I heart the Google

I'm not exactly an early-adopter when it comes to new technology. I don't like to spend a lot of money on the latest souped up laptop mobile phone, PDA or digital camera. I prefer something that is cheap and popular because it's familiar.

However, there's one situation where I'm all for the early-adoption.
Google.

I remember the first day I was introduced to Google. It was back in high school, during my sophomore or junior year. Mind you, this was a time when search engines were horrible things to use; there was some clunky programming language you had to learn in order to pull up items from the internet to make it remotely useful. This was a time of Gopher and AltaVista and Yahoo. I was at my friend J's house (where we'd occasionally convene to have "LAN parties" and hook our computers together to play a game) and he said "hey, there's these people from stanford that are trying this new idea out for search." I liked the layout. It was clean and simple. It bugged me that they misspelled the word googol though... but it was a dream to use.

Since then, I've been keeping track of their progress into internet apps. I use Gmail and Google Reader as my main processing applications. I tried to convince my friends to use Google Docs with only some success. I heart the Google.

Google is free.
Google is open.
Google is creative.
Google is friendly! Recently, I emailed Google Scholar the suggestion that they include PubMed IDs into their searches. Less than a day later, I got an email from one of the developers, thanking me for the idea! Cool beans.
Google's motto is "do no evil"... which pleases me immensely that a company believes in something like the Hippocratic Oath.

Google's latest endeavor is Google Health., announced on the Official Google blog a few days ago. My local drugstore (Longs) is participating with Google as they prepare to debut the Personal Health Record later this year.

I'm very excited about this project.
As people collect more and more of their lives (their e-information) online through photos, diaries and other such services, it makes sense to have something like their Health accessible as well. It's the ideal of Patient Autonomy -- a quick list of their medications, further resources for health topics they are interested in, a link to their family history, etc... all at their fingertips should the need arise. I can foresee a subset of very involved, very dedicated net-savvy people utilizing the PHR to great effect.

However, I've got a few questions.

1. Who has access to what?
   * Will doctors be the only ones who can modify the patient's list of medications?
   * Security problems are of special concern in this area. I already dread the idea of someone finding my username and password because they could hijack my gmail, my subscriptions, my blog... basically my entire internet life. What would happen if a hacker got ahold of my health as well?
2. To what degree will patients finesse their PHRs to sound good? I was surprised the first time I got ahold of my own medical records and found that 'patient denies smoking, drinking alcohol or using illicit drugs.' I'm not in denial! It's a language thing and the point remains.
   *Will patients lie about their diet, exercise and other lifestyle choices more or less with a PHR than with their own doctors?
3. Will this affect the quality of health information find through "google"?
   *Free medical information is not equivalent to trained medical judgment. I have access to the same free info that everyone else does (yay!), but I'm learning more and more everyday what it takes to be a clinician. It requires journal articles and guidelines and understanding of basic science and mechanisms of action... which are all found more easily through closed channels than the open ones.
4. Will people have better contact with and access to their doctors through the PHR?

Eric Schmidt, the CEO of Google Inc. provides a few answers.

He starts off with great story how Google saves a man's life (he was having a heart attack, typed his symptoms into a search engine and the first hit said: you're having a heart attack. dial 911.")

PHRs have been done before. Google Health aims to integrate closed-systems and help them talk to each other. Standardization is currently lacking in fields like cell phone menus and health management systems.

You own your own PHR data and determine who has access. Transferring to a new doc? Boom. Privileges granted with a simple shift in privacy settings. Trust is important to Google.

Cloud-computing, server-side storage of important information means that your information will be accessible via any computer rather than just one hospital or one clinic.

A health advisory counsel was formed to advise Google on the services needed. Issues like organization, reliability and security, the same concerns that I have are mentioned.

Companies like Longs, Walgreens, and Walmart, as well as places like UCSF and Cleveland Clinic cooperated with Google through a series of ongoing projects to try and integrate Google Health into their services.

Go to ~30:40 to hear more about "Diana", the Cleveland Clinic patient. Her conditions page has a list of things that she added herself, as well as those she added in from her doctors. A safety check alerts her to a prescription of amoxicillin since she's allergic to penicillin. Health reference pages provide basic context on health conditions, illustrations, news, web searches, google scholar links and discussion groups. Diana can opt to "connect" her PHR to third-party programs. A google gadget can provide her with medication reminders to her google homepage(hey, maybe a text msg would be a better idea!)

A few other notions are entertained and illustrate Google Health's potential for offering even more services. They like the idea of a mother writing a vaccination checklist for her kids, news alerts on a Cure for their condition (which brought laughter to my lips in delight)

Q&A follows, bringing up questions on the success and long-term implementation of something like Google Health, Doctors being informed by Google Health, Monetization of Medical information, Open-vs-Closed models, Google EMR for billing and insurance, etc.

Wow.

Disclaimer! I know very well that I'm just promoting Google through viral advertising, but they've got some great ideas and I've always been a huge fan. I hope Google Health succeeds.... hey and maybe someday I could get hired as a consultant! hmmm?!? hehe.