Looking for where to get a seasonal flu shot or that hard-to-find vaccine against H1N1 swine flu? Google has a new flu shot locator that can help.

When the locator loads, you many need to manually enter your location. Do so using the “Change Location” option:

After doing your search, a red needle icon shows where to get regular seasonal flu shots, a blue needle for the H1N1 vaccine or colored both ways if both are offered at a particular location (so many needles — don’t let your kids see this map before you go!):

Click on any of the icons, and you’ll be shown more information about that location:

A list along the left-hand side of the map also gives more details about a particular place and reflects all the locations on the map. Many of these are pharmacies, but Google says more locations will be added:

We’ve been working with HHS, the Centers for Disease Control and Prevention (CDC) and state and local health agencies to gather information on flu vaccine locations across the country, particularly for the H1N1 flu vaccine (both the nasal-spray vaccine and the shot). At the moment we have data for locations of flu vaccine directly from 20 states and counting. We are also continuing to add information from chain pharmacies and other providers in all 50 states; today, you’ll find results from chains such as Walgreens, CVS and PDX participants, such as Kmart, Duane Reade, WinnDixie and Giant Eagle.

Unfortunately, you can’t tell at-a-glance if a particular location is out of stock on flu vaccine. For example, in the map above, you can see H1N1 is said to be available near Fountain Valley. But according to the list, it’s out of stock:

It would be nice if the map could also reflect the availability status. Plus, I wish there was a way to share a map tailored to a particular location. Even when you’re signed in to Google and using the My Maps feature, it doesn’t seem possible to save a map for a particular ZIP code. Using the share options also just shares the generic URL, not one that will bring up a location-specific map.

The locator will also soon be added the the Flu.gov site from the US government and the American Lung Association’s flu site.

Google also maintains a Google Flu Trends site designed to help you spot where flu activity may be peaking.

Netbase is an enterprise-facing software and search company that appears to have one of the most advanced search platforms in the market. Earlier this week during a briefing Netbase marketing and product VP Jens Tellefsen asserted that no other search provider in the consumer or enterprise segment was as advanced — an audacious claim.

Tellefsen went to considerable lengths with me to back up the assertion, however. He said, “The closest thing we’ve seen is what Powerset was trying to do.” But he added that Powerset was essentially an elaborate proof of concept (subsequently acquired by Microsoft), while Netbase is a fully functioning search technology platform that is being used today by major publishers, enterprises and the US government.

To “come out” in a manner of speaking and demonstrate its capabilities to a broader public, Netbase has launched vertical search site HealthBase, a kind of “technology showcase” for the company’s “content intelligence” platform and semantic search capabilities. If HealthBase gets a positive response I was told perhaps the company will move into the consumer search business. But that’s not the main point of the site at the moment. Indeed there’s a very “enterprise-y” quality to the look and feel of HealthBase.

According to the press release that came out this morning:

One might look at this page and say “that’s just clustering.” And other companies have made similar claims about parsing and “understanding” content. But validation seems to come from Netbase customers. The company’s platform and technology have been in the market for several years (in various forms since 2004) and are being used today by P&G, the US Army, Reed Elsevier and others. To  independently test Netbase’s claims you’d have to systematically do lots of searches across a number of top health sites and compare results. However I was impressed with the material I saw and demonstration that I received.

The American healthcare system is very broken, in my opinion and in the opinion of many others. Health insurance carriers and providers hold almost all the cards. However the internet has gone a long way to arm consumers with information and help them become more sophisticated about their conditions and treatment options. And while the health vertical online is quite competitive, many of the names in the segment are not well known to consumers because of the occasional nature of “health search.” One of the most sophisticated and powerful is Healthline, which offers “semantic health search” built on an elaborate taxonomy of diseases and symptoms.

The site, which was originally founded in 1999 but relaunched in late 2005, claims about 40 million uniques, directly or through its partner network. Today Healthline is announcing two new search tools for its site: treatment search and doctor search. From the press release:

While most treatment information online is embedded deep within articles on health websites, Healthline TreatmentSearch is the first online health application to surface a semantically-generated list of possible treatment options for a disease or condition. The application covers 4,500 treatments, including 1,200 medications and 3,300 medical, surgical and alternative therapies. Healthline Treatment Search results are ranked algorithmically, and sub-categorized into the following:

• Diagnostic Tests
• Medical Procedures
• Surgical Procedures
• Self Care
• Alternative Procedures
• Prescribed & Over-the-Counter Medications
• Nutritional Supplements

TreatmentSearch also offers the ability to estimate costs for the intended procedure by local market. In addition, it provides a range of alternative treatments and therapies to surgical procedures in many cases. Indeed, there’s a dizzying amount of available information on the site.

