As we exhibit at the Health Information and Management Systems Society (HIMSS) trade show this year in Atlanta, we want to share with you some of our latest thinking. Google Health has been on the market for a little over two years, and in that time we have seen a growing understanding of the value of consumers being able to own, use, manage and share their medical data online with whomever they choose. While companies like ours work to build technologies like Google Health to make this a reality, we've also seen growing support from the U.S. Government. President Obama has included incentives for doctors to adopt electronic health records (EHRs) in the the American Recovery and Re-Investment Act of 2009 (AARA), and in recent months there have also been a series of Health IT provisions around "Meaningful Use" and EHR Certification all of which should help empower consumers with access to their own information. (Read our recent op-ed for more info about this topic.)
At Google, we understand that changes in the health care industry take time and persistence, including health IT. We have been steadily analyzing feedback from our user surveys and field studies to help make Google Health more useful and relevant to a broad set of consumers on a daily basis. People have been telling us they want more tools to personalize, customize and track their own medical information. These are directions we're certainly exploring, and if you stop by our booth this week at HIMSS you can see a demo of what we're working on.
While we work to refine the Google Health product, we also continue to pursue integration agreements with providers to make it even easier for people to access their own medical information. We've learned over these past two years that getting a current and past medication history assembled and ready in case of emergencies is one of the strongest value propositions for using an online Personal Health Record (PHR). So today at HIMSS, we're announcing an integration with Surescripts, the leading electronic prescribing network in the United States, to help accelerate the availability of prescription drug history to our users. The Surescripts network connects doctors who prescribe medication to all of the nation’s major pharmacy chains, leading health insurance plans and pharmacy benefits managers (PBMs), as well as more than 10,000 independent pharmacies nationwide. Surescripts provides access to prescription benefit and history information on behalf of health insurance plans representing 65 percent of patients in the U.S.
Recognizing that hospital and ambulatory data is critical to our consumers, we're also announcing a future integration with the University of Pittsburgh Medical Center (UPMC) that will give patients the ability to add health information to an EHR maintained by doctors using their own Google Health PHR. UPMC is working on this integration with Google Health, Carnegie Mellon University and their technology partner dbMotion. Finally, we're announcing the launch of three more integration partners: Citizen Memorial Healthcare (CMH), a rural healthcare network providing care to residents in southwest Missouri, Iatric Systems, an integration consultant, which can facilitate Google Health integrations for hospitals and healthcare systems, and the Withings WiFi Body Scale, which allows Google Health users to seamlessly update their weight and other data to their online profiles.
We hope to see you this week at HIMSS. Come by our booth, see our demo and say hello.
Showing posts with label healthcare. Show all posts
Showing posts with label healthcare. Show all posts
Finding flu vaccine information in one easy place
This year, it's especially important to have clear information on what you can do to prepare for the flu season. With this in mind, we are happy to share a new feature for the U.S. which allows you to more easily find locations near you for getting both the seasonal and H1N1 flu vaccine. After expanding Google Flu Trends to a total of 20 countries and 38 languages, allowing more people to see near real-time estimates of flu activity, we began brainstorming with the U.S. Department for Health and Human Services (HHS), their flu.gov collaborators and the American Lung Association on the flu shot finder and other ways Google can be helpful to people this flu season.
You can check out the flu shot finder at www.google.com/flushot. The same tool will also be available shortly on www.flu.gov and the American Lung Association websites. It's important to note that this project is just beginning and we have not yet received information about flu shot clinics for many locations. In addition, many locations that are shown are currently out of stock. We launched this service now in order to help disseminate information about locations where vaccines are available, and also to make more vaccine providers aware of the project so that they can contribute.
Especially given slower than expected vaccine production, we think it's important to bring together flu shot information in a coherent manner. We've been working with HHS, the Centers for Disease Control and Prevention (CDC) and state and local health agencies to gather information on flu vaccine locations across the country, particularly for the H1N1 flu vaccine (both the nasal-spray vaccine and the shot). At the moment we have data for locations of flu vaccine directly from 20 states and counting. We are also continuing to add information from chain pharmacies and other providers in all 50 states; today, you'll find results from chains such as Walgreens, CVS and PDX participants, such as Kmart, Duane Reade, WinnDixie and Giant Eagle.
Of course you should still call flu vaccine providers ahead of time to find out more about availability and eligibility for the two vaccines.
We hope to continue providing you with relevant information to help keep you and your loved ones healthy.
You can check out the flu shot finder at www.google.com/flushot. The same tool will also be available shortly on www.flu.gov and the American Lung Association websites. It's important to note that this project is just beginning and we have not yet received information about flu shot clinics for many locations. In addition, many locations that are shown are currently out of stock. We launched this service now in order to help disseminate information about locations where vaccines are available, and also to make more vaccine providers aware of the project so that they can contribute.
Especially given slower than expected vaccine production, we think it's important to bring together flu shot information in a coherent manner. We've been working with HHS, the Centers for Disease Control and Prevention (CDC) and state and local health agencies to gather information on flu vaccine locations across the country, particularly for the H1N1 flu vaccine (both the nasal-spray vaccine and the shot). At the moment we have data for locations of flu vaccine directly from 20 states and counting. We are also continuing to add information from chain pharmacies and other providers in all 50 states; today, you'll find results from chains such as Walgreens, CVS and PDX participants, such as Kmart, Duane Reade, WinnDixie and Giant Eagle.
Of course you should still call flu vaccine providers ahead of time to find out more about availability and eligibility for the two vaccines.
We hope to continue providing you with relevant information to help keep you and your loved ones healthy.
Update on 11/19: We just added the flu shot finder as a search feature on Google.com. Now, if you search for terms like [flu], [flu shot], [h1n1 shot] or [flu vaccine], information will appear at the top of your search results, including flu tips from flu.gov as well as the flu shot finder box with an expanding map that displays locations where you can receive seasonal and/or H1N1 flu shots.
Fall update on Google Health
We're still hard at work improving Google Health, our online Personal Health Record (PHR). We've gotten valuable feedback from many of you who are importing data into Google Health from connected providers. We often hear that you want to import data from your health insurance plans, so we're working on just that.
Today, at the Health 2.0 conference in San Francisco, we're announcing the addition of two new health insurance companies to the Google Health platform: Harvard Pilgrim Health Care and the American Postal Workers Union Health Plan (APWU Health Plan).
The APWU Health Plan, the not-for-profit department of the American Postal Workers Union, now offers Google Health through their High Option PPO plan. Members get 18 months of data copied into their Google Health Account upon linking their member portal with Google Health and then automatic updates from that point on. Harvard Pilgrim Health Care serves more than one million members across Massachusetts, Maine, New Hampshire and beyond and roughly 777,000 of their members who use the HMO, POS and PPO products can securely import their Harvard Pilgrim health history into Google Health. This includes prescription data used in the last year and any records on illnesses, conditions, procedures and immunizations dating back to 2006. Once a member links his health plan portal account with Google Health, his data will be automatically updated when a new claim is generated by a physician.
With these new additions and Blue Cross Blue Shield of MA, which joined in December of 2008, we now have three health insurance plans that are connected to Google Health and actively promoting it as a PHR option to their members. We'll be studying how useful this data is to our users, as we've learned that some data is not as useful as others.
