The startup learning exponential at Medicast

I haven’t had a chance to write for a few years as I’ve been creating a truly groundbreaking company that preserves the sacred relationship between the physician and the patient. During these 2 years we’ve learned many lessons, none greater than the ones taught by my business partners. We are the first mobile company to facilitate housecall visits between patients and doctors utilizing technology. We are currently working with hospitals and healthcare systems to bring back the timeless housecall visit. Looking forward to continuing my journey with you!

Injected Nanoparticles Maintain Blood Sugar Levels In Diabetic Mice For Ten Days:

Written by Peter Murray

[Source: Broad Institute]

Modern medicine is once again turning to nanotechnology to help our bodies help themselves. A new device comprised of nanoparticles monitors blood sugar levels and releases insulin when sugar levels get too high. It has already been shown to work in mice. If it does the same for humans, keeping people with type 1 diabetes healthy could be a simple matter of swallowing a pill.

While the exact cause of type 1 diabetes is unknown it is thought to be an autoimmune disorder in which the body attacks cells in the pancreas that produce insulin, a hormone that causes blood sugar to be taken up by cells and used for energy. In type 1 diabetes the pancreas makes little or no insulin, leading to high levels of sugar in the blood which can lead to blindness, limb amputation and kidney failure. Untreated, the disease is fatal.

Right now type 1 diabetes patients have to receive insulin shots, several times a day, for the rest of their lives to keep blood sugar levels under control. And there’s added risk if the patient’s dose isn’t correct – too much insulin is harmful too. The new device would relieve patients of the need to monitor and control their own blood sugar levels by controlling them automatically.

Nano-networks of porous beads are engineered to respond to high levels of blood sugar by releasing insulin. [Source: Journal of Agriculture and Food Chemistry]

It is comprised of a network of nanoparticles that releases insulin into the blood in response to changes in blood glucose levels. Each of the nanoparticles have a core of insulin, a charged molecular chain called dextran and the enzyme glucose oxidase. When blood glucose levels are high, glucose oxidase breaks the sugar down into gluconic acid, which then breaks down the dextran chains to release insulin. The gluconic acid and dextran are broken down by the body and the released insulin returns blood sugar levels back to normal. The degradable nano-network was shown to work in mice where a single injection kept blood glucose levels normal for a minimum of 10 days.

“This technology effectively creates a ‘closed-loop’ system that mimics the activity of the pancreas in a healthy person, releasing insulin in response to glucose level changes,” Zhen Gu, lead author of the study and an assistant professor in the joint biomedical engineering program at North Carolina State and University of North Carolina Chapel Hill, said in a press release.

The study was published recently in the Journal of Agricultural and Food Chemistry. The next step, the researchers say, is to test the technology in humans.

The current technique works in principle similarly to the ‘Silicon Pancreas,’ a microchip that regulates blood sugar levels by mimicking both the insulin-producing beta cells and glucagon-producing alpha cells in the pancreas. The current technique is more elegant in its simplicity, however, as the Silicon Pancreas requires a separate blood sugar level monitor embedded in the skin.

Diabetes affects 366 million people worldwide. It’s the seventh leading cause of death in the United States where 25.8 million children and adults, or 8.3 percent of the population, have the disease. And as people continue to grow in size, so will diabetes as an epidemic, and devices such as the one developed by Dr. Zhen and colleagues will be needed more than ever.

http://singularityhub.com/

Engineered molecules boost immune attack on cancer, researchers say

BY CHRISTOPHER VAUGHAN - Building on previous research showing that cancer cells send signals to the immune system to avoid being attacked, Stanford scientists have engineered new molecules that are highly proficient at neutralizing those signals.

Christopher Garcia

The molecules dramatically increase the effectiveness of certain existingcancer therapies and may open up other avenues for treating cancerusing patients' own immune systems.

School of Medicine researchers have previously shown that CD47, a molecule found on the surface of many cancers, acts as a "don't eat me" signal that protects the cancer from roving immune cells called macrophages. The scientists found that when they used drugs to block this "don't eat me" signal, macrophages engulfed and destroyed the cancer cells.

More recently, Stanford scientists wondered if they could engineer molecules that block the signal more effectively. They began by modifying a protein called SIRP-alpha, which is found on macrophages and is the natural receptor for CD47. In a paper published online May 30 in Science, a team of scientists working with professors Christopher Garcia, PhD, and Irving Weissman, MD, report that they have engineered new versions of SIRP-alpha that bind much more strongly to CD47 than the natural version of the molecule, making them extremely potent blockers of the "don't eat me" signal.

Two MD/PhD students in the Stanford Medical Scientist Training Program — Kipp Weiskopf, MPhil, and Aaron Ring, MS — devised the strategy for engineering these new molecules and were lead authors of the Science paper.

