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On the Third Hand: Google Winds Down Personal Health Record Project

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The writer Frederik Pohl predicted that a service like Google would exist back in the late 1970s, so I loved Google passionately about 20 years before it actually existed.

The Google search engine makes it possible to figure out what happened to your old second grade classmates without hiring private detectives. It gives you the tools you need to figure out where that funny quote you can’t get out of your head actually came from.

Google the company – Google Inc., Mountain View, Calif. (Nasdaq:GOOG) – has mapped strange and mysterious things all over the Earth, sent cars to take pictures of my parents’ house and my late grandparents’ house, and (according to The New York Times) developed a laboratory full of robots that might go to work and do my work for me. If we ever have a colony on the Moon, maybe it will be sponsored by Google.

But Google tried to enter the personal health record (PHR) market with the free Google Health PHR service and fell on its digital tuchis.

A PHR is a patient-controlled and patient-managed version of the electronic health records (EHRs) that doctors, hospitals and insurers are supposed to be developing.

Google started Google Health as a free service in 2008. The company announced in June that it would be ending the service in December. Users will lose the ability to enter new data Dec. 31, and they will lose the ability to get to the records at the end of 2012, according to Google.

Google says it is shutting Google Health down because few people were using it.

Many consumers probably have what amount to messy, incomplete, hacker-friendly PHRs stored in the Google Mail e-mail system and other online e-mail and document storage systems. What was the problem with using an actual secure PHR system?

One problem is that, today, in a world where simply going to a counseling session to try to patch up your marriage could make it impossible for you to qualify for individual health insurance, the idea of even letting a doctor know your real name seems risky. The idea of actually maintaining formal permanent health records seems like putting Big Brother on your annual Christmas newsletter list, so he can call you in for sessions with motivational rats if you slack off on eating your vegetables and flossing your teeth.

A more important problem is that, because of the difficulty the federal government and standards groups have had with getting everyone to agree on and use digital data standards, and patient data access standards, patients who want to use PHRs often can’t easily import data easily from any entities other than, possibly, their health insurers. And the kinds of high-tech health insurers that are good at populating PHRs often have pretty good EHR systems of their own that plug into their consumer benefits management portals.

Richard Marks, a McLean, Va., PHR system company executive, has written in an op-ed posted on the website of Healthcare Information and Management Systems (HIMSS), Chicago, that lack of consumer awareness of the need for PHRs has limited the ability of Google and other PHR system companies to use viral marketng to promote the systems.

But creating widely used federal standards for getting hospitals and doctors to make patients’ records available to the patients is the key to promoting widespread use of PHRs and EHRs, Marks says.

“Until consumers have convenient access to digital copies of records in these legacy systems, copies that can be moved into PHRs almost automatically, barriers to PHRs (and to health information exchange among clinical systems) will remain high,” Marks says.

On the one hand: The need for PHRs seems obvious, and chances are some mysterious database company or federal anti-terrorism agency already actually has all of the data it needs to populate the PHR, any way.

On the other hand: Doctors are skeptical about the value of EHRs, report that converting paper files into EHRs is extremely expensive, and believe that the most important information in the paper files consists of the off-hand observations that are hardest to get into a digital EHR format.

On the third hand: Everyone loves to rag on health insurance companies, but, if you call them up, you can get live human beings on the telephone, and the live humans can handle simple tasks and provide basic information fairly easily, because they have good databases. Conversely, getting basic information out of hospitals and doctors’ offices is often a nightmare. It seems as if all that effort they’re putting into trying to provide quality care is partly wasted if patients can’t get the information they need to improve their health or seek additional care.


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