July 2008 • www.clinicalpsychiatrynews.com Practice Trends 71 , Vie to Lead IT Change

Eventually, system will enable patients to schedule Mr. Scriban said that he understands to test the transfer of data from Kaiser’s that some physicians get nervous at the into HealthVault. appointments, refill prescriptions, and use other tools. thought of patients in control of their own The pilot project, launched last month , is medical records. But he believes that sys- open to Kaiser’s 159,000 employees. The BY ERIK GOLDMAN tient permission, of course—at no cost. tems like HealthVault and idea is to combine the clinical data entered Contributing Writer “We don’t have any plans for ads within are really just systematizing what already by Kaiser physicians, which are available in the Google Health product,” Mr. Wiseman happens informally. the Kaiser personal health record, with pa- WASHINGTON — Search engine giant said. “We see it as a way to drive more “When a patient gets a referral from one tient-entered health information and clin- Google has joined software giant Mi- traffic.” The search returns, doctor to another, it is really that patient ical information from providers outside of crosoft in an attempt to revolutionize of course, will arrive with ads and spon- who acts as an information transporter, the Kaiser system. health care information technology, one sored placements (just like every Google telling the new doctor his or her medical his- “Providing new ways to manage their patient at a time. search), but he stressed that the PHR side tory, medication use, and in some cases ac- health online is one more way we can en- Google launched Google Health this of things will remain free of commercials. tually transferring paper records,” he said. gage consumers in their care,” Anna-Lisa spring with an aim of establishing itself as Google is currently running a pilot field HealthVault tries to standardize, stabi- Silvestre, vice president of online services the leading repository of personal health test of the Google Health system in part- lize, and formalize that process, and Mr. at Kaiser Permanente, said in a statement. records (PHR). Google is also positioning nership with the Cleveland Clinic. “We’re Scriban contends that this will reduce er- “We believe that Microsoft HealthVault itself as a primary clearinghouse for clin- 2 months into that, and we have 1,600 rors, prevent loss of important informa- will be a valuable supplement to our ex- ical information, self-care tools, and Cleveland Clinic patients storing their tion, eliminate redundancy, and give physi- panding set of online features.” provider ratings to help patients make ed- PHRs right now. This will go up to about cians a fuller picture of their patients’ Kaiser officials plan to reevaluate the pi- ucated health care decisions. 10,000. We’re testing the process of data health. He added that HealthVault is be- lot later in the year before expanding it to Google Health emerged just as the sharing in a live clinical-care delivery set- Kaiser members. smoke began to clear from Microsoft’s ting, with real patients and real doctors. Google’s Mr. Wiseman said it is partic- launch of its own HealthVault PHR plat- The goal is simply proof of concept.” EALTH ularly important to create alliances with H form last fall. Mr. Wiseman pointed out that Google health plans. “A lot of people won’t use

Both companies see individual patients, has significant advantages over other com- OOGLE Google Health unless their health plans not health care systems, as the primary lo- panies vying for a piece of the evolving /G support it.” Google’s other major focus is cus of change for health care information PHR market. For one, the company is on consumer decision support tools. technology, and both provide individuals wholly independent and not tethered to Among Google Health’s new partners is ORPORATION with secure but user-friendly systems for any health care plan or provider system, so C HealthGrades, the private company that aggregating all of their health care records, a Google Health PHR is completely has quietly emerged as the leader in online data, diagnostic images, laboratory re- portable. Users would be able to access physician and hospital ratings. Health- sults, and medical histories. They hope to their records even if they change health ICROSOFT Grades uses publicly available data on put an end to the fragmentation, duplica- plans, jobs, or even countries. quality outcomes based on 32 standard-