We're also working with companies that offer unique "convenience" services, such as secure email and video consultations with doctors. One example is a company called MDLiveCare, a telehealth provider now available in the Google Health online services directory. MDLiveCare is helping to empower patients by sending the complete doctor's clinical note to Google Health from any consultation a patient has with their network of oncall board certified doctors and licensed mental health therapists. Hello Health is another example of a company that facilitates connecting with a doctor online and is launching with Google Health today.
Also, in case you missed our updates, here are some improvements we worked on over the summer:
Today, at the Health 2.0 conference in San Francisco, we're announcing the addition of two new health insurance companies to the Google Health platform: Harvard Pilgrim Health Care and the American Postal Workers Union Health Plan (APWU Health Plan).
The APWU Health Plan, the not-for-profit department of the American Postal Workers Union, now offers Google Health through their High Option PPO plan. Members get 18 months of data copied into their Google Health Account upon linking their member portal with Google Health and then automatic updates from that point on. Harvard Pilgrim Health Care serves more than one million members across Massachusetts, Maine, New Hampshire and beyond and roughly 777,000 of their members who use the HMO, POS and PPO products can securely import their Harvard Pilgrim health history into Google Health. This includes prescription data used in the last year and any records on illnesses, conditions, procedures and immunizations dating back to 2006. Once a member links his health plan portal account with Google Health, his data will be automatically updated when a new claim is generated by a physician.
With these new additions and Blue Cross Blue Shield of MA, which joined in December of 2008, we now have three health insurance plans that are connected to Google Health and actively promoting it as a PHR option to their members. We'll be studying how useful this data is to our users, as we've learned that some data is not as useful as others.
We're also working with companies that offer unique "convenience" services, such as secure email and video consultations with doctors. One example is a company called MDLiveCare, a telehealth provider now available in the Google Health online services directory. MDLiveCare is helping to empower patients by sending the complete doctor's clinical note to Google Health from any consultation a patient has with their network of oncall board certified doctors and licensed mental health therapists. Hello Health is another example of a company that facilitates connecting with a doctor online and is launching with Google Health today.
Also, in case you missed our updates, here are some improvements we worked on over the summer:
- File Upload: Still dealing with paper files at home? You can now upload files you have scanned or have on your computer, such as test results you previously received in the mail. Each file you upload can be anywhere from 4MB to 100MB. Start by completing and uploading an advance directive.
- Insurance Information: You can now store all of your health insurance information in your Google Health profile, including your plan name, plan ID, group number, subscriber and policy ID and member phone number.
- Graphing: Keep track of your test results visually to see how key numbers progress over time. If you have more than one cholesterol lab result saved in your profile, you can view these results over time in a graph and track your progress.
Listening to Google Health users
At Google, we believe that consumers should have convenient and secure access to all their health data so that they can be better informed and be more involved in their care. Recently, a data-savvy patient known as e-Patient Dave blogged about data that was imported into his Google Health Account from his hospital in Boston, Beth Israel Deaconess Medical Center. Once he saw his data in Google Health, he saw diagnoses that were both alarming and wrong. Where did they come from?
It turns out that they came from the billing codes and associated descriptions used by the hospital to bill the patient's insurance company. These descriptions, from the International Classification of Diseases (ICD-9), often do not accurately describe a patient because the right ICD-9 code may not exist. So the doctor or hospital administrator chooses something that is "close enough" for billing purposes. In other cases, the assigned code is precisely what the doctor is trying to rule out, and if the patient turns out not to have that often scary diagnosis, it is still associated with their record. Google Health faithfully displayed the data we received on Dave's behalf. We and Beth Israel knew that this type of administrative data has its limitations but felt that patients would find it a good starting point. Too often, this is wrong.
At Google, we are constantly learning important lessons from our users. Two days after we learned about this issue, I met with Beth Israel CIO John Halamka, the patient's physician Dr. Danny Sands, and e-Patient Dave himself. We agreed on a reasonable plan: Beth Israel will stop sending ICD-9 billing codes and will instead only send to Google Health the free text descriptions entered by doctors. Beth Israel is also working with the National Library of Medicine (NLM) to associate those free text descriptions with a more clinically useful coding system called SNOMED-CT, so that we can offer patients useful services like automatic drug interaction checking. The result will be more accurate and useful information in patients' Google Health profiles.
This week, all four of us were also at a conference called Health 2.0 in Boston. Dave's story, and the lessons we all learned, were the focus of much discussion. We are grateful to Dave for his openness and passion for making things right. We're also glad this happened because we and many others now better understand the limitations of certain types of health data and we are working with partners to improve the quality of the data before it gets to Google Health and our users. We look forward to sharing what we learn with the broader community. We also learned that the patient community is surprisingly interested in understanding these data issues. Dave and his doctor Danny Sands collaborated on an informative post about different data vocabularies used in different aspects of healthcare. The patient-controlled "data liquidity" that Google Health supports is clearly an important part of the future of health care. We are more committed than ever to putting consumers in charge of their own health information.
It turns out that they came from the billing codes and associated descriptions used by the hospital to bill the patient's insurance company. These descriptions, from the International Classification of Diseases (ICD-9), often do not accurately describe a patient because the right ICD-9 code may not exist. So the doctor or hospital administrator chooses something that is "close enough" for billing purposes. In other cases, the assigned code is precisely what the doctor is trying to rule out, and if the patient turns out not to have that often scary diagnosis, it is still associated with their record. Google Health faithfully displayed the data we received on Dave's behalf. We and Beth Israel knew that this type of administrative data has its limitations but felt that patients would find it a good starting point. Too often, this is wrong.
At Google, we are constantly learning important lessons from our users. Two days after we learned about this issue, I met with Beth Israel CIO John Halamka, the patient's physician Dr. Danny Sands, and e-Patient Dave himself. We agreed on a reasonable plan: Beth Israel will stop sending ICD-9 billing codes and will instead only send to Google Health the free text descriptions entered by doctors. Beth Israel is also working with the National Library of Medicine (NLM) to associate those free text descriptions with a more clinically useful coding system called SNOMED-CT, so that we can offer patients useful services like automatic drug interaction checking. The result will be more accurate and useful information in patients' Google Health profiles.
This week, all four of us were also at a conference called Health 2.0 in Boston. Dave's story, and the lessons we all learned, were the focus of much discussion. We are grateful to Dave for his openness and passion for making things right. We're also glad this happened because we and many others now better understand the limitations of certain types of health data and we are working with partners to improve the quality of the data before it gets to Google Health and our users. We look forward to sharing what we learn with the broader community. We also learned that the patient community is surprisingly interested in understanding these data issues. Dave and his doctor Danny Sands collaborated on an informative post about different data vocabularies used in different aspects of healthcare. The patient-controlled "data liquidity" that Google Health supports is clearly an important part of the future of health care. We are more committed than ever to putting consumers in charge of their own health information.
CVS joins Google Health Rx network: millions can access medication records online
When I first started working on Google Health, I was shocked by how hard it is for people to access their own medical records. I wondered why that's the case when it's so easy to access other types of personal information like bank transactions, cell phone records, and utility bills. In many states you can even renew your car registration online with a few clicks. Yet when it comes to something arguably much more important, such as your own medical records or a current list of medications, we have little to no access. It just doesn't seem right.
