Like so many attempts before it — drkoop.com and RevolutionHealth.com to name just two — Google has found that implementing personal health records in a meaningful way is really, really hard.
So hard, in fact, that it has given up and is shuttering its Google Health service, after just 3 years being open to the public.
Now’s a good time to review Google Health and why it may have never been the roaring success Google had hoped it would be. Perhaps this can act as a warning for future companies who think that (a) there’s a huge, pent-up demand for personal health records and (b) implementing them in a way that is engaging and helpful is easy.
Let’s start with Google’s statement about Google Health’s failure to capture any significant component of the electronic health record space:
In the coming months, we’re going to retire two products that didn’t catch on the way we would have hoped, but did serve as influential models: Google Health (retiring January 1, 2012; data available for download through January 1, 2013) and Google PowerMeter (retiring September 16, 2011). Both were based on the idea that with more and better information, people can make smarter choices, whether in regard to managing personal health and wellness, or saving money and conserving energy at home. While they didn’t scale as we had hoped, we believe they did highlight the importance of access to information in areas where it’s traditionally been difficult.
Of course, when you shut down a product, you have to put as a good a face on it as possible. It’s not a failure — it was a “influential model” for the entire industry! Despite have zero data to demonstrate that Google Health actually helped “people make smarter choices [about their health],” they promote the claim to make it seem like Google Health made a difference.
Objectively, it’s hard to exactly see what kind of difference — for better or worse — Google Health may have made. Since they’ve never publicized numbers of total or active users, it’s hard to gauge whether it had any impact whatsoever. But we know how it helped move the needle in at least better understanding the complexity and difficulties of medical and health data.
That’s because of our own e-Patient Dave, who took Google and his hospital up on the promise of Google Health. As he he detailed a year after Google Health launched, he had a difficult time using it with actual real-world data from his doctor. He had good reason to believe Google Health could help him gain better access to his health records, because that’s what the hype machine suggested:
When Google Health launched last May, my hospital’s CIO blog said “we have enhanced our hospital and ambulatory systems such that a patient, with their consent and control, can upload their BIDMC records to Google Health in a few keystrokes. There is no need to manually enter this health data into Google’s personal health record, unlike earlier PHRs from Dr. Koop, HealthCentral and Revolution Health.”
Sadly, it appears Google’s QA team never actually tried to do what they and their partners said was readily do-able with Google Health — use it to view and interact with their medical and health data.
When it launched to the public in 2008 (after being in development and private testing for two years), Marissa Mayer, who took over the Google Health initiative from Adam Bosworth, was very optimistic about the product’s potential and future:
Google Health, Ms. Mayer said, represents a “large ongoing initiative” by the company, which she said she hoped would eventually include “thousands of partners and millions of users.”
She had good reason to be optimistic. Because, after all, people already use Google to search for health information. Why not help them even more?
“If you look at health care, there’s already a huge user need, people are already using Google more than any other tool on the Web to find health information,” Mayer said. “And the health care industry generates a huge amount of information every year. It’s a natural core competency fo us, to understand how to organize all that data.” […]
While the focus will be on improving health care and making records more accessible and portable for patients, Google will also improve life for physicians, Mayer noted.
“The goal for a lot of doctors is how many patients can they see in a day,” Mayer said. “That means their minutes per patient has got to go down, and the less time they have to spend finding and going over patient records the better. Ultimately we will design a product that’s useful for users, and also helps doctors do their job more quickly and more efficiently.”
Great ideas. But they never materialized into a product that either doctors or patients (or just ordinary people) could readily or easily use and master.
My own review of the initial release of Google Health demonstrated a product that left more than a little to be desired in lack of bringing anything much new to the table. No cool visualizations. No engaging game component. Nothing other than your manually-entered data (if you didn’t want the nightmare e-Patient Dave experienced) and some boring graphs. Combined with not being a HIPAA-covered entity, it may have been enough to sink expectations as the product’s updates were few and far between.
