While European governments are trying to network health systems, doctors are increasingly using the internet to establish professional medical communities. ‘Web 2.0’ is finally arriving at the MD level in Europe, creating considerable interest from industry players.

Europe is a little late in constructing medical communities online. English language services, such as Doctors.net.uk in the UK or Sermo.com in the US, have tens of thousands of users already. Nevertheless, Europe is beginning to catch up. In Germany for example, a number of services have sprung up recently, some of which have clear international ambitions.

“Web 2.0-plattforms for medical doctors are all about improving communication among doctors. Doctors do not have proper political representation in times of tight budgets, and thus they need to join forces in different ways”, says Nikolaus Gentner-Esch, founder of Dooox.de, a leading doctor specific German Web 2.0 community. About one year after its launch, around 3,000 doctors are now using the service, priced at €99 per year.

Online networking and knowledge pooling

Dooox offers networking possibilities for its members in much the same way as Xing, the former OpenBC, does for a broader professional target group. “We have been especially careful in recruiting a broad spectrum of medical experts both from Germany and from abroad in order to make it attractive to be a paying member of the community”, Gentner-Esch told E-Health Europe.

Apart from the networking possibilities, doctors can debate medical issues and health policy using discussion forums. They also have the ability to create closed communities within Dooox, enabling them to use the platform for a variety of communication purposes.

A good example is Interplast, an international non-profit organisation of plastic surgeons and anaesthesiologists. These specilaists use the Dooox infrastructure for coordinating philanthropic medical interventions for patients in the developing world who do not have the money for regular care.

“The possibility to form closed communities is certainly an important aspect of Web 2.0-services for doctors”, stresses Felix Rademacher, founder of Coliquio.de. His website has managed to attract around 700 doctors, in the few months since launch. Coliquio takes a slightly different approach from Dooox, as it enables doctors remain anonymous and use the platform, among other things, for critical incident reporting (CIRS).

“Hospitals or regional health networks use Coliquio to form closed CIRS-communities”, says Rademacher. Doctors can upload patient data, including radiological pictures, in order to discuss with colleagues or just inform them about critical situations or treatment errors. It is also possible to post CIRS cases anonymously in the regular discussion forum and benefit from the feedback of colleagues from different institutions and specialities.

Knowledge sharing among medical specialists is also the focus of Esanum.de, with around 4,000 medical doctors registered as users in Germany. Like Dooox, where the provider is currently working on an English version, Esanum is looking to expand globally. A Spanish version, Esanum.es, went live in Novermber 2006 with an Italian version planned for 2008.

Success and the role of industry

The question remains of which business model, if either, will be successful. Coliquio and Esanum currently offer their services free of charge, but both have plans to create premium content, in areas such continuous online medical education. “We are also actively watching out for partners among medical publishers that might be interested in the content our users are generating”, stresses head of Esanum, Max Renneberg.

Dooox has similar plans: “We are planning to cooperate with publishers. But they have to be chosen very carefully, because many of the professional medical publishers are a bit too cosy with the pharmaceutical industry”, says Gentner-Esch. Independence both from industry and politics is a key factor for success, and is a notion generally agreed by all providers of Web 2.0 services for doctors.

Still, industry remains an interesting partner for the new online communities. One possibility is that industry pays for product specific discussion forums, accessible by community members, but clearly separated from other content. The pharma industry could also provide specific education and training via the portal, as Microsoft is already doing with its Office products at Dooox.

Banner advertising and paid for content in community specific search engines are options that are under discussion, as are advanced web-based online training courses for doctors. “At Dooox we are planning to offer open university style studies for doctors who want to acquire an additional title together with a German Medical School from 2009 onwards”, says Gentner-Esch.

The the pharmaceutical industry in particular, is keeping an eye on the new communities, as highlighted by the example of the US-community Sermo.com, which claims more than 30,000 medical doctors registered. Sermo recently announced a collaboration with Pfizer for e-detailing, though no details of the value of the deal were disclosed. The collaboration gives Pfizer an additional means to inform doctors directly about its products and about new clinical data. In addition to this, Pfizer is hoping the communication will be interactive and to get back relevant information from the online medical community.

“In the long run, one could imagine that these Web 2.0-services are used to gather data on physician’s experiences with new drugs, very much like what is done with the traditional and far more expensive Phase IV-studies”, says Franco Fracella, an independent E-Business consultant with previous experience as a manager in the pharmaceutical industry. Pfizer, at least, is already planning to engage with the FDA to define guidelines for the use of social media in communication with healthcare professionals.







Philipp Grätzel