Zeiger’s Smart Patient Approach: Ask for Nothing. Provide Value. Ask for Something.

Optimized-RoniZeigerIn preparation for Health:Refactored, our code and design focused conference taking place May 13–14, we sat down with CEO of Smart Patients Roni Zeiger, MD. His talk “Data and Context” will take place during “Dreaming of Data: Big, Open, & Interoperable – Part II” on May 14. Follow the Health:Refactored speaker interview series here.

Q. Your particular segment within this panel is about how an obsession with data can create problems. So now data is getting in our way? How did we get here?

A. I think part of the problem is we’re still not sure what data we need. Being appropriately opportunistic geeks like many of us are, we get good at analyzing the data we have. It’s important to take a step back and remember that in medicine, we still don’t have a very good understanding of exactly how to measure quality.

What we sometimes end up doing, I think, is measuring what we can measure and making assessments of it and not quite often enough asking the questions: are we measuring the right thing, how do we know, and why does it matter?

Q. Can you specifically talk about your approach to data with your new startup Smart Patients. You made a point of saying that you’re collecting unstructured data. 

Our site isn’t designed to collect data per se. It’s designed to help cancer patients and caregivers have conversations with each other and learn from each other. But ideally the technology gets out of the way from the users’ perspective and just facilitates conversations, provides some tools to help people have richer conversations.

One thing I think we’re going to try to resist is asking people a lot of questions that are essentially asking them to fill out structured data forms. And instead help people have more and richer conversations, and of course, there’s a lot of data — explicit and implicit — within conversations. It just doesn’t have to happen to be in a super structured way.

But over time it’s getting easier and easier to pull structured data out of conversations. So our bias is going to be, let unstructured data flow, and force ourselves to be smart and spend the appropriate resources to learn what we can from that data, even though it wasn’t delivered in a pretty structured format.

Q. And what would be wrong with asking people to fill out structured data forms?

A. I think it’s fine to ask, but I think most humans are appropriately selfish, really. And the question is, if you’re asking me to fill out some data, the question I’ll ask myself as a user is, what am I going to get out of it? And I think too often, certainly in the health space, we build systems that say, OK answer these 16 or even six questions and then something good will happen.

But it’s not clear yet to the user what that good thing is or whether it’s going to be worth it. And so a lot of people walk away at that point. What we really want to do is, while there are of course more clever things we could do if we knew even more structured information about somebody’s context, we’d really like to start with a much gentler, cleaner slate, We want to say, look there are rich conversations going on here. Really smart people are answering others’ questions, so ask a question and someone will answer it.

And over time, you can imagine that we might say, oh look, you’ve mostly been looking at questions about melanoma, it seems like you might also be interested in x,y, and z. People with melanoma are often talking about these other topics. Then over time we can say, we can provide you additional value if you give us a little bit more information. But from the beginning, we want to ask people for nothing and start giving them value. I think we forget to do that sometimes when we build products in the health space.

Q. One of the main features of your site is a clinical trial search engine. Can you talk about some ideas you have for making clinical trial search more effective?

A. This actually wasn’t our intent. We started just building the conversation platform the way we thought it ought to be, and one of the first pieces of feedback we started getting consistently from the initial community was, because this is oncology and because we’re doing as much homework as we can about what our treatment options are, we’re talking about clinical trials a lot. We’re frankly unsatisfied with what we can do with clinical trials.gov. It’s hard to use and there are a bunch of things that we want to do that it doesn’t support.

And we took that to heart and built a clinical trial search engine into the conversation platform. And we built it so that it works as a standalone as well. But the real idea is that we want to make it easy for cancer patients to find trials and discuss them. It’s what they’re doing anyway, and we want to facilitate that.

The idea is that, from any clinical trial page that you might find through the search engine on Smart Patients, you can start a conversation about that trial, and before too long, join an existing conversation about that trial. And we think there’s an interesting intersect in there between the somewhat structured and more officially sourced data about the clinical trial, combined with the less structured narrative from informed patients.

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