Google Makes Splash in Health Care
Google announced the formation of a Health Advisory Council that includes an eclectic group of health care insiders. The result has been speculation on Google's plans ranging from an application for patients to store their medical information online to the acquisition of an EMR vendor.
The acquisition of an EMR vendor will render Google just another EMR vendor (admittedly with one with lots of money). What I wonder is how (or if) Google will go beyond their brand and Internet application platform to really differentiate and drive greater adoption of whatever vehicle the chose for the health care market.
A significant portion of the data that goes into an EMR (and that includes the whole alphabet soup of PHR and EHR) comes from medical devices. Device data is the most specific and exact data found in EMRs, and is the data that serves the bedrock for diagnosis and managing therapy. As a patient’s problem list or acuity increases (predominately due to chronic diseases) the amount of data generated by patient-attached medical devices increases exponentially. Manually entering medical device data into charting systems has the following problems:
- Data availability is delayed due to the lag between the reading and when the caregiver has a chance to enter it into the system (this lag is frequently measured in hours)
- Missing data results from readings that are taken, but never entered into the system
- Transposed data or typing errors – the analog to illegible entries in paper charts
- Selecting the wrong patient for correctly entered data – the analog to improper patient identification, a common patient safety problem
In hospitals the literature has reported the percent of data entered in error to range between the low teens and mid twenties. I’m not aware of studies looking at similar activities in physician practices or patient homes.
Medical device connectivity is a requirement with growing awareness. Last week Rob Kolodner gave the keynote at a conference on medical device connectivity (the Improving Patient Safety Through Medical Device Interoperability and High Confidence Software workshop in Boston). The FDA has signaled that they are looking at regulating medical device interfaces that write straight to an EMR’s database. And vendors continue to struggle with device connectivity – with vendors creating “open” interfaces that only work with their own medical device or EMR (think Welch Allyn or AllScripts). Retrospective connectivity via HL7 is easy to develop, but expensive to deploy (each installation must be configured); prospective “plug and play” connectivity is the easiest to deploy, but requires that competing vendors work together (something they are traditionally loath to do).
Google may well acquire an EMR vendor. Given their strengths they will probably stay as close to consumer as possible, launching a PHR and/or acquiring a practice based EMR (rather than a hospital EMR vendor). In any event, the patient populations who will benefit the most, and be Google’s greatest source of pressure to drive adoption, are those patients with chronic diseases. Care delivery for chronic disease is centered around medical device data – glucometers, non-invasive blood pressure monitors, weight scales, and more. Leaving patients to manually enter this data themselves will not work for most patients, and sending caregivers to the home to gather readings will be too expensive.
Google is uniquely positioned to provide plug and play connectivity for any site with an internet connection or even a mobile phone. Actually creating the connectivity is something they have no experience with, but they have plenty of resources and smart people – they can learn it the hard way, or use a connectologist to help. This is a potential differentiator and competitive barrier (because the industry’s not going to support more than one pervasive connectivity method) for whoever gets there first.
To be more than just “another EMR vendor,” Google will have to do something different. Medical device connectivity is the biggest unmet need on the patient side of the equation. (On the systems side, there is interoperability between EMRs and prescribing and between providers and payors – but there’s already a lot of work being done here.) Their ability to deploy web applications could be leveraged in important ways.
Pictured right is the Google holiday logo commemorating the 50th Anniversary of Understanding DNA – April 25, 2003.
[Hat tip: iHealthBeat]
Google Makes Splash in Health Care
Google announced the formation of a Health Advisory Council that includes an eclectic group of health care insiders. The result has been speculation on Google's plans ranging from an application for patients to store their medical information online to the acquisition of an EMR vendor.
The acquisition of an EMR vendor will render Google just another EMR vendor (admittedly with one with lots of money). What I wonder is how (or if) Google will go beyond their brand and Internet application platform to really differentiate and drive greater adoption of whatever vehicle the chose for the health care market.
A significant portion of the data that goes into an EMR (and that includes the whole alphabet soup of PHR and EHR) comes from medical devices. Device data is the most specific and exact data found in EMRs, and is the data that serves the bedrock for diagnosis and managing therapy. As a patient’s problem list or acuity increases (predominately due to chronic diseases) the amount of data generated by patient-attached medical devices increases exponentially. Manually entering medical device data into charting systems has the following problems:
- Data availability is delayed due to the lag between the reading and when the caregiver has a chance to enter it into the system (this lag is frequently measured in hours)
- Missing data results from readings that are taken, but never entered into the system
- Transposed data or typing errors – the analog to illegible entries in paper charts
- Selecting the wrong patient for correctly entered data – the analog to improper patient identification, a common patient safety problem
In hospitals the literature has reported the percent of data entered in error to range between the low teens and mid twenties. I’m not aware of studies looking at similar activities in physician practices or patient homes.
Medical device connectivity is a requirement with growing awareness. Last week Rob Kolodner gave the keynote at a conference on medical device connectivity (the Improving Patient Safety Through Medical Device Interoperability and High Confidence Software workshop in Boston). The FDA has signaled that they are looking at regulating medical device interfaces that write straight to an EMR’s database. And vendors continue to struggle with device connectivity – with vendors creating “open” interfaces that only work with their own medical device or EMR (think Welch Allyn or AllScripts). Retrospective connectivity via HL7 is easy to develop, but expensive to deploy (each installation must be configured); prospective “plug and play” connectivity is the easiest to deploy, but requires that competing vendors work together (something they are traditionally loath to do).
