New Toys

I spent the weekend working with some new toys:

1. Google Chrome
2. Blackberry Bold

Google Chrome is the new browser (beta version) from Google (you can download it here). It's new, it's cool and I'm using it. When you open a new tab it automatically shows a list of windows that you recently visited. It also has one box for search and addresses with autofill/suggestions. I've had some problems getting into our office system using a Remote Desktop Web Connection. Hopefully those bugs will be worked out in the coming months.

Blackberry Bold is the new crackberry from RIM. The Bold is fantastic. A little larger than the curve with a high resolution screen and excellent document management properties. You can zoom in and out with one finger. Switch to internet through WiFi with a button. Surf the net with Java Script enabled. I've also ordered a bluetooth device that will let me present PowerPoint presentations from the Bold (no more laptop!). All in all it was worth the wait.

Google Health

Yesterday Google Health (Beta) allowed new users to take Google's new Personal Health Record (PHR) platform for a test drive. Although Google Health has little to do with health care wait times, EMR (Electronic Medical Records) is an integral part of office efficiency. I could not resist reviewing the product. As I'd previously posted, my belief is that Google would have done a greater service for the medical community by harnessing the power of their analytic abilities to improve health care delivery. Instead, Google is focusing on the Personal Health Record.

Overall Feel: Thank you Google for taking the initiative. Regardless of my thoughts on your business plan I still found the PHR to be intuitive and easy to use. The welcome screen is straight forward and information is easily entered. I had some trouble entering my past medical history (previous hospitalizations and the collar bone fracture I had when I was 12) but it records other aspects of my health easily.

Privacy: From a privacy point of view I was left wondering. The privacy statement itself is short and straight forward (in a nutshell, my medical history will not be sold or shared without my permission and I can revoke that permission at any time). But what will happen if Google is audited or general information is subpoenaed for some reason? Is my information still secure? Does it remain my property or that of Google's? I can't believe I'm saying this, but I wish the legal statement was a little more detailed.

Commercialization: Most of the web site has no advertisements on it but there are some subtle commercialized aspects. In the “Explore Health Services” there are both profit and not-for-profit agencies listed that offer advice. I wonder how organizations will make it to that list (highest bidder?). In the “find a doctor” section it seems to search by paid advertising if you search by specialty and as a general Google search if you search by name. Our office, for instance, is listed in the phone book but we do not take out advertising. I could not find my office in the search by specialty list and when I search by name many Google hits are returned.

Professional Use: The Google Health product is definitely geared to the consumer and not the professional. In its’ current state data entry takes too long and the chart format is not organized in a manner that a professional would find useful. I did not have any health records to import (you have to be connected to one of the beta centres such as the Cleveland Clinic) but I would have liked to seen how those records are organized.

Overall, Google Health easy to use but too simplistic. At this stage the early adopters and technology savvy patients will make use of it but I do not think there will be wide spread adoption. I also suspect, even fewer family doctors will make there records reconcilable with the Google database unless there is mass adoption or it benefits them in some way. Regardless, it is a start and will be interesting to watch over the next 5 years.

Google Missed the Boat on Health

At the risk of having my blog removed by the very people that host it (OK, I admit it, I have secret fantasies that the upper echelon at Google reads and cares about my blog) I have to say I was disappointed with the Google Health announcement.

Google has teamed with the Cleveland Clinic to create portable health records. The new Google platform uses GData protocol to allow people to store and share their medical records from a central repository. The screen shots of the new platform resemble a Google page to allow the patient to import records, search for information and find resources.

While I cannot argue the utility of being able to have a portable record, nor can I argue the nobility of Google for taking on this cause I can’t help but think they’ve absolutely missed the boat. The truth, as I see it, is that most of the population rarely visits their physician during the year and when they do it’s for a specific problem. While their past medical history is important it is rarely critical or difficult to review verbally. From the provider point of view, we usually make our clinical decisions by listening and examining the patient. The medical record is absolutely necessary but doesn't usually “make” the diagnosis.

I wish that Google had put their efforts into improving access and efficiency in the system. For a lot of the world, it’s not the portability of medical records but access to care that’s at stake. Improving efficiency at the primary care level would go a long way to helping with that cause. Take a look at www.google.com/analytics. When I read my web-statistics there is an amazing amount of data about visitor type, usage, time of day, time on site, and many other demographics. I have long dreamed of having a similar Google dashboard to organize and control patient flow, wait times and treatment delay. Giving clinics the ability to visualize patient flow will help reduce wait times.

Health institutions can afford to have IT, Six Sigma and Lean consultants do this type of work but it’s out of reach for smaller clinics who provide the majority of primary care. It’s not technically easy to do either, because of the disparity in clinic IT systems. If Google applied the same use of programming cookies and central processing to small clinics, dissimilar IT systems could have key performance indicators summarized the same way disparate web sites do. Google’s forte has always been putting information into the hands of the “little guy” so I hope they’ll one day take a look beyond the major health institutions and put some of their computing power into organizing primary care.