The Health of Google and Google Health

Very interesting post over at ZDNet by Tom Foremski on an upcoming meeting of Google hacks at the Googleplex set for May 19.

Fascinating description of Google's use of machines and software to produce results rather than humans and how this might exist in the health care environment. I have not heard of this description of what Google does and why it does it better and cheaper.

Also, he offers compelling thoughts on the pharma advertising market target that Google may be looking for as it goes about developing Google Health.

Tip to the NewsGang Twitter feed.

Google Health: Google Partners with Cleveland Clinic

The New York Times Technology Section reports on a pilot project between Gooogle and the Cleveland Clinic in an article, Google to Store Patients' Health Records.

The article indicates the pilot project will involve a volunteer patient group transferring their personal health records so that they are available via Google Health, a new health record product being developed by Google. The article quotes Pam Dixon of the World Privacy Forum concerning privacy issues under HIPAA (incorrectly referenced by the Times as HIPPA).

I don't necessarily agree with the scope of the comments regarding the applicability of HIPAA in this situation. Although I don't know the full details of the relationship for the proposed project but it would appear that Google in this situation might be serving as a business associate of the Cleveland Clinic for the project. As a business associate it is likely that Google would be held contractually to many of the HIPAA privacy standards.

Tip to Matthew Holt at Health 2.0 Blog for noticing the NYT article.

UPDATE (2/22/08): ZDNet's Larry Dignan at Between the Lines has more on the pilot project including the Cleveland Clinic's press release.

The comments to Dignan's post are interesting reading especially a couple with a legal perspective. The comment, two misconceptions, highlights the overall light enforcement efforts by OCR and lack of penalties, whether Google might fit the "healthcare clearinghouse" definition under the "covered entity" definition, entering into a contract with the health care provider (business associate requirement) and discusses the subpeona and marketing misconceptions.

Also, more from NYT's Steve Lohr, Google Health Begins Its Preseason at Cleveland Clinic which indicates that Google Health will be made available to the public following completion of the pilot project (appoximately 2 months). The article also has a quote from fellow health care blogger and CIO of Beth Israel Deaconess Medical Center in Boston, John Halamka, who indicates that the hospital is also interested in linking its EMR with Google Health. As a board member of the West Virginia Health Information Network I would like to explore the idea of utilizing and integrating Google Health into our statewide effort to bring about an integrated/interoperable health information system.

Jane Sarasohn-Kahn at HealthPopuli shares her thoughts and additional link commentary on the Google/Cleveland Clinic project. Jane highlights a recent report, Personal Health Records: Why Many PHRs Threaten Privacy, by the World Privacy Forum looking into privacy issues for PHRs.

Matthew Holt's follow up post taking a closer glimpse at the privacy questions, motives and opportunities both pro/con surrounding the Google Health project.

UPDATE (2/24/08): For the latest article covering the Google Health project check out Newsweek's article, Web Surfer, Health Thyself, out in the March 3 edition.

Also, MSNBC provides some additional insight on how Google Health will interact with the existing Cleveland Clinic EHR (or PHR) in Google Goes to the Doc's Office. The article describes the pilot project as follows:

. . . The Cleveland Clinic already keeps electronic records for all its patients. The system has built-in smarts, so that it will alert doctors about possible drug interactions or when it's time for, say, the next mammogram. In addition, 120,000 patients have signed up for a service called eCleveland Clinic MyChart, which lets patients access their own information on a secure Web site and electronically renew prescriptions and make appointments.

The system has dramatically cut the number of routine calls to the doctor and boosted productivity, though it has yet to effectively deal with information from an outside physician, Harris says. Those records are typically still on paper, and have to be laboriously added to the Cleveland Clinic system. It is a big problem, especially for the clinic's many patients who spend winters in Florida or Arizona, where they see other doctors.

Adding Google's technology lets patients jump from their MyChart page to a Google account. Once on Google, they'll see the relevant health plans and doctors that also keep electronic medical records. That means the patient can choose to share information between, say, the Arizona doctor and the Cleveland Clinic . . .