"This is the best example of how science and medical trainingcan lead to discovery and medical translation," said Weissman, professor of pathology and of developmental biology. "Weiskopf and Ring fleshed out the ideas that led to this project, bringing the complementary expertise of our groups together."

The engineered SIRP-alpha variants bind approximately 50,000 times more strongly to CD47 than native SIRP-alpha, making them highly potent drugs, Weiskopf said. But the researchers found blocking the CD47 "don't eat me" signal is not, by itself, enough to stimulate macrophages to attackcancer cells. Instead, the group demonstrated that blocking CD47 boosts the activity of macrophages when a second "eat me" signal is provided. This signal can be provided by certain anti-cancer antibody therapeutics, many of which are already approved by the FDA and in use clinically.

These findings have tremendous therapeutic implications, Ring said, because the high-affinity SIRP-alpha molecules could selectively boost the destruction of cancer cells by these antibody therapies, without increasing toxic side effects such as the destruction of healthy, non-cancerous cells.

The authors found that their engineered SIRP-alpha molecules would enhance a number of widely used antibody therapies such as rituximab (which targets certain lymphomas and leukemias), trastuzumab (which targets certain kinds of breastcancer) and cetuximab (which targets certain kinds of head and neck cancer and colon cancer).

When physicians used an anti-cancer antibody like these to fight cancer, the antibody's "eat me" signal to the macrophage is fighting against the cancer's "don't eat me" signal coming from the CD47, the researchers explain. When the high-affinity SIRP-alpha binds tightly to the CD47 molecules on the cancer, it takes the brakes off the macrophage attack on the cancercells.

"When physicians use an anti-cancer antibody like trastuzumab to fight breast cancer, the 'don't eat me signal' from CD47 on the cancer limits the effectiveness of the antibody," said Ring. "Potentially, any anti-cancer antibody that stimulates immune cells could benefit from this combination therapy."

In one experiment, when either rituximab or the high-affinity SIRP-alpha variants were used by themselves on mice with human lymphomas, they were only able to slow tumor growth. However, when the two therapies were combined, researchers found they were able to eliminate the tumors completely. "Antibodies are like guided missiles in terms of targeting cancercells," Weiskopf said. "By combining them with the high-affinity SIRP-alpha variants, you are adding high-explosive warheads to those missiles ."

The researchers hope that their work with high-affinity SIRP-alpha molecules will lead to more effective targeted-cancertherapies in the clinic. "This work further validates the strategy of targeting CD47 to enhance macrophage attack of cancer," according to Weissman. "This strategy must still be tested in humans to evaluate safety, but anti-CD47 antibodies are on schedule for the first trials in patients next year."

Other authors of the paper include graduate student Chia Chi M. Ho; instructor Jens-Peter Volkmer, MD; former postdoctoral scholar Aron Levin, PhD; postdoctoral scholars Anne Kathrin Volkmer, MD, Engin Özkan, PhD, and Nathaniel Fernhoff, PhD; and Matt van de Rijn, MD, PhD, professor of pathology.

This work was supported by the National Cancer Institute, theNational Institute of Diabetes and Digestive and Kidney Diseases, the Stanford Medical Scientist Training Program, the School of Medicine's SPARK program, the Deutsche Forschungsgemeinschaft, the Joseph & Laurie Lacob Gynecologic/Ovarian Cancer Fund, the Virginia and D.K. Ludwig Fund for Cancer Research and the Howard Hughes Medical Institute.


http://www.healthcanal.com/

Melanoma now detectable by skin odor

SolarScan, a device to detect skin cancer, is demonstrated at its launch in Sydney May 7, 2002. The SolarScan works by capturing an image of a patient's skin spot and then an image analsis software compares the features against images of melanomas and non-melanomas in a database. Melanoma is the most common form of cancer in men and women aged 15-44 and is the most deadly form of skin cancer. Credit:Reuters

Responsible for more than 75 percent of skin cancer deaths, melanoma is a cancer of the skin, which affects the melanocytes (pigment carrying cells of the body). A new study now suggests that this dangerous cancer may be easily detectable - by odors from skin cells.

The study, carried out by a team of researchers from the Monell Center revealed two new ways to help early detection of skin cancer- by odors emitted by human skin, and by using a nanotechnology-based sensor that could differentiate between normal skin cells and melanoma skin cells.

"There is a potential wealth of information waiting to be extracted from examination of VOCs associated with various diseases, including cancers, genetic disorders, and viral or bacterial infections," senior author George Preti, PhD and an organic chemist at Monell, noted.The researchers took into consideration the fact that human skin produces a number of airborne chemical molecules, also known as volatile organic compounds (VOCs), many of which emit odor too, and put it to use as an early melanoma detection tool.

