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.

Google to store patients' health records

Google Inc. will begin storing the medical records of a few thousand people as it tests a long-awaited health service that's likely to raise more concerns about the volume of sensitive information entrusted to the internet search leader. The pilot project to be announced Thursday will involve 1,500 to 10,000 patients at the Cleveland Clinic who volunteered to an electronic transfer of their personal health records so they can be retrieved through Google's new service, which won't be open to the general public.

Each health profile, including information about prescriptions, allergies and medical histories, will be protected by a password that's also required to use other Google services such as e-mail and personalized search tools. Google views its expansion into health records management as a logical extension because its search engine already processes millions of requests from people trying to find more information about an injury, illness or recommended treatment.

But the health venture also will provide more fodder for privacy watchdogs who believe Google already knows too much about the interests and habits of its users as its computers log their search requests and store their e-mail discussions.

Prodded by the criticism, Google last year introduced a new system that purges people's search records after 18 months. In a show of its privacy commitment, Google also successfully rebuffed the U.S. Justice Department's demand to examine millions of its users' search requests in a court battle two years ago.

Pilot project has uncertain timetableThe Mountain View-based company hasn't specified a timetable for unveiling the health service, which has been the source of much speculation for the past two years. Marissa Mayer, the Google executive overseeing the health project, has previously said the service would debut in 2008.

Contacted Wednesday, a Google spokesman declined to elaborate on its plans. The Associated Press learned about the pilot project from the Cleveland Clinic, a not-for-profit medical cente founded 87 years ago. The clinic already keeps the personal health records of more than 120,000 patients on its own online service called MyChart. Patients who transfer the information to Google would still be able to get the data quickly even if they were no longer being treated by the Cleveland Clinic.

"We believe patients should be able to easily access and manage their own health information," Mayer said in a statement supplied by the Cleveland Clinic. The Cleveland Clinic decided to work with Google "to create a more efficient and effective national health care system," said C. Martin Harris, the medical centre's chief information officer.

Google isn't the first high-tech heavyweight to set up an online filing cabinet in an effort to make it easier for people to get their medical records after they change doctors or health insurance plans.

Health services go online
Rival Microsoft Corp. last year introduced a similar service called HealthVault, and AOL co-founder Steve Case is backing Revolution Health, which also offers online tools for managing personal health histories.

The third-party services are troublesome because they aren't covered by the Health Insurance Portability and Accountability Act, or HIPPA, said Pam Dixon, executive director of the World Privacy Forum, which just issued a cautionary report on the topic.

Passed in 1996, HIPPA established strict standards that classify medical information as a privileged communication between a doctor and patient. Among other things, the law requires a doctor to notify a patient when subpoenaed for a medical record. That means a patient who agrees to transfer medical records to an external health service run by Google or Microsoft could be unwittingly making it easier for the government or some other legal adversary to obtain the information, Dixon said. If the medical records aren't protected by HIPPA, the information conceivably also could be used for marketing purposes.

Google, which runs the internet's most lucrative ad network, typically bases its marketing messages on search requests and the content on web pages and e-mail contained in its computers. It's not clear how Google intends to make money from its health service. The company sometimes introduces new products without ads just to give people more reason to visit its website, betting the increased traffic will boost its profits in the long run.

View Original CBC News Article © The Canadian Press, 2008

Google preparing ehealth portal initiative

Google is planning a product that it hopes will overhaul the way patients, doctors, vendors and pharmaceutical companies manage their medical information online. Dubbed the Google Health Scrapbook, the product is in developmental stages now and there is no certainty that it will be launched. Google executives met last week with their counterparts at WebMD in New York to pull them in as a partner for the new online service. They plan to pitch the product to other potential partners in the coming weeks.

The plan, as it stands now, calls for there to be four different directories for each different type of user. The prospect of listing a separate directory for medical devices seems to have been scrapped. Users will be able to log in with their own account information and do things such as add a new medical provider, check their medical records or pay their bills.

The product would also provide information about hospitals such as the frequency that a hospital performs a specific type of procedure or which hospitals perform which procedures most often.

Aside from WebMD, Google is hoping to partner with Intuit on the product. Intuit currently offers consumers a software program that helps them keep track of their medical expenses. The company has already met with the CEO of AllScripts LLC, Glen Tullman, and representatives of Epic Systems Corp., which has signed a non-disclosure agreement.

Involved in the project is Missy Krasner, a project manager who joined Google earlier this year. She was previously a top official in the Office of the National Coordinator for Health Information Technology. Adam Bosworth is rumored to be the one directing the company's overall health initiatives.

Google observers who have been expecting a major Google Health initiative to be announced in May were surprised that the company’s health-related release was Google Co-op. Google Co-op is a social search product focused around vertical areas such as health, autos and travel. Its health directory allows users to bookmark interesting pages and add them into the directory, which can then be viewed by others. It also allows users to subscribe to feeds from a variety of sources such as WebMD and the Mayo Clinic.

A Google press official declined to comment specifically on their plans. The press official released this statement: "Health has been an area of interest at Google for some time. We have been doing a variety of research in the health area, including how to improve the quality of health-related search results. Google Co-op is one reflection of that. We continue to look for more ways to benefit our users in the area of health, but we do not have any products to announce at this time. As part of our efforts, we work with many companies in formal and informal ways.”

If the company’s Google Health Scrapbook launches, its health information offering will immediately go far beyond what is currently available to its users via Google Co-op.
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