Google Health Allows Users to Store and Retrieve Health Information Online
Google has just announced the release of its new Google Health service. They join a growing panel of online services (including Microsoft’s HealthVault and America Online founder Steve Case’s Revolution Health) designed to allow users to store and retrieve health information online. The search engine powerhouse brings an impressive pedigree of technological expertise that has engineered the likes of Google Earth, Google Maps, and Google search-driven commercial tools, all sizable successes in their own right. Now they toss their hat into the healthcare information arena.
The concept is compelling, in theory: Allow individuals to enter, transfer, and store personal health information in an online repository, and allow it to be accessed immediately when desired. Consultation for a complex medical problem at a new facility, for instance, could be facilitated without phone calls and requests for old records if such an online system could archive prior health records. An emergency room visit for a traumatic injury while you are incapacitated Voilá, and your health records are available online within seconds (provided you or your designate provide permission to do so). It avoids the usual phone calls to one or more medical records departments in other hospitals or doctors’ offices, which may or may not make them available, especially at off-hours, slowed by the human factor of retrieval and transmission by fax or other slower media. Privacy of information is maintained, in theory, accessible only by knowing your chosen username and password.
Google Health’s capacity for uploading of personal information is still rudimentary. To date, sources capable of interfacing with the Google Health service include the following:
- Medco, a pharmacy management service, allows people who obtain their prescription information and history that can be uploaded to Google Health.
Quest Diagnostics, a nationwide clinical laboratory system, allows users to view laboratory results online if tests were performed in a Quest laboratory.
- National pharmacy retailer, Walgreen’s, like Medco, allows users to import prescription drug history from the pharmacy’s database.
In addition, there is a service to help convert hard copy medical records to digitized format, an online search service that automatically performs Web searches that provides information relevant to user health concerns, even a fee-for-service that allows nurses to extract relevant data from conventional medical records into a format usable on Google Health.
While the service itself is free to use, and despite Google’s announcement to not host advertisements, there are some potential hidden commercial advantages evident. For instance, the Cleveland Clinic has a strong presence. When Explore Health Services is selected, for instance, the Cleveland Clinic’s MyChart comes up among the first. This service, provided by the Cleveland Clinic, allows patients in their system to upload their medical records to Google Health. Look for doctors, and you’ll find that doctors affiliated with the Cleveland Clinic system apparently are already up and running with medical record systems interfaced with the services on Google Health.
The foremost concern expressed by critics is the potential for loss of privacy. In an age in which privacy concerns in conventional medical settings have actually been stretched to the point of absurdity (aka HIPAA, or the 1996 Health Insurance Portability and Accountability Act), services like Google Health introduce a degree of health information accessibility and transfer that threatens to degrade privacy. Imagine, for instance, your list of drugs from the pharmacy giant you use includes a list of medications that point precisely to your diagnoses HIV drugs, cancer drugs, heart disease drugs, chronic infections, etc. Of course, information you download from, say, Medco or Walgreen’s, is already online (as we speak), and making it accessible on Google Health is simply a matter of porting it from one online database to another.
So the essential question is how secure is Google Health and how effectively will a username/password barrier maintain security?
Most of us would like our personal health records to remain restricted. Most of us would prefer that employers, insurance companies, or anyone with a stake in knowing about our health would not be allowed access to our records without express permission. While Google Health does not allow unrestrained access, and in fact pains have been taken to prevent unauthorized access, it remains a theoretical risk. Will occasions arise, for instance, when you provide your username and password to the urgent care center to access your medical records, in which the barriers break down due to human frailty or error? They surely will, but is that occasional cost and small risk too great to stop this tidal wave of information accessibility?
What if we take the flip argument: Will single-site potential for accumulated health information empower us? Will it allow healthcare providers and medical consumers an opportunity to review in detail what has transpired in our care? Will this make us smarter healthcare consumers, more effective judges of healthcare . . . healthier? This is where my hopes lie: the emerging phenomenon of the individual as captain of his or her own healthcare. Nobody cares more about your own health than you; not your doctor, not your pharmacy provider, not your insurance company (who, we might argue, cares least). I envision an age (many years from now) in which the level of healthcare sophistication of the average healthcare consumer of the future matches or exceeds the knowledge of the average healthcare provider of today. Services like Google Health that cultivate this phenomenon of knowledge dissemination is, I believe, a step towards this new age in health. (I would go as far as predicting that the most promising solution to the runaway costs in healthcare is not in tort reform, or in guaranteed healthcare for all, or in Medicare or insurer cost-cutting, but in the potential for the average person to seize control of preventive practices, and to become a discerning buyer-beware consumer of healthcare services sensitive to cost differences.)
The Google Health service is clearly a work in progress, with much more polish needed. Many prominent healthcare service providers are not available on the service and will need to participate in order for the majority of Americans to be able to benefit from the service. Despite the Cleveland Clinic’s clear headstart, other hospitals and physicians will need to sign up in order to allow patients access to their records. I only stumbled upon the Google Health service by accident: Nobody has educated my staff, nor shown us how to even begin to allow Google Health access to our computer records, nor has the hospital system I use for my patients made any mention of interfacing with the service. Clearly, a considerable amount of work will need to be done before this service can work for the majority of Americans.
Microsoft’s HealthVault has an 8-month headstart over Google in launching a similar service. In particular, HealthVault is farther ahead in partnering with hospitals, a crucial step towards a genuinely useful online health record. After all, even with current healthcare delivery models, it is the hospital record that is most helpful and details an individual’s health history, much more so than a doctor’s office records. HealthVault has clearly obtained the input of healthcare providers, with an eye towards building “data portability,” “clipboard-free admissions,” and “medication reconciliation.” They have also just begun to incorporate unique online health information tracking tools, such as a blood sugar tracker that uploads blood sugars from the One Touch glucose monitor; body composition data from Tanita body analyzers; and heart rate records (e.g., during exercise) from Polar heart rate monitors.
This is no easy task. Despite approaching 20% of U.S. gross domestic product (GDP), the healthcare industry itself has not been able to coordinate a nationwide data-sharing standard that would permit such widespread, seamless sharing of health information. It is ironic that the potential solution emerges from outside of healthcare. But the simple fact that information technology giants, Google and Microsoft, have entered the ring demonstrates just how enormous (and potentially profitable) this issue has become. Will the services of these technology information experts but outsiders to healthcare provide a usable and secure solution? Will they accelerate the push towards an exclusively electronic medical record? Could it even take us a step further towards reduction in medical errors, improved quality of care, even reduced costs? My bet is that after the inevitable beginner’s fits and starts, they will.
Read more on Google Health with Jane M. Martin's post Who's Looking at Your Medical Records?