For this study, the researchers made use of sophisticated analytical and sampling techniques that helped detect VOCs emitted from melanoma skin cells at different levels of progression of the disease. They also sampled VOCs emitted from normal skin cells by using an absorbent device. Analysis of these VOCs was done using mass spectrometry and gas chromatography techniques.

To translate the results obtained from the VOC analysis into a diagnostic analysis, a reliable and portable sensor would be required, to which, the researchers used a nano-sensor.

The nano-sensor was made up of two nano-sized tubes that were coated with strands of DNA. The use of DNA as a sensor could be clarified by the fact that DNA tend to act as a wonderful sensor, which makes identification of the target easy. The results so obtained revealed a stunning fact- human skin cells emit odor different from that of melanoma skin cells; a new early diagnostic tool which may help cut down death rates due to melanoma considerably.

"This study demonstrates the usefulness of examining VOCs from diseases for rapid and noninvasive diagnostic purposes," Preti said. "The methodology should also allow us to differentiate stages of the disease process."

The study is now published in the Journal of Chromatography B. 

http://www.itechpost.com/

Innovative nanoparticle therapy to treat infected burn wounds

(Nanowerk Spotlight) Despite significant advances in the medical/surgical management of severe thermal injury, wound infection and subsequent sepsis persist as frequent causes of morbidity and mortality for burn victims not only due to the extensive compromise of the protective barrier against microbial invasion, but also as a result of growing pathogen resistance to our therapeutic options.Burn wounds are further complicated by injury induced suppression of the immune system, further facilitating localized colonization and systemic entry of microbes from both endogenous and exogenous origins. Candida yeast species represent a prevalent threat to these patients, many variants demonstrating resistance to first line systemic antifungal treatments as these medications are not directly toxic, but instead inhibit yeast growth through a single mechanism of action.Therefore, innovative therapies are urgently needed that overcome mechanisms of pathogen resistance, and are easily administered without concerning systemic side effects.Nanoparticles represent a practical platform through which both established drugs and novel agents can be encapsulated and delivered more effectively or via new routes to target and reach pathogen cells/machinery with greater success then their macromolecular counterparts.In a paper published in the June 14, 2013 online edition of Nanomedicine: Nanotechnology, Biology and Medicine ("Amphotericin B releasing nanoparticle topical treatment of Candida spp. in the setting of a burn wound") we demonstrated that encapsulating Amphotericin B, a intravenously administered potent fungicidal polyene macrolide, in nanoparticles increased its killing impact against numerous candida species, was more effective at preventing candidal biofilm formation, and cleared a mouse burn model infected with candida more effectively than solubilized amphotericin.Images were taken on day 9 after infection. a) is topically applied solubilized Amphotericin B and b) Amphotericin B nanoparticle applied. (Images: Dr. Friedman, Montefiore - Albert Einstein College of Medicine)Materials at the nanoscale have a greater likelihood of interacting with their desired target, here, the cell wall, and therefore the payloads have greater efficacy. Furthermore, the nanoparticles themselves can physically damage pathogen structures and prevent cell-to-cell communication and sharing of resources, offering synergists but different antifungal properties.Encapsulating amphotericin in nanoparticles not only made it more effective, but also allowed for it to be directly and topically applied to a wound – an option not currently available. Systemic delivery, while very effective, comes at a great cost as amphotericin has multiple well established side effects and toxicities associated with its use.Our team here at Einstein represents a broad range of expertise calling from multiple departments including medicine (infectious diseases, dermatology), physiology and biophysics, and immunology and microbiology, highlighting the multidisciplinary nature of nanotechnology research. Other authors included David Sanchez; David Schairer; Chaim Tuckman-Vernon; Jason Chouake; Allison Kutner; Joy Makdisi; Joel Friedman; and Joshua d Nosanchuk.By Dr. Adam Friedman, Assistant Professor of Medicine (Dermatology)/ Physiology and Biophysics, and Director of Dermatologic Research at Montefiore Medical Center - Albert Einstein College of Medicine.

Read more: http://www.nanowerk.com/spotlight/spotid=30997.php#ixzz2X9QjwHzd

Regenerative Heart Medicine Could Get Boost With Nanotechnology

Researchers at the Stanford University School of Medicine have developed a new visualization technique which they believe could eventually help make the repair of damaged hearts through regenerative medicine a reality.

In a study published in Wednesday’s edition of the journal Science Translational Medicine, senior author and Stanford radiology professor Sam Gambhir and colleagues describe how they plan to mark the stem cells which would be used in the repair process.

