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.
Roni Zeiger shows off the beta debut of Google Health at Google headquarters.
(Credit: Stephen Shankland/CNET News.com)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."
Google Health is now live, in beta testing.
(Credit: Google)
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.
Marissa Mayer, vice president of search products and user experience
(Credit: Stephen Shankland/CNET News.com)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.
Updated at 7:40 a.m. PT with Schmidt's news conference comments.
ORLANDO, Fla.--Search giant Google launched Google Health and announced major industry partners on Thursday, aiming to be the Intuit for personal health care, where people can access all their health information in one spot.
Google Chief Executive Eric Schmidt answers reporters' questions after announcing Google Health.
(Credit: Elinor Mills/CNET News.com)"Why would Google be here?" Google Chief Executive Eric Schmidt said during a keynote speech at the Health Information Management Systems Society trade show, which he said was not one the company has normally attended. "What's the most important search I could do?"
The answer: health. Nearly one out of two Americans has a chronic health condition, he said. Meanwhile, people are already using the Web to get information, including one man, who told Google a search for heart attack symptoms on Google led him to call an ambulance and saved his life, Schmidt said.
"We're going to partner with leaders in health care to cross-connect...and apply the principles of the Internet" to improve the industry, he said. "The first principle is, it's the user's data. The data follows the consumer wherever they go" when they change doctors or insurers.
Currently, there are more than 200 personal health record systems that are closed or tethered to a particular health system, he said.
Google Health aims to untether the 2 billion X-rays taken in the U.S. each year, 62 million CAT scans, and other health data, and put them all online for the patients to access.
Future partners include major hospitals, pharmacies, and insurers, including Walgreen, Aetna, Wal-Mart Stores, the University of California at San Francisco, the American Heart Association, Quest Diagnostics, Long's Drugs, the American Medical Association, Cedars-Sinai Medical Center, and the Lucile Packard Children's Hospital at Stanford University.
Google turned to experts in the field in creating Google Health and formed a health advisory council that included Dean Ornish of the Preventive Medicine Research Institute, Molly Coye of HealthTech, Paul Tan of the Palo Alto Medical Foundation, and Sharon Terry of the Genetic Alliance.
A Google employee who is also an emergency room doctor demonstrated Google Health, which was previewed at Google's booth at the HIMSS show.
The system stores all the health records of a patient and enables users to import records from different health provider systems, as well as search for doctors and get information on conditions from Google Scholar, discussion groups, and other sources.
Google Health lets consumers get information about medical conditions, including illustrations to help identify symptoms, as this screenshot from CEO Eric Schmidt's keynote shows.
(Credit: Elinor Mills/CNET News.com)Third-party developers have created gadgets that can be embedded in iGoogle home pages for things like alerts to remind patients to take their medicine, and other developers have created interfaces for displaying a weekly view of all the medicines a patient takes.
During a question-and-answer session, a physician told Schmidt that he has "a pang about 'Big Brother Google' knowing so much about me." Schmidt assured him that the system would be safe and secure, and that no information could be shared with anyone without permission from the user.
During a news conference after the keynote speech, Schmidt said that if the government tries to subpoena Google for the consumer records, the company would have to comply, but he hinted in answering a follow-up question that patients could circumvent that by deleting their records.
"We are subject to U.S. law. In the case where we are forced by court to turn over information, we would do it," he said. "If the information were not there, it would be (hard) to subpoena it," he added.
Asked if insurance companies would have access to the data, Schmidt said that barring a law, the only way Google would share with insurers is "if someone were to force us with a gun to do it."
"We have taken a pretty aggressive position with regard to protecting (consumer) privacy in the U.S., but we are subject to U.S. law," he said.
Earlier, an attendee asked whether Google has a "monetization path" for Google Health.
"Not in the short term," Schmidt said, adding that the hope is that people using the site will also use other Google sites and ultimately click on ads there. Google News similarly drives people to search on Google.
UPDATE 2:30 p.m. PT with hospital CIO comment.
ORLANDO, Fla.--Google Chief Executive Eric Schmidt will detail the company's plans for Google-izing the health care industry at a health care trade show on Thursday morning, starting with a consumer destination site called Google Health.
Schmidt is scheduled to give the morning keynote speech at the Healthcare Information and Management Systems Society (HIMSS) 2008 annual conference here and will outline Google's vision on tackling the next Internet frontier of medical data. The move, rumored for a few years, makes sense, given how much people use the Web to get health information and how much they spend on medicines and health care.
Google Health is being previewed at the company booth and gives a glimpse of what consumers participating in a trial in Cleveland will experience--a clean and simple interface where people can get to their health information in one place, share it with others, and search for information and care providers. Google Health will be available for anyone with a Google account to use later this year, said Missy Krasner, product marketing manager for Health Team Google.
