personal health records


What Killed Google Health? And What Does Its Untimely Demise Mean?

I love a good mystery. And I’ve noticed one post-mortem analysis after another lately exploring the recently announced impending demise of Google Health, a service aimed at helping people manage their own health information. Why would as powerful an entity as Google abandon so major a project in such a seemingly promising field?

Google’s own explanation, in a blog post, is that the service just “didn’t catch on” as hoped. That rings true to me: Here I am, immersed in health care news, and I’d heard little about Google Health and nothing enticing enough to make me want to sign up. But the answers go deeper.

In MIT’s Technology Review, David Talbot recently wrote of Google Health that its passing reflects a broken medical system: “Experts say its untimely death is, in many ways, an extension of U.S. health-care providers’ failure to share data across institutions, or make it easy for patients to obtain it.” (Tech Review also has an interesting new article out here about a Cambridge company’s health-tracking platform for employers.)

I just spoke with Dr. Kenneth Mandl, an associate professor at Harvard Medical School, physician and researcher in the informatics program at Children’s Hospital Boston, and co-founder of the open-source project Indivo, the first electronic personal health record. Indivo, he says, began in 1998, inspired the Google Health model in 2006 and is still in wide use, including for patients at Children’s.

The concept behind personal health records is that each of us should have access to our own medical information, and the ability to share it where needed—with our doctors, our family, and with computer apps that can help care for us. Here is his detective work, lightly distilled:

Q: So, Ken, whodunit?

Basically, it was a combination of a couple of factors—the stagnant data flow in the health system and some failures in Google’s strategic execution.
The data about our health histories, medications and treatments, usually captured by our physicians on paper or, increasingly, in electronic health records, usually stay put—in physicians’ offices or hospitals–even though federal law entitles patients to copies of their electronic health records.

‘They didn’t do very well in establishing a trust model. What would Google do with your health data once they had it?’

And Google was more dependent on real ‘data liquidity’ than I think they fully realized. Job number one for them, with their enormous resources, should have been to try to ensure that there were generalizable, standardized ways to move data around in the health system. They needed to dig in and do serious engineering with clinical systems. But they didn’t do that. They were hoping to sit on a high perch and to provide storage and applications for managing that data. But the data were not there.

So there’s real work to be done. Google was a little ahead of its time in a sense, but really, they should have spent more energy and dollars helping to generate data flows through policy reform and technological innovation.

Also, Google Health fell short as an “apps” platform. Contrast it with the iPhone platform — Google never really captured a serious community of third-party developers who could add value to data by generating apps that could run against their programming interface. Continue reading