Cleveland Clinic Alumni Magazine on AskDrWiki.com

Wiki is a Hawaiian word for “fast”, and cardiologist Ken Civello, MD, is all about fast. When he wants information, he wants it pronto. And a year ago, he decided to do something about it.

Along with cardiology colleagues Brian Jefferson, MD, Shane Bailey, MD, and Michael
McWilliams, MD, Dr. Civello established AskDrWiki.com, a non-profit, grassroots, physician-run, physician-maintained online community to publish review articles, clinical notes and medical images.

Modeled after the popular online encyclopedia, Wikipedia, the four doctors thought it would be a great way to share information with each other. Doctors have been consulting each other for years. Dr. Civello thinks those consults don’t always have to be face to face. When the idea came to him, Dr. Civello says it was truly like a light bulb appeared above his head. “In medicine we are constantly looking to share information across long distances,” he says. “I couldn’t believe no one ever thought of this before.”

Dr. Civello says he had no idea others would embrace the idea so quickly. “I knew it was a good idea,” says Dr. Civello,“but I sure can’t say I thought it would have the legs that it has.” Once the doctors realized its potential, they had to decide if their wiki would stick strictly to cardiology or expand to include other fields. “We figured that as long as we had doctors in other specialties willing to review all the articles, we should definitely expand,” he says. The site now addresses Now an average day brings close to 500 visitors—a total of 82,000
telling him who is searching and why. “Mostly it’s doctors and medical students, residents and interns brushing upon a topic,” he says.

Early on, there was some doubt about the ability of a site like this to provide accurate information. The four doctors responded promptly to constructive criticism. In order to safeguard the site, Dr. Civello now has established a detailed editorial policy, a review process, verification of the credentials of contributors and lists the names of all online editors on the site. Each specialty has an editor assigned to police the data, and all content is constantly under review.

Dr. Civello loves to log on to see who is visiting the site. Over half of the visitors are from outside the United States. “You really see the impact that the ability to provide free medical information has on other communities,” he says. “A lot of places in the world don’t have the kind of access we have to information. Now, if you have a laptop and a cable, you can get the medical information you need.”

The four cardiologists now are located in different states. Dr. Civello is in Louisiana, Dr. Jefferson is in Tennessee, Dr. McWilliams is in Delaware and Dr. Bailey continues at Cleveland Clinic. AskDr.Wiki.com keeps them in close contact.

For now, they continue to run the site. But eventually, Dr. Civello says they would like to hook up with an institution that would embrace and help direct the site. Dr. Civello figures he’s been staring at computer screens for about three decades. At 35, he says he doesn’t remember when there were no computers. “From the time I was in kindergarten, I had access to a computer,” he says. “It was very new at that point. As the current generation comes of age, they will really demand to have quick, accurate access to all types of information.”

Dr. Civello considers this type of information crucial to the medical field. “We spend an enormous amount of money and time publishing medical textbooks, and by the time they are actually available, much of the information is old,” he says. “A lot of medical information changes way more quickly than that. The goal is to get to the point where information is updated on a daily basis. “What Wikipedia has done for the encyclopedia is what I would hope to do for medical textbooks.”

American College of Physicians Article on Medical Wikis

Another article was recently published by Jessica Berthold on medical wikis, called Living in the brave new world of medical wikis.

Cleveland Plain Dealer Revisits AskDrWiki

It has been eight months since an article appeared on AskDrWiki appeared in the Cleveland Plain Dealer. I was interviewed by Brie Zeltner last month regarding our progress and a follow up story was published this week discussing how we have fared this year. We are very excited to see the progress that we have made in 2007 and hope that in 2008 we will continue to grow and become a leading source of free and credible medical information.

Ask Dr Wiki Receives Not For Profit Status!

It has been close to a year since we started AskDrWiki.com. One of our initial objectives was to obtain 501(c)(3) status from the IRS. After filling out what seems like thousands of forms we received our letter from the IRS this week approving us as a non profit company. I hope that this will help increase collaboration and contributions by removing the perception of a financial interest and allow us to continue on our mission of creating a free online source of up to date medical information.

Another Lesson Physicians Can Learn from their Kindergarden Teachers

Free Online Wiki could Save Schools Billions
An article in the USA Today by Greg Toppo, describes how Free-Reading.net, a wiki reading program for kindergartners and first graders may make big, bulky - and expensive - textbooks go the way of the film strip. The wiki which allows teachers to post their own lessons, comments and modifications has been approved by a textbook adoption committee in Florida and is awaiting approval by the state’s incoming education commissioner.

Since Florida is one of the five textbook markets in the USA, its move could lead to the development of other free materials that might someday challenge the dominance of a handful of big education publishers. Schools spend $4.4 billion for textbooks in the 2006-2007 school year, so the prospect of free state approved materials could have profound influence on how schools spend money.

Can healthcare providers learn a lesson from our Kindergarden teachers using Free-Reading? We hope so! If the medical information that is published on a medical wiki is free and high quality it will be hard to ignore.

The Cost of Medical Information....Priceless

Cost of 5 new textbooks............................................ $750
Cost of First Year Subscription to Up to Date....... $495

Having all of your Medical Information Stored on a Medical Wiki for Free.....PRICELESS


Medical textbooks and subscription based medical websites, such as Up To Date consume an enormous amount of dollars from physicians, nurses and medical students yearly. I recently purchased several textbooks with a average purchase price of $155 per text book and it is not unusual to find some medical textbooks to be priced in the $200- 300 range. Since my medical training started I have noticed a creep in the cost of textbooks which are likely due to more graphics, color photos, and bundling of books with a CD-ROM, but should we expect medical students, nurses, and residents to continue to pay these prices on little to no salary?

For the residents and students who have a library who will pay the cost of a site license for subscription based site, such as Up to Date, they are a great source of information. For users who work in smaller hospitals or clinics the price of $495 for an individual subscription to these services can be prohibitive.

A wiki, on the other hand with 500 GB of storage cost less than $100 a year. This amount of storage would equal 51 million pages in a medical text book. That is a lot of information and could be a potential huge savings for medical professionals.

Are Physicians Starting To Wiki a Diagnosis?

The BMJ article on Googling for a diagnosis published last year brought attention to the use of the internet to help make the correct diagnosis. We have also noticed a trend that we have seen on AskDrWiki, which is use of the word "wiki" that accompanies a medical search query. We have had over 1400 queries this year in which a medical term was linked with the word wiki.

Such as "cardiac index wiki", "empiric trial wiki", "amyloidosis wiki", or "captopril wiki". Clearly medical students, nurses, and physicians are not only Googling for a diagnosis but they are also directing their search toward a wiki.

We hope that we can help make another tool for the physicians bag that can help diagnose difficult cases.