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Improving Medical Communication Online

By John S. James

June 29, 2006

Summary: Medicine has not made full use of online information -- and doing so might save thousands of lives. Part I looks at what has been most successful online in other fields, for background on how medical information could be improved.

In the past few years some Web sites have become enormously successful, providing services useful enough to attract many millions of visitors, and with no need to advertise. (When was the last time you saw an ad for Google?) This communication revolution builds largely on information contributed by multitudes of users -- not just by a few celebrities or by management. Information is the lifeblood of science and medicine; a similar revolution in medical communication could be worth billions of dollar a year by making all of medical research and medical practice more effective -- while saving thousands of lives, and improving the everyday health of millions.

Medicine has its own needs and must find its own way, not simply follow what works elsewhere. A key difference is that medicine and science rate information based on the authority of expert peer review, while many successful Web sites use other forms of popularity for their ratings.

But imagine a world where individuals could choose among many different flavors and philosophies of expert review, and mix or change these "views" of the universe of available information at any time. Also, informal recommendations by many different experts, public figures, organizations, and others could help everyone manage information overload, by combining expert and popular referrals to help people find what they most want or need, and what others in their situation have found most helpful.

These reviews and recommendations could help individuals navigate an AIDS conference -- or recent scientific or medical publications -- or the entire body of information published on the Web as it relates to a particular medical need. Important work even by unknown authors could be widely recognized immediately, if it is accurate and uniquely useful.

Our next issue will propose such designs for medicine. Here we look at sites that already work very well online in other fields, to see what can be learned from them.

Successful Internet Models

Some online communication system to look at (but not necessarily copy for medical use) include:

Note that all these very successful sites are free, and all of them give users lots of valuable information and a good experience without making them register first. Usually visitors do need to register or sign up in some way before publishing their own comments or other information on these sites, but typically such sign-up is minimal: make up a user name and password, provide an email address that must work, read a few funny-looking numbers or letters to prove you are a person not a robot, and confirm as instructed by email. Or just be signed up already at a cooperating site.

For more information about these and other online communication systems that have been most successful recently on the Web, see the special section "Among the Audience" in The Economist.6

Part II of this article will look at major problems in medical communication today, and explore possible improvements.


  1. Giles, J. Internet encyclopedias go head to head. Nature. December 15, 2005; volume 483, pages 900-901. For a BBC news report, see

  2. Alexa, owned by, lists traffic rankings for the top 100 sites in each of over 70 countries; it gets the information by offering people a toolbar that provides additional search help, in return for automatically reporting users' Web use to Alexa. Visit and click "United States" or one of the other countries, or click "See more Global Top 500."

    You can get the Alexa traffic ranking for almost any Web site -- and see the top sites its visitors also visit. At click the "Traffic Rankings" tab. Type the site you want to check into the box, and click "Get Traffic Details."

    These rankings are not perfect, due to self-selection, operating-system, and other biases in who uses the toolbar that reports the Web sites they visit. But the information is free, easy to use, and good enough for many discussions.

  3. "Growing Wikipedia revises Its 'Anyone can edit' policy," The New York Times, 2006-06-17.

  4. "Their Master's Voice," The Guardian (UK), 2003-02-17; "The Murdoch Interview" is here.

  5. On the ISO International Date Format, see

  6. "Among the Audience," The Economist Survey on New Media. For free access, click "our survey" (highlighted in the subtitle) for the first article, then choose articles or interviews in the column on the right.

Copyright 2006 by John S. James. See "Permission to Copy" at:

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