The advances in digital medicine described in this special report have already started to move patients from the margins of the medical system to its centre. Some think there are bigger things to come. "The key is patient-driven research," explains Gregory Simon, head of Faster Cures, an advocacy group in Washington, DC. Most of the push for adopting electronic health records has come from institutions anxious to cut costs and reduce medical errors, but he thinks the biggest gains will come in the shape of better treatments for difficult diseases. He sees patients increasingly getting together online and sharing medical data and treatment histories.
On a website called PatientsLikeMe, members from around the world swap stories about their ailments and discuss subjects like adverse drug interactions, dosing strategies, new drugs and trials for more than a dozen diseases. A report by the California HealthCare Foundation, a think-tank, argues that in dealing with multiple sclerosis, a neurological disorder for which there is as yet no cure, "the collective wisdom on this website may rival the body of information that any single medical school or pharmaceutical company has assembled in the field."
Mr Brown of Ideo argues that until recently the flow of information in medicine has tended to be one way. In future, he thinks, medical knowledge will increasingly flow in many directions. Mr Brown points to a proliferation of health blogs, online groups and peer-to-peer portals as a sign that the age of social networking in medicine has arrived. Google already has a feature that allows users of its EHRs to share their health information with others.
It is easy to be sceptical about such online communities. A fatal illness will not be cured by Twittering about it. And for many people nothing will replace the personal relationship between a patient and his doctor. But it seems clear that patients are going online to get more information on their illness, to see what other consumers think of new medications and to get emotional support from fellow sufferers.
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