Interview with Dr. Marlene Beggelman, Founder of Enhanced Medical Decisions, Inc. (transcript)

This is a transcript of my recent podcast interview with Dr. Marlene Beggelman.

David Williams: This is David Williams, co-founder of MedPharma Partners and author of The Health Business Blog.

I spoke earlier today with Dr. Marlene Beggelman, founder of Enhanced Medical Decisions. Her company has just released a public beta version of DoubleCheckMD, a free web-based tool that enables users to enter their medications and symptoms to identify possible drug interactions and adverse effects.

The tool uses advanced natural language search technology to instantly compile and organize information that would otherwise take hours to pull together and interpret. Dr. Beggelman and I spoke about how the system can be used, plans for integration with other tools, and the company’s business model.

Marlene, thanks for being with me today.

Marlene Beggelman: Thank you very much, David. It’s great to be here.

David: What is DoubleCheckMD?

Marlene: DoubleCheckMD is a website where anyone, either a professional or a layperson can look up their medications and ask if any of their medications could be causing any of the problems that they’re experiencing.

David: How is that different than the tools that are out there now to, for example, check drug/drug interactions?

Marlene: There’s a large difference. Most of the tools that check drug/drug interactions will only tell you whether your drugs could be interacting. But, they won’t really give you information. If you’re having a problem, they won’t specifically tell you if the drug interaction could be causing that particular problem that you’re experiencing.

It’s interesting. You can be taking a couple of drugs. There could be potential interaction between those drugs. The information that you get is, “Oh, gee. These drugs could cause an interaction.” Then the product will tell you, these are the most common interactions that could be caused.

But in most cases that won’t be relevant for your particular case. Most of the time, those interactions don’t actually end up occurring. With our product, you can say, “I’m having a particular problem. Could these drugs either individually, or in combination, cause this problem?”

None of those interaction checkers will give you that kind of information.

David: What if I don’t understand the medical literature, I don’t know the right terminology and I can’t describe my symptoms? Can I still use the tool?

Marlene: Our tool will recognize any sorts of common ways of describing a symptom, and will also recognize the medical terms for those symptoms. So, you can say, “My head is killing me.” or “I have an ache on the side of my head.” The system will recognize that the drug that you’re on can cause a myalgia, a facial myalgia, and know that they’re related.

David: Do you expect consumers to use this on their own? Or is it physicians or pharmacists using it, or will there be some interactions among the different parties?

Marlene: The way we encourage the system to be used, we think that both clinicians –such as physicians, nurses, pharmacists– will find this tool very useful simply because they can’t look up this sort of information in any other way, anywhere. They can look it up, but it will take them hours of time. Hours more than it will take using this system.

When consumers use the system, we very specifically say that you really shouldn’t change your drugs on your own, but you should take this information to your caregivers to make sure that any change would be safe. Some drugs, if you stop them prematurely, or stop them too rapidly, can cause very serious side effects.

So, we encourage people to look up the information and bring it to their providers.

David: If I am taking five or 10 or 15 medications –and they all have a lot of potential side effects and a lot of potential problems– am I just going to be left with a laundry list? Will it actually be useful? Or, no matter what I see it’s going to say, “That could be causing the side effect and you need to discuss it with your physician.”

Or will it provide more useful, personalized information?

Marlene: The information that you get is highly personalized rather than the laundry list that you get right now with other products. One thing that many people are not aware of is that the average person, the average adult, in the United States takes five medications, if you count over the counter medications.

The other fact that many people are not aware of is that there really is an epidemic going on. There are so many wonderful new drugs available that can be very helpful. But, because of all these new medications, and people are taking so many of them in combination, there’s really an epidemic of adverse drug reactions.

I think the Institute of Medicine’s recent publication indicated that of hospitalized patients, adverse medication reactions were the third or fourth leading cause of death. It’s very common.