The second part of the announcement, DocSearch allows consumers to search for and compare doctors across a range of criteria:

Starting with only a health condition and a geographic location, Healthlilne DocSearch culls results from a database of 1.3 million health professionals, including MDs, chiropractors, nurses, clinicians, and alternative practitioners to find the right care in their area. For example, if a consumer searches on doctors who treat strep throat, Healthline will automatically surface a list of otolaryngologists as well as internists in the selected geographic location. Healthline DocSearch can be further refined by a doctor’s length of experience, languages spoken, education, hospital affiliation, and even letters in a last name. A unique doctor-compare feature opens a window that lets users compare up to 20 different doctors – as opposed to 3-5 on other doctor compare products — in an easy-to-read format.

The things that DocSearch won’t tell you (yet) unfortunately are whether the doctor takes your insurance and what past patients think of the doctor. But Healthline COO Dean Stephens told me that this content was on the roadmap.

Can a search engine accurately diagnose health problems? Can it someday replace your doctor? Questions like this aren’t new, but the discussion has gotten a bit louder in recent weeks.

Just a couple weeks ago, I reported on a Microsoft investigation of cyberchondria, when inaccurate medical information online makes actual health problems worse. On Friday, Dilbert cartoon creator Scott Adams shared a different point of view, telling blog readers how Google helped him find treatment for a speech defect known as Spasmodic Dysphonia.

More specifically, Adams was using Google Alerts to get information about the condition. Google notified him of an “obscure medical publication” that wrote about Spasmodic Dysphonia. He took the information to his own doctor, was referred from there to other doctors, and eventually had successful surgery to fix the voice defect.

“I never would have found that path without Google Alerts,” Adams writes.

But is his story representative of what typically happens when we use the Internet to search for medical information? The Microsoft paper released last month explained that using the Internet to diagnose health problems can make the problem worse than it really is:

“… the Web has the potential to increase the anxieties of people who have little or no medical training, especially when Web search is employed as a diagnostic procedure. We use the term cyberchondria to refer to the unfounded escalation of concerns about common symptomatology, based on the review of search results and literature on the Web.”

About 30% of people in the Microsoft study experience “heightened anxiety” because of what they learn online after doing a web search about medical conditions. But Adams says he’s used the Internet — “Dr. Google” as he calls it — “dozens of times to diagnose various minor medical problems, or to find out what things are dangerous or not.” And he poses some interesting questions about how well the Internet could diagnose non-emergency medical problems, both common and uncommon:

“With the uncommon problems, such as my spasmodic dysphonia, I have to wonder if Google (or WebMD, etc.) can do a better job than a doctor, if not now then maybe in the near future. If you could call up videos of people with identical symptoms, couldn’t you diagnose most of your own problems?

For example, are you any worse than your doctor at looking at High Definition pictures of a skin problem and comparing it to your own skin problem?

My guess is that the Internet could equal your doctor in diagnosing uncommon problems. WebMD for example asks a bunch of diagnostic questions and narrows down your symptoms just as a doctor would. That system will only improve over time.

Adams goes on to wonder about using an online database to handle prescriptions, with pharmacist oversight built-in. Something like that may already be included in government discussions of a national health database; I don’t follow the details enough to know for sure if it is or not.

Ultimately, it’s an interesting discussion. Adams’ concept of “Dr. Google” doesn’t seem too outlandish, but — to borrow a common medical analogy — four out of five doctors would probably disagree.

Those muscle twitches you get probably aren’t a sign that you have ALS (Amyotrophic Lateral Sclerosis, aka “Lou Gehrig’s Disease”). But if you’re using search engines to diagnose what ails you, there’s a chance you’ll come to that conclusion.

In a new paper, Microsoft investigates cyberchondria: “… the unfounded escalation of concerns about common symptomatology, based on the review of search results and literature on the Web.”

Microsoft researchers Ryen White and Eric Horvitz studied a 40-million page sample of search results (from Live Search) and surveyed 500 Microsoft employees about how they search for health information. They found that health search on the web sometimes makes our problems worse, in the form of heightened anxiety that can disrupt other aspects of normal, daily life. In other words, the information we learn from search engines often adds stress to whatever our current health problem might be.

“…the unreliability of Web sources and the content of Web search engine result pages contributed to the heightened anxiety of around three in ten survey respondents.

The responses show that search engine result pages, the contents of the pages visited directly from the result pages, and pages visited thereafter, may all contribute to health-related anxiety to different extents.”

