiothoracic surgeons or cardiac surgeons, a specialty of general surgery.

The site is free to use, requiring only registration. More than 11,000 physician contributors from primarily in the US but also internationally participated in the creation of the articles. Novel at the time, eMedicine content could also be accessed as an e-book, and could be downloaded into a palm top device. [3]

An e-reader, also called an e-book reader or e-book device, is a mobile electronic device that is designed primarily for the purpose of reading digital e-books and periodicals.

Palm (PDA) company

Palm is an American tech company that developed and designed Personal Digital Assistants (PDAs), mobile phones, and software. Palm devices are often remembered as "the first wildly popular handheld computers," responsible for ushering in the smartphone era. Palm's first PDAs ran the Palm OS, were smaller than competing handhelds, and proved to the industry that there was a market for a new category of portable computing device.

eMedicine Firsts

A list of all the revolutionary achievements of eMedicine from its founding in 1996 until its acquisition by WebMD in 2006 would be very long. Highlights of these achievements would include the following: First significant healthcare web based publishing and education system, one of the earliest web based learning management systems (GPS 1), first web based multilevel peer reviewed healthcare professional and later healthcare consumer content system, developed first mobile (Palm system) healthcare education apps, one of the earliest web based healthcare continuing education systems, and the recruitment of over 11,000 board certified healthcare professionals who created and edited content entirely online.

Usage among specialists

In 2012 Volsky et al. [4] evaluated the most frequently used internet information sources by the public, (1) identifying the three most frequently referenced Internet sources; (2) comparing the content accuracy of each of the three sources and (3) ascertaining user-friendliness of each site; and (4) informing practitioners and patients of the quality of available information. They found Wikipedia, eMedicine, and NLM/NIH MedlinePlus were the most referenced sources. For content accuracy, eMedicine scored highest (84%; p<0.05) over MedlinePlus (49%) and Wikipedia (46%). The highest incidence of errors and omissions per article was found in Wikipedia (0.98±0.19), twice more than eMedicine (0.42±0.19; p<0.05). Errors were similar between MedlinePlus and both eMedicine and Wikipedia. On ratings for user interface, which incorporated Flesch-Kinkaid Reading Level and Flesch Reading Ease, MedlinePlus was the most user-friendly (4.3±0.29). This was nearly twice that of eMedicine (2.4±0.26) and slightly greater than Wikipedia (3.7±0.3). All differences were significant (p<0.05). There were 7 topics for which articles were not available on MedlinePlus. They concluded "Knowledge of the quality of available information on the Internet improves pediatric otolaryngologists' ability to counsel parents. The top web search results for pediatric otolaryngology diagnoses are Wikipedia, MedlinePlus, and eMedicine. Online information varies in quality, with a 46-84% concordance with current textbooks. eMedicine has the most accurate, comprehensive content and fewest errors, but is more challenging to read and navigate. Both Wikipedia and MedlinePlus have lower content accuracy and more errors, however MedlinePlus is simplest of all to read, at a 9th Grade level.

MedlinePlus is an online information service produced by the United States National Library of Medicine. The service provides curated consumer health information in English and Spanish. The site brings together information from the National Library of Medicine (NLM), the National Institutes of Health (NIH), other U.S. government agencies, and health-related organizations. There is also a site optimized for display on mobile devices, in both English and Spanish. In 2015, about 400 million people from around the world used MedlinePlus. The service is funded by the NLM and is free to users.

In 2012, Laraway and Rogers reported a structured review of journal articles that quoted The University of Washington Quality of Life Scale for head and neck cancer patients.

"The University of Washington Quality of Life Scale (UW-QoL) is one of the most frequently reported health-related quality of life (HR-QoL) questionnaires in head and neck cancer, and since its first publication in 1993 has been used in many different cohorts. There is a considerable amount of information to assimilate and, to date, we know of no attempt that has been made to summarise publications specific to its use in a peer review journal. The aim of this review was to systematically search published papers that report its use, identify common themes, and present a tabulated summary. Several search engines were used (PubMed, Medline, Medical-Journals.com, eMedicine), and 222 abstracts were found and hand searched. A total of 66 papers were eligible for inclusion, 21 on functional outcome, 25 on predictors of HR-QoL, 19 on development or validation of the questionnaire, and one clinical trial. The review includes a diversity of studies and a range of HR-QoL outcomes following head and neck cancer. It provides clinicians and their colleagues in multidisciplinary teams with a source of quick reference to relevant papers reporting the UW-QoL, and gives a short summary of the pertinent conclusions drawn from each paper."

