SharePractice: Putting “Experience-Based Medicine” in Your Pocket

Ever wish you could hold the entire field of medicine in your hand? Tap into the wisdom of longtime doctors who’ve “seen it all?” Get the shortcuts on what really works and what doesn’t?

With SharePractice, Dr. Andrew Brandeis has taken that wish list and put it into a smartphone app.

sharepractice 880x586Since the earliest times, when seasoned healers carefully scribed their observations on parchment for posterity, doctors have relied on reference tools to help optimize their clinical outcomes. But the amount of research and information out there these days is staggering.

And as we all know, there’s often a big gap between the realities of a highly-controlled clinical trial with carefully selected subjects, and the chaotic free-for-all of daily practice.

Dr. Brandeis, a young San Francisco-based naturopathic physician, recognized early on in his career that tapping into the on-the-ground knowledge of his peers could help him treat his patients more effectively. But there was no good way to find the right information quickly.

That frustration led him to create SharePractice, an iPhone app for doctors and other licensed health professionals all over the world to freely share treatment information and clinical insight. The system combines crowd-sourced clinical experience with evidence-based guidelines, allowing each user to literally hold the very best of “Evidence Based Medicine” enhanced by peer-driven feedback literally in the palm of her hand.

“I realized that there was no structured way for us to share our experiences,” Brandeis says. “When you are busy seeing patients, you don’t have time to sort through a ton of information. I want to collect doctors’ brains and experience in one place where it can spread quickly.”

SharePractice allows doctors to turn to each other for advice, and helps MDs and NDs share insight and healing opportunities. Call it “Experience-Based Medicine.”

A Worldwide Collaboration

SharePractice is a free collaborative medical reference tool for practicing health care professionals across a range of disciplines. Doctors can rate and review the effectiveness of drugs, herbs and supplements for various ailments.

The goal? To democratize the standards of care based on real world, real time feedback from practicing clinicians.

There are already more than 10,000 health care practitioners participating, and the numbers are growing.

By crowdsourcing the consensus of a global medical community, SharePractice helps doctors instantly get thousands of qualified, evidence-backed second opinions from trusted colleagues on almost any diagnosis.

Users can search thousands of illnesses to find preferred treatments based on others’ experience in the field.

Search a problem, and the app produces a list of pharma and non-pharma options, along with dosages and frequencies, allowing practitioners to quickly find the best treatments for a specific diagnosis. SharePractice integrates conventional and non-conventional treatments and is the only evidence-based, crowd sourced repository of it’s kind.

“It’s a point-of-care clinical reference with information about 20,000 drugs and 10,000 supplements,” Dr. Brandeis says. “Doctors curate the content, putting forth their best ideas.” Compared to traditional streams of medical knowledge, SharePractice has the ability to evolve very quickly.

This is a key feature of a collaborative resource like SharePractice. Unlike traditional streams of medical knowledge which depend on the slow-moving machinery of academic research centers, peer-reviewed journals and inertia-bound institutions, the practice guidance from SharePractice evolves on the fly as new data emerge, and as users try new things.

“Research” Meets “Medicine”

Brandeis says that when it comes to decision-making information, doctors look for two things: research and medicine. case SharePractice

In his view, “research” represents the tightly controlled world of randomized trials where investigators can include or exclude people based on pre-set criteria; where “confounding variables” (also called life) can be conveniently eliminated or at least statistically neutralized.

On the other hand, “medicine” is what happens in the trenches of daily practice, where doctors must see individuals whose “variables” cannot be controlled, and who care about what’s likely to happen to them, not what happened in a “cohort.”

SharePractice brings the two together, drawing from medical research databases to include the values of evidence-based medicine while at the same time framing RCT data in the context of clinical experience.

The system also addresses the fact that peer-reviewed study results are not available for many cases and for many types of treatment, Dr. Brandeis says.

As is the case with other non-medical social media apps (ie Facebook, Twitter, etc), SharePractice users can opt to follow any other SharePractice users. By pressing the “follow” button in the clinician’s profile, a user can keep track of what that colleague is doing, and how he or she thinks about particular treatments.

Unlike medical journals, with their top-down “authoritative” dissemination of data, participation on SharePractice is a two-way street. Users can reality-check one another, post questions, and share alternative viewpoints.

“It’s all about trust,” says Brandeis. “This isn’t always available in journal articles, trial outcomes, and drug company studies, which often have certain biases, though many doctors rely on them.”

He believes the experiential piece is essential to making SharePractice useful. “It’s become a reliable source of information for treating acute illnesses now that doctors with specialized niches are sharing their techniques and protocols. Free from all bias.” The app allows practitioners to “collaborate and share protocols, provide framework and create content.”

It’s also evolving into a valuable mentoring tool. “Experienced practitioners are essentially downloading their brains via the app, and younger ones benefit. Doctors who are retired after decades of experience, with a vast amount of knowledge, now have a channel to share it,” Dr. Brandeis says.

Dr. Yelp

With clinicians worldwide able to rate and review different treatment methods based on their own professional experience, SharePractice has also been called the “Yelp for medicine.”

Just like the restaurant rating app, it allows users to quickly create a new standard of care through their ratings. Doctors can vote treatments up or down, add new treatments, and leave comments about their experiences. SharePractice ranks treatments for more than 2,000 diagnoses, including nutraceuticals, botanical supplements and pharmaceuticals.

SharePractice has a medical director—Mark Berenson, MD--who oversees the staff and mediates the crowd-sourced content. It’s no small feat to clean up all the irregularities (such as name misspellings) and to cross-check the users’ clinical experience against data from PubMed and other medical research databases.

SharePractice has opened up the channels of communication between MDs and NDs, leading them past ideological differences and into the specifics of helping patients, where they find they have much in common.

Both MDs and NDs are vital to patient care, and the future of medicine lies in combining their shared experience, tools, and wisdom.

Dr. Brandeis believes that collaborative, evidence-backed knowledge sharing will be commonplace in the future, and should be an essential part of every doctor’s medicine bag today.

“I think this will ultimately prove to be a valuable piece of the future of medicine,” he says. And really, who wouldn’t want to download all the world’s evidence based protocols and the brains of ten thousand smart doctors and keep them handy in their back pocket?

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