The Internet has been a boon for consumers who want to learn more about their medical symptoms and conditions. According to the Pew Internet and American Life Project, 80% of the American adults who use the Internet report that they regularly go online for access to health information. But so far, the Internet has not helped drive the adoption of health records created and maintained by consumers. That's why Google announced last week that it is shutting down Google Health, a personal health record service that allows individuals to centrally store and manage their health information online.
The theoretical appeal of such a service is that people can make better decisions about health care when they have all of their health information readily available. After a very successful pilot test with 1,600 patients of the Cleveland Clinic, Google Health launched a little over three years ago. It joined similar consumer-driven offerings from Microsoft, Dossia and Indivo. While none of these other services have outright failed, they cannot be considered home-run successes. Why not? Why hasn’t the Internet empowered consumers to manage their personal health information the same way it has better informed them about medical conditions?
There are three reasons. But the underlying cause is that there is no such thing as a consumer in the American health care system today. A consumer is someone who uses personal dollars to buy goods and services for his or her own use. In our health care system, the users of medical services are, of course, individuals. But users don’t pay the largest share of costs for these services. Employers, the government, and health insurance companies do. So while people may be highly concerned about quality medical care, most are not motivated to manage costs. With that fundamental understanding, it’s easy to see why Google Health failed.
First, people are not really interested in entering information at a website unless they get value in return. And gathering personal health information from many different sources and entering it in an online database can be time-consuming and tedious. Dossia works with employers to pre-populate their employees’ health records with information from their group health plans. This saves people time, and also has the effect of making the employer a partner with employees in taking control of health information.
One can imagine how this has an effect similar to that of 401(k) employer matching. An employee puts in some amount of money and the employer matches it, with the total automatically invested in mutual or exchange-traded funds chosen by the employee. There are now dozens of studies that show that when employers match the 401(k) contributions of their employees, the number of accounts skyrockets. And what if employers took it a step further? After helping to create personal health records for their employees, what if employers engaged them to "manage" their health care more efficiently in return for a lower annual deductible? That would go a long way toward motivating employees and save millions of dollars for both employers and themselves.
Second, Google Health failed because Google did not offer tools that allowed people to put their health information to good use. One of the greatest needs is for comparative pricing tools for purchasing medical services.
For example, my son was ill last year and needed to have some blood tests done. I called our local laboratory and got some basic price information. However, it turned out that the lab was closed on the weekend we needed the tests done. So we went to a lab owned and run by the same company, but situated across the street in the basement of the large tertiary hospital in our town. The prices we were quoted were five times more expensive for exactly the same tests. What if Google Health had a tool that could allow me to "shop" for other labs in the area open on the weekend—but independent from the expensive ecosystem of a large hospital?
Third, Internet consumers expect connected interactions that create real economic value. If Google Health offered such interactions, more people would have found a way to use the service—even if it meant arduously pre-populating an online record. For example, what if Google Health had a tool that allowed individuals to compare their own medical bills to those of others with health records stored on Google Health (anonymously, of course)? Or what if Google Health had a tool that searched for better deals from medical providers based on the aggregated experiences and claims of other health care consumers in the same geographic area?
These types of comparative Internet tools are commonly available to consumers in other markets. I’m surprised that innovative companies have not launched them for health care yet, but I’m sure they will soon. It just seems like Google will be missing the opportunity.
[Image: Flickr user zerok]
Bryce Williams is the President and CEO of Extend Health. Mr. Williams holds a J.D. degree from George Washington University and a B.A. from Baylor University.