By Dean Stephen
Recently, Google announced that it will close Google Health to new consumers on January 1, 2012 and that the service will be retired a year later. Google Health was much different than Google as a search engine; it required that consumers use their site to upload their personal health data and store this in a personal health record (PHR). Google stated that they were shuttering it because consumers did not adopt this practice as widely as was imagined.
Why Couldn’t Google Conquer Health?
This is perhaps the wrong question. Google remains today the single largest source of health information on the planet.
I’ve heard that 2 to 3 percent of all Google search traffic is looking for healthcare information. We’re not talking about health, beauty, lifestyle or wellness information – that’s in addition to those consumers and medical professionals who go to Google to search on medical conditions, symptoms, drug data, and other directly related healthcare information.
Using my “educated guess” algorithm, that’s in the range of 4 million to 6 million Google users per day searching for healthcare information. Compare that to between 5 million and 6 million doctor visits in America on a given weekday. Google has a “patient panel” very similar to that of the entire American healthcare “system” and its 700,000+ active physicians.
What Google is dropping is its personal health record (PHR) solution. I recall seeing Eric Schmidt, then CEO, publicly announce the launch in 2008 as a keynote speaker at the largest annual healthcare information technology convention (known as HIMSS). Schmidt said that launching Google Health was important to Google and that it would receive the Google innovation treatment.
“This is version one and before I say anything else I want to mention that Google is not a company that designs a product and ships it and then just sort of waits,” Schmidt said at the time. “We iterate and iterate and iterate and iterate and we iterate on a weekly basis.”
We in the audience thought this was a bold move that could produce a win after so many failed PHR attempts. Google had scale, a reputation for making search simpler in a complex, highly fragmented information intensive world and an opportunity to help address the billions of dollars of inefficiencies in the healthcare industry. Plus, Google could again outshine Microsoft in an arena where it had spent huge resources trying to deliver better healthcare consumer solutions.
For more detail, Michael Shrage’s article in the Harvard Business Review’s Blog Network provides a thoughtful viewpoint Google Health’s innovation demise.
I believe Google Health failed for the following three reasons.
1. Lack of Leadership, Which Ultimately Translated Into a Lack of Innovation
Google’s original business leader left to start another health information company and the position never got filled with a visionary innovator. And, it was common knowledge that new Google CEO and co-founder Larry Page didn’t have much faith in the PHR experiment.
In launching the PHR, Google chose to license highly duplicated content and didn’t try to unlock unique content that could drive consumer engagement and behavior change. Very important questions such as “who is the best surgeon or medical specialist in my geographic area for my particular condition?” or “what are the alternative treatments and associated costs best suited to my personal profile?” did not get answered.
Moreover, personal data that flowed into a consumer’s PHR did not execute alerts or reminders, or even put relevant information at the user’s fingertips (e.g., via the smartphone) and at the point of need (e.g., what should I ask the doctor or nurse as I enter the appointment). FrogDesign wrote a good article on Google Health’s lack of connectivity and meaningfulness here.
2. Lack of Interest and Support From Providers and Health Information Technology Companies
Hospitals and doctors have a hard enough time deploying electronic medical record (EMR) systems, and when they do, most of the functionality is ignored; it certainly isn’t embraced at the point of care.
Search functionality in these systems has been notoriously weak, and patient portals, if available, were non-core add-ons that did were confined to information only available through that specific physician’s office or hospital. Google Health provided fairly easy functionality to import / export information from the source data within the EMR but, alas, such data did not cover much of the patient’s healthcare history.
3. Lack of Help From Payers
Health plans remain an important source of healthcare information about individuals. Their claims data can pre-populate a user’s PHR but because consumers tend to switch plans fairly often, it requires all plans to participate. Also, the government now pays for over 50 percent of all claims made today through Medicare and Medicaid.
Besides information about individuals, the aggregated information about doctor performance, such as which performs the most cardiac bypass surgeries, is locked up inside these payer databases. The single greatest impact on American healthcare quality could be achieved by having our PHRs steer us to the doctors who perform the most procedures.
Consequently, with the loss of ingenuity and leadership from our star search engine, the Google user lost an opportunity to access information that could save thousands of lives and billions of dollars annually, and an unquantifiable amount of pain and suffering.
There are other PHR solutions on the slow rise, including Microsoft’s HealthVault and the Intel-backed Dossia. HealthVault is already broadcasting the ease with which a Google Health user can migrate to their system.
These PHR solutions are going to the next level – beyond pre-populating a person’s PHR with healthcare information from one or more sources. They are adopting more applications to track behavior and encourage better behavior to personalize the user interface and are entering the realm of providing quality and pricing information about local healthcare resources.
Putting Google Health aside, general Google healthcare information search results have evolved over time. There is what I call a “regression to the mean” for sources on the first page results for the more common healthcare terms such as chronic condition terms such as asthma, diabetes, and arthritis.
Google has consolidated results from three general sources: WebMd and its owned and operated affiliates, federal government agencies, and the top brands representing U.S. healthcare (MayoClinic and Cleveland Clinic principally). Here’s a sample from today:
Two-thirds or more of the first page results come from the same sources for these three different diseases, and adding to Google’s predictability, the sources appear in about the same order on the page. Is this good, bad or indifferent? That’s a question for another article.