UPDATED 2/26/08: Scott Shreeve goes Giga over Google Health. Read his first impressions of the Google PHR after his test drive at HIMSS.

However, Dmitriy at TrustedMD makes some great points, including this quote:

Yet, even with free PHRs out there, consumers simply do not care for spending their time to learn and use them. Who would bother entering and checking their medical records if you are healthy and would rather go see a movie? And once you get sick, you do not want to enter them either. You just want your doctors and hospitals to hand your medical records to you. But you see, the providers have different priorities that a mere piece of software just cannot solve . . . PHRs' real problems are not technical, usability or even privacy. The real problem is consumer and provider motivation . . .

He ends his posts with some questions we should all be discussing. Until we see a reimbursement model that creates incentives for providers to look at more health information and consumers to care about and take an active part in their health -- I'm not sure the PHR/EHR initiatives will fully develop and mature.

Follow the latest news (blog posts) and the Techmeme reaction to the project.

Get Your Google Health . . . Soon

Various reports out about the coming of Google Health. As Matthew Holt indicates, the Google purists found a log in page (screen shot).

The log in page has since been pulled down but Matthew and Tech Crunch provide a list of what the log in page said Google Health will do for you, including:

With Google Health, you can:

• Build online health profiles that belong to you
• Download medical records from doctors and pharmacies
• Get personalized health guidance and relevant news
• Find qualified doctors and connect to time-saving services
• Share selected information with family or caregivers

I'm particularly interested to check out the "Google Health Privacy Policy" which is referenced on the log in screen shot.

Stay tuned . . .

Hospital Mashup: Google and HHS Hospital Data

NetDoc now as a mashup of Google Maps and HHS hospital data. As Shahid Shah says, these types of tools takes mountains of data and makes it more accessible and easier to digest by the average public health consumer. Here is the view/data of hospitals that are 100 miles from Charleston, West Virginia.

Here is the summary of what the tool provides:

When it comes to treating heart attacks, pneumonia, surgery and other emergencies, you want to find the best medical care available.

To help you make these decisions, visit the NetDoc.com Hospital Rankings tool and enter your ZIP code to see how hospitals in your neighborhood rank on benchmarks set out by the U.S. Department of Health and Human Services in four categories: Heart Attack, Heart Failure, Pneumonia and Surgical Care Improvement/Surgical Infection Prevention.

Thanks to Shahid for the tip on this new tool.

NYT Looks At Dr. Google and Dr. Microsoft

Today's NYT article, Dr. Google and Dr. Microsoft, takes a look at how Google and Microsoft are focusing efforts on the health care industry and how to improve the traditional health care system by utilizing technology to allow patients greater access and control over their personal health information. Both companies are still in the planning phase and trying to determine what will work and what patients might want, use and need.

The entry of these two tech giants along with a slew of other health-technology companies are likely to cause disruption in the health marketplace traditionally controlled by historic models (physicians, hospitals, insurers, etc.) Whether there will be enough momentum to bring change and whether patients are willing to trust these new models is the question that has yet to be answered.

Interestingly, the article mentions a little more about what Google Health might look like. The Google Health prototype focuses on the health consumer:

The welcome page reads, “At Google, we feel patients should be in charge of their health information, and they should be able to grant their health care providers, family members, or whomever they choose, access to this information. Google Health was developed to meet this need.”

A presentation of screen images from the prototype — which two people who received it showed to a reporter — then has 17 other Web pages including a “health profile” for medications, conditions and allergies; a personalized “health guide” for suggested treatments, drug interactions and diet and exercise regimens; pages for receiving reminder messages to get prescription refills or visit a doctor; and directories of nearby doctors.

