GOOGLE HEALTH ACCUSED OF INACCURACY IN ELECTRONIC MEDICAL RECORDS

Google Health, Google's health care IT solution, has been taken to task by physicians who say the billing information it uses for some patients' electronic medical records can give an inaccurate picture of their health conditions. Since rolling out in Feb. 2008, Google Health has been positioned as competition for Microsoft's health care IT offerings, as well as sites such as WebMD.

Google is encountering protests from users who say the information its Google Health beta Website presents has the potential to be inaccurate when it comes to electronic medical records. Much of the online traffic over the issue has stemmed from one particular case, that of kidney cancer survivor Dave deBronkart, who transferred his medical records from Beth Israel Deaconess Medical Center to Google Health, only to find that the latter had taken information from his billing records to incorrectly state that he had chronic lung disease and other conditions.

"I've been discussing this with the docs in the back room here, and they quickly figured out what was going on before I confirmed it: The system transmitted insurance billing codes to Google Health, not doctors' diagnoses," deBronkart wrote on his personal blog on April 4. "And as those in the know are well aware, in our system today, insurance billing codes bear no resemblance to reality."

He also wrote, "I suspect processes for data integrity in health care are largely absent, by ordinary business standards. I suspect there are few, if any, processes in place to prevent wrong data from entering the system, or tracking down the cause when things do go awry." deBronkart took care to say the post was not "a slam on Google Health."

However, the story reached the Boston Globe on April 13 under the title "Electronic Health Records Raise Doubt." The article quotes deBronkart's primary physician, Dr. Daniel Sands, as saying the information from billing records, incorporated into Google Health, should never be used clinically.

When contacted by eWEEK, a Google spokesperson referred to the Globe article's quoting of Dr. Roni Zeiger, product manager for Google Health, as saying having such information available online will benefit users in the long term as the solution's accuracy improves.

"That's something I think we could do better on," the article quotes Zeiger as saying with regard to whether Google Health indicates the source of data for each diagnosis.

A number of online pundits have stated that physicians and other health care providers should be concerned about the importing of insurance billing records into Google Health precisely because of this lack of accuracy. Google has not posted a response on its blogs yet. 

Google upgraded Google Health in March 2009 to allow users to share medical records and other personal health information with doctors and trusted contacts. The announcement was greeted with skepticism by some users, who voiced privacy concerns.

That same month, Google unveiled that it was participating in a pilot program with the CMS (Centers for Medicare & Medicaid Services) that would let Medicare beneficiaries in Arizona and Utah import their Medicare claims data into Google Health. First introduced in February 2008, Google Health allows Google to share competitive space with Microsoft's health care IT offerings, as well as Websites such as WebMD.

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PROVINCE OF ONTARIO UNVEILS YET ANOTHER ELECTRONIC HEALTH DATA PLAN

March 30th, 2009
If it doesn’t work the first (second or third) time---rebrand and start over. Taxpayers have short memories.

To this end, Ontario has unveiled another round; a $2.1 billion strategy that hopes to give every diabetic patient in the province an electronic health record by 2012. Apparently the original $650 million was required to ensure the "right people" are working on the initiative.

The "eHealth Ontario" initiative will also connect doctors, patients and pharmacists electronically to better manage the flow, safety and effectiveness of prescription drugs and cut wait times at Ontario hospitals, the head of the group developing the program says.

"There is a very clear line between investing in information and information technology in these three areas and seeing improvements from a patient perspective," says Sarah Kramer, president of eHealth Ontario.

The 53-page strategy aims to have 65 per cent of the province's primary physicians and two-thirds of their patients hooked up to the electronic medical data by April 2012. The eHealth agency was formed last September after a previous costly and controversial program failed to produce viable health record plans.

The original program, called Smart Systems, had been created in 2002, employed 300 people and wasted $650 million as part of its mandate to electronically link and support Ontario's 150,000 health-care providers. But a 2007 operational review found it was riddled with delays, lacked any accountability and its privacy policies were incomplete.

When the new, restructured and rebranded agency was formed, the province brought in Dr. Alan Hudson - head of Ontario's drive to shorten wait times in key areas. Hudson, who is chair of eHealth Ontario, quickly created a new board of directors filled with Bay Street notables.

Conservative health critic Elizabeth Witmer called Ontario's record on eHealth extremely poor. "(The government) has already invested half-a-billion dollars and we have seen NO results," she said. One might think there would be greater accountability. Or any!? In an attempt to prove, if you throw enough money at something it looks like progress, the new agency says its goal is to have enrolled 100 per cent of physicians and all of their patients by 2015. It also would like to see 65 per cent of medication orders filled electronically in three years with 35 per cent of physicians ordering drugs via secure, electronic prescriptions.

Key to the program, Kramer says, is the enrollment of as many as 800,000 diabetes patients in the province into the electronic record system. Currently, Kramer says, only half of diabetics receive the kind of basic, preventative checkups that can keep them out of hospital by catching common complications of the disease before they cause acute harm. The plan will implement a tracking system that will allow physicians and patients to follow care and alert them when any of those signal examinations are due or have been missed.Both physicians and patients will be able to access this information through the use of passwords.
On the pharmacy side, Kramer says the electronic triangle the strategy will form between patient, doctor and pharmacist will cut back significantly on the frequent mistakes that accompany prescription drug use.

Kramer says the strategy will cut wait times most significantly by keeping diabetics out of hospital. Once the infrastructure and training are in place, it will be easier to bring other diseases into the electronic system. The money, approved by the provincial cabinet in May 2008, will also fund such programs as Ontario Telemedicine Network, which provides over-the-phone medical advice to hundreds of people annually. Dennis Darby, head of the Ontario Pharmacists' Association, welcomed the new strategy. "It certainly will allow pharmacists to provide better patient care," he says.


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