Why Google Health Failed—It's because of how Doctors are reimbursed

Any competent analysis which relies on the US system as the model for healthcare has to address the non-compliance of Google Health with HIPAA and the inability of healthcare providers to enter data into an insecure system.

That's not to say that reimbursement is not at the root of many of the unique problems of US healthcare. But nevertheless, Google Health was fatally flawed from inception.

[http://en.wikipedia.org/wiki/Hipaa]

Google "failed" because they didn't have to succeed. In terms of corporate culture Google makes products that do well with the general public, but anything with health is both very niche and mission critical. To really crack that market takes a singular focus -- and that's not just creating the product but dealing with things like lobbying and sales. I'll grant you that the folks at Google are very bright, but very bright doesn't mean you can do anything. And I suspect that this was just a bit too much of a stretch for them (unless they purchased a company that was already in that space).

The author is correct in suggesting that for any such system to work, there has to be involvement of health care providers and, without being reimbursed, they are not likely to get involved.

But I really feel Google Health failed because there simply wasn't enough consumer involvement. It could have continued as a system that allowed patients to monitor their own medication use, blood sugar, blood pressure, etc. and analyze it for them and provide information for them to take to their physician - but that never happened. By and large, most consumers of healthcare in this country are the elderly, and a lot of the current generation is not going to go online and store and update all their healthcare data.

I do some work in the long term care setting and recently I saw an older patient in this setting get an iPad. Some of the facilities have started talking about implementing wifi, a few already have because gradually some patients are beginning to demand it. When you see this becoming more widespread, you'll know there's a paradigm shift taking place, and that's when you'll see things like Google Health, or Microsoft Health Vault or Avado really start taking off.

I don't think the problem with Google Health was really money or lack of reimbursement. My employer OptumInsight has software to push out copies of medical data to personal health record (PHR) systems within the context of a larger health information exchange (HIE). So if the community has an HIE in place then the data just flows (almost) automatically after the patient has signed up with a supported PHR: it doesn't cost the physicians any more. I think our competitors and even stand-alone electronic health record vendors have similar capabilities.

I think the real problem with Google Health is that they just didn't try. After the initial launch there were minimal resources devoted to it. Their data model was obsolete from the beginning. And they could only accept data in Continuity of Care Record (CCR) format which is itself an obsolete and poorly supported standard, now supplanted by various specializations of HL7 CDA. Those were fixable problems but would have required a lot of work.

This post is entirely self serving and misses a key point: Why would I want the world's largest advertising company to have access to my healthcare data?!

Most doctors work for a big healthcare system these days. For better or worse, those systems are already using Epic, or something like it.