How a Broken Medical System Killed Google Health

Google would have had to fix a balkanized U.S. health-care system to make the service catch on.

At the end of this year, Google Health will flatline. The service couldn’t encourage many people to import or analyze their health data, and 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.

Google’s free online service lets people upload, store, analyze, and share their health information. But there are hundreds of different health-care institutions in the U.S. that use different systems to record and store data, and many doctors don’t use electronic records at all, making the task of retrieving and updating data extremely difficult for the average person, says Isaac Kohane, who directs the informatics program at Children’s Hospital in Boston, and codirects Harvard Medical School’s Center for Biomedical Informatics.

For Google to make its service attractive, it would have had to solve this health IT mess, which is in the early stages of being addressed through recent national policy moves. These include 2009 federal stimulus incentives for doctors and hospitals to adopt electronic medical records, and for hospitals to share data with one another.

Kohane says it will be at least five years before data flows smoothly enough to make something like Google Health worthwhile. “Google is unwilling, for perfectly good business reasons, to engage in block-by-block market solutions to health-care institutions one by one,” Kohane says, “and expecting patients to actually do data entry is not a scalable and workable solution.”

Google did forge some partnerships—including one with the insurer Blue Cross Blue Shield—that let patients upload insurance billing and medical information into its service more easily. Even so, the user experience was uneven, as Technology Review described in 2009. Some patients, for example, would need to obtain copies of their records and then manually enter all the information.

Google announced on its blog late last week that Google Health would be canceled as of January 1, 2012. Users can retrieve their data for an additional year, but after that, the data will be deleted.

Other, similar services survive. Prominent among them is Microsoft’s HealthVault. Microsoft was quick to announce ways that Google Health users could move their data over to HealthVault. In a blog spelling out this process, Sean Nolan, chief architect and general manager of Microsoft’s health solutions group, also said “the only way to fix health care is to consumerize it,” and added that “we’ll get there, and Google Health moved the ball forward.”

Some limited health data exchanges among hospitals and other health-care providers are cropping up around the United States, but right now, there’s no requirement for full sharing. “There is still no flow,” Kohane says. “There still has to be additional cultural shifts to actually make the information flow.”

Through 2019, up to $36 billion could be spent under the federal stimulus for adoption and meaningful use of electronic medical records. (The final federal outlay—taking into account expected savings and income from penalties for failure to adopt the records—is projected to be $19.6 billion.) “The investment has been committed, but a lot of the money has not been spent yet, and we will see in the next couple of years whether it will happen or not,” Kohane adds.

But Google isn’t waiting to find out.

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