What is significant for eMedicine, is that Laraway and Rogers used PubMed, Medline Medical Journals.com and eMedicine as primary sources of information. [5] This is significant because medline is the compendium of all NIH sponsored research. Emedicine is made up of articles translating the body of current research in medline into clinical practice guidelines from the perspective of each subspeciality. [1]

Cao, Liu, Simpson, et al revealed that medline and emedicine were used as primary resources in developing the online system AskHERMES. [6] Physicians were asked to solve complex clinical problems using three different sources of information: AskHermes, Google and UpToDate. Surveys of the physicians who used all three systems were asked to score the three systems by ease of use, quality of answer, time spent, and overall performance.[ citation needed ]

A 2009 study showed that "89.1% of ophthalmologist respondents accessed peer-reviewed material online, including Emedicine (60.2%)." [7]

A 2007 study showed that 12% of radiology residents used eMedicine as their first source when doing research on the Internet. [8]

A 2005 study ranking 114 sites rated it the second-highest Internet-based source of information for pediatric neuro-oncology, after the site of the National Cancer Institute. [9]

A 2002 study described the site's coverage of dermatology as "excellent and comprehensive." [10]

In 2000 an article in the Journal of Ear Nose and Throat by AD Meyers from the University of Colorado School of Medicine, Denver, CO, announced the unveiling of the ENT textbook online at emedicine.com. [1]

Related Research Articles

Pediatrics field of medicine dealing with the care of children

Pediatrics is the branch of medicine that involves the medical care of infants, children, and adolescents. The American Academy of Pediatrics recommends people be under pediatric care up to the age of 21. A medical doctor who specializes in this area is known as a pediatrician, or paediatrician. The word pediatrics and its cognates mean "healer of children"; they derive from two Greek words: παῖς and ἰατρός. Pediatricians work both in hospitals, particularly those working in its subspecialties such as neonatology, and as primary care physicians.

MEDLINE is a bibliographic database of life sciences and biomedical information. It includes bibliographic information for articles from academic journals covering medicine, nursing, pharmacy, dentistry, veterinary medicine, and health care. MEDLINE also covers much of the literature in biology and biochemistry, as well as fields such as molecular evolution.

Pulmonology medical specialty

Pulmonology is a medical speciality that deals with diseases involving the respiratory tract. The term is derived from the Latin word pulmō, pulmōnis ("lung") and the Greek suffix -λογία, -logia. Pulmonology is synonymous with pneumology, respirology and respiratory medicine.

WebMD is an American corporation known primarily as an online publisher of news and information pertaining to human health and well-being. The site includes information pertaining to drugs. It is one of the top healthcare websites by unique visitors.

Neonatology medical care of newborns, especially the ill or premature

Neonatology is a subspecialty of pediatrics that consists of the medical care of newborn infants, especially the ill or premature newborn. It is a hospital-based specialty, and is usually practiced in neonatal intensive care units (NICUs). The principal patients of neonatologists are newborn infants who are ill or require special medical care due to prematurity, low birth weight, intrauterine growth restriction, congenital malformations, sepsis, pulmonary hypoplasia or birth asphyxia.

Medical education in the United States includes educational activities involved in the education and training of physicians in the United States, from entry-level training through to continuing education of qualified specialists.

Clinical pathology medical specialty that is concerned with the diagnosis of disease based on the laboratory analysis of bodily fluids

Clinical pathology, Laboratory Medicine, Clinical analysis (Spain) or Clinical/Medical Biology, is a medical specialty that is concerned with the diagnosis of disease based on the laboratory analysis of bodily fluids, such as blood, urine, and tissue homogenates or extracts using the tools of chemistry, microbiology, hematology and molecular pathology. This specialty requires a medical residency.

<i>Annals of Internal Medicine</i> scientific journal

Annals of Internal Medicine is an academic medical journal published by the American College of Physicians (ACP). It is one of the most widely cited and influential specialty medical journals in the world. Annals publishes content relevant to the field of internal medicine and related sub-specialties. Annals' mission is to promote excellence in medicine, enable physicians and other health care professionals to be well-informed members of the medical community and society, advance standards in the conduct and reporting of medical research, and contribute to improving the health of people worldwide. To achieve this mission, the journal publishes a wide variety of original research, review articles, practice guidelines, and commentary relevant to clinical practice, health care delivery, public health, health care policy, medical education, ethics, and research methodology. In addition, the journal publishes personal narratives that convey the feeling and the art of medicine. Selected articles in the journal are open access; these include patient oriented content and Clinical Guidelines.

Index Medicus (IM) is a curated subset of MEDLINE, which is a bibliographic database of life science and biomedical science information, principally scientific journal articles. From 1879 to 2004, Index Medicus was a comprehensive bibliographic index of such articles in the form of a print index or its onscreen equivalent. Medical history experts have said of Index Medicus that it is “America's greatest contribution to medical knowledge.”

ReachMD helps healthcare professionals discover, participate in, and share medical education and clinical information through on demand programming and 24/7 streaming broadcasts. Its content is offered on air, online, and via mobile apps and includes video, audio, slides, and text-based formats. The ReachMD distribution network includes websites and mobile apps of ReachMD, iHeartRadio, TuneIn, Stitcher, iTunes, and more. ReachMD has produced more than 10,000 medical broadcasts featuring clinical research, medical practice, disease management, and patient care strategies.