By marking the cells, doctors would be able to track them by using standard ultrasounds as they leave the needle and enter a patient’s body. The process would allow for the stem cells to be guided to their intended destination more precisely, and would also allow doctors to monitor them using magnetic-resonance imaging (MRI) technology for several weeks afterwards, the researchers explained.

To date, both human and animal trials in which stem cells were injected into cardiac tissue to treat severe heart attacks or heart failure have been largely unsuccessful, said Gambhir.

“We’re arguing that the failure is at least partly due to faulty initial placement,” he explained in a statement. “You can use ultrasound to visualize the needle through which you deliver stem cells to the heart. But once those cells leave the needle, you’ve lost track of them.”

For this reason, scientists have been unable to precisely determine whether or not the stem cells actually reached the heart wall, and whether they remained there or diffused away from the cardiac tissue. In addition, there has been no way to determine how long the cells managed to stay alive, or if they successfully replicate and eventually develop into heart cells.

Gambhir’s team method could help answer some of those questions.

“All stem cell researchers want to get the cells to the target site, but up until now they’ve had to shoot blindly,” he said. “With this new technology, they wouldn’t have to. For the first time, they would be able to observe in real time exactly where the stem cells they’ve injected are going and monitor them afterward.”

“If you inject stem cells into a person and don’t see improvement, this technique could help you figure out why and tweak your approach to make the therapy better,” Gambhir added.

In addition to the issues surrounding the initial position of the therapeutic stem cells, tracking them once they enter the body has proven troublesome since there is no way to distinguish them from any other cell in the patient’s body. Since they normally cannot be tracked upon entering the body, if the attempt to repair the heart fails, doctors often are unable to pinpoint exactly why the process proved unsuccessful.

The new technique, however, aims to solve those problems by using extremely small nanoparticles that act as imaging agents. The nanoparticles, which have a diameter slightly less than one-third of a micron (or less that one-thirtieth the diameter of a red blood cell), are made of silica so that they can be visualized by ultrasound. Furthermore, an MRI contrast agent known as gadolinium was also added to the imaging agents.

Gambhir and his colleagues were able to successfully demonstrate that mesenchymal stem cells – a class of cells frequently used in heart-regeneration research – could store the nanoparticles without sacrificing any of their ability to survive, replicate and differentiate into living heart cells.

Lead author Jesse Jokerst, a postdoctoral scholar in Gambhir’s lab, said there were concerns that the signal would be fairly weak. However, he and his colleagues found that once they were ingested, they clumped together within the cells, reflecting the ultrasound waves far more dramatically and providing a far stronger signal than anticipated.

Despite the optimism, it will probably be at least three years before the technique can be tested in humans.

http://www.redorbit.com/news/health/1112808074/nanotechnology-boost-regenerative-heart-medicine-032113/

One Drug to Shrink All Tumors

A single drug can shrink or cure human breast, ovary, colon, bladder, brain, liver, and prostate tumors that have been transplanted into mice, researchers have found. The treatment, an antibody that blocks a "do not eat" signal normally displayed on tumor cells, coaxes the immune system to destroy the cancer cells.

A decade ago, biologist Irving Weissman of the Stanford University School of Medicine in Palo Alto, California, discovered that leukemia cells produce higher levels of a protein called CD47 than do healthy cells. CD47, he and other scientists found, is also displayed on healthy blood cells; it's a marker that blocks the immune system from destroying them as they circulate. Cancers take advantage of this flag to trick the immune system into ignoring them. In the past few years, Weissman's lab showed that blocking CD47 with an antibody cured some cases of lymphomas and leukemias in mice by stimulating the immune system to recognize the cancer cells as invaders. Now, he and colleagues have shown that the CD47-blocking antibody may have a far wider impact than just blood cancers.

"What we've shown is that CD47 isn't just important on leukemias and lymphomas," says Weissman. "It's on every single human primary tumor that we tested." Moreover, Weissman's lab found that cancer cells always had higher levels of CD47 than did healthy cells. How much CD47 a tumor made could predict the survival odds of a patient.

To determine whether blocking CD47 was beneficial, the scientists exposed tumor cells to macrophages, a type of immune cell, and anti-CD47 molecules in petri dishes. Without the drug, the macrophages ignored the cancerous cells. But when the anti-CD47 was present, the macrophages engulfed and destroyed cancer cells from all tumor types.

Next, the team transplanted human tumors into the feet of mice, where tumors can be easily monitored. When they treated the rodents with anti-CD47, the tumors shrank and did not spread to the rest of the body. In mice given human bladder cancer tumors, for example, 10 of 10 untreated mice had cancer that spread to their lymph nodes. Only one of 10 mice treated with anti-CD47 had a lymph node with signs of cancer. Moreover, the implanted tumor often got smaller after treatment—colon cancers transplanted into the mice shrank to less than one-third of their original size, on average. And in five mice with breast cancer tumors, anti-CD47 eliminated all signs of the cancer cells, and the animals remained cancer-free 4 months after the treatment stopped.

