Today is Residency Match Day, the moment when over 20,000 applicants learn where they have “matched” to pursue residency training come July. For the uninitiated, here are more articles on match day and the residency match process.

You can imagine the amount of jubilation surrounding this event. Stress- and anxiety-ridden medical students discover the light that follows their four years of slavery through medical school (little do they know that the slavery continues into residency, but let’s not spoil the moment). Families proudly rejoice the significant achievements of their loved ones. Friends find another reason to capture the excitement over a pint or two. And then … there are the overworked, overstressed, over-everything interns who look forward to their replacements arriving soon.

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On The Wards participates in this week’s Grand Rounds with our report on the weight loss management (WLM) clinical trial. Version 4.26 of Grand Rounds is hosted at Polite Dissent, and comes packaged with a theme of the Wild Wild West. The blog’s author is a family physician from Southwestern Illinois whose love for comics is also apparent in his other writings. Many previous posts provide excerpts of medical themes found in traditional comic book genres. This is indeed a unique and interesting feature of his blog.

It almost seems that a million-and-one books are published everyday touting the secret to rapid and sustained weight loss. But, how many of these diet schemes have been verified to produce the results they advertise? In the latest JAMA (Journal of the American Medical Association) issue, a group of academic centers involved in the Weight Loss Maintenance (WLM) initiative published their results from a three-year study comparing strategies for sustaining weight loss. The project is sponsored by the National Heart, Lung, and Blood Institute (NHLBI), and includes four clinical centers: Duke University, Johns Hopkins University, Pennington Biomedical Research Center, and the Kaiser Permanente Center for Health Research.

The design of the WLM clinical trial involves two phases. Phase 1 comprises a 6-month period where all participants undergo similar intervention to obtain weight loss. Working closely with a trained interventionist, the group strives to achieve a weekly weight loss goal of 1-2 pounds per week through a combination of strategies, such as caloric reduction, dietary modification, and increased physical activity. After having lost weight in phase 1, participants in the 30-month phase 2 trial are randomly divided into three groups, each with a different level of intervention to encourage maintenance of weight loss: 1) minimal intervention; 2) technology-based intervention, with use of an interactive website which sets personal goals, action plans, and provides an online support community; and 3) personal-contact intervention, involving monthly contact with a weight-loss interventionist.

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TechCrunch, a technology blog focused on Internet-related products and companies, reports on the brewing partnership between Healthline (medical information portal) and Aetna (health insurance company) to create a personalized health portal. Similar to the Google and Cleveland Clinic deal, Healthline will benefit from a rapid infusion of new users, comprising the thousands of individuals insured by Aetna. It is unclear what Aetna gains from this marriage, as additional details surrounding the collaboration are yet sparse. It seems that dynamic duos are now the trend to remain competitive in the personal health record (PHR) industry.

Related Posts:

• Google Health collaborates with Cleveland Clinic
• Industry giants vie for your online health records

Late last year, I met my new 64 year-old clinic patient who just moved into town. During a brief discussion about preventive health, I asked her when she had her last colonoscopy for colon cancer screening. She emphatically responded: “Never. I will probably be dead in 10 years anyway [from an unrelated cause]“. Her view on life may have been surprising, but her reluctance to obtain a colonoscopy wasn’t. Who could blame her? The prospect of having a scope inserted into the rectum and advanced through the colon is not appealing. Fortunately, there are alternate modalities for colon cancer screening, two of which (stool DNA and virtual colonoscopy) have just been added to official guidelines.

A consortium of specialty organizations (American Cancer Society, US Multi-Society Task Force on Colorectal Cancer, and American College of Radiology) recently published in CA: A Cancer Journal for Clinicians¹ the first consensus guidelines for colorectal cancer (CRC) screening. The guidelines are designed for asymptomatic average-risk adults over the age of 50; these criteria exclude individuals with a personal or family history of CRC, adenomas, inflammatory bowel disease (IBD), or other genetic risk factors.

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Google’s official blog revealed today some details and screenshots of its yet unreleased Google Health project, a web portal for your personal health records (PHR). It appears the site will provide more than just storage space for medical records. Complementary tools may include health information resources and a doctor directory. The two screenshots are only a first look into the new service, and it is likely that more features will be announced in future posts.

Related Post: Google Health Collaborates with Cleveland Clinic

Last month, I wrote an article on the brewing battle between Microsoft and Google to create the de facto portal for your online personal health records (PHR). It seemed that Microsoft’s HealthVault may have had the edge with its earlier deployment and collaboration with the Mayo Clinic.

In a move to equalize the playing field, CNN recently reported that Google Health will work with the Cleveland Clinic to store records of several thousand patient volunteers. Google has been relatively silent about its unreleased project, but I assume it will primarily serve as a portable repository of personal medical information, including demographic data, past medical and surgical histories, current medications, and allergies. It is reasonable to speculate that the web service would also store select test results and discharge summaries from participating hospitals. I doubt that the excruciating details of progress notes or consultations will appear in the near future.

Details about the Google Health project are largely unavailable to the public, but it is clear that both Google and the Clinic have potential to reap great benefits from this symbiotic relationship. Google will instantly acquire a user base in the thousands, while drawing consumers to its brand of products. More importantly, Google would create a working hospital-web service model to market to other health care centers. Hospitals are the natural gold mines of medical records. The web service (e.g., HealthVault or Google Health) that more quickly gains broad acceptance by hospitals will likely dominate the market. The exorbitant costs to develop and maintain an EMR (electronic medical record) infrastructure may prohibit interested hospitals from integrating with multiple web services; that is, it may have to choose one or the other, likely the more popular or widely accepted web service. There is a reason why Windows dominates the desktop OS market (hint: it is not for technological superiority).

As for the Cleveland Clinic, the project benefits the hospital by establishing itself as a leader in health care technology. The association with Google will also boost brand recognition for the Clinic. This is important in a highly competitive health care market where recognition and prestige have tangible effects on patients’ decisions and donors’ pocketbooks.

As I mentioned in my earlier article, there are reasonable privacy concerns with either Google or Microsoft having access to so much personal information. But, the general public has spoken with its money clicks: These are among the most popular web companies in the world. So who’s next in the line-up of PHR marriages … Revolution Health (created by AOL’s co-founder Steve Case) and Johns Hopkins?

On The Wards would like to announce its first article entry (Industry Giants Vie for Your Online Health Records) in the Medicine 2.0 blog carnival. This biweekly collection of blog posts focuses on the application of Internet and related web technologies in health care. The article has been included in the 18th edition.