We're working to solve this problem. With the recent addition of CVS/pharmacy to our network of pharmacy partners, more than 100 million people can now access their prescription history online and import it into a central, secure place — a Google Health Account. In addition to CVS, we're proud to be working with several other well-known national and regional pharmacy chains to improve patient safety, reduce medical errors, and increase efficiencies in health care.
Having a list of all your medications all in one place from the pharmacies you shop at helps your doctor, pharmacist and other care providers do a better job of taking care of you. In fact, it's estimated that 1.5 million Americans are sickened or injured each year by errors in prescribing, dispensing and/or taking medications. Some experts suggest that medication errors claim more than 7,000 lives each year. Making your medications known to those who care for you is a simple step to ensure you get the best possible care. Not to mention, imagine how important having immediate access to this information could be during an emergency.
To get started, first see if your pharmacy is connected with Google Health. If so, just sign up for an online account at your pharmacy's website, and then you can securely import your data into your Google Health account. Once your medication information is in Google Health, you can use our new sharing feature to share it with anyone in your care network, including family members, doctors, and other caregivers.
If you have pharmacy benefits through your employer or your health plan, you may also be able to import your prescription history into Google Health. We are working with two of the largest pharmacy benefit managers in the nation, Medco and CVS Caremark, so check your wallet to see if you have a prescription drug card from either one of them today (see examples below). If you are a Medco or Caremark member, simply log in to your online Medco or Caremark account (or register for one if you don't already have an account set up) and then link your Google Health profile to it. If you are unsure if Caremark or Medco manages your pharmacy benefits, check your prescription drug card for one of their logos, or call the number on the back of your card.
We're working to solve this problem. With the recent addition of CVS/pharmacy to our network of pharmacy partners, more than 100 million people can now access their prescription history online and import it into a central, secure place — a Google Health Account. In addition to CVS, we're proud to be working with several other well-known national and regional pharmacy chains to improve patient safety, reduce medical errors, and increase efficiencies in health care.
Having a list of all your medications all in one place from the pharmacies you shop at helps your doctor, pharmacist and other care providers do a better job of taking care of you. In fact, it's estimated that 1.5 million Americans are sickened or injured each year by errors in prescribing, dispensing and/or taking medications. Some experts suggest that medication errors claim more than 7,000 lives each year. Making your medications known to those who care for you is a simple step to ensure you get the best possible care. Not to mention, imagine how important having immediate access to this information could be during an emergency.
To get started, first see if your pharmacy is connected with Google Health. If so, just sign up for an online account at your pharmacy's website, and then you can securely import your data into your Google Health account. Once your medication information is in Google Health, you can use our new sharing feature to share it with anyone in your care network, including family members, doctors, and other caregivers.
If you have pharmacy benefits through your employer or your health plan, you may also be able to import your prescription history into Google Health. We are working with two of the largest pharmacy benefit managers in the nation, Medco and CVS Caremark, so check your wallet to see if you have a prescription drug card from either one of them today (see examples below). If you are a Medco or Caremark member, simply log in to your online Medco or Caremark account (or register for one if you don't already have an account set up) and then link your Google Health profile to it. If you are unsure if Caremark or Medco manages your pharmacy benefits, check your prescription drug card for one of their logos, or call the number on the back of your card.
Getting your Medicare records in Google Health
Google Health is working with the Centers for Medicare and Medicaid Services (CMS) on a pilot program in Arizona and Utah that lets Medicare beneficiaries import their Medicare claims data into Google Health.
The pilot is one of several CMS programs to test out how the government can give beneficiaries secure access to their medical data online. Before I came to Google, I worked at the U.S. Department of Health and Human Services, which houses CMS. At the time, the idea of giving beneficiaries access to their own Medicare claims data in electronic format was just that — an idea. Today, it's becoming a reality. And given the more than $19 billion investment the government is making in Health IT as part of the stimulus package, now is the perfect time.
As a part-time caregiver to my mother who has a serious chronic illness and someone who just lost both elderly grandparents in the past four months to illness, I can see the benefit of having all of my family’s medical information organized in one place. When Google Health launched last year, I promptly set up accounts for my mother and both grandparents. But at the time, I found it frustrating that I was not able to access electronic copies of my grandparents' Medicare claims — where most of their medical data resided.
The Medicare Arizona and Utah pilot is designed to give beneficiaries choice in the tools they use to manage their medical records online. Google Health is one of four personal health records (PHR) that beneficiaries can choose from. While only traditional fee-for-service (FFS) Medicare beneficiaries with a primary residence in Arizona and Utah are eligible to participate, this includes nearly 1.1 million beneficiaries living in those regions.
For beneficiaries who choose to participate, it's important to know that Medicare does not have access to information in your Google Health Account — Medicare will only be sending data to your Account. Beneficiaries who participate in the pilot will still have access to data imported into their Google Health Accounts after the pilot concludes at the end of 2009. And with the recently launched Google Health sharing feature, any beneficiary enrolled in this pilot can now share this data with family members and doctors in their care network.
If I had this type of electronic access to my grandparents' medical records during my family's medical crisis, it would have been a huge help to me. I applaud CMS for taking this big step towards empowering consumers with access to their own health records.
If you're a Medicare beneficiary living in Arizona or Utah and are interested in participating in the pilot, you can get started here.
The pilot is one of several CMS programs to test out how the government can give beneficiaries secure access to their medical data online. Before I came to Google, I worked at the U.S. Department of Health and Human Services, which houses CMS. At the time, the idea of giving beneficiaries access to their own Medicare claims data in electronic format was just that — an idea. Today, it's becoming a reality. And given the more than $19 billion investment the government is making in Health IT as part of the stimulus package, now is the perfect time.
As a part-time caregiver to my mother who has a serious chronic illness and someone who just lost both elderly grandparents in the past four months to illness, I can see the benefit of having all of my family’s medical information organized in one place. When Google Health launched last year, I promptly set up accounts for my mother and both grandparents. But at the time, I found it frustrating that I was not able to access electronic copies of my grandparents' Medicare claims — where most of their medical data resided.
The Medicare Arizona and Utah pilot is designed to give beneficiaries choice in the tools they use to manage their medical records online. Google Health is one of four personal health records (PHR) that beneficiaries can choose from. While only traditional fee-for-service (FFS) Medicare beneficiaries with a primary residence in Arizona and Utah are eligible to participate, this includes nearly 1.1 million beneficiaries living in those regions.
For beneficiaries who choose to participate, it's important to know that Medicare does not have access to information in your Google Health Account — Medicare will only be sending data to your Account. Beneficiaries who participate in the pilot will still have access to data imported into their Google Health Accounts after the pilot concludes at the end of 2009. And with the recently launched Google Health sharing feature, any beneficiary enrolled in this pilot can now share this data with family members and doctors in their care network.
If I had this type of electronic access to my grandparents' medical records during my family's medical crisis, it would have been a huge help to me. I applaud CMS for taking this big step towards empowering consumers with access to their own health records.
If you're a Medicare beneficiary living in Arizona or Utah and are interested in participating in the pilot, you can get started here.
