Seven Reasons Google Health Is Overblown

Now that Google has finally launched its long-awaited Google Health service, it’s hard not to sense a kind of boredom across the blogosphere. So much has been written about the service in advance — including a fair amount by yours truly — that there’s probably no way the real thing could live up to all the hype, at least among the health and IT geeks who’ve followed it obsessively.

For a full review of the service, see Deepak Singh’s take over at business|bytes|genes|molecules, as he seems to be one of the few observers still willing to dive into its details. My own take is pretty simple: Google Health is underwhelming in what it actually offers people who want to store their health history and medical information online, and without Google’s name attached to it, it might well have already vanished without a trace. (Which, oddly enough, is more or less what I thought the first time I saw leaked screenshots of the proposed service almost a year ago.)

A more important question, however, is how Google Health and services like it will change health care and the business of running hospitals and medical practices. While it’s still awfully early to say for sure, it looks pretty likely that for all the hoopla, the answer is, “not very much.” Here are seven reasons such “personal health records,” or PHRs, aren’t likely to transform the healthcare business any time soon:

1. Patient input of medical information is cumbersome and error-prone. Google Health essentially asks people to build their profiles by picking medical conditions, drugs they take and procedures they’ve undergone from scrollable menus. This is a big problem for people who, like me, don’t know Parinaud Syndrome from Paraquat Lung. The situation is a little better for drugs, since Google Health allows users to input their prescription history from Walgreens or Long’s Drug (pharmacies are way ahead of doctors when it comes to digital information). Still, anyone not a customer of these two chains is out of luck, and Google Health places a big burden on these individuals to navigate medical terminology correctly — which is not a winning proposition.
2. Few medical providers use electronic medical records or allow record export to PHRs. Only 14 percent of U.S. doctors use electronic medical records in the first place, and even fewer are set up to transmit that data to a PHR like Google Health. (For an alternate perspective, see John Halamka’s description of Google Health from the perspective of Beth Israel Deaconess Hospital, one of two medical systems to partner with the service at launch.) Unless and until this roster expands dramatically, the Google PHR is little more than a vanity system for most people.
3. Doctors have little reason to take Google Health information seriously. Doctors are already notoriously bad about trusting other doctors — it’s common, for instance, for a doctor with a new patient to re-run tests that have already been performed, just to be certain. They have even less incentive to trust patient-entered — worse, patient-edited — information from a PHR like Google Health, particularly given the likelihood that the information stored there may be medically erroneous. This is especially dangerous where someone’s prescription-drug regimen is concerned, because seemingly small mistakes in drug names or dosages could have catastrophic effects if, for instance, an ER physician doesn’t catch them.
4. Privacy concerns at Google are real. My colleague Larry Dignan got a lot of attention for pointing out Monday that Google Health isn’t covered by the privacy protections of the grab-bag federal law known as HIPAA. This is true, although of course it isn’t exactly a new concern — almost none of the new “Health 2.0″ Web services are covered by HIPAA, largely because they were barely imaginable when the law was passed 12 years ago. As Deepak notes, HIPAA is a pretty good proxy for patient trust, so if I were Google, I’d think seriously about lobbying for HIPAA reform that would explicitly cover online services that handle sensitive medical information.
5. Privacy concerns at Google’s partners are worse. Part of Google Health’s selling point is the way it lets people share their records with third parties that will, for instance, provide personalized schedules for taking prescription drugs, check their vaccination history against federal guidelines or send health records to a doctor prior to an appointment. Google takes no responsibility for what these third parties do with patient data, which means reading through a new, dense privacy policy for each new service. Worse, these services might well market to patients based on their medical history, something Google itself has sworn not to do. And while Google promises to wipe personal data when a user deletes his or her profile, third parties aren’t necessarily bound by the same pledge.
6. Google Health locks in users. The service doesn’t offer any way to export its data, despite its embrace of various open medical-record standards, so anyone who spends a lot of time inputting profile information is sort of stuck. Once word gets out, savvy users are going to be wary about committing too heavily — and without early adopters, innovations like this one typically go nowhere.
7. Getting Google Health data to doctors is anything but easy. With no export function, the easiest way to get data out of the service is… to print it. In such cases, the supposedly game-changing PHR ends up as yet another piece of paper in a color-coded file folder somewhere. And, of course, if a patient is critically injured or seriously ill, they’ll have no way of printing out that information for the emergency-room staff in the first place. (Neither will family members unless they happen to have access to the patient’s Google account, since there’s no provision for sharing information with other trusted individuals.)

Proponents like to argue that PHRs give people more control over their health information and help coordinate medical care for those who regularly see multiple doctors, such as snowbirds who head to Florida or Arizona for the winter. That may well be true eventually, but it’s awfully hard to figure how the service is going to make much of a difference without a lot of maturing — not to mention a huge amount of catch-up on the part of the U.S. medical system.

Update: Google Health’s privacy policy is even more problematic than I first thought.