One problem, according to the paper, is that web searches for common symptoms sometimes lead to information about serious, rare illnesses. A search for “headache” might lead to information about tension, but could also lead to information about brain tumors, which are extremely rare; a search for “chest pain” can lead to information about heartburn or heart attacks.

The paper puts the burden of responsibility for reducing this escalation of anxiety onto the search engines themselves:

“Search engine architects have a responsibility to ensure that searchers do not experience unnecessary concern generated by the ranking algorithms their engines use. They must be cognizant of the potential problems caused by cyberchondria, and focused on serving medical search results that are reliable, complete, and timely, as well as topically relevant.”

The 32-page research paper is available for download here. There’s also more discussion on Techmeme.

Wondering if it’s just you or if others have the flu, too? Google’s announced a new tool that tells you. Google Flu Trends allows you to see flu activity across the United States.

How’s Google doing this? Is it now indexing actual human beings, in the way it does web pages? Nah. Turns out that when you’re sick with the flu, you search for that word and other flu-related topics. Google can tell which areas are seeing a spike in flu-related searching, and from that, trends can be plotted.

Consider this chart that compares actual flu activity to searches for flu-related terms, over time:

States with more flu activity are shown in darker blue. Click on any state to see the exact level:

Right now, folks in the states of Arkansas, Mississippi, Kentucky, Delaware, Maine and Hawaii are showing “moderate” levels of flu activity. Stop searching about the flu, folks! Step away from your keyboards, have some chicken soup and get back into bed!

When you select a state, above the US map, you’ll see the trend chart change to show you flu activity for that state over time. Flu activity over time for the entire US is shown by default. You can also download data plus enter a ZIP code to find the nearest flu shot location to you.

Postscript: Techmeme has related coverage.

Kaiser Permanente, with the largest HMO in the US, has selected Microsoft’s Health Vault personal health records initiative over Google in a big new test with Kaiser employees, according to the NY Times. If successful, the offering could be extended to all of Kaiser’s almost 9 million members.

According to the article:

The partnership, announced Monday, will begin with a pilot project open to Kaiser’s 156,000 employees, which will run until November. If successful, the product linking Kaiser’s patient information with Microsoft’s Health Vault personal health-record service will be offered to Kaiser’s 8.7 million members in nine states and the District of Columbia.

Kaiser reportedly selected Microsoft because the two entities shared a similar document format vs. Google: Continuity of Care Document, or CCD vs. Google’s Continuity of Care Record, or CCR. Kaiser was reportedly also impressed by Microsoft’s handling of privacy and data security issues.

The fight for partnerships with health insurance carriers is not unlike these toolbar and default search deals that Google and Microsoft compete for. However, consumers will ultimately be given a range of choices about which records system to use. But the competition and ultimately the combined push by Google and Microsoft promoting adoption of online personal health records will accelerate the mainstreaming of such a system.

Vertical health search engine Healthline has introduced what it’s calling the Healthline Media Network, a contextual ad network for medical and health-related sites. According to the company, the new ad network will utilize Healthline’s “semantic health search technology” to better understand partner page content and do a better job of matching ads accordingly.

From the press release:

Healthline HealthSTAT (Semantic Taxonomy Ad Targeting) is a new ad-focused application that recognizes rich health-related concepts (as opposed to simple keywords) within the content on publisher sites, and matches them with contextually relevant health advertising. For example, a page describing certain symptoms – scratchy throat, watery eyes – could trigger a relevant ad for treatments of Rhinitis, Bronchitis, or even the common cold. HealthSTAT can also work with pharmaceutical campaigns that have precise requirements, e.g., a general SSRI medication can be matched to any page where HealthSTAT recognizes depression content. On the contrary, if an antipsychotic drug needs adjacent placement to only bipolar content, HealthSTAT can make that distinction just as easily.

Healthline claims 10 million uniques at launch, distributed across a range of partner sites that include United Healthcare’s new MyOptumHealth, AARP, Elder.com, Health.com, HealthPricer, Just Answer, PracticeFusion, and USNews.com. Previously the company launched personalized health search on the Aetna site, which leveraged Aentna insureds’ medical records to provide customized search results in conjunction with Healthline’s search algorithms.

Healthline also has a range of partnerships beyond those listed that includes the health-related Smart Answers on Ask.

There’s no behavioral targeting in the Healthline Media Network, so there aren’t the same potential privacy questions and issues that critics have raised with initiatives such as Microsoft Health Vault and Google Health. Healthline’s technology reportedly just does a better job of understanding page content and mapping related advertising on a conceptual level.