"Health 2.0" is a term introduced in the mid-2000s, as the subset of health care technologies mirroring the wider Web 2.0 movement. It has been defined variously as including social media, user-generated content, and cloud-based and mobile technologies. Some Health 2.0 proponents see these technologies as empowering patients to have greater control over their own health care and diminishing medical paternalism. Critics of the technologies have expressed concerns about possible misinformation and violations of patient privacy,

Medical encyclopedia specialized encyclopedia on medicine

A medical encyclopedia is a comprehensive written compendium that holds information about diseases, medical conditions, tests, symptoms, injuries, and surgeries. It may contain an extensive gallery of medicine-related photographs and illustrations. A medical encyclopedia provides information to readers about health questions. It may also contain some information about the history of diseases, the development of medical technology uses to detect diseases in its early phase. A licensed physician should be consulted for diagnosis and treatment of any and all medical conditions.

Society of Hospital Medicine

The Society of Hospital Medicine (SHM) is an American membership society for hospitalists, that is, physicians and other caregivers who practice the specialty of hospital medicine.

Glenn Laffel is a physician and health IT entrepreneur. He formerly served as the Senior Vice President of Clinical Affairs for Practice Fusion, a San Francisco-based company that offers a Web-based Electronic Health Record (EHR) for free to physicians.

The online encyclopedia Wikipedia has, since the late 2000s, served as a popular source for health information for both laypersons and, in many cases, health care practitioners. Health-related articles on Wikipedia are popularly accessed as results from search engines, which frequently deliver links to Wikipedia articles. Independent assessments have been made of the number and demographics of people who seek health information on Wikipedia, the scope of health information on Wikipedia, and the quality of the information on Wikipedia.

Health information on the Internet any use of Internet to publish or share health information

Health information on the Internet refers to all communication related to health done on the Internet.

James Heilman Emergency physician and advocate for the improvement of Wikipedias health-related content

James M. Heilman is a Canadian emergency department physician, Wikipedian, and advocate for the improvement of Wikipedia's health-related content. He encourages other clinicians to contribute to the online encyclopedia.

MDLinx is an internet-based service for physicians and healthcare professionals provided by M3 USA Corporation. It offers physicians and other healthcare professionals a means of staying current with academic literature. The typical medical specialist needs to read 30 to 80 journal articles every day to keep up with the flow of information in his/her specialty. MDLinx scans, sorts, summarizes, and disseminates new literature in a digestible form.

References

  1. 1 2 3 4 Meyers, AD (Apr 2000). "eMedicine Otolaryngology: an online textbook for ENT specialists". Ear, nose, & throat journal. 79 (4): 268–71. PMID   10786388.
  2. Hunt, Katherine. "WebMD acquires eMedicine.com for $25.5M". MarketWatch. Retrieved 2017-08-28.
  3. Platt, AF (2008). Evidence-Based Medicine for PDAs: A Guide for Practice. Jones and Bartlett Publishers. pp.  80–82. ISBN   0-7637-5476-5.
  4. Volsky, PG; Baldassari, CM; Mushti, S; Derkay, CS (Sep 2012). "Quality of Internet information in pediatric otolaryngology: a comparison of three most referenced websites". International Journal of Pediatric Otorhinolaryngology. 76 (9): 1312–6. doi:10.1016/j.ijporl.2012.05.026. PMID   22770592.
  5. Laraway, D.C.; Rogers, S.N. (2012). "A structured review of journal articles reporting outcomes using the University of Washington Quality of Life Scale". British Journal of Oral and Maxillofacial Surgery. 50 (2): 122–31. doi:10.1016/j.bjoms.2010.12.005. PMID   21239091.[ non-primary source needed ]
  6. Cao, Yonggang; Liu, Feifan; Simpson, Pippa; Antieau, Lamont; Bennett, Andrew; Cimino, James J.; Ely, John; Yu, Hong (2011). "AskHERMES: An online question answering system for complex clinical questions". Journal of Biomedical Informatics. 44 (2): 277–88. doi:10.1016/j.jbi.2011.01.004. PMC   3433744 . PMID   21256977.[ non-primary source needed ]
  7. Somal, K; Lam, WC; Tam, E (2009). "Computer and internet use by ophthalmologists and trainees in an academic centre". Canadian Journal of Ophthalmology. 44 (3): 265–8. doi:10.3129/i09-057. PMID   19491979.
  8. Kitchin, Douglas R.; Applegate, Kimberly E. (2007). "Learning Radiology". Academic Radiology. 14 (9): 1113–20. doi:10.1016/j.acra.2007.06.002. PMID   17707320.
  9. Hargrave, D. R.; Hargrave, UA; Bouffet, E (2006). "Quality of health information on the Internet in pediatric neuro-oncology". Neuro-Oncology. 8 (2): 175–82. doi:10.1215/15228517-2005-008. PMC   1871939 . PMID   16533758.
  10. Maibach, HI; Bashir SJ; McKibbon A (2002). Evidence-based dermatology. PMPH-USA. pp.  289–91. ISBN   1-55009-172-7.