This will be extremely convenient. Who hasn't struggled at the doctor's office to remember when that smallpox vaccine immunization was received or been overwhelmed by the task of trying to find a specialist doctor who takes your insurance plan and is located near your home or office?
Consumers using the site will be able to create a customized profile of their health, and share that with doctors and family members, as well as eventually important medical records from hospitals, doctors' offices, and pharmacies. The site is integrated with Google Maps and Gmail to enable people to search for health care providers, see their locations on a map, and save the contact information in Gmail.
Like it does with home page gadgets, Google will allow third parties to create gadgets that work within the platform. For instance, one gadget could alert people through Google Calendar when they need to take medication, Krasner said.
Google representatives weren't allowing anyone to take photos of the screen, but I snuck this one on my iPhone. On the table next to the chairs were the requisite colored lava lamps, infusing the sterile medical trade show environment with some cool, Silicon Valley Google aesthestic.
The screen shown at the Google booth featured three main columns of information. On one side were links to notices, drug interactions, and medical contacts, among others. In the middle were links to allow you to add more stuff to the profile, import medical records, discover more health tools, and find a doctor. On the right side is the profile summary, where you can link to conditions, medications, allergies, procedures, and test results.
The Google booth was tiny in comparison to others around it, but it was extremely crowded with representatives from other companies wanting to partner with Google and with consumers eager to know what Google has in mind for their medical information.
"I spend more time on Google than anywhere else on the Web," said one woman, who stepped up for a demo and was handed a Google mug and a cookie because the Google oven mitts handed out in prior days were gone. (Google also gave out aprons at a party for partners the night before to go along with its "Google Home" theme for the event, to signify that Google Health is a "safe and central place on the Web for medical information," Krasner said.)
Given Google's strong brand in search and its reputation for innovation, there's no doubt that consumers will be riveted. However, Google will have to convince people that it can adequately protect their personal information, particularly sensitive information like medical conditions that could be misused by employers, insurers, and others, if exposed.
"There's going to be a time when law enforcement wants to see the records of someone," said Michael Zimmer, who is the Microsoft resident fellow at the Information Society Project at Yale Law School. "We know law enforcement has already asked for search records."
Google Health will be serving as a proxy for the consumer and therefore is not subject to government regulations such as the Health Insurance Portability and Accountability Act (HIPAA), as hospitals and doctor clinics are. This worries the World Privacy Forum, which issued a report (PDF) last week on the privacy consequences of personal health records. Such records can be more easily subpoenaed by a third party than health records covered under HIPAA, and data could leak into a marketing system or otherwise sold, the report said.
Krasner said Google Health users will actually have more control of their data because their express consent is required for any data sharing. Users can also hide portions of their profile, if they share it with others, and can delete data.
"I don't think consumers really understand this stuff," said Greg Sterling of Sterling Market Intelligence. "The convenience of having a health profile online would be valuable, but the issues of privacy and security really trump others, until there is legislation in place to protect consumers."
Google and others "want to become a new generation of digital Park Ave. doctors. They claim they are protecting medical and health privacy, but the real goal is to harvest consumer health data so they can target individuals with precision advertising for specific prescription drug brands and over-the-counter remedies," said Jeff Chester of the Center for Digital Democracy. "Behavioral targeting and other interactive marketing require a range of specific privacy safeguards, when it comes to health marketing."
Krasner told CNET Networks' ZDNet that Google won't sell the data and won't put ads on the site, but rather hopes to drive traffic to partner sites where there will be ads. In addition, Web searches will not be used to provide services or information to users of Google Health, Google representatives said.
One hospital administrator who hasn't seen Google Health yet is optimistic about the plan. "Generally speaking, personal health records are a good thing. I'm all in favor of individual responsibility, and having information close to you and in your control," said Craig Vercruysse, chief information officer at California Pacific Medical Center in San Francisco. "It is smart on Google's part to tie that into their overall search strategy."
Microsoft as friend or foe?
Google also faces competition from others, such as Microsoft's HealthVault, Healthline, WebMD and Revolution Health, founded by AOL founder Steve Case.
One of the most popular features of Revolution Health's Web site is the free personal health record, and people feel comfortable using it, Case said in his keynote at the HIMSS conference Wednesday. Consumers also like the Care Pages section, where friends and family can get updates on how a patient is progressing.
"We believe care pages can be the initial link between hospitals and consumers," Case added.
Earlier in the week, Microsoft announced that it was planning to spend $3 million to drum up developer support for its HealthVault electronic-records platform. Google Health could work with HealthVault, Microsoft representatives said.
"We are committed to being open," said Peter Neupert, corporate vice president for Microsoft's health solutions group. "We're just the custodian for the data. If you want to move the data from HealthVault to Google, you can."
Microsoft is creating a back-end ecosystem for developers, while Google is jumping in with a front-end site for consumers.