Google Health: helping you better coordinate your care
We continue to learn a tremendous amount since launching Google Health in the spring of 2008. We're listening to feedback from users every day about their needs, and one issue we hear regularly is that people want help coordinating their care and the care of loved ones. They want the ability to share their medical records and personal health information with trusted family members, friends, and doctors in their care network. I can relate to this.
Just a few years ago, my father suffered a minor heart attack and was sent to the ER. I arrived on the scene in a panic, and was asked what medications he was taking. To my surprise, I had no clue. If my father had a Google Health account, and had shared his profile with me, I would have been up-to-date on his current medications.
I'm happy to announce today Google Health has addressed this issue with the release of a new "Share this profile" feature enabling Google Health users to invite others they trust (whether it's a family member, a trusted care network provider, friends, and/or a doctor) to view their medical records and personal health information.
Log into Google Health, click on "Share this Profile," and type in the email address of the person with whom you'd like to share your profile. Google Health will send an email to them with a link to view your profile. The link will only work in connection with the email address of that person — your profile can't be accessed if the link is forwarded on. You can stop sharing at any time, and you can always see who has access to your information. Those who are viewing your profile can only see the profile you share — not any other one in your account. We've also built in some extra protections to make sure your health information stays safe, private, and under your control:
For doctors and family members who are not yet online, we've also made it easier to share a hard copy of your information via our new printing feature. The wallet format prints a wallet-sized card that includes a user's medications, and allergies; the PDF format prints a letter-sized copy of a user's profile, including medications, allergies, conditions, and treatments.
Finally, we've launched a new graphing feature that helps patients visualize their medical test information. This is great for, say, someone who has high cholesterol. They can use Google Health to enter their lab results on a monthly basis and see the trend over time.
There is still a lot more work to do on Google Health, and we're excited to keep hearing from you so we can continue to make improvements. For now, we hope this new sharing feature makes coordinating your care, or the care of loved ones, a little easier.
Update on 3/6: Clarified the first bullet point.
Just a few years ago, my father suffered a minor heart attack and was sent to the ER. I arrived on the scene in a panic, and was asked what medications he was taking. To my surprise, I had no clue. If my father had a Google Health account, and had shared his profile with me, I would have been up-to-date on his current medications.
I'm happy to announce today Google Health has addressed this issue with the release of a new "Share this profile" feature enabling Google Health users to invite others they trust (whether it's a family member, a trusted care network provider, friends, and/or a doctor) to view their medical records and personal health information.
Log into Google Health, click on "Share this Profile," and type in the email address of the person with whom you'd like to share your profile. Google Health will send an email to them with a link to view your profile. The link will only work in connection with the email address of that person — your profile can't be accessed if the link is forwarded on. You can stop sharing at any time, and you can always see who has access to your information. Those who are viewing your profile can only see the profile you share — not any other one in your account. We've also built in some extra protections to make sure your health information stays safe, private, and under your control:
- The sharing link in the email expires after 30 days, but the sharing access itself does not expire — it will stay in place until the user decides to stop sharing
- Viewers can only see — not edit — your Google Health profile
- You can review a user activity report to see who has viewed your profile
For doctors and family members who are not yet online, we've also made it easier to share a hard copy of your information via our new printing feature. The wallet format prints a wallet-sized card that includes a user's medications, and allergies; the PDF format prints a letter-sized copy of a user's profile, including medications, allergies, conditions, and treatments.
Finally, we've launched a new graphing feature that helps patients visualize their medical test information. This is great for, say, someone who has high cholesterol. They can use Google Health to enter their lab results on a monthly basis and see the trend over time.
There is still a lot more work to do on Google Health, and we're excited to keep hearing from you so we can continue to make improvements. For now, we hope this new sharing feature makes coordinating your care, or the care of loved ones, a little easier.Update on 3/6: Clarified the first bullet point.
Helping healthcare providers become more efficient
Healthcare professionals have always focused on reducing costs while still increasing the quality of the care they provide to patients — and this kind of efficiency becomes even more important in challenging economic times.
Fortunately, healthcare providers can turn to the web for a growing number of resources that help them achieve these goals. With our health initiatives and solutions for businesses of all kinds, Google is committed to helping bring exactly these kinds of productivity gains and cost reductions to healthcare providers. We're also committed to harnessing the power of the web to help people everywhere effectively manage their healthcare records and information in a private, secure online setting.
To learn about our latest innovations in this area, tune in to our free webinar scheduled for Wednesday, December 10, at 10:00 am PT.
The session will include a current look at Google Health, which empowers patients to securely organize and manage their health information online. For the full lineup of topics that will be covered, check out our post on the Enterprise blog.
We hope to see you there.
Fortunately, healthcare providers can turn to the web for a growing number of resources that help them achieve these goals. With our health initiatives and solutions for businesses of all kinds, Google is committed to helping bring exactly these kinds of productivity gains and cost reductions to healthcare providers. We're also committed to harnessing the power of the web to help people everywhere effectively manage their healthcare records and information in a private, secure online setting.
To learn about our latest innovations in this area, tune in to our free webinar scheduled for Wednesday, December 10, at 10:00 am PT.
The session will include a current look at Google Health, which empowers patients to securely organize and manage their health information online. For the full lineup of topics that will be covered, check out our post on the Enterprise blog.
We hope to see you there.
How we help track flu trends
This post is the latest in an ongoing series about how we harness the data we collect to improve our products and services for our users. - Ed.
Google search isn't just about looking up football scores from last weekend or finding a great hotel for your next vacation. It can also be used for the public good. Yesterday, we announced Google Flu Trends, which uses aggregated search data in an effort to confront the challenge of influenza outbreaks.
By taking Google Trends — where you can see snapshots of what's on the public's collective mind — and applying the tool to a public health problem, our engineers found that there was a correlation between flu-related queries and the actual flu. They created a model for near real-time estimates about outbreaks, in the hopes that both health care professionals and the general public would use this tool to better prepare for flu season.
Since we launched yesterday, the response from the medical community has been positive. "The earlier the warning, the earlier prevention and control measures can be put in place," said Dr. Lyn Finelli of the influenza division at the Centers for Disease Control and Prevention, to The New York Times. "[T]his could prevent cases of influenza." You can check out the tool for yourself.
We couldn't have built this flu detection system without analyzing historical patterns. Because flu season is different every year, just a few months of data wouldn't have done the trick. For example, the 2003-2004 flu season was unusually severe in many regions. The data from that season was especially robust and allowed us to discover a more accurate, reliable set of flu-related terms. To learn more about how we built the system, see this page on how Flu Trends works.
Because we're committed to protecting your privacy, we made sure that the searches that we analyze for Google Flu Trends are not drawn from personally-identifiable search histories but rather from an aggregated set of hundreds of billions of searches.
In order to provide a rough geographic breakdown of potential flu outbreaks, we use IP address information from our server logs to make a best guess about where queries originate. To protect your privacy, we anonymize those IP addresses at nine months. And we don't provide this aggregated, anonymized data to third parties. For more information about the privacy protections for Flu Trends check out our FAQs and privacy policy.
This is just the first launch in what we hope will be several public service applications of Google Trends in the future. And as we continue to think of ways to use aggregated and anonymized search data in helpful ways, we're also committed to safeguarding our users' privacy.