"We showed that even after the tumor has taken hold, the antibody can either cure the tumor or slow its growth and prevent metastasis," says Weissman.

Although macrophages also attacked blood cells expressing CD47 when mice were given the antibody, the researchers found that the decrease in blood cells was short-lived; the animals turned up production of new blood cells to replace those they lost from the treatment, the team reports online today in the Proceedings of the National Academy of Sciences.

Cancer researcher Tyler Jacks of the Massachusetts Institute of Technology in Cambridge says that although the new study is promising, more research is needed to see whether the results hold true in humans. "The microenvironment of a real tumor is quite a bit more complicated than the microenvironment of a transplanted tumor," he notes, "and it's possible that a real tumor has additional immune suppressing effects."

Another important question, Jacks says, is how CD47 antibodies would complement existing treatments. "In what ways might they work together and in what ways might they be antagonistic?" Using anti-CD47 in addition to chemotherapy, for example, could be counterproductive if the stress from chemotherapy causes normal cells to produce more CD47 than usual.

Weissman's team has received a $20 million grant from the California Institute for Regenerative Medicine to move the findings from mouse studies to human safety tests. "We have enough data already," says Weissman, "that I can say I'm confident that this will move to phase I human trials."

*Correction, 2 April 2013: One reference to the compound used to treat mice was previously named as CD47, but in all cases was the antibody to that protein, anti-CD47.

http://news.sciencemag.org/

Mice 'cured' of lung cancer with gene therapy

By blocking production of a protein which drives the development of tumours, researchers were able to eliminate the tumours without any evidence of adverse sideeffects.

The study found that the treatment was effective even after several rounds of therapy suggesting that the mice did not become resistant to it – a major problem for cancer doctors.

Scientists now hope to adapt the treatment into a form that is suitable and safe for use on humans so that its effectiveness can be tested in clinical trials.

Dr Laura Soucek of the Vall d'Hebron Institute of Oncology in Barcelona, who led the study, said: "We're so excited about reaching this turning point and I am quite certain that it will change the course of cancer therapy, despite there being a long road ahead."

The therapy targeted a protein known as Myc, which plays an important role in our cells but can lead to uncontrolled cell growth and the onset of cancer if it is overproduced by the body.

Mice were given an antibiotic in their drinking water which activated a mutant gene known as Omomyc, and this in turn blocked the production of Myc.

Previous studies had already established this procedure for inhibiting Myc, but there were concerns it could have serious sideeffects.

In the new experiment, described in the Genes and Developmentjournal, Mice with up to 200 lung tumours were given the therapy for four weeks, followed by four-week rest periods for more than a year.

After the first treatment all the mice's tumours disappeared, but 63 per cent then relapsed. Following the second treatment, only 11 per cent of the original tumours resurfaced. After eight therapy cycles, only two tumours could be identified.

Dr Soucek said: "The most important finding was that there were no signs of resistance to treatment. This is one of the biggest disadvantages of many anticancer therapies: the disease develops resistance and can return even more aggressively.

"The fact that the results are maintained over time, that there is no tumour relapse and no resistance, suggests that Myc-targeted therapy may offer an unprecedented way forward."

Francesco Pezzella, Professor of Tumour Pathology at Oxford University, who was not involved in the study, said it was a promising proof of concept but cautioned that the approach was not directly applicable to humans.

"It would be a good idea in humans to try and find a way to block that gene," he said. "But the way they have done it is not possible in humans because it requires a modified gene which is inserted inside the [mice's] cells.

"It gives the green light for pharmaceutical studies to try to find a compound that can block this gene...but whether it would be possible to block it in humans is still completely unknown."

http://www.telegraph.co

Interview With Atlanta Startup Medicast, The Uber Of Healthcare

14 Statistics on Physicians Considering Concierge Medicine

Nearly 7 percent of physicians nationwide are considering moving to direct pay or concierge medicine in one to three years, according to a recent survey conducted by Merritt Hawkins.

The survey received responses from 13,575 physicians across the nation. It revealed that 6.8 percent of all physicians are considering concierge medicine.

The following is a breakdown of how many physicians are considering concierge medicine, by type and states selected by Merritt Hawkins:

Type

Primary care: 7.7 percent
Male: 7.1 percent
Female: 6.4 percent
Specialists: 6.4 percent
Employed physicians: 4.5 percent

Select states

Texas: 10.6 percent
Florida: 9.1 percent
New York: 8 percent
California: 6.7 percent
North Carolina: 5.6 percent
Illinois: 5.3 percent
Washington State: 4.8 percent
Pennsylvania: 4.5 percent

http://beckersspine.com/

Employers Developing Reliance on Direct Primary Care Providers Like Qliance

As states gear up to establish health insurance exchanges by 2014, one provision in the federal health care reform law has gone largely unnoticed. Yet experts say it could open the door to a new medical practice model called direct primary care.

