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Health IT Pulse

Jun 29 2011   11:45AM GMT

Google Health, code blue. What’s next in PHR space?

Posted by: DonFluckinger
google health, halamka, Microsoft HealthVault, personal health records, PHR

In officially announcing it would pull the plug on its Google Health personal health record (PHR) last week, Internet giant Google pulled a Cee Lo, saying forget you to developers who had built connectors to large hospital electronic health record (EHR) systems, the hospitals who’d expended resources to build and test that connectivity, and of course the patients — admittedly, not the millions Google had hoped would help monetize the site — who had come to rely on the service to aggregate their health data.

Pundits posit many reasons for Google Health’s epic fail, blaming everyone from patients to payers to Google’s marketing team. Pile on another from us: Corporate impatience.

“It takes a long time to get traction in the healthcare IT space,” IDC Health Insights practice director Lynne Dunbrack wrote Health IT Pulse in an email, “so there is also a certain amount of impatience on the part of Google. It took more than 10 years for online banking to gain significant consumer acceptance and PHRs will follow a similar trajectory.”

Shame on Google for launching this service in the first place if they weren’t planning on supporting it for the long haul — meaning, until public and private entities settle upon health data standards and the execution of national health information exchange. That could be a decade-long health IT construction project, according to former U.S. HIT coordinator David Blumenthal.

Hospitals run on razor thin 3%-4% margins in this atrocious economy, when they’re profitable at all. Some invested IT dollars to port patient data to Google Health. Patients, who we’ll concede didn’t have to pay for Google Health, still had to invest time and personal bandwidth learning how to use it. Imagine, for a minute, how it’s sometimes tough to learn how to use a new computer system when you’re well. Now, imagine how patients — by definition, they’re sick, or they wouldn’t be patients — get to go out and shop for a new PHR and figure out how it will parse their health data.

Forget you, too, Google.

Personal health records will become more relevant to patients as more and more of the country’s health care providers convert their paper workflows to digital and patients get more involved in the economics of choosing their own health care options — including comparison shopping now possible at sites such as the Massachusetts Health Connector — and they port their genomic data to a PHR to customize personalized medicine plans.

Post-Google Health, who are the front-runners to capture mind share in this emerging market? It’s impossible to predict in these still-early stages, but here’s our three to watch:

  • Microsoft. Never count these guys out. In talking with the physicians and other company leaders involved in HealthVault, I get the sense they’re in it for a much longer haul and have a lot more to lose if they were to pull the plug. Out in the industry, people like LifeImage’s Hamid Tabatabaie tell us of Microsoft’s willingness to build vendor alliances and expend resources up-front that benefit patients now and whether or not they eventually pay off. As one would expect, Microsoft’s already posted easy instructions on how Google Health users can port their health data over to the other side. While the Microsoft blogger was quite gracious toward Google in that blog, one can only imagine the Stanley Cup-esque celebration in the HealthVault headquarters last Friday.
  • AHIMA. The American Health Information Managers Association lists right on its MyPHR home page the patient subgroups who most need PHRs: Students, the chronically ill, soldiers and their families, seniors, parents, caregivers, athletes, travelers and physicians. Wow. What if Google focused its message so clearly? What if Google Health had been run by health information managers, and not Web monkeys? What if, like AHIMA, Google made personal health records an outreach project to improve patient health and quality? These guys — and gals — are for real.
  • Anyone who received a $1.25 million federal grant for PHR development and who is working with Indiana’s health information exchange innovators probably have their heads screwed on straight and aren’t planning to send their PHR horse to the glue factory anytime soon.

In the end, it might be that PHRs will be relevant to only the 10% or 20% of patients who are chronically ill and using a vast majority of the U.S. health care system’s bandwidth. But unless accountable care organizations become the standard of health care management — making primary care physicians (and the information managers who work for them) the ultimate custodians of patient data, not patients themselves — that’s still a lot of people who will need PHRs. Google won’t be around to help them. Guess that’s better to know now than later, when Google would have let millions more down.

Oh, and in a classic “Don’t let the door hit your backside on the way out” move, Google sent a missive to its partners reminding them of their obligations. Our pal Dr. John Halamka, CIO of Beth Israel Deaconess Medical Center in Boston, reprinted the email. Get those Google logos off your site soon, partners, unless you want to run afoul of the trademark police!

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LynneDunbrack  |   Jun 29, 2011  1:41 PM (GMT)

Updating PHRs from a consumer perspective can be daunting. Extremely daunting. When I was researching my [I]When Will PHRs Gain Consumer Acceptance[/I] report, I revisited my Google Health and Microsoft HealthVault accounts I established when both PHR platforms were launched. I [A href=””]blogged [/A]about that experience using Google Health on [A href=””]IDC Health Insights Community[/A]. To be fair to Google Health, while it was cumbersome to find the data the application needed to validate me (and as a former privacy officer I get why they needed all this information, but for the average consumer hunting down prescription bottles for the Rx number, trying to remember member portal login information, etc. would be enough to discourage PHR use), it was the data coming from my health plan that was of greater concern. Again, as an industry analyst and healthcare veteran, I understand that claims data is a poor proxy for clinical information and coding for billing purposes is inherently different than coding for clinical documentation. But again, thinking back to the average lay consumer, how would she react if she discovered she had an abnormal result — 11 months after the test was done — when she was updating her PHR?


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