Google search isn't just about looking up football scores from last weekend or finding a great hotel for your next vacation. It can also be used for the public good. Yesterday, we announced Google Flu Trends, which uses aggregated search data in an effort to confront the challenge of influenza outbreaks.
By taking Google Trends — where you can see snapshots of what's on the public's collective mind — and applying the tool to a public health problem, our engineers found that there was a correlation between flu-related queries and the actual flu. They created a model for near real-time estimates about outbreaks, in the hopes that both health care professionals and the general public would use this tool to better prepare for flu season.
Since we launched yesterday, the response from the medical community has been positive. "The earlier the warning, the earlier prevention and control measures can be put in place," said Dr. Lyn Finelli of the influenza division at the Centers for Disease Control and Prevention, to The New York Times. "[T]his could prevent cases of influenza." You can check out the tool for yourself.
We couldn't have built this flu detection system without analyzing historical patterns. Because flu season is different every year, just a few months of data wouldn't have done the trick. For example, the 2003-2004 flu season was unusually severe in many regions. The data from that season was especially robust and allowed us to discover a more accurate, reliable set of flu-related terms. To learn more about how we built the system, see this page on how Flu Trends works.
Because we're committed to protecting your privacy, we made sure that the searches that we analyze for Google Flu Trends are not drawn from personally-identifiable search histories but rather from an aggregated set of hundreds of billions of searches.
In order to provide a rough geographic breakdown of potential flu outbreaks, we use IP address information from our server logs to make a best guess about where queries originate. To protect your privacy, we anonymize those IP addresses at nine months. And we don't provide this aggregated, anonymized data to third parties. For more information about the privacy protections for Flu Trends check out our FAQs and privacy policy.
This is just the first launch in what we hope will be several public service applications of Google Trends in the future. And as we continue to think of ways to use aggregated and anonymized search data in helpful ways, we're also committed to safeguarding our users' privacy.
Google Health feels accessible
From time to time, our own T.V. Raman shares his tips on how to use Google from his perspective as a technologist who cannot see -- tips that sighted people, among others, may also find useful.
Keeping track of personal health records using printed paper is painful at best for most users; as someone with a visual impairment, this is a show-stopper for me. As I begin paying more attention to my own health, I've come to realize first-hand how hard it is at present to track one's health using the means that traditional health care programs provide.
As luck would have it, Google Health arrived at around the same time that I started dealing with these issues, and focusing on the usability of Google Health from the perspective of someone who cannot see was therefore a no-brainer. Today, we are launching a version of Google Health that has been augmented with several usability enhancements that aid users of screen readers and self-voicing browsers. These enhancements are implemented using W3C ARIA, an emerging set of Web standards that make AJAX applications work smoothly with screen readers — see our related post on the GWT blog for details. With these enhancements, I can now easily navigate Google Health to not only manage my own health records; Google Health enables me to quickly research various relevant health conditions, track medications and do a myriad health-related tasks.
Google Health gives me a single unified web interface to manage all of my health-related information. Kudos to the Google Health and GWT teams for creating an extremely useful and usable solution!
Wiping out the next smallpox
The Internet has had an enormous impact on people's lives around the world in the ten years since Google's founding. It has changed politics, entertainment, culture, business, health care, the environment and just about every other topic you can think of. Which got us to thinking, what's going to happen in the next ten years? How will this phenomenal technology evolve, how will we adapt, and (more importantly) how will it adapt to us? We asked ten of our top experts this very question, and during September (our 10th anniversary month) we are presenting their responses. As computer scientist Alan Kay has famously observed, the best way to predict the future is to invent it, so we will be doing our best to make good on our experts' words every day. - Karen Wickre and Alan Eagle, series editors
It took more than a village: it took the entire world -- people of all races, countries and religions -- to eradicate smallpox. The final naturally occurring cases of "Variola major" in Bangladesh in 1978 and "Variola minor" in Somalia in 1977 marked the end to a chain of suffering and early death dating back to the Biblical plagues, and to Pharoah Ramses, who died from the very same disease. Since then we have continued to face countless pandemics -- the Black Death, cholera, and now bird flu, SARS, HIV/AIDS and a new generation of zoonotic diseases -- diseases that, often because of changes in population or climate, jump from animals to humans. We can't be sure where the next smallpox will emerge, but we can be sure that it will take an effort larger than any single person or organization to defeat it.
Today there are some real heroes working to check off two more diseases from the list. The World Health Organization has led the charge against the highly infectious disease of polio. Along with UNICEF and dozens of NGOs, and millions of national and local health workers, members of Rotary International and volunteers from moms to Mullahs have stepped up to the plate and contained polio so that hundreds, not millions, of kids are paralyzed annually, but we cannot consider the case closed until we erase the last case, in the last country. The Carter Center has also accomplished a tremendous feat by leading the effort to shrink the cases of Guinea worm to the tens of thousands from the millions. Just as it took 150,000 health workers -- the world's unsung heroes -- to make one billion house calls in India searching for hidden cases of smallpox, it will take collaboration on a global scale to track and eliminate the next pandemic.
There is no Nobel Prize for "Preventing a Pandemic," and the hardest part about working in this field is imagining the unimaginable. What will be the next SARS, the next ebola, the next H5N1 bird flu? Epidemiologists try to "out think" the massive numbers of permutations and combinations that may give rise to the newest threat to our lives. Chances are a microbe capable of sweeping the globe will emerge in the next decade or two, and chances are it will cross to humans from an animal host (as did SARS, the Spanish flu, and HIV/AIDS). We need new ways to find these emerging threats earlier in the process, before thousands are infected and the epidemic spirals out of control.
Google.org's Predict and Prevent initiative is working with partners to use digital, genomic and IT technology to identify "hot spots" of emerging threats and provide early warning before they become global crises. When you're fighting a pandemic, early detection and early response can be the difference between dozens and hundreds of millions infected. What better birthday present could we offer the world after our 20th year, than to say we joined hands with a global movement and helped prevent the next smallpox?
It took more than a village: it took the entire world -- people of all races, countries and religions -- to eradicate smallpox. The final naturally occurring cases of "Variola major" in Bangladesh in 1978 and "Variola minor" in Somalia in 1977 marked the end to a chain of suffering and early death dating back to the Biblical plagues, and to Pharoah Ramses, who died from the very same disease. Since then we have continued to face countless pandemics -- the Black Death, cholera, and now bird flu, SARS, HIV/AIDS and a new generation of zoonotic diseases -- diseases that, often because of changes in population or climate, jump from animals to humans. We can't be sure where the next smallpox will emerge, but we can be sure that it will take an effort larger than any single person or organization to defeat it.
Today there are some real heroes working to check off two more diseases from the list. The World Health Organization has led the charge against the highly infectious disease of polio. Along with UNICEF and dozens of NGOs, and millions of national and local health workers, members of Rotary International and volunteers from moms to Mullahs have stepped up to the plate and contained polio so that hundreds, not millions, of kids are paralyzed annually, but we cannot consider the case closed until we erase the last case, in the last country. The Carter Center has also accomplished a tremendous feat by leading the effort to shrink the cases of Guinea worm to the tens of thousands from the millions. Just as it took 150,000 health workers -- the world's unsung heroes -- to make one billion house calls in India searching for hidden cases of smallpox, it will take collaboration on a global scale to track and eliminate the next pandemic.