Direct primary care is viewed as one way to improve access to affordable health care by charging patients a monthly fee of less than $100 for unlimited access to primary care, eliminating the need for insurance. It will be available to consumers on the state health care exchanges established by the Patient Protection and Affordable Care Act.

IT'S NOT ALL COFFEE AND COMPUTERS AS HEALTH CARE INNOVATION THRIVES IN WASHINGTON STATE

The medical-homes concept and more help bolster Washington's position as a health care leader.

Although it may be new to most people, direct primary care has been flourishing in Washington state since 2007 when physician Garrison Bliss opened the first practice.

The concept initially was not universally embraced by state officials who were concerned that direct primary care would "cherry pick the wealthiest and the healthiest" patients, Bliss says. There was also confusion over how these practices would be regulated. Despite the skepticism, Qliance had the support of some influential believers, such as Amazon founder Jeff Bezos and Dell Computer pioneer Michael Dell. Both are major investors in Qliance, which declines to disclose its revenue.

Today Qliance operates five clinics in Washington. The largest is in Seattle, which employs six full-time doctors and a nurse. As of 2011, there are 24 direct primary care practices in the state serving 10,525 patients.

The concept has proven to be popular among small and midsize employers, many of which pay for part of their employees' membership fee. About 60 percent of Qliance's clients come from small to midsize businesses and unions, but the company is in negotiations with a major employer that wants to develop an onsite direct primary care clinic.

http://www.workforce.com/       

http://www.google.com/

HealthTap Buys Avvo’s Health Business, Looks To Become The Go-To Resource For Medical Advice, Info

Instead of anxiously searching Google or WebMD, people would rather turn to a real human being for answers to their pressing health questions — preferably one who’s been to school for 10 years. The problem is, of course, that visits to the doctor’s office cost money. Plus, you need an appointment and you’ll probably sit in a waiting room. Wellsphere’s Ron Gutman founded HealthTap in 2010 to give anyone and everyone the opportunity to consult with human doctors in realtime, for free.

But the real, big picture goal, the HealthTap founder says, is to become the go-to resource for reliable health information — a mission that has led to the development of a searchable doctor directory (complete with ratings, peer-reviews and direct booking) alongside its HIPAA-secure Q&A offering. With plenty of cash in the bank, HealthTap has been looking for ways to expand its knowledge network and is doing so today by making its first acquisition.

HealthTap announced this morning that it has acquired Avvo Health in an all-cash deal. While the specific terms of the deal weren’t revealed, Avvo will be turning over all assets of its health business to they buyer and will be shutting down its health vertical beginning today.

For those unfamiliar, Avvo is a Benchmark-backed Q&A portal and ranking service that initially focused exclusively on lawyers. In 2010, it expanded to include doctors, offering a ratings directory for 90 percent of the doctors in the U.S. along with profiles that include information on their education, residencies, board certification, etc.

Like HealthTap, Avvo’s Health service also included a Q&A service in which users can ask anonymous questions of its network of physicians, as well as a library of health guides covering a host of topics.

But more recently, Avvo has been looking to get back to its core competency and move out of the health business altogether, making it an attractive acquisition candidate. By scooping up Avvo Health, HealthTap has expanded its Medical Expert Network to more than 30K licensed U.S. doctors and dentists, broadening local coverage to all 50 states in 128 specialties — along with hundreds of additional group practices and hospitals.

The acquisition is a win for both companies, giving Avvo some extra cash with which to continue growing its legal business, in turn allowing a company that’s on the rise (and actually focuses on health) to quickly add depth to its information network. Plus, HealthTap’s dentist directory has been pretty bare-bones up to this point, making Avvo’s comparative strength in this area particularly appealing.

As a result of the acquisition, HealthTap now counts 1.2 million doctors and dentists in its network, making it one of the largest mobile physician directories and Q&A portals on the Web. The startup has raised $14 million in venture capital to date from Eric Schmidt’s Innovation Endeavors, Mohr Davidow, Mayfield Fund, Esther Dyson and Aaron Patzer.

http://techcrunch.com

HealthTap Brings Transparency, Peer Review and Merit-Based Ratings to Help Consumers Identify the Best Doctors for Them

 HealthTap, the company putting the care back into healthcare by connecting people directly with a network of 16,000+ U.S.-licensed physicians, today unveiled its Top Doctors Competition to provide visibility into the quality of care doctors provide. For the first time, consumers will be able to find the Top Doctors for any health issue, specialization or procedure based on the ratings provided by other doctors who have the expertise to make qualitative judgments on their peers.