If Hakia were using an automotive analogy, the site might be saying to Google, “We’re BMW, you’re Chevrolet.” The Hakia blog explains how the engine is taking a “quality” approach, trying to assess the credibility of sites in ranking them, together with the help of professional librarians. Hakia specifically discusses this in the context of health-related search and contrasts its approach with that of “popularity,” a general reference to Google’s original PageRank algorithm.

The company says that it will roll out “Quality Search” in a range of verticals — “law, finance, science, and in many other content-rich verticals” — based upon expert sources and librarian-aided indexing.

Stepping back, the irony here is that it’s a bit of a return to the “directory” approach of old. At the highest level, humans originally compiled lists of websites (e.g., the original Yahoo directory). That was eventually replaced by machine algorithms when the internet got to be too large to categorize everything with an editorial staff. Enter Google.

But when the internet became so large that information overload became somewhat overwhelming and routine, the trend of human-powered search or “social search” emerged to rectify some of the seeming randomness and inefficiency of these giant indexes. Social search, generally speaking, thus sought to inject a community filter into search results (e.g., Eurekster).

Hakia’s blog post and approach suggests a return to the “top-down” editorial efforts of the earlier days, albeit with the knowledge base and capabilities of today’s internet. (This simplification probably doesn’t fully capture what they’re doing.)

One can also see the blended/universal search trend as an effort to get to “answers” beyond the information overwhelm that intrudes into the prior “10 blue links” approach that defined general web search for years.

Vertical health destination and search engine Healthline has teamed up with US health insurance carrier Aetna to offer what the company is calling Aetna SmartSource — customized health search. The service, powered by Healthline, will roll out on Aetna’s member self-service website and offer personalized search results based on individual health records and profiles. That means that two different Aetna customers searching for “diabetes type II” will see potentially different results based on their individual health histories.

What’s different about this vs. what Microsoft, Google, and Revolution Health are doing is that it’s all taking place within the context of the existing relationship between insurance provider and customer-patient. Aetna already has the health records and histories of its insureds so there’s little or no effort for the users to obtain the benefits (so to speak) of the system. In other words, they don’t have to construct detailed profiles or upload information themselves.

What’s also interesting is that this is the most developed version of personalized search yet in the market. In the relatively protected context of the existing carrier-insured relationship, most of the concerns about tracking and data-mining go away. Aetna won’t be using search behavior on its site, presumably, to advertise or market products to its customers.

However, in a cautionary tale about corruption in the US healthcare industry, one of Aetna’s competitors in California, HealthNet, had a secret practice of canceling policy holders who were perceived as “expensive” in order to save the company money. It actually tied employee bonuses to the number of customer cancellations they accomplished. According to the LA Times:

One of the state’s largest health insurers set goals and paid bonuses based in part on how many individual policyholders were dropped and how much money was saved.

Woodland Hills-based Health Net Inc. avoided paying $35.5 million in medical expenses by rescinding about 1,600 policies between 2000 and 2006. During that period, it paid its senior analyst in charge of cancellations more than $20,000 in bonuses based in part on her meeting or exceeding annual targets for revoking policies, documents disclosed Thursday showed.

The revelation that the health plan had cancellation goals and bonuses comes amid a storm of controversy over the industry-wide but long-hidden practice of rescinding coverage after expensive medical treatments have been authorized.

The hypothetical concern raised by this practice is that the carrier using personalized search could potentially monitor behavior and identify insureds who are conducting searches for, say, Leukemia, and potentially discriminate against them if the carrier thinks they’re going to start costing the company more in benefits — along the lines described in the report above. (Note: Aetna has not been accused of any such practice.)

Healthline will no doubt be pursuing similar deals with other carriers in the US, setting up a competing vision for management of personal health records with Google, Microsoft, and Revolution Health on one side, and the carriers, with enhanced services and capabilities, such as personalized search, on the other.

Aetna may also regard the Healthline provided search tools as features that will help the company retain customers. However, when people change jobs in the US they also typically change insurance carriers involuntarily because coverage is generally tied to the employer.

Therefore, in an ideal world, centralized management and consumer control of personal health records, along the lines of the Google and Microsoft systems, is the best solution because it would be independent of any carrier or health insurance program. But there are myriad other concerns, previously discussed, in those scenarios.

Nonetheless, the vision of personalized health profiles and customized health search offered by Microsoft, Google, and Healthline’s deal with Aetna represent the future. It will, however, be critical for data security measures and legal protections to be in place so consumer information cannot be improperly accessed or abused before they can have full confidence in these programs.