The article also mentions West Virginia native, David Brailer, former Bush administration National Coordinator for Healthcare Information Technology, who now heads up Health Evolution Partners. Note: Yesterday Matthew Holt posted at The Health Care Blog that Dr. Brailer will be joining the list of speakers at the Health 2.0 Conference to be held next month. Mr. Bosworth of Google will also be on the consumer aggregator panel being moderated by another top health care thinker, Jane Sarasohn-Kahn.

UPDATE: Interested in learning more about Google Health? Check out this post by Jeff O'Conner at the Health Care Information System Blog with links to the Clinical Cases and Images Blog with links to screen shots of the prototype.

Also check out what Doc Searls perspective at ProjectVRM Blog.

UPDATE2: Good insightful follow up post, Here comes Google and Microsoft, from Tony over at Hospital Impact. I especially agree with the last two paragraphs:

Of course, all the same old data issues have to be worked out - privacy, malpractice, storage, interoperability, and security . . . Plus, there's a little problem with funding and business model (hopefully we will never see a Google banner ad within our medical record!) . . . Make no mistake about it- this is not a continuation of the Google vs. Microsoft War that's been going on for years. This is Google or [insert brave company name here] against the most powerful force of them all: the healthcare industry status quo.

Google Health: A Virtual-Doctor In Your Family

Roni Zeiger, MD, Product Manager at Google and part of Adam Bosworth's health team at Google has this recent post on the difficulty of patients getting the information they need.

I can related to his post, Is there a Doctor in the Family? and his discussion of having "better access" to health information. There is incredible value in having a family member who understands the clinical side of health care. My dad, a retired country doctor in West Virginia, at 83 is still my "primary" resource to discuss health issues and get a valuable second opinion on anything related to my health and the health of our family. When the kids get sick we call him to confirm that the advice given by our pediatrician is accurate. When I had to make decisions on whether or not to have knee surgery - he was my sounding board for the pros/cons. I could give 100 more examples where I or others in my family have relied on him to help interpret health care options, treatments and management of our health.

Dr. Zeiger poses the following question in his post, "When I help my loved ones navigate an illness or get up to date with screening tests, I wonder how those who don't have a doctor in the family manage their health."

The answer: They don't manage their health. Most patients find themselves in a sea of information and at the mercy of a complex system. This is one of the fundamental questions that we as health care professionals need to seek solutions for today. Americans have always been great at mass production and we have taken this same approach to our health system. We produce a lot of health care but it is not individualized or coordinated as well as it could be.

If Google can find a way to become this trusted virtual-family doctor and fill this need the patients and providers will be better off in the future. I'll be interested to hear more from Dr. Zeiger at the Health 2.0 Conference who will be participating on the panel discussion on Search in Healthcare.

Tip to Shahid Shah the Healthcare IT Guy for alerting me to this new Google Blog post dealing with health care in his post Google Planning a PHR?

For more information on the Google Health initiative check out this post over at The Health Wisdom Blog which includes links to Adam Bosworth's recent presentation at the American Medical Information Association's annual convention.

UPDATE (6/21/07): Rita Schwab at MSSPNexus Blog adds an insightful post on the topic of Google as Healthcare Advocate? and what to expect when you navigate the health care system.

Scoble On Google Privacy Discussion

Scoble has a good round up of the ongoing discussion about Google's ranking in the recent Privacy International Report titled, A Race to the Bottom: Privacy Ranking of Internet Service Companies and Privacy International's Open Letter to Google.

EWeek.com Article: Google and Health Care

Today I noticed a little more traffic to my blog with much of it coming from www.eweek.com. As a result of a little searching I found an article (Google Aims to Extend Data Mantra into Health Care) quoting from one of my previous post (What Google Health Might Look Like).

My previous post on Google Health was a a reaction and response to a post at the Google Blog by Adam Bosworth, Google's VP, asking to hear from others about how you and I as patients know whether we are getting the best care. The post was not just about "concerns over what could be lost in the digitizing of medical information" (as quoted in the article) but rather an overall examination of what Google Health and some of the other Health 2.0 type companies may bring to bear on our traditional health information system and how this may ultimately impact the quality of health care we receive.