Thus, when Google contacted Chilmark last week to schedule a briefing in advance of a major announcement, we were somewhat surprised and welcomed the opportunity. Yesterday, we had that thorough briefing and Chilmark is delighted to report that Google Health is still in the game having made a number of significant changes to its platform.
Moving to Health & Wellness
Today, Google is announcing a complete rebuild of Google Health with a new user interface (UI) a refocusing on health & wellness and signing on additional partners and data providers. Google told Chilmark that the new UI is based upon significant user feedback and a number of usability studies that they have performed over the last several months. Rather than a fairly static UI (the previous version), the new UI takes advantage of common portal technologies that allow the consumer to create a personalized dashboard presenting information that is most pertinent to a consumer’s specific health and wellness interests and needs. So rather then focusing on common, basic PHR-type functions, e.g., view immunization records, med lists, procedures and the like, the new UI focuses on the tracking of health and wellness metrics. This is not unlike what Microsoft is attempting to do with MSN Health and their health widgets that subsequently link into a consumer’s HealthVault account, though first impressions lead us to give a slight edge to Google Health’s new UI for tracking health metrics.
A particularly nice feature in the new Google Health is the consumer’s ability to choose from a number of pre-configured wellness tracking metrics such as blood pressure, caloric intake, exercise, weight, etc. Once a given metric is chosen, the user can set personal goals and track and trend results over time. There is also the ability to add notes to particular readings, thereby keeping a personal journal of what may have led to specific results. And if one cannot find a specific health metric they would like to track, the new platform provides one the ability to create their own, for example the one in the figure below to measure coffee consumption. Nice touch Google.
On the partnership front, Google is also announcing partnerships with healthcare organizations Lucille Packard Children’s Hospital, UPMC and Sharp Healthcare and has added some additional pharmacy chains such as Hannaford and Food Lion among others. On the device side, Google has the young Massachusetts start-up fitbit (novel pedometer that can also monitor sleep patterns) and the WiFi scale company, Withings. On the mobile front, Google has added what they say is the most popular personal trainer Android app, CardioTrainer and mPHR solution provider ZipHealth (full disclosure, I’m an advisor to the creators of ZipHealth, Applied Research Works) which has one of the better mPHR apps in the market.
If any metric is a sign of pent-up consumer demand for what Google Health will now offer it may be CardioTrainer. In our call yesterday, the new head of Google Health, Aaron Brown stated that they did a soft launch of CardioTrainer on Google Health by just putting a simple upload button in CardioTrainer that would move exercise data to a Google Health account. In two weeks, over 50K users have uploaded their data to Google Health. Pretty incredible.
Challenges Remain
Chilmark is delighted with what Google has done with Google Health. The new interface and focus takes Google Health in a new direction, one that focuses on the far larger segment of the market, those that are not sick and want to keep it that way through health and wellness activities. Today, within the employer market, there is a major transition occurring with employers focusing less on disease management and looking towards health and wellness solutions that keep their employees healthy, productive and out of the hospital. Google may be able to capitalize on this trend provided it strikes the right partnership deals with those entities that currently serve the employer market (payers and third party administrators). Chilmark will not be holding its breath though as to date, Google has not had much success in the enterprise market for virtually any of its services.
And that is one of many challenges Google will continue to face in this market.
First, how will Google readily engage the broad populace to use Google Health? Google has struggled in the enterprise market, regardless of sector, and will likewise struggle in health as well, be it payers, providers or employers. Without these entities encouraging consumers to use Google Health (especially providers as consumers have the greatest trust in them), Google Health will continue to face significant challenges in gaining broad adoption and use of its platform. But as the previous example of CardioTrainer points out, Google may have a card up its sleeve in gaining traction by going directly to the consumer through its partners, but it will need far more partners than it has today to make this happen.
Second, the work that Google has done to re-architect the interface and focus on wellness, particularly the tracking and trending of biometric or self-entered data is a step in the right direction, but Google has not been aggressive enough in signing on device manufacturers that can automatically dump biometric data into a consumer’s Google health account. Yes, Google is a member of the Continua Alliance but Continua and its members have been moving painfully slow in bringing consumer-centric devices to market. HealthVault, with its Connection Center, is leaps and bounds beyond where Google is today and where Google needs to be to truly support its new health and wellness tracking capabilities. Google’s ability to attract and retain new partners across the spectrum of health and wellness will be pivotal to long-term success.