With our system, you can put in 10 drugs, 20 drugs, 30 drugs. I think for the most recent case we put in the person was on 17 drugs. You can look at all the information for those 17 drugs, or you can say, as this person did, “I’m experiencing this symptom. Could my 17 drugs, either alone or in combination, could any of them be causing this symptom?”

David: You mentioned adverse drug reactions being a leading cause of death in the hospital. Is it practical to expect that this system would be used within a hospital setting?

Marlene: Yes. If I were still practicing within the hospital setting, I would find a tool like this very useful. I could look to see if there was some puzzling symptom, some mysterious symptom and when we couldn’t figure out what the cause of it was and the person was on a lot of medications, I would find it enormously useful to be able to put in that symptom, see if the drugs were reported as the cause.

The system also tells you how commonly each of these medications could cause that symptom and under what circumstances it would be more likely. So I would find it enormously useful.

David: Do you expect that your tool will be used on a standalone basis or would it be part of an electronic health record or personal health record or e-prescribing tool?

Marlene: The system is easily used as a standalone, but there is more value to it when it is integrated with another record. And the value is that if the medications that you are on can be put into our system automatically through your record, then there is much less information that you have to enter as the individual user.

Also our system can accept medical conditions, so that a person who has a contraindication or reason that they shouldn’t take a particular medication because of their underlying medical conditions, we will be able to analyze that as well.

So, as the electronic medical record or the personal health record is able to input information to the system, it will just get smarter and smarter results out of it.

David: Are there other competing products that are out on the market either for consumers or for physicians? Do you think people will just copy what you are doing?

Marlene: I am not aware of any other products that are capable of doing specifically what our product does. I think that what we do is so useful that I assume that there are going to be companies that try to copy what we are doing but because of our underlying natural language recognition technology, I think we have a huge jump-start.

For example, another thing that our product is capable of doing is that we not only recognize symptoms, but we actually translate very complicated concepts from the original text.

So for example, if a patient comes in and they are told that their medications can cause a drug interaction, we will take the original medical text and we will translate not only what it says about the potential drug interaction, but we will also translate information about what symptoms to look for, when to be suspicious of a drug interaction occurring, under what kinds of circumstances you would want to speak to your physician, what kinds of blood tests might be recommended based on your specific symptom.

So, we go well beyond what another competitor might deliver and I think we are well poised to keep ahead of the pack.

David: And I understand that the tool is free on the web at the moment. Do you expect it to be something that is free forever or is this a charitable enterprise or do you expect to be able to generate revenue as well?

Marlene: We will be generating revenue and we will be generating it by eventually linking advertising over the Internet. And in our case, we will be able to use relevant advertising for our products since we will have information very specifically about the consumer.

On the B2B side, we think that the ability for us to automate the collection of the information to input the information about the drugs will be enough of a differentiator, so that we will be able to license our system on the B2B side.

David: Beyond having a company succeed financially, how will you measure if you have been successful or not?

Marlene: Our real measure of success is going to be the impact that we have on the lives of the people who are using this system.

What we really want to do is improve health care, decrease medication-related errors, and have a positive impact on people’s health. And the other impact that we would like to have is we think that if people really found our system valuable and used it, we would be a great source of outcomes information.

David: Are consumers ready for what you are doing or does there need to be some sort of a shift in the way consumers think about their interactions?

Marlene: There definitely needs to be a shift. Consumers are not used to getting the kind of information that we are delivering. In fact physicians aren’t used to getting the information that we are delivering. People are used to having their information delivered in a general format, in basically an electronic pamphlet.

What we are delivering is not only information, but information that is targeted specifically to the person. Not only information, but knowledge, where underneath the surface we are doing the analysis.

So this product is really a decision support tool that is doing the kind of analysis that you would expect from a human expert. And that is the paradigm shift that needs to happen for people who realize the value of the products that we are delivering. I am looking forward to the time when the expectations change.

David: I have been speaking today with Dr. Marlene Beggelman, Founder of Enhanced Medical Decisions and

Marlene, thank you very much for your time.

Marlene: Thanks so much David, I appreciate it.

November 19, 2007

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