Tuesday, July 01, 2008

Google Health and the Personal Health Record (PHR): Do Consumers Care?

By Keith Schorsch

Google Health’s unveiling last week and Microsoft’s HealthVault launch last October are important milestones in the evolution of Health 2.0. Both of these heavyweights have the resources and potential to improve the health consumer’s customer experience. I have followed the active (and important) conversations about privacy concerns, HIPAA, and Google Health’s terms of service, which are well represented by Erik Schonfeld’s post on Techcrunch and Larry Dignan’s post on ZDnet. And I read with interest Google’s rapid response offered by Google Senior Product Counsel Mark Yang.

What’s missing from all of these conversations is the elephant in the room. Namely, do consumers really care about having online personal health records? Current evidence suggests that less than 3 percent of health consumers maintain a PHR online, according to Lynne Dunbrack, program director at Health Industry Insights, who commented in a recent interview. It reminded me of the post on The Health Care Blog a couple of years ago, PHRs, EMRs, and pretty much useless surveys.

And while Google trotted out some great enterprise partners last week for its announcement, I didn’t hear any consumer voices or testimonials on how Google Health will fulfill an unmet need. To me, PHRs and electronic medical records remain an industry-driven vision, not a consumer-driven one — focused on efficiency and reducing costs. It seems we’ve lost sight of whether the consumer really desires and is willing to participate in these services. What are the circumstances for using a PHR and do the benefits outweigh the perceived risks?

Google Health does seem simple, straightforward, and easy to use, albeit with some major holes in content and functionality that I imagine will be filled over time. However, I struggle to see how it’s creating value for the average health consumer. Yes, data portability is important in some sense and does add a level of control for the consumer, but how much work is required by the user to create this asset? And how important is data portability to the consumer? We all remember the predictions of the paperless office. The “paperless record” feels like this decade’s version of the “paperless office.”

The best news around this announcement is the upcoming Google API that will allow others to create applications on this platform. There are myriad privacy and security issues with data moving from Google to third parties. For example, I’m not sure what personal health info was sent to Daily Apple when I signed up for their widget, nor am I fully aware or comfortable with Daily Apple’s privacy and security. But despite this, I think the API holds the most promise for consumers.

The bottom line, for me anyway, is that Google Health feels like a good, incremental step toward putting more control in the hands of the health consumer. People should have more information about their next treatment or medication than they do about their next book or automobile. Without a clearly delineated consumer benefit, however, this is a platform waiting for a killer app.

Keith Schorsch is the founder and CEO of Trusera.com, a social health Web site. Read Original Article.

Google Health beta -- What's really new and different?

May 23, 2008 | Google Health beta -- What's really new and different?
By David Kibbe

From his role as Director of Health IT for the AAFP, co-creator of the CCR and with his involvement behind the "NDA firewall" with the Google Health team, David Kibbe probably has a better vision than most about what's new and different with Google Health. And he is indeed optimistic.

Much of the discussion about Google Health beta's recent launch as an online PHR or healthURL seems to me to miss the point about what is really new and different. Here's how I see it:

1) Computability. What Google Health does that no other platform is yet capable of doing is to make personal health data both transportable AND computable. Right now, this is the news. By supporting a subset of the Continuity of Care Record (CCR) standard for both inbound and outbound clinical messages, Google Health beta makes it possible for machines to accept, read, and interpret one's health data. It is one thing to store health data on the Web as a pdf or Word text file, for example one's immunizations or lab results, where they can be viewed. It is a giant leap forward to make the data both human and machine readable, so that they can be acted upon in some intelligent way by a remote server, kept up-to-date, and improved upon in terms of accuracy and relevance. That is what the CCR xml subset supported within Google Health beta achieves for the consumer that is really new and different; this is what HealthVault and Dossia are to date missing.

Right now, those web services are only mildly useful and sort of "toyish" -- allowing the user to create a meds calendar and get email reminders (ePillBox), or setting up preferences for health and medical news searches (MyDailyApple), or suggesting alternative medications to the ones you now take (SafeMed). But disruptive innovations are often considered simplistic and compared to toys when they first emerge (remember the first Apple computer?) and there is no stopping these developers and these partner companies from making their services more intelligent, more useful, and more convenient to the consumer. Which brings me to ....

2) Rapid design evolution. Google Health beta has established a robust and growing community of programmers and developers eager to attach their widgets, services, and full-scale apps to the Google Health beta juggernaut. Most of the public doesn't see this activity, because it is hidden behind the Google NDA that the developers have to sign, swearing themselves to secrecy about what's going on at Google Health. But it is an enthusiastic, really smart, and tirelessly innovative group of people who have been attracted to the Google Health platform. They are going to help Google's engineers rapidly evolve the design of Google Health over the next few months and years, in ways that are completely impossible to predict, depending mainly on how fast Google Health's operators are willing to move. Design creates value, and value causes infrastructure to change. Modularization of the entire EHR and PHR space may now be possible.

While I recognize that most of the commentary about Google Health beta and Microsoft HealthVault will concentrate on privacy concerns, barriers to data entry, and questions about whether mainstream health data sources will participate or not, I think the disruptive potential has already been unleashed. Watch what happens as the Google Health platform modules and component services grow and start to interact with one another. Read original article.