There is no Nobel Prize for "Preventing a Pandemic," and the hardest part about working in this field is imagining the unimaginable. What will be the next SARS, the next ebola, the next H5N1 bird flu? Epidemiologists try to "out think" the massive numbers of permutations and combinations that may give rise to the newest threat to our lives. Chances are a microbe capable of sweeping the globe will emerge in the next decade or two, and chances are it will cross to humans from an animal host (as did SARS, the Spanish flu, and HIV/AIDS). We need new ways to find these emerging threats earlier in the process, before thousands are infected and the epidemic spirals out of control.
Google.org's Predict and Prevent initiative is working with partners to use digital, genomic and IT technology to identify "hot spots" of emerging threats and provide early warning before they become global crises. When you're fighting a pandemic, early detection and early response can be the difference between dozens and hundreds of millions infected. What better birthday present could we offer the world after our 20th year, than to say we joined hands with a global movement and helped prevent the next smallpox?
A peek into our search factory
Today we hosted an informal gathering -- a factory tour of sorts -- to offer a glimpse into what we think is most exciting about search, and where innovation is most likely to come from. We also gave an update on Google Health.
On the search front, we wanted to share news about the way we think search is expanding. When we talk about search, we mean images, news, finance, books, local, and geographical information as well as web search. These media types are becoming more and more integral in our core universal search, but each presents its own challenges, innovations, and triumphs. Today R.J. Pittman, Director of Search Properties, showed some of the amazing advances we've made in image search -- we now offer an early form of face recognition on advanced search, for example -- as well as how ads might work to enhance the user experience on image search. He also demonstrated the interesting innovative technologies that Google News has deployed to support features like quotes from newsmakers and better quality search for local news.
Carter Maslan, Director of Local Search Quality, talked about our Geo products (Maps and Earth and their features) and the fact that they represent a considerable search problem: how do you take all of the information about the physical world and make it searchable? How do you label disputed borders? How can Street View help you find where you are going? Google Earth has helped archaeologists find things they've looked for for years (i.e. a Roman villa in someone's backyard). User-generated content is the rage right now, but in addition to entertaining shared videos and photos, the user-generated content that we're seeing on geo products is profoundly useful and helps us better understand the world.
Then, we turned to core search quality and got the latest update on web search from Johanna Wright, Director of Search Quality. It's amazing to me how sophisticated web search has become in such a short period of time. We've accomplished a lot with universal search this past year by bringing new form and function to our results page. Now, our search quality team is turning its attention toward the ever-elusive "user intent" ("this is what I typed, here's what I meant"). This will help us make universal search even more useful. You'll get pictures or maps when that's what you meant. Understanding user intent also helps us break down language barriers and find the best possible answer regardless of what language it's in or where it lives on the web.
In terms of new products, we made Google Health publicly available. It offers users a safe and secure way to collect, store, and manage their medical records and health information online. How many of us have touched, or even seen, our medical records? In this day and age of information, isn't it crazy that you don't have a copy of your medical records under your control? You could use those records to develop a better understanding of your health and ultimately get better care. It's your data about your own health; why shouldn't you own and control it?
Back in February, I wrote about how Google Health will harness the power of the Internet to put users in control of their own medical records. Data will stay with you -- if you change doctors, want a second opinion, if you're traveling -- and not stay siloed or stuck in files or databases that you can't get to. To break down these information silos, we launched Google Health today with several partners and third party services already integrated. These partners are as committed as we are to solving this urgent need. Our flagship partners include everyday brand names such as Walgreens, Quest Diagnostics and Longs Drugs, to name just a few.
In addition to helping you get better control of your medical information, we've also put strong privacy policies in place to keep your information safe and private. (Read more about this on our public policy blog.) There's a lot left to do in health -- literally thousands of partnerships to forge and petabytes of data to move around -- but we're looking forward to hearing feedback from early Google Health adopters about our first step.
Unrelated to Google Health but in the interest of helping people get healthier, we launched our Go for Good campaign with the Cleveland Clinic. The Walk for Good iGoogle gadget encourages you to be good to yourself by walking regularly and tracking your progress. If you finish week 15 of the program by October 25th this year and have completed at least half of the total walking program by then, you can vote to tell us which of the health charities from our list should receive part of a $100,000 donation.
Updates: Added links to partner sites and related public policy blog; embedded webcast from the event.
Google Health, a first look
It's been a busy week for the Google Health team. Last week we announced our partnership and pilot with the Cleveland Clinic. This week, the team has been at the HIMSS (Healthcare Information and Management Systems Society) conference in Orlando, Florida, where Eric Schmidt gave the closing keynote. Eric's keynote marks the first time we've talked publicly about the product we've been designing and building. His talk also offered a deeper view into our overall health strategy. (Watch the video.)
Google Health aims to solve an urgent need that dovetails with our overall mission of organizing patient information and making it accessible and useful. Through our health offering, our users will be empowered to collect, store, and manage their own medical records online.
For the healthcare industry, online personal health records (PHRs) aren't a new idea and, in some cases, online PHRs already exist for patients. Here's what we think sets Google Health apart:
- Privacy and Security - Due to the sensitive and personal nature of the data that will be stored in Google Health, we need to conduct our health service with the same privacy, security, and integrity users have come to expect in all our services. Google Health will protect the privacy of your health information by giving you complete control over your data. We won't sell or share your data without your explicit permission. Our privacy policy and practices have been developed in thoughtful collaboration with experts from the Google Health Advisory Council.
- Platform - One of the most exciting and innovative parts of Google Health is our platform strategy. We're assembling a directory of third-party services that interoperate with Google Health. Right now, this means you'll be able to automatically import information such as your doctors' records, your prescription history, and your test results into Google Health in order to easily access and control your data. Later, this platform strategy will mean that you will be able to interact with services and tools easily, and will be able to do things like schedule appointments, refill prescriptions, and start using new wellness tools.
- Portability - Our Internet presence ultimately means that through Google Health, you will be able to have access and control over your health data from anywhere. Through the Cleveland Clinic pilot, we have already found great use-cases in which, for example, people spend 6 months of the year in Ohio, and 6 months of the year in Florida or Arizona, and will now be able to move their health data between their various health providers seamlessly and with total control. Previously, this would have required carrying paper records back and forth. With Google Health, the user can simply import the data from each medical facility and then choose to share it with the other facilities. It's advances in data portability like this that we think can really make a difference in the quality of healthcare. The clearer and more comprehensive the information regarding your health becomes, the better your care will be.
- User focus - We aren't doctors or healthcare experts, but one thing Google can create is a clean, easy-to-use user experience that makes managing your health information straightforward and easy. We're still iterating and testing our user interface, but here is what the welcome screen looks like:
Here is a screenshot deeper in the application:
- We're proud of the product that we've designed and are continuing to build, but recognize that we are just at the initial stages of our "launch early and iterate" strategy. We look forward to the feedback we will receive from our Cleveland Clinic pilot, from all of you, and from the initial users of our service when we make it publicly available in the coming months.