Third, Google has chosen not to update its support of standards and remains dedicated to its modified version of CCR. While CCR is indeed a standard that has seen some uptake in the market, Chilmark is seeing most large healthcare enterprises devoting their energies to the support of the CCD standard. In our conversation with Google yesterday we mentioned this issue and Google stated that they are hoping the VA/CMS Blue Button initiative will take hold and provide a new mechanism by which consumers retrieve their healthcare data and upload it to Google Health. The Blue Button is far from a done deal and has its fair share of challenges as well. Google is taking quite a risk here and would be better off swallowing the CCD pill.
In closing, Chilmark is quite excited to see what Google has done with their floundering Google Health. They have truly hit the reset button, have a new team in place and are refocusing their efforts on a broader spectrum of the market. These are welcomed changes and it is our hope that with this new focus, this new energy, Google will begin to show the promise that we at Chilmark have always had for this company to help consumers better manage their health.
Addendum:
9/24/10 – Earlier this week, I was interviewed by SearchHealthIT.com. They have created a podcast of that interview that provides further “color” to the Google Health Reset story.
Too bad Google is not supporting CCD. All certified EMR vendors have to support CCD and Google is missing a great opportunity to exchange information with EMR vendors.
I think Google Health or Health Vault will become useful, once the patient charts are populated into Patient Portals.
Agree with the assessment that the Blue Button initiative will not help. Just getting ICD and CPT codes does not tell the whole story. You need to exchange information with EMRs and provide connectivity to Physicians to make these portals really valuable. Seems to me adding on additional functionality – CCD, define/standardize new APIs for communication with Physician offices – Appointment requests, prescription refills, communication with physician .. would enable EMR vendors to adopt these APIs and provide the needed bridge between Patient Portals and Physician EMR and PMS systems and would benefit both Patient and Physicians.
If there is a push from patient side – Portals .. and a push from the Govt side – ARRA and MU to have Physicians adopt EMRs and a solution is provided to connect both these both the Patients and Physicians win.
Prasad,
What we are seeing with this latest announcement/rebuild of Google Health is to us at least, a clear decision NOT to focus on patient records and connecting to the multitude of healthcare providers, but instead a direct outreach to consumers to assist them with simple health & wellness tracking.
There are a lot of different directions they could go with this, but clearly it will not be about appt scheduling, Rx refills, eVisits and the like, Google has left that to the MEDSEEKs and Epic MyCharts of the market. Remains to be seen if such a strategy will ultimately prove successful for Google Health, but at least it is a strategy, something that has been lacking for sometime now.
Why was nothing mentioned of the damage done gy Google over their breach and consequent affect ithas had on consumer trust in use of a PHR ?
To me this strategy lacks what consumers really want that includes: data integrity, trust, simplicity, portability and interoperability. It’s all about point of care access to vital data. How in the world does Google Health expect the special needs populations manage their PHR
Jerry Theis, LCSW
Jerry,
Thanks for your comment. Clearly, Google is going after the health & wellness market and not so much the traditional PHR/patient market. A change in direction and one that may not be as concerned with sensitive PHI. That being said, if any large company such as Google or Microsoft were to have a breach of consumers’ PHI, it would be a PR disaster. Thus, these two companies and others like them have far better privacy and security practices than virtually any hospital, clinic or practice in the country today.
“People don’t buy what you do, they buy why you do it” (http://www.ted.com/talks/simon_sinek_how_great_leaders_inspire_action.html)
What I heard Roni Zeiger say at OSCON 2010 (http://www.youtube.com/watch?v=tukHE8H8xqA) was that Google was doing Google Health to drive search traffic.
Why is Google in the PHR space and how committed to it are they? How big is the team now (I’ve repeatedly heard rumors that they have 5 developers on this)?
Why can’t Microsoft and Google come up with a common data model? If they were working to the same ‘standard’, then the question of Google’s commitment to this space wouldn’t be as big of a weight slowing down adoption by ISVs and consumers – because the data layer could be swappable.
