An e-health model for Australia?

CNET has published a long analysis of Google and Microsoft’s efforts at dominating the e-health market in the US. Apparently, the two technology giants, at war on so many fronts, are having a love fest when it comes to e-health.

An excerpt from the article: “‘I love Google Health,’ said Sean Nolan, the chief architect of Microsoft’s HealthVault service. ‘What they are trying to do is a good thing…We are in the same boat. We’re not really fighting with these guys. We’re all trying to make it work.’

“The love, apparently, is mutual. ‘I think it is critically important that there is more than one company trying to do this. (Personal health records) are very hard to get right,’ Google Health product manager Roni Zeiger said. ‘We certainly haven’t done so yet.'”

Hunh? What’s this about? Apparently they have a few common enemies in this territory. “Perhaps mutual interest comes before brass-knuckled competition. Google and Microsoft face many of the same issues–privacy, bureaucracy, and technological intransigence in the health industry–as they attempt to put their own spin on e-health.”

Read the full article for a detailed look at all the issues raised by Health Vault, Google Health and all their competitors.

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Your heart rate, now on Google

Google and IBM have announced a partnership that will enable Google Health to connect to and stream from medical devices.

According to Forbes, “In demonstrations, IBM and Google fitted Wi-Fi radios to gadgets like heart rate monitors, blood pressure cuffs, scales and blood-sugar measurement meters, allowing the devices to communicate with a PC and feed real-time medical information directly into Google’s online records.

“Hooking up those devices to the Web, IBM argues, will offer a new immediacy and granularity of health monitoring. A user can remotely track the blood pressure readings or glucose levels of a diabetic parent living alone, or stream his or her medical information like weight or heart rate directly to a doctor or physical trainer.”

“….For IBM, the new Google Health functions are also a dress rehearsal for “smart” health care nationwide. The computing giant has been coaxing the health care industry for years to create a digitized and centrally stored database of patients’ records. That idea may finally be coming to fruition, as President Obama’s infrastructure stimulus package works its way through Congress, with $20 billion of the $819 billion fiscal injection aimed at building a new digitized health record system.”

Privacy concerns abound. As Forbes reports: “‘They give consumers the appearance of an effective way to keep their health information, but it’s also a digital gold mine for health marketing,’ says Jeff Chester, director of the Center for Digital Democracy, who points to Google’s sponsorship of the ePharma drug marketing conference taking place in Philadelphia next week. ‘It’s one thing to turn your search queries over to Google. This is like making them your next of kin,’ Chester says. ‘Why would you give an advertising company access to your moment-by-moment expression of health concerns and risks?'”

Google, Microsoft, now Amazon?

Call it the commercialization of healthcare online. First it was Microsoft Health Vault and Google Health offering personal health record (PHR) solutions for consumers. Now Internet pundits are saying the healthcare industry should look to Internet giants Amazon for ideas on how to bring healthcare into the 21st century. Anna Maria Virzi, writing on the ClickZ network, says that patients should have access to information about their health records in the same way UPS or Amazon tracks package deliveries.

“A doctor’s follow up communications with a patient – though not exactly marketing – are all part of a customer feedback loop that can help keep a patient and her family informed to make better choices about continuing care,” she writes.

She cites the example of Group Health Co-operative, a Seattle-based managed care organisation. Patients there were first given the opportunity to contact physicians by e-mail about eight years ago and by 2008, “nearly all of the organization’s 850 physicians communicate with patients online; physicians respond to 97 percent of the queries by or before the next day.

“First and foremost, this is to take better care of patients,” associate medical director Matt Handley said. “It saves a patient in-person visits. It leaves a record for patients to access, and it indirectly improves access [to a physician].” He said it was “much safer than paper records.” 

“Once patients realized the benefits of e-visits, Group Health Cooperative promoted the initiative in advertisements.

“But, Group Health patients won’t find any ads popping up in the clinical messages they receive from physicians. ‘There is no spamming, no promotional messages to patients through our electronic medical records,’ Dr. Handley said.

“Group Health professionals say the retention rate was 6.5 percent higher for enrollees who used the digital health record system than those who didn’t. ‘Two-thirds of the patients say this is a very important thing to them when they think about where to get their healthcare,’ Dr. Handley said. ‘It’s hard to give this up.’

Why Google Health?

