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What Should We Make of Google Health’s Failure?

Posted on June 26, 2011 I Written By

Katherine Rourke is a healthcare journalist who has written about the industry for 30 years. Her work has appeared in all of the leading healthcare industry publications, and she's served as editor in chief of several healthcare B2B sites.

So, Google Health’s slow collapse — akin to a tire with a slow but obvious leak — has finally come to an end. This week, Google officially ended the project, one of the pioneering efforts in the Personal Health Records space. While GH will stumble along through January 1, 2012, the jig is finally up.

Why did a high-visibility project backed by one of the world’s premier Internet companies fail so miserably? Well, according to former Google employee Adam Bosworth, who first launched GH, the effort failed because “it’s not social,” TechCrunch reports.  Another pundit, more convincingly, argued that unless PHRs are tied to reimbursement somehow, they’ll be “irrelevant” for most providers.

So, why should we care about the failure of a project that, I’d argue, was pretty much pie in the sky from day one? And more importantly, is the failure of GH relevant to people who care about the future of EMRs?

Well, for one thing, Google Health does offer some pretty interesting insights into what doesn’t work in the world of patient-centered clinical data. As I see it, they include the following:

*  Clinical data projects that aren’t interoperable are eventually going to wither away.

I think it’s telling that Google is, at the last possible moment, rolling out the ability for patients to transfer health data to other services supporting the Direct Project protocol.  Also notable is that Google is offering patients the option of downloading data that meets the Continuity of Care Record format. (That’s ASTM E2369 – 05e1 to any standards geeks out there.)

Does that imply that EMRs that don’t share data are going to be outmoded or a waste of time?  Certainly not, as EMRs can potentially solve many in-house problems that providers face, and serve a far more expansive purpose. That being said, the failure of siloed PHRs should be a warning.

* Without a live, fluid source of data, PHRs don’t matter.

In this cynic’s mind, the idea that patients would suddenly begin to post data to PHRs on their own was, to put it simply, pretty dumb.  Why would they?  Consumers seldom think about their health data unless they’re at a doctor’s office, if at all, and they don’t exactly know what do do with the data once they’ve compiled it.

Since day one of the PHR craze, I’ve been wondering who thought they’d change patient behavior en masse by dangling a technology carrot. What were they thinking? I’m not just slamming Google, I’m targeting pretty much any PHR that isn’t linked to an EMR or other clinical data source directly. (I’m talking about you, HealthVault, and probably Dossia too.)

* PHRs must be run by a trusted intermediary, and marketed vigorously to patients, before patients will take heed.

I think it’s no coincidence that while Google’s PHR, and possibly Microsoft’s, haven’t won over many consumers, patients are beginning to pay a bit more attention to PHRs provided by providers and health insurers.  (OK, I don’t have hard data on this, just a strong gut feeling — can any of you provide stats that support or contradict this assumption?)

A case in point: While they’ve arguably spent way, way too much to get there, Kaiser Permanente has built what may be the largest PHR user-base in the world — 3 million users as of spring 2010 — linked to KP’s big Epic installation.  True, Kaiser had to spend millions in advertising and other forms of outreach to get patients on board, but what’s telling is that patients seem to have stayed once they arrived.

So, I’m just wondering when the managers behind HealthVault will throw in the towel. Hey, MS, just turn out the light when you leave, OK?

PHR Model At Turning Point

Posted on March 26, 2011 I Written By

Katherine Rourke is a healthcare journalist who has written about the industry for 30 years. Her work has appeared in all of the leading healthcare industry publications, and she's served as editor in chief of several healthcare B2B sites.

So,  Google is going through some internal upheaval as co-founder Larry Page prepares to take over the reigns as CEO.  According to an piece appearing in today’s Wall Street Journal, Page is aggressively reviewing existing projects and is likely to take an axe to those that don’t seem to be working. Does it surprise any of you that one of the programs facing cutbacks may be Google Health and its faltering PHR?

As HIT expert Shahid Shah notes, Google has created some decent PHR technology — but despite having a vast reach and rich resources, hasn’t figured out how to grow its user community.  Even with its massive bank account, I’m not surprised to see that it hasn’t turned healthcare into a major income source. Google just isn’t that great at going outside of its box.

Then, consider that Microsoft doesn’t seem to be pushing Health Vault very hard these days, and you’ve got to wonder whether the whole “massive tech company builds PHR” thing can possibly work.   Yes, I realize I might get flamed by Microsoft execs saying this, but let’s get real here.  Microsoft isn’t great at connecting to markets it doesn’t monopolize either.

Oh the other hand, evidence is mounting that PHRs may be popular when driven by a provider and its own EMR.  Perhaps the highest-profile example of this may be Kaiser Permanente’s EMR/PHR ecosystem.  Its “My Health Manager” PHR system is closely integrated with its Epic EMR installation and now has millions of users.

Why is Kaiser succeeding at generating PHR interest where Google has failed? It’s largely because rather than offering a mixed bag of apps and options, as tech vendors have been doing, My Health Manager allows patients to securely exchange messages with physicians, refill prescriptions, review test results and schedule medical appointments.  Patients aren’t being asked to become updater and curator of their medical information, but rather, to use it. This just makes sense.

As I see it, the whole notion of a PHR as a freestanding app is basically circling the drain.  Realistically, patients have little incentive to interact with their health data unless it has some immediate impact on their lives.  An EMR/PHR combination, on the other hand, has tremendous potential, as it connects patients to both their providers and their health data effectively.  If I were Microsoft or Google, I’d just throw in the towel at this point.