Yes, Mark, a common data model would be nice but like the rest of the HIT market, or any other market for that matter (think Apple and Android), the last thing competitors want to do is settle on a common standard, unless of course it is THEIR standard.
Dr. Dean Ornish, the king of lifestyle change/preventative medicine wrote a post on Huffington about this: http://www.huffingtonpost.com/dr-dean-ornish/google-health-takes-a-ste_b_716866.html
Read the comments – from a non-industry audience. They are overwhelming opposed to using this service because they don’t trust Google’s motives.
Again, it’s not what you do, it’s why you do it. It would be nice to get some clarity from Google on why they are doing Google Health and how committed to it they are.
People mostly trust Google apps for email, word processing, location/map services – horizontal tools. The ‘why’ in this case is clear – they want to expand and evolve the Internet as a tool in our lives and expand their online advertising revenue.
Dr. Ornish chaired the Google Health Advisory Council from 2007-2009, but apparently is no longer on that board. He left, Adam Bosworth left… why are these key individuals who really want to make a difference in the way we look at health care leaving Google behind?
John, it would be great if you could use your contacts at Google to learn and post more on ‘why’, in addition to the work you’ve already done on ‘what’.
-mark
The changes by Google certainly convert the tool into something useful in ways that the previous tool really wasn’t. However, aside from their being a major player, their solution is not that original or different from many tracking applications and web sites already available. People are only going to want to enter so much data manually and the basic interface they are providing means lots of data entry so better approaches are required in this regard so that people can have the data without having to enter it.
Let me first advise that I am with an EHR, so I am biased. That said the challenge for our industry and the failure to date is at the point of contact. Google and many others fail to collect discreate data during the doctor patient interaction. This detailed data must be collected as fast or faster than can be done on paper. Meaningfully data exchange is not feasible when data collected is ” text strings” dictation blurbs, or scans of text. This is particularly true for the high pathology specialist, with unique chart needs. Untill this issue is addressed EHR will fail at the core making data exchange, delivery methods etc all mute. In short, start with doctor patient interaction, fast, detailed, data.
Agreed Roland, this is the ideal but an extremely difficult one to achieve. Even EMR/EHR vendors haven’t been able to do it and they’ve been at this problem for decades.
Augmentation will definitely help in the process with using bar codes to enter information and working with the API process to do this too, has to be easy for the consumer and Google Health, HealthVault and Dossia all have this but needs a bit more work.
http://ducknetweb.blogspot.com/2010/06/digital-health-tokens-connect-google.html
The WiFi Withings Scale is one device set up to use the encrypted gateway to add information to PHRs too.
http://ducknetweb.blogspot.com/2010/03/connecting-healthvaultgoogle-health-and.html
Once this moves a bit further and all the code is written and integrated it will certainly stand to make it a lot easier to move information into a PHR for sure.
It is not a simple process to walk someone through all the various situations to where they have to set up the all the processes of getting labs, medications, etc. into one place either and it takes time too.
Yup, even with Google’s simplistic design/approach, it is still too difficult for most to gather their PHI into one location. Maybe HIEs with the Blue Button will ultimately address this issue allowing a consumer to relatively quickly and easily create a longitudinal record.
Interesting little twist on Google Health. I still remember the first announcements and the wonder about what they might accomplish.
The idea that they don’t support CCD is just silly. Shows a lack of understanding of what’s going on with interoperability standards which is kind of sad considering there’s not that much going on.
Yes John, it is a silly stance by Google. Still can’t figure out why they are so dead-set against CCD. Even the CCR standard they are using, is a bastardized version that they created for their purposes. Crazy.
Clearly Patients are not just rushing into either Microsoft or the Google platform. The simple explanation being
“either one is not complete at any given time and requires a lot of hand holding, manual updation and not to mention not very user friendly”
Having said that, I as a patient and a Healthcare Technologist (one who has prototyped a PHR based on Google’s UI – simplicity and Microsoft’s platform – easy development env) I am pretty certain that if Healthcare needs to improve or cost lesser than predicted, we will need a “complete integrated yet simple to use EMR to PHR to EHR system” This is the core essence of Meaningful use.
Perhaps Google and Microsoft need to meet halfway on standards and then have Apple design the UI for this system! Just my thought!