"It's extremely challenging to select the best doctor for a specific issue. If you want to choose a movie or a pizza shop, there's a world of sites and reviews to help. But there's nowhere trustworthy to go with a vital concern like your health," says HealthTap CEO Ron Gutman. "We've created a comprehensive, high-quality and impartial voting and ranking system to help people find the top doctors who are also the right fit for them. This is a transparent and meritocratic alternative to all the doctor reviews out there that are based on non-qualitative factors."

Through the new feature, doctors and patients can have their say in determining which doctors are best in a wide range of medical topics from oncology to pregnancy and from headache to hip replacement surgery and beyond. Health consumers everywhere will benefit from the resulting ratings that combine the expert estimation of doctors' qualified peers with patients' votes on softer qualitative factors such as bedside manner.

Doctors and people are encouraged to nominate and vote for the physicians they hold in high esteem by going to www.healthtap.com/vote/learnmore and creating a free HealthTap account. Here's how the two-track voting will work:

Doctors can judge their peers based on their knowledge and expertise. They will rise in the rankings based both on their peers' votes and the quality of the knowledge they disseminate on HealthTap.

Consumers provide balance to the picture by rating characteristics other than medical expertise such as bedside manner, personality, sense of humor and empathy.

HealthTap is already the most trustworthy place online to access the top health information, most cutting-edge research and best doctors for any health issue. By involving millions of doctors and patients in transparent physician ratings, it will also be the premier destination for anyone looking for an objective, qualitative 360-degree view of the best doctors in the nation.

About HealthTap HealthTap is the only source of health information that puts people and doctors first. The company offers immediate access to relevant, reliable and trusted health content that is kept current through daily contributions from top physicians. Its web and mobile app connects HealthTap's Medical Expert Network of 16,000+ high-quality U.S.-licensed doctors with people seeking answers to their health-related questions. Sign up for a free HealthTap account and download their app for iPhone, iPad or Android at www.healthtap.com .

http://www.marketwatch.com

Medical app HealthTap launches feature that lets doctors translate medical research for the masses

HealthTap, an app allowing users to ask questions of a community of more than 15,000 medical doctors, is beefing up its mobile and Web application. It is integrating the wealth of published medical data in the National Library of Medicine’s PubMed database with its existing services.

The doctors cannot offer diagnoses to patients on HealthTap, but they can answer questions as more people turn to the Web for medical information.

The company announced Monday that it is integrating research from peer-reviewed medical journals into its network of doctors, allowing them an opportunity to respond to users’ questions and to translate medical research from doctor-speak to plain English.

The explanations doctors provide are — like their advice — rated by their peers. The better the community deems their colleague’s contribution to be, the higher their rating. In that way, the app serves as both informative for users who need advice on health issues and, potentially, great public relations for doctors in search of new patients.The new feature, called “MedPubs,” now offers the entire PubMed database and the peer-reviewed research submission and rating feature. The research database is indexed, with relevant research filed under a “known-for” list available via a doctor’s profile page.

HealthTap also offers a paid ($9.99) private messaging service, where users can speak with a doctor one-on-one. The service, according to chief executive Ron Gutman, is the first HIPAA-secure platform for mobile and desktop Web to be provided by a company.

“We’re extremely excited about the release of HealthTap Medical Publications, because it does something meaningful and important – it truly democratizes the highest quality medical knowledge,” Gutman said Saturday.

Gutman added later that “hundreds of new doctors” have joined the app as well as a “huge number of new signups from users.”

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Have a pressing medical question? There's an app for that:

(Credit:HealthTap)

(CBS News) When most people have a medical question, they head to the doctor's office. But, what if instead you could type out a question in your phone and have it answered by physicians without leaving your home or office? What if you could go a step further and send test results to a specialist on a weekend and receive a personalized explanation in your inbox?

That's exactly what HealthTap is attempting to do for its users. The website and app, available on iPhone, iPad and Android, connects regular people with more than 14,000 U.S. licensed physicians in 115 different specialties who can answer questions about medical concerns. It's not the only app out there attempting to answer patient's pressing questions, but it claims to be the only one that contains a HIPAA-secure feature to send out medical records, meaning that private conversations you have with a doctor are considered confidential.

While founder and CEO of HealthTap Ron Gutman's experience is in business, he's worked with organizations including Stanford University on their personalized health care systems for about a decade. What he realized over that time was people turn to the Internet for their health questions. Google had reported receiving 1.4 billion searches on health every month, and more than 80 percent of people reported using the Internet for health information, according to a PEW survey. That same survey revealed that 59 percent of people with chronic conditions and 40 percent without called online health information useless.