Google's strength in search technologies gives it a leg up over the others, said Alfred Spector, vice president of research and special initiatives at Google, as well as an engineering executive for Google Health. "Other core advantages are the infrastructure for storage, high availability, and scalability."
Other challenges remain for Google. The slow-moving health care industry is focused on long-term planning, while Google grew up in the rapid-pace environment of the Internet.
If it wants to extend its reach beyond the consumer portal, Google will need to find ways to work with more entrenched industry giants, such as Intel and General Electric, which are already working to bring the medical field into the Digital Age.
Update at 12:19 PM PT: This story was updated to reflect the World Privacy Forum's position on PHRs in general.
Google is set to announce on Thursday that it will be using the Cleveland Clinic hospital in Cleveland, Ohio as the pilot site for its new personal health records initiative.
The Cole Eye Institute (foreground) and the taller Crile Building, which is the flagship facility of the Cleveland Clinic.
(Credit: Cleveland Clinic)Between 1,500 and 10,000 patients at the Cleveland, Ohio, facility will participate in the project's test run, volunteering to have their medical records transferred to their Google accounts. The hospital already keeps electronic records for over 100,000 patients in an internal system called MyChart, but when those personal health records, or PHRs, are shared with Google, patients will be able to use them outside of the Cleveland Clinic. Included in the data will be prescription information, medical histories, and details about conditions and allergies.
"Patients are more proactively managing their own healthcare information," Dr. C. Martin Harris, the Cleveland Clinic's chief information officer, said in a statement. "At Cleveland Clinic, we strive to participate in and help to advance the national dialogue around a more efficient and effective national healthcare system."
"We believe patients should be able to easily access and manage their own health information," Marissa Mayer, Google's vice president of search projects and user experience, said in the same statement. "We chose Cleveland Clinic as one of the first partners to pilot our new health offering because as a provider, they already empower their patients by giving them online tools that help them manage their medical records online and coordinate care with their doctors." Additionally, Cleveland Clinic president and CEO Delos M. Cosgrove is a member of Google's Health Advisory Council.
Google isn't the only tech titan looking to change the healthcare industry. AOL founder Steve Case has launched a new company, Revolution Health; InterActiveCorp has invested in several health-related start-ups; and Microsoft has been working on a medical record service.
But all these "health 2.0" initiatives will inevitably raise privacy concerns, and critics of such projects have already begun to make themselves heard. The World Privacy Forum, which has highlighted concerns about medical identity theft in the past, has already issued a report voicing concerns about third-party PHR systems that aren't covered by the Health Insurance Portability and Accountability Act (HIPPA), which has been in effect since 1996 and requires individuals to be notified when a party other than a patient's doctor wants to access confidential medical data.
Not only is security an issue, the nonprofit has said, so is the likelilhood that marketers and other corporate entities will be able to exploit otherwise confidential data. The World Privacy Forum has not taken a specific stance on Google's new project or on others like Microsoft's.
Google is of particular concern to some privacy advocates because the company already has so much data about its users.
"While PHRs may have some laudable goals," the report by privacy consultant Robert Gellman read, "they are also a tempting target for companies or others that want to evade whatever privacy protections remain in the health care system in order to make a profit."
The Wall Street Journal is reporting that Adam Bosworth, who headed up Google's health-related projects, is leaving the company. The news was first reported on Search Engine Land.
A Google spokesman said Bosworth was on vacation and had "decided to pursue other opportunities after that." He joined Google in 2004 after leaving BEA Systems.
Google and its main rivals have been preparing to expand their health and medical information-related services as more and more people seek out such information online.
Vince Kuraitis has dissected a multitude of postings and literature produced by Google's vice president, Adam Bosworth, and here's his theory on the search giant's health initiative.
Kuraitis, principal and founder of healthcare consultants Better Health Technologies, predicted Monday at the fourth annual Healthcare Unbound conference that Google may develop the next generation of the personal health record.
After combing through Bosworth's material, Kuraitis said he wouldn't be surprised to see a Google Health that is patient-centric, where consumers own their personal health data and access it via a Web site, which acts like a repository for the information.
With proper approvals, a user could share their health information by giving designated people access to their online content, Kuraitis speculated.
A Google Health project may involve XML, a Continuity of Care Record, and tight security measures, Kuraitis surmised.
"Google wants to inject themselves and become the personal health record platform," Kuraitis said in his keynote speech at Healthcare Unbound. "Personally, I would like what Google Health would do, but I realize not everyone will feel as warm and fuzzy."
Warm and fuzzy may not be the words to describe Google's health related efforts, including its Google Health Advertising Blog, which launched on June 18. Here's one perspective, posted on DeliFaks.
Anyways, Kuraitis' hunch may not be all that far off. There have been some rumblings of a Google Health effort since last year.
Is the doctor in?
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