RIP Google Health; I’m not sure how “influential” you were, other than to act as a role model of how not to role out an online personal health record without significant real-world testing ahead of time. You were not a good idea ahead of its time; you were simply an idea tried many times before and coming up against the exact same problems of prior efforts — nobody is much interested in data for data’s sake.
I’ve been reflecting on this whole story. One aspect (I’m not saying it’s the whole story, not by a long shot) is that the interface from my hospital to Google was released without ever being tested with real patient data, particularly a patient with a mess of conditions in their history, like me. (People who like gory details can click the link to my story in John’s post.)
I’m willing to bet that a significant reason is that it would have been really time-consuming to get the HIPAA permissions to use enough patients’ data to do a thorough test. That’s why I’m positively tickled by the “Green Button” idea that’s been circulating in social media lately: for people who are interested, provide a green button on a PHR screen, saying “Donate My Data.” (See ekivemark’s post that mentions it, from DC Health Innovation Week this month.)
What especially tickles me is that the idea was generated not from within the health IT industry, but by non-professionals at a HealthCamp “unconference” last fall.
Throughout this whole adventure the question I keep asking is, “What could be said that would make any difference?” (Anyone can spout opinions, flame, etc; what could make any difference?) That’s why my original post ended with “Do you know what’s in YOUR wallet, medically?” I wanted people to go look in their record, to clean it up before there’s a crisis someday.
Here’s hoping our reflecting on GH’s “passing” will lead to some useful observations …
It really would be useful to get a detailed postmortem and understand why Google Health failed; we could learn a lot from that process. I think we have to rethink health data policy, and probably data privacy policy more broadly, before we can make something like this work. And we need more data in digital formats, and more standard formats. Google was probably too early, and (especially given antitrust clouds on the horizon) unwilling to push for whatever changes would have made Google Health more viable.
Data ownership is still a big question, not just in healthcare. I suppose some of us from the world of participatory medicine should be hanging out at the Internet Identity Workshops.
(repasted from SPM thread)
This is sad news, but unfortunately not
unexpected. As seen in other tech-consumer industries, sometimes people who should care, don’t. It seems like the health 2.0 success stories either make the healthy healthier (Nike+, fitbit), or see adoption in serious or acute
conditions (first time pregnant moms, cancer, etc.). There’s nothing wrong with “winning” in those areas, but I think most of us in this
space really want to see much broader adoption, much broader benefit.
Technology has yet to solve the motivation-behavior-change problem. Scales are a great technology that can be used to fight obesity. How
many of us actually use this time tested, affordable device?
Hi,
This online PHR will likely work only when physician consultations and health records are tightly linked. Unless people start receiving medical advice using data from the record, it just becomes a data repository. There is no incentive for users to spend their time on a tool like this.
Check out http://www.pinkwhalehealthcare.com/ as an alternative. This is an attempt to bridge the two.
It’s a humongous problem, but we have to continue to try.
Thanks,
Sai
Sai has the crux of the problem here. As much as I would like to share my data for good use, and be able to store and edit my medical data online somewhere, if my personal physicians aren’t actively using it, I don’t care about it.
Roni Zieger, who is listed on the “About Us” page of this group, is also listed as someone who led the Google Health project.
How about getting him to comment on it’s closing?
I’ve been quiet on this topic until now. Here’s a link to my post on why Google Health failed:
http://www.healthcontentadvisors.com/blog/2011/6/28/google-health-post-mortem.html
My perspective is that of a business consultant and I consider how Google Health fit–or didn’t fit–into Google’s overall strategy.
Yes, recent changes at the top may have affected the timing on Google Health’s demise, but the writing was on the wall from the start IMO. Check out my earlier post from 2009 on Google Health: PHRs Still Need Human Touch (http://www.healthcontentadvisors.com/blog/2009/4/16/google-health-phrs-still-need-human-touch.html). That’s the post that first connected me to e-Patient Dave & we met IRL shortly after that. So, I can thank Google Health for serving as the catalyst for my connection to Dave and to S4PM.
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