May 20, 2008

On Monday, Google announced that it has started to offer online personal health records to the public. The Google PHR, which provides users with tools to collect manage and store their personal health information online, was previously only available to patients at the Cleveland Clinic as part of a pilot program.

From InformationWeek:

For years, the Cleveland Clinic has provided its patients with electronic access to their health information via the clinic's MyChart initiative. But back in February, the clinic and Google announced that 1,600 MyChart patients were involved with a pilot in which they could add information online about their medical histories and conditions.

That's because like most Americans who get their health care from multiple providers -- specialists, family physicians, dentists, eye doctors, and so on -- many Cleveland Clinic patients also receive their care from multiple providers, many of whom may not be part of the clinic.

By having a Google Health account, Cleveland Clinic patients who were part of the pilot -- and now any patient anywhere -- have the ability to enter medical information into their Google PHR, whether it be about treatments they're receiving from other doctors, medical history, allergies, or the drugs doctors have prescribed to them.

InformationWeek also says that third-party alliances -- such as those with pharmacy chains, testing labs and prescription drug management companies -- will be key to Google's initiative. However, it's my opinion that biggest outside player to the ultimate success of Google's PHR or similar programs such as one launched by Microsoft last fall will be the insurance industry.

Certainly, PHRs can help improve patients' quality of health care by providing physicians and other healthcare providers with a more holistic clinical record. Still, PHRs are only as valuable as the information they contain.

What if a patient forgets to add a new drug they're taking to their PHR? What if they aren't vigilant enough in updating their PHR with their most recent medical history? In some cases, PHR integrations with physician or third-party data feeds can help catch what falls through the cracks.

Health insurers, though, with their claims data are best equipped to fill-in those gaps. Just about any patient is going to receive healthcare from multiple sources in a given year or over the course of a few years. What will remain relatively consistent will be the health insurer handling all those disparate claims.

It seems to me that the best way to keep PHRs up-to-date (and thus, actually useful) isn't to rely on patients to populate the records with data. It's to create a central depository for a patients medical data by integrating with disparate data sources . Then, allow the patient to control it. Let them choose how to use that information and which health care providers they want to have access to it. In that scenario, claims data would be key.

If Google or Microsoft are looking to improve the usefulness of their respective online health management efforts, they'd be well served to partner with as many insurers as possible. Of course, then the questions becomes: will insurers, many of which have PHR offerings of their own, be willing to cooperate?Why insurance carriers might ultimately be the key to success for Google's newly launch PHR initiative.

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