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Google Health Post-Mortem: Where Did We Go Wrong?

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altWe store our email online. Documents. Photos. Financial information. Various companies offer these services, and one — Google — does them all, very well, for free. Why not add health information to the mix?

altWe store our email online. Documents. Photos. Financial information. Various companies offer these services, and one — Google — does them all, very well, for free.

Why not add health information to the mix? There’s been great interest in being able to store vaccination information, or some old EKG’s or chest X-rays, online, securely but easily accessible. A lot of people would love to trend their own cholesterol levels, or have a record of their doctor’s prescriptions.  

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Google Health was introduced in mid-2008 with some fanfare and (on my end, at least) a lot of optimism. At that point, Google could do no wrong, having revolutionized the process of web search, and then email, for free. Google had a knack for transforming cumbersome computer experiences into something intuitive, fast and fun. Could they do the same for health information?

As it turns out, the answer is no. Google recently announced their Health offering will be shuttered next January 1, though it will still be possible to export health data off Google Health until 2013.

What went wrong? There are several theories. Adam Bosworth, former Google Health head, said, “It wasn’t social enough.” He might have a point, though at first pass, the idea of sharing one’s health data the same way we share Facebook photos or status updates seems laughable. But if you notice, a lot of Facebook status updates are health-related, from food discussions to 5K run times, even chemo updates (for a few  friends in my network). Would Google Health have taken off if more data was sharable? Maybe — witness some of the Biggest Loser-like apps where peer pressure motivates exercise and weight loss. There’s even a WiFi scale you can buy, so data can be shared efficiently and honestly.

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So maybe Google Health just needed to be more than a repository — something fun and engaging for patients. Or, it needed to be a better repository — users have criticized how difficult it was to load data into the service. Google’s claim that they were exempt from HIPAA should’ve helped streamline the process, but only made users wary (Google denied having a therapeutic relationship with customers or their providers and hence, they were not a covered entity). One user told me that the data, once (finally) loaded, was not easy to trend or analyze. What’s the point of having this information in the cloud if it can’t be easily interpreted?

These are all reasonable complaints. What’s really strange to me, however, is that Google didn’t put more effort into improving the service before announcing its demise. After all, Gmail wasn’t a full-featured webmail service on day one; it took years for Google to introduce the features that make it a worthy enterprise competitor to Outlook.

And don’t tell me that healthcare requires partnerships and common standards. Of course it does, and Google does this well. Google leads the Android consortium of telecommunications companies and handset makers, and, since around the same time Google Health was announced, Google quickly established the world’s leading smartphone operating system. Google knows how to do partnerships and standards when they want to, and Google Health was built on a common standard (CCR) and worked with several high-profile hospitals and big drug store chains. The problem appears to be that they didn’t have enough partners, and didn’t work with them enough to make the data entry process smoother.

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What’s especially strange about Google pulling the plug on its Health offering is that PHRs (personal health records) are really about to take off. One of the key provisions of Meaningful Use (the federal program to incentivize adoption of electronic medical records) is that patients should be provided with electronic copies of their records, if they ask for them. Very soon, patients are going to have access to their health data on a scale that was difficult to imagine in 2008. Where are they going to put this data? How are they going to be able to show it to their next doctor? There is a burgeoning opportunity here, and while other companies are racing to fill this need, Google Health is walking away.  

Why? Other PHR companies would kill for Google’s brand recognition and installed user base. But Google is fighting a lot of other battles now – with Apple over mobile web use, with Facebook over referrals and personal information sharing, and with Microsoft over search, browsing and office apps. Maybe new CEO Larry Page thought that was enough to focus on.

It’s too bad. Healthcare is definitely an industry that needs the simplification and improved user experience that Google typically provides. That such a powerful company decided this goal was too difficult, or not worth the effort, is discouraging.

Regardless, the fundamentals are still in place for a revolution, from meaningful use and the rise of EMRs, to a do-it-yourself population comfortable with managing their information online. Google Health was a service before its time, but that doesn’t mean other services can’t take its place or accomplish great things for patients. 

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