Patients Eyed as Agents of Change for Health IT


WASHINGTON — Search engine giant Google has joined software giant Microsoft in an attempt to revolutionize health care information technology, one patient at a time.

Google launched Google Health this spring with an aim of establishing itself as the leading repository of personal health records (PHR). Google is also positioning itself as a primary clearinghouse for clinical information, self-care tools, and provider ratings to help patients make educated health care decisions.

Google Health emerged just as the smoke began to clear from Microsoft's launch of its own HealthVault PHR platform last fall.

Both companies see individual patients, not health care systems, as the primary locus of change for health care information technology, and both provide individuals with secure but user-friendly systems for aggregating all of their health care records, data, diagnostic images, laboratory results, and medical histories. They hope to put an end to the fragmentation, duplication, and lack of portability that characterize paper-based health record-keeping.

Executives at both HealthVault and Google Health said that they believe digitally enabled patients will help push more doctors to implement electronic medical records systems in their offices.

Todd Wiseman, head of Google's Federal Enterprise Team, says the creation of Google Health was a natural move. “We now have more than 1 billion people worldwide using Google every day. Google is the No. 1 search engine for health information, and health topics are a top search category for Google,” he said at the fifth annual World Health Care Congress.

Google Health will eventually enable people all over the country to store their PHRs and allow them to make their own determinations about who may have access to those records. Users can also store medical contacts and other relevant information. “Users should have easy access to their medical records, and should be able to act on their data. Medical records should follow the patient and exist in an environment of interoperability, portability, privacy, and security,” Mr. Wiseman said. “We don't hold our users' data hostage.”

The system can automatically import physician reports, prescription history, and lab results. Eventually, it will enable people to schedule appointments, refill prescriptions, and employ personal health and wellness tools, Mr. Wiseman said. Google Health's PHR function also will be enriched with specialized health-oriented search functions, clinical trial matching, and a host of other health management tools, all of which can be integrated with a user's Gmail e-mail account.

Google Health will not charge people to store PHRs; likewise, doctors will be able to access their patients' PHRs—with patient permission, of course—at no cost.

“We don't have any plans for ads within the Google Health product,” Mr. Wiseman said. “We see it as a way to drive more Google search traffic.” The search returns, of course, will arrive with ads and sponsored placements (just like every Google search), but he stressed that the PHR side of things will remain free of commercials.

Google is currently running a pilot field test of the Google Health system in partnership with the Cleveland Clinic. “We're 2 months into that, and we have 1,600 Cleveland Clinic patients storing their PHRs right now. This will go up to about 10,000. We're testing the process of data sharing in a live clinical-care delivery setting, with real patients and real doctors. The goal is simply proof of concept. At Google, we strongly believe in testing things.”

Mr. Wiseman pointed out that Google has significant advantages over other companies vying for a piece of the evolving PHR market. For one, the company is wholly independent and not tethered to any health care plan or provider system, so a Google Health PHR is completely portable. Users would be able to access their records even if they change health plans, jobs, or even countries. He stressed that, as a company, Google is a neutral stakeholder as far as how someone uses their PHR, which is different from PHR systems tied to specific health plans. “We stand by the user and the user only.”

Google has one more major advantage: massive data storage capacity. “We can store and manage a lot of data,” Mr. Wiseman said, noting that Google already gives its Gmail users six gigabytes of e-mail storage capacity. “That's a lot. And when you think about storing x-rays, MRIs, and other things like that, there will be a big need for memory.”

Google Health essentially is head-on competition for Microsoft's HealthVault, which has been up and running since last fall. While Microsoft has been involved in health care IT solutions for hospitals and health plans for more than a decade, its PHR efforts are fairly new, said George Scriban, senior product manager for HealthVault.


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