Google Health beta test begins

Update 4:20 p.m.: I added some more detail and comment. Update 12:50 p.m. PDT: I added more detail.

MOUNTAIN VIEW, Calif.--Google on Monday launched a beta test of its Google Health service to archive medical records and find medical services.

The site is a personal portal that can be used to upload, store, and view personal information, retrieve records from partners, investigate health matters, set alerts such as a reminder to take medication, and run applications that can, for example, keep track of how many miles a person has walked.

In some areas, Google's expansion from just search takes on incumbent powers; Google Docs, for example, competes with Microsoft Office. But Google Health competes more with a tangled mess of regulatory and privacy complexity.

"Personal health records is an area that's just beginning," said Roni Zeiger, the Google Health product manager. "The fact that only few people are using those tools means we"--the computing and health care industries--"haven't gotten it right yet."

Google has been talking about the health initiative for a year. Now, "we actually have the product," said Marissa Mayer, vice president of search products and user experience. "You can sign up today. It is open to the public."

The service will never sell a patient's information and will only share it with the patient's permission, Zeiger said. And a user can revoke rights to share at any time.

"No Google Health user will ever find their Google Health information as search results anywhere on Google. That information is yours," Zeiger said.

To join, users must agree to various terms of use, including this: "When you provide your information through Google Health, you give Google a license to use and distribute it in connection with Google Health and other Google services."

Growing beyond Google's control?
Google has done well with privacy for Google Health, but there are larger issues that pose problems, said Leslie Harris, CEO of the Center for Democracy and Technology.

"I think Google's privacy policies are good and the fact that they are going to vet applications and services is also good," Harris said. But there are potential problems, too, if Google Health grows beyond Google's grasp.

"I think the biggest concern is about the applications and services that will ride on top of the service that Google will have only limited control over," Harris said. "The company has appropriately developed a set of rules for those providers and will screen them before they are allowed to offer services. Those rules require express user consent for any use or sharing. But it will be impossible for Google to monitor all the vendors closely over time."

And, she added, "Consumers are going to need to have a legal remedy for misuse of their personal health information." The Health Insurance Portability and Accountability Act (HIPAA) doesn't govern much of what Google itself does, and after that, the only recourse is trying to get the Federal Trade Commission to enforce companies' privacy policies.

Central copy of medical data
Google essentially creates a master record of an individual's health information by importing data from health-related institutions or by letting the individual add it themselves.

"Google on your behalf is storing a copy of your records," Zeiger said. Connections with medical organizations can be set to update regularly to stay up to date.

The service integrates with medical records already stored electronically at pharmacies including Walgreens, Medco, RxAmerica, and Longs Drugs; medical facilities such as Beth Israel Deaconess Medical Center and the Cleveland Clinic; Quest Diagnostics, which stores medical test results; and AllScripts, which stores medical records for more than 40,000 doctors. For importing doctor records from AllScripts, the doctor must approve the connection to Google Health, said AllScripts spokesman Todd Stein, but the company's software is enabled to make the link.

If a patient permits sharing, right now it's an all-or-nothing affair, Zeiger said, so if you want to share your data but keep information about a sexually transmitted disease secret, you'd best wait for now. Google is working on making a finer-grained permission system, Zeiger said.

For more details on regulatory issues, see Google's blog entry on privacy and data protection with Google Health.

Making money?
Google was mum on how exactly it hopes to make money from Google Health other than driving a bit more traffic to its search engine, which of course shows ads alongside search results, and in increasing the user loyalty--in other words to keep them coming back for more.

But I could see a longer-term possibility similar to what the company has done with Google Apps, the collection of online applications for word processing, e-mail, calendars, and other tasks. It's free for average folks, but the company charges subscription rates for enterprise users.

Perhaps Google Health could be free for ordinary patients but a managed storage subscription for doctors, hospitals, or others that need to archive this sort of data. Few relish the task of storing huge quantities of data--think of a large hospital's daily output of high-resolution images from X-ray film and MRI scanners. But Google can't get enough of it.

Plus, it's programmable
Google wants more elaborate software to run in conjunction with Google Health, and accordingly has an application programming interface (API) so people can, for example, integrate Web site widgets.

"Today we're publishing our APIs--our instructions for how programmers connect," Zeiger said.

The service right now is only available in the United States, but Google will expand it, he added. To do so, Google Health must navigate choppy waters.

"Health care is more complex than other products Google launches. Even at the level of privacy and regulation, we have a lot of homework to do and a lot of learning," Zeiger said.