A pilot with the Cleveland Clinic for health information access
I suffer from poor eyesight and intense seasonal allergies, but I'm thankful that health issues occupy just a small portion of my life. Even though I'm rather healthy, I sometimes find myself needing access to accurate health information. I can get a long way by searching for health facts online, but I also need to incorporate what I find with my own history of conditions and treatments. I didn't even realize I had allergies until my early twenties -- for more years than I care to admit, I'd forget that the "cold" I came down with in April was suspiciously similar to the one I had at exactly the same time the year before. I've often been overwhelmed when trying to determine or track a condition, because my personal record of health information is either nonexistent, or it's spread on forms and receipts from (at least) a dozen doctors and five insurance companies.
Working as an engineer here on the health team, I've been excited to participate in building tools that will help me and others manage our personal health information more effectively. Many innovators in the healthcare industry have worked hard to make results of doctor visits, prescriptions, tests and procedures available digitally. By using the GData protocol already offered in many Google products, and supporting standards-based medical information formats like the Continuity of Care Record (CCR), our health efforts will help you access, store and communicate your health information. Above all, health data will remain yours -- private and confidential. Only you have control over when to share it with family members and health providers.
This week, we hit another important milestone. We launched a pilot with a medical institution committed to giving patients access to their own medical records: The Cleveland Clinic. A large academic medical center, Cleveland is one of the first partners to integrate on our platform. Because of their size and reach with patients who already have access to their medical records online, Cleveland has been a great partner for us to test out our data sharing model. Patients participating in the Cleveland pilot give authorization via our AuthSub interface to have their electronic medical records safely and securely imported into a Google account. It's great to see our product getting into the hands of end users, and I look forward to the feedback that the Cleveland patients will provide us.
Cleveland is just the first of many healthcare providers that will securely send medical records and information via Google APIs at your request. We've been hard at work collaborating with a number of insurance plans, medical groups, pharmacies and hospitals. While this pilot is open initially to just a few thousand patients, I see it as an important first step to show how Google can help users get access to their medical records and take charge of their health information.
Google and health care
In a world of 24/7 news cycles, a summer weekend can bring considerable -- and unanticipated -- excitement. Take for example the reaction we've just seen to an item on our new health advertising blog. Frankly, we were surprised by the pickup, but perhaps we shouldn't have been. We've been proponents of corporate blogging for some time, despite the significant communication challenges that obviously arise from having many voices from all parts of our company speak publicly through blog posts. In this case, the blog criticized Michael Moore's new film "Sicko" to suggest how health care companies might use our ad programs when they face controversy. Our internal review of the piece before publication failed to recognize that readers would -- properly, but incorrectly -- impute the criticisms as reflecting Google's official position. We blew it.
In fact, Google does share many of the concerns that Mr. Moore expresses about the cost and availability of health care in America. Indeed, we think these issues are sufficiently important that we invited our employees to attend his film (nearly 1,000 people did so). We believe that it will fall to many entities -- businesses, government, educational institutions, individuals -- to work together to solve the current system's shortcomings. This is one reason we're deploying our technology and our expertise with the hope of improving health system information for everyone who is or will become a patient. Over the last several months, we have been blogging about our thinking in this area. See: November 30, 2006, March 28, May 23, and June 14, 2007.
In the meantime, we have taken steps on our own to address the failures we see in our health care system. In our case, the menu of health care options that we offer our employees includes both direct services (for example, on-site medical and dental professionals in certain locations) as well as a range of preventive care programs. It's one of the ways we're attempting to demonstrate corporate responsibility on a major issue of our time.
New advisory group on health
Every day, people use Google to learn more about an illness, drug, or treatment, or simply to research a condition or diagnosis. We want to help users make more empowered and informed healthcare decisions, and have been steadily developing our ability to make our search results more medically relevant and more helpful to users.
Although we have some talented people here with extensive backgrounds in health policy and technology, this is an especially complex area. We often seek expertise from outside the company, and health is no exception. We have formed an advisory council, made up of healthcare experts from provider organizations, consumer and disease-based groups, physician organizations, research institutions, policy foundations, and other fields. The mission of the Google Health Advisory Council is broadly to help us better understand the problems consumers and providers face every day and offer feedback on product ideas and development. It's a great privilege for us to work with this esteemed group
Google Health Advisory Council
(Institutions or affiliations are listed for identification purposes only.)
Chairman
Dean Ornish, M.D., Founder and President, Preventive Medicine Research Institute, Clinical Professor of Medicine, University of California, San Francisco
Douglas Bell, M.D., Ph.D., Research Scientist, RAND Health, RAND Corporation
Delos M. Cosgrove, M.D., Chief Executive Officer, The Cleveland Clinic
Molly Coye, M.D., M.P.H., Chief Executive Officer, HealthTech
Dan Crippen, Former Congressional Budget Office Director & Reagan White House Assistant
Linda M. Dillman, Executive Vice President, Risk Management, Benefits and Sustainability, Wal-Mart
John Halamka M.D., M.S., Chief Information Officer, Beth Israel Deaconess Medical Center & Harvard Medical School and Chairman, Healthcare Information Technology Standards Panel (HITSP)
Bernadine Healy M.D., Former head of the National Institutes of Health (NIH), Health Editor & Columnist, U.S. News & World Report
Bernie Hengesbaugh, Chief Operating Officer, The American Medical Association (AMA)
Douglas E. Henley, M.D., F.A.A.F.P., Executive Vice President, American Academy of Family Physicians (AAFP)
David Kessler, M.D.,Former FDA Commissioner, Vice Chancellor-Medical Affairs & Dean, School of Medicine, UCSF
John Lumpkin M.D, Senior Vice President, Director of Health Care Group, Robert Wood Johnson Foundation
John Rother, Group Executive Officer of Policy & Strategy, AARP
Anna-Lisa Silvestre, Vice President, Online Services, Kaiser Foundation Health Plan, Inc.
Greg Simon, J.D., President, FasterCures
Mark D. Smith, M.D., MBA, President & Chief Executive Officer, The California HealthCare Foundation
Paul Tang, M.D., Internist & Vice President, Chief Medical Information Officer, Palo Alto Medical Foundation (PAMF) & Chairman, Board of Directors, American Medical Informatics Association (AMIA)
Sharon Terry, M.A., President & Chief Executive Officer, Genetic Alliance
John Tooker, M.D., MBA, F.A.C.P., Executive Vice President & Chief Executive Officer, American College of Physicians (ACP)
Doug Ulman, President, Lance Armstrong Foundation
Robert M. Wachter, M.D., Professor of Medicine, University of California-San Francisco (UCSF); Associate Chairman, UCSF Department of Medicine; Chief of the Medical Service, UCSF Medical Center
Matthew Zachary, Cancer Patient Advocate, Founder & Executive Director, The I'm Too Young for This! Cancer Foundation for Young Adults
Update: Added links to two more bios.
Is there a doctor in the family?
Before joining Google, I was a full-time primary care doctor. My time working with patients every day, hearing their stories and trying to help make them better, is an experience I will cherish forever. And about once a week, I still practice as an urgent care doctor at a county hospital. Based on these experiences, I have witnessed the problems patients face. One of the biggest ones I see is the difficulty patients have getting answers to the most basic questions, such as 'What tests and treatments should I know about if I have type 2 diabetes? Is the care I am getting on par with what most experts recommend?'