“You know that money beats soul, every time.” – Jim Morrison, the Doors

I have been itching to write a post where I can slip in a quote from my favourite anti-hero, Jim Morrison. So what on earth does this have to do with Google Health? As I was researching a story about Google and e-health for my oft-mentioned feature for Australian Doctor, I came across some interesting questions – and potential answers – about Google’s foray into something seemingly so far from their core business:

“When it comes to health, Google has become the main place patients turn to for health information online. As well as anecdotal stories such as the US man who walked into a hospital after a Google search of his symptoms correctly led to a self-diagnosis of a heart attack, research shows that seeking health information has consistently rated among the most popular activities of Internet users (more than 80%), and Google is the place where 70% of them start their search.

“Doctors like it too. A study published in Australian Family Physician last month revealed that Google was also more popular with Australian GPs surveyed than the next five web sites combined. They said they used Google because of its ability to lead to other web sites of value, its speed and ease of use, its convenience and its wide applicability.

Looking to the future, Google is also positioning itself for a dominant role in a world where medicine is increasingly linked to the Internet with the recent launch of Google Health, an online personal health record service where patients can enter any or all of their medical histories to create a portable data record that can be accessed by a variety of doctors and other health professionals.

“…. Advocates argue that a Google Health personal health record will result in better-informed patients, fewer redundant tests and better-prepared doctors who can get a more complete picture by having their patients’ entire medical history in front of them. Access to crucial information such as allergies and current medications will allow doctors in scenarios such as emergency rooms to avoid many of the medical mistakes that injure patients or land them in hospital for long stays.

Privacy experts, meanwhile, are up in arms about the potential downsides of such a system, particularly in the hands of a company with no history of handling trusted medical data. They have raised strong concerns that private and personal records could be bought and sold by organisations such as pharmaceutical companies.

“…. Like its other services, Google Health is available free to anyone who is willing to take the time to fill out their profile. The “do no evil” cynics have questioned Google’s motives in straying from its core search business. As a Washington Post writer put it: ‘Why would Google take on such a big, difficult project — creating complex data exchange systems and storing all that personal information — if there’s no way to make money?

“’A strong personal health dashboard linked to other Google services, including its cash-cow search business, can make sure those health-seekers stay with Google rather than with the competition. Like Microsoft, for instance.’”

They may seem like they’re just out to provide a useful service to the Internet-using public, but in the long run, making money – and keeping money out of competitors’ pockets – is behind Google Health.

Money beats soul, every time…

More on Google Health

In researching a feature I’ve been writing about Health 2.0 (more on that next week when it gets published), I’ve been looking into Google Health. While most commentators have focused on the commercial/social/medico-legal aspects of the world’s largest Internet company entering into the murky world of personal health records (PHRs), I came across some technical evaluations of the service. David Kibbe, writing in the Health 2.0 blog, discusses what sets Google Health apart from other online PHR services.

He writes: “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 …Google Health beta achieves for the consumer that is really new and different; this is what HealthVault [Microsoft’s PHR offering] and Dossia [a service set up by five big employer groups in the US including Wal-Mart and AT&T] are to date missing.

“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.”

Take the time to read through the comments on the posting, which are quite interesting. Here’s an example: “As it is, Google PHR is a non-starter for any open-source advocate (“rapid design evolution” [which seems like marketing 2.0 speak] notwithstanding). Patients want options, not “disruptive” technologies. Again, more marketing-speak and hype. Sorry, but most real patients are a little wiser than that.”

Hands up if you want an EHR – anyone?

With all the discussion and developments going on in terms of electronic health records/personal health records online, someone has finally asked the question: is this what consumers want? Keith Schorsch wrote on the Health 2.0 blog the other day about “the elephant in the room: Do consumers really care about having online personal health records?”

He cited current evidence suggesting that less than 3% of health consumers maintain a personal health record online (presumably US figures – Australian figures would only be a fraction of that). While Google “trotted out some great enterprise partners” for its recent announcement about its trial of Google Health with the Cleveland Clinic, Schorsch pointed out that there were no consumer testimonials talking about how Google Health would change their lives for the better.

“I struggle to see how it’s creating value for the average health consumer,” he writes. “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.”

“Google Health fels like a good, incremental step toward putting more control in the hands of the health consumer,” Schorsch concludes, but “without a clearly delineated consumer benefit, this is a platform waiting for a killer app.”