Google may well acquire an EMR vendor. Given their strengths they will probably stay as close to consumer as possible, launching a PHR and/or acquiring a practice based EMR (rather than a hospital EMR vendor). In any event, the patient populations who will benefit the most, and be Google’s greatest source of pressure to drive adoption, are those patients with chronic diseases. Care delivery for chronic disease is centered around medical device data – glucometers, non-invasive blood pressure monitors, weight scales, and more. Leaving patients to manually enter this data themselves will not work for most patients, and sending caregivers to the home to gather readings will be too expensive.
Google is uniquely positioned to provide plug and play connectivity for any site with an internet connection or even a mobile phone. Actually creating the connectivity is something they have no experience with, but they have plenty of resources and smart people – they can learn it the hard way, or use a connectologist to help. This is a potential differentiator and competitive barrier (because the industry’s not going to support more than one pervasive connectivity method) for whoever gets there first.
To be more than just “another EMR vendor,” Google will have to do something different. Medical device connectivity is the biggest unmet need on the patient side of the equation. (On the systems side, there is interoperability between EMRs and prescribing and between providers and payors – but there’s already a lot of work being done here.) Their ability to deploy web applications could be leveraged in important ways.
Pictured right is the Google holiday logo commemorating the 50th Anniversary of Understanding DNA – April 25, 2003.
[Hat tip: iHealthBeat]
GE Healthcare Launches Blogs
With little fanfare, GE Healthcare has launched a suite of blogs as part of a new campaign called PeerVision. Initially targeting the diagnostic imaging market, PeerVision could easily be expanded to include other health care market segments. Included in the site are a few blogs, a discussion forum, and the usual marketing materials.
Most medical device vendors are pretty old school, and consider things like blogs or discussion forums with distrust. The usual excuse is that as an FDA regulated vendor, everything on their web site is considered “labeling.” This is not really true, but it makes a good excuse. GE has overcome this objection with a pretty comprehensive disclaimer acknowledgment that users must accept before accessing the rest of the site. The disclaimer is pretty reasonable, but one part struck me:
consultant or have any other financial interests in the information you
provide to this site including, but not limited to the promotion of
“off-label” product uses or the disclosure of confidential or
proprietary information.
I'm a consultant and clients pay me, so does this mean I can't access the site? My interpretation of this is that if another vendor can't pay a consultant to leave forum posts or blog post comments that represent that vendor's interests. Of course the wording bars the consultant from doing this rather than trying to bar another vendor.
Time will tell whether GE's blogging and forum efforts are successful. There are many things GE can do to ensure adoption and it will be interesting to see if they do any of them and how well they work. The guest bloggers have only written a few posts, and the only posts in the forum are by the moderator. I don't recognize any of the bloggers from other sites, so they may be newbies.
From the Government Health IT story on blogs:
like the first wave of Web sites,” said David Ritter, chairman of the
Labor and Employment Practice Group of the Chicago-based law firm Neal
Gerber Eisenberg, which advises companies on social media practices.
“The health care industry will catch up. But it has to stop being
hesitant about dipping a toe into the social media area.”
As an aside, the folks at Windover Information have a nice blog called In Vivo. Check it out.
UPDATE: Blogger Steve Severance offers his view on PeerVision here. I have to agree with Steve, it is unclear how much mind share PeerVision will actually garner. What is news worthy is that the first medical device vendor has launched Web 2.0 social media (that's geek-speak for the forum and blogs) focused around regulated medical devices.
If you would like help formulating and executing your own blog or Web 2.0 marketing strategy, let me know.
New HIT Implementation Testing and Support Web Site Launched by NIST
The feds have launched a new web site, “help vendors test products to determine if they meet the required
standards for participation in the Nationwide Health Information Network.” You can visit the site here. The site will provide HIT vendors with access to the tools and resources needed
to ensure their systems properly support evolving standards for health
information systems and interoperability.
[Hat tip: iHealthBeat]
Blogs Are Here to Stay
Government Health IT ran a story on the growing impact of blogs on the health care industry. “Estimates differ on the number of people using
such tools to find health information. But if blogs are any indicator,
the health care industry — often accused of lagging behind the rest of
the business world — may now be in the forefront in the use of
information technology.” In addition to blogs written by patients and physicians on health and medicine, numerous sites have sprung up that focus on the business and technology sides of health care. (Emphasis mine below.)
professional interests. Not surprisingly, some of the earliest health
care blogs meld IT with health care content. Examples include the
Healthcare IT Guy, HIStalk, Medical Connectivity Consulting and
HITSphere, an aggregator of other health IT blogs.
You can find all of the blogs mentioned above in the Blogroll in the left hand column of this web page. A common feature on blogs, a blogroll is a listing of recommended blogs.
Blogs are proving to be important marketing vehicles in the business of health care:
written by skilled consultants whose viewpoints were not accessible
before,” said Matthew Holt, a researcher who worked with health care
companies before launching his own consulting practice and the Health
Care Blog.
“Health care is a major political issue, and the
informed commentary of blogs will ultimately impact mainstream
thinking,” Holt said. “Blogs create a bridge between academics and
health services and spill marketplace knowledge back into the health
care community.”
For a good sampling of health care blogs, check out the Healthcare 100 listing of the world's top blogs on health care and medicine. General health related blogs are over represented on this list because of their broad appeal. There are many excellent blogs that are more narrow in scope that may never reach “top 100″ status. You can find some of those blogs in my Blogroll on the right.