tion, and lack of portability that charac- Mr. Wiseman stressed that, as a com- ©2008 M ized procedures and health conditions to terize paper-based health record-keeping. pany, Google is a neutral stakeholder as far Google Health and HealthVault aim to grade physician and hospital performance. Executives at both HealthVault and as how someone uses their PHR, which is help patients make informed decisions. The ratings parameters are based on work Google Health said they believe digitally different from PHR systems tied to specific done by the National Quality Forum. enabled patients will help push more doc- health plans. “We stand by the user and ing designed to interface with many dif- “HealthGrades’ mission is to guide tors to implement electronic medical the user only.” ferent electronic medical records systems. Americans to better health care,” said Dr. records systems in their offices. Google has one more major advantage: He said that he hopes that as more patients Samantha Collier, chief medical officer of Todd Wiseman, head of Google’s Fed- massive data storage capacity. create PHRs, more doctors will see the ul- HealthGrades. “There are enormous gaps eral Enterprise Team, says the creation of “We can store and manage a LOT of timate value in interconnectivity. between what we know we could do and Google Health was a natural move. “We data,” Mr. Wiseman said, noting that HealthVault and Google Health are sim- should do, and what actually happens in now have more than 1 billion people Google already gives its users six ilar in many respects. health care. There are vast gaps between worldwide using Google every day. Google gigabytes of e-mail storage capacity. “Both are backed by large companies the best and worst hospitals and clinics.” is the No. 1 search engine for health in- “That’s a lot. And when you think about with a lot of resources; [both companies] Currently, Web users seeking Health- formation, and health topics are a top storing x-rays, MRIs, and other things have looked at the same problem and ar- Grades ratings for a doctor or hospital search category for Google,” he said at the like that, there will be a big need for rived at similar conclusions. One conclu- must pay a fee. Under the partnership fifth annual World Health Care Congress. memory.” sion is that you cannot revolutionize agreement, Google Health users would Google Health will allow people across Google Health essentially is head-on health care in one big step. The other is have free access to the ratings. the country to store their PHRs and allow competition for Microsoft’s HealthVault, that the consumer is really the agent of The specifics have not yet been worked them to make their own determinations which has been up and running since last change in all of this,” Mr. Scriban said. out, but the idea is that Google Health about who may have access to those fall. While Microsoft has been involved in Still, there are some differences. He users searching for doctors or clinics records. Users also will be able to store med- health care IT solutions for hospitals and stressed that Microsoft is primarily fo- would obtain a listing of the top 10 ap- ical contacts and other relevant information. health plans for more than a decade, its cused on enabling people to manage their propriate practitioners locally. Each list- “Users should have easy access to their PHR efforts are fairly new, said George health information, and less engaged in ing would contain contact infor- medical records, and should be able to act Scriban, senior product manager for providing self-care tools, something that mation, as well as a “more” button, on their data. Medical records should fol- HealthVault. Google is pursuing. clicking on which would allow the user low the patient and exist in an environ- In an interview, Mr. Scriban said Health- Although it is natural to view the cur- to see the full HealthGrades profile for ment of interoperability, portability, pri- Vault, which is also free to consumers, rent landscape as a clash of the IT titans, that physician or hospital—including any vacy, and security,” Mr. Wiseman said. tries to solve one of the most frustrating Mr. Scriban thinks that view is overstated. disciplinary actions or malpractice cases, “We don’t hold our users’ data hostage.” health issues for ordinary people: frag- “In the end, we’re really glad that Google past or pending. The system can automatically import mentation. “Fragmentation of delivery of has joined us in attempting to deal with the At issue is how Google and Health- physician reports, prescription history, and care has a lot to do with fragmentation of problems of personal health information Grades will determine which practitioners lab results. Eventually, it will enable peo- someone’s health care identity. Every- management. I don’t think it’s really a or facilities show up on the top 10 list for ple to schedule appointments, refill pre- body’s health care identity is spread Google vs. Microsoft scenario. It’s more like a particular search. Dr. Collier and Mr. scriptions, and employ personal health around in little slices in different sectors. Google, Microsoft, and all of us who are in- Wiseman said that initially, the order of and wellness tools, Mr. Wiseman said. The employer has some information, var- volved in PHRs and EHRs versus paper!” rank would be based on Google’s standard Google Health’s PHR function also will be ious doctors have others, hospitals and Google and Microsoft are engaged in model, which lists the most trafficked sites enriched with specialized health-oriented payers and pharmacies have still others. lining up partners across the health care highest. The rankings would not be based search functions, clinical trial matching, The ideal is to have all one’s information, landscape, including insurers and man- on the HealthGrade scores. and a host of other health management presentable and portable and useful to aged care plans, information service One thing is certain: With major IT tools, all of which can be integrated with any and all providers,” Mr. Scriban said. providers, medical organizations, and pa- players like Google and Microsoft entering a user’s Gmail e-mail account. Essentially, HealthVault is a consumer- tient advocacy groups. the arena, PHRs and electronically em- Google Health will not charge people to controlled hub for gathering and control- Microsoft recently partnered with powered patients are going to play a sig- store PHRs; likewise, doctors will be able ling information from various sectors of a Kaiser Permanente, an integrated health nicant role in reshaping health care over to access their patients’ PHRs—with pa- person’s “health care ecosystem.” plan with more than 8 million members, the next decade. ■