"If people already go to the Internet, let's figure out why they are so disappointed, why they are so unhappy with the information they find," Gutman told HealthPop. "We started doing research and focus groups and discovered that people find a lot of information on the Internet, but they don't know who to trust because every search that you are running (pulls up) multiple websites, and everyone says something else."

What people said they trusted were doctors: More than 90 percent of surveyed participants said they honored their physicians' opinions the most.

The way HealthTap works is any user can ask any question, which will be answered by one of the physicians, who are all screened and guaranteed to be in good standing. The question and answer (but not the asker's name or account) will be posted publicly for all the other registered members to see.

"HealthTap is the only place on the Internet... that you can ask any questions and you can get an answer from a U.S. licensed physician sometimes in minutes but definitely less than 24 hours for free," he said.

(Credit: HealthTap)

However, if a person wants to ask a personalized question to a particular doctor or send along their charts, they'd have to pay a small fee, usually $9.99. Using the apps system, they would be able to upload pictures and medical documents to further explain what they are asking about. A free clarifying question or two follow-up questions at $5.99 each are allowed. The questions are guaranteed to be answered with 72 hours or the person gets their money back. All private correspondence in this platform is considered confidential.

While paying $9.99 for a question may seem costly, Gutman explained that the average person who doesn't have insurance pays about $200 each visit and co-pays average out to about $29. Seeing that 25 percent of all doctor's visits are just patients asking questions, he feels the app not only saves time for both parties but also provides quick, accurate reassurance.

Dr. Patrick Weix, an obstetrician/gynecologist in Irving, Texas, who is one of the doctors featured on HealthTap, liked using the app, but didn't realize how valuable a tool it could be until he answered a question from a woman asking if antidepressant medication was safe for pregnant women. A few days later, the woman was thanking him in his office for his quick response - he hadn't recognized her on the app as one of his patients. She told him that she didn't want to call anyone about the question even though it was bothering her because it was the weekend, but the app allowed her to get her concerns answered quickly.

The app may also help curb incorrect self-diagnoses, which have been spurred by the ease of searching for medical conditions online or finding answers that may not pertain to a specific case. One time, Weix noticed a message from a young woman who was concerned that she might be pregnant because she had unprotected sex. She had looked up some symptoms online, and even though she had her period and tested negative on a pregnancy test, she was still concerned. While Weix reassured her that there was a very minute chance she was pregnant, he realized that the symptoms she was experiencing might be from an STD and urged her to get tested.

With so many symptoms shared by a variety of diseases, just searching for what you are experiencing online might not give you a correct diagnosis, Weix said. While HealthTap doctors can't 100 percent tell you what's going on with you, they can at least steer you in the right direction.

"If you have headaches, fever and a cold, you can have anything to dengue fever to Ebola to sinusitis," Weix explained. "But, it's not likely that you have dengue fever or Ebola: You probably have sinusitis."

Dr. Bradley Flansbaum, an internist at Lenox Hill Hospital in New York City, agrees with Weix. Although he is not involved in HealthTap, he can see benefits of doctors helping people find out what's wrong with them without the patient having to pay a fee or take time out of their daily lives.

"There are countervailing forces," Flansbaum said. "We can dwell on the negative of people doing their own research, but what about the features in which people do their own research and avoid expensive trips to the emergency room and get their questions adequately answered and get a better sense of well-being?"

There are some benefits for physicians as well. Gutman explained that if a person likes answers from a specific doctor, they can set up an appointment with him or her directly. 

But what Weix finds most helpful is reading other doctor's explanations about medical terminology. He said it's often hard to explain procedures to the average person without slipping into complicated scientific words and concepts. For example, he'd have difficulties describing what organs are removed for different types of hysterectomies, but now he uses another doctor's simplified answer he found on the site.

"It's really a good way to explain it so most people can understand it," he said. "There's a reason why not everybody goes to medical school. It takes a lot of time, but a lot of people have these problems."

Still, Weix doesn't tell all his patients to jump on the app and ask him questions any time they like. He admits that he's only answering questions a couple times a week, and that if someone wants a response from him, they're better off contacting him directly if it's an emergency or setting up an appointment for an answer. That's part of the problem of the app, he pointed out: A lot of times, the best answer for the question is that the person should make an appointment and see their medical provider.

"I don't think it's the be all and end all," he explained. "I don't think that's it's the answer to all health questions, but I do think it is a good way for physicians to get and answer questions."

Flansbaum added that medical apps like HealthTap are exciting and new technology and the positive or negative impact on the health care industry won't be known for quite some time.

"We're in an early phase of app development and the use of different kinds of platforms of medical care," Flansbaum said. "To render opinions on what will work and what won't work is premature. We're going to have test these things and see how it goes."

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