Many patients are comfortable letting their doctors worry about these questions for them. But I think patients get better care when they are more informed about generally accepted standards of care, and know more when talking to their doctors. Of course, I don't recommend that patients treat themselves. They can't simply do searches on the Internet, self-diagnose and treat. While there is an endless amount of information available online, it's difficult to know what is quality information and what is not. Patients need to see their doctors to get the right medical care. But better-informed patients recover faster, manage chronic illnesses better and may even avoid some illnesses altogether. And patients should feel in control of their situation.
I was recently reminded of these issues when I was hospitalized. I wanted to know more about the best treatment options for my situation, so I called a few doctor friends and got all the information I needed. Because of that, I think I recovered faster, and I certainly felt better as a more active participant in my own care. But most people don't have this kind of access to medical expertise.
In addition to my medical training, I studied medical informatics before coming to Google. I learned about computer systems that are designed to remind doctors about tests and treatments that their patients should have. I can say from personal experience that it is difficult to remember everything I should be doing for my patients, or to read every new article on the latest test or drug. These systems help doctors get the information they need to deliver quality care.
I believe patients should also have access to these kinds of systems so that they can help make sure they are getting the best care. If you search online to learn more about diabetes, it should be easy to find out what the generally recommended treatments and tests are.
Now I'm part of the team here working on health and we're trying to do something about this problem. Adam Bosworth, who is leading our team, has alluded to this in previous posts such as this one as well as in some speeches he has made at healthcare conferences.
We have been talking to many medical experts to understand what the best guidelines are, and how we can determine which ones apply in different circumstances. If such guidelines were more available to patients, they might be able to, by inputting information such as age, gender or medications, learn about recommended screening tests and other preventive measures, or about harmful drug interactions. (The problem of drug interactions is reason enough to work on this: in the U.S. alone, it is estimated that over 770,000 people are injured or die each year in hospitals from adverse drug events. Many of these medical errors could be prevented if patients or doctors checked for drug interactions.)
As we work on this project, we are of course paying very close attention to privacy. If such a tool were available, you should be able to enter as much or as little information as you want -- and it's important that you be allowed to access this kind of information without entering your name, insurance number or other personal information. We also think that if you want to save this information, you should have that choice so you can access it later or share it with your doctor.
When I help my loved ones navigate an illness or get up to date with screening tests, I wonder how those who don't have a doctor in the family manage their health. When a patient comes to see me with a pretty good understanding of their treatment options, I find that refreshing. But really, I wish it were just easier for patients to get the information they're looking for. While we don't expect to develop the perfect solution, I hope that some day we'll be able to offer something that is a step in the right direction.
Putting health into the patient's hands
I gave a speech today at the 2007 American Medical Association of Informatics (AMIA) Spring Congress. I used this opportunity to suggest a vision of what I think consumers should expect from our health care system over the next decade, including three core principles of a future health care system:
- Discovery - Consumers should be able to discover the most relevant health information possible
- Action - Consumers should have direct access to personalized services to help them get the best and most convenient possible health support
- Community - Consumers should be able to learn from and educate those in similar health circumstances and from their health practitioners
How do you know you're getting the best care possible?
When I talk to people using Google to search for information about their health questions and how well search answers these questions, I hear several common concerns. I want to list them and discuss our thoughts about them.
How do I know if the information is trustworthy and reliable?
There is a lot of material out there about drugs, diseases, procedures and treatments. How do you know what is trustworthy and what isn’t? Search is great at finding us places with relevant information, but it is hard to know which links are reliable and which are less so.
Honestly, this is a hard problem. At Google, we have tried, as I said in an earlier post, to enlist the help of the health community to help us know which links contain medically reliable information, sift these reliable links so that they tend to show up relatively earlier in the search results, and then let you decide which groups in the health community you trust. If you go to Google and type in [Lipitor], for example, and then you click on the “For patients” link and look carefully, you’ll see that the search results often include at the bottom the word “Labeled By,” followed by words like NLM and HON. NLM stands for the National Library of Medicine, the world’s largest medical library, and HON stands for Health on the Net Foundation, an organization which is in the business of certifying web sites with health content that is reliable. These are organizations that have marked the part of the web that this link in the search results points to as medically reliable. It seems that we at Google may not have done a great job of making this clear enough. Unfortunately, many of you either don’t notice these words when you’re searching about health questions at Google or have no idea what they mean. Clearly, we can do better at making this kind of labeling noticeable and your ideas on how we could make it clear to you that a site is medically reliable or trustworthy would be greatly appreciated as we think this through.
Am I getting the best standard of care?
There is, actually, a lot of information out there about generally accepted medical guidelines for care. For most diseases, the medical literature lists the medically agreed-upon standard of treatment, rules to follow, and guidelines for which tests to administer and the best course of treatment - although it is hard to pull together from the various medical organizations and texts as it is constantly evolving. Experts determine which drugs make sense based upon a patient’s condition, other conditions and drugs, age, gender, weight, and so on. There are of course always cases where doctors need to make exceptions to these rules about which drug to administer due to side effects and/or prescribe an alternative drug due to the patient’s specific medical history. The point is that there are guidelines to help doctors with these decisions. However, this information isn’t really accessible to those of you who aren’t health professionals.
Speaking, I think, both for those of us at Google and most of you, given our specific condition or conditions and medicines, just knowing what the guidelines and generally accepted standard of care is for us specifically would be hugely helpful in knowing what to discuss with our doctors and what to research further. Today, even if we can figure out which sites upon which to rely, it is hard to find this out. We don’t know where to start. Our treatment scares us, or our drugs have worrying side effects, or we’re just frightened that we’re not getting the treatment we should be getting.
Honestly, this information can even help our doctors sometimes. They are over-worked and often pressed for time and it cannot ever hurt to double check. Sometimes they didn’t get accurate or complete information from us. While most drug-to-drug and drug-to-condition interactions are known to our doctors, they do change and the doctor might miss a new one or not know about all your drugs because we forgot to tell your doctor about one. The statistics show that mistakes happen. In fact at some point in a patient’s life, the odds of them being treated in a way which doesn’t follow the guidelines and rules is about 45%. There are estimates that somewhere between 44,000 and 98,000 Americans die every year from a preventable medical error at a hospital — or about 150 to 300 preventable inpatient death a day. And approximately 770,000 people are injured or die each year in hospitals from an adverse drug event. There are roughly 5,000 preventable medical errors a day taking place at doctor’s offices.
So it seems that it would really help to let people know. It is tricky, however. Everybody’s condition is unique. It isn’t possible to just play doctor and tell you exactly what your treatment should be and why. Even doctors have a hard time with this because of the incredible and ever changing complexity of modern medicine. What is the best way to help people searching for answers to their health questions to know the right standard of care they should be receiving, what treatments or classes of medicines they should be researching, and what procedures might be indicated?
Who is the best doctor or institution for you?
Isn’t it strange that you can find out a lot about a restaurant on the web or about a movie, but not about a doctor? In fact you usually don’t even know who to go to and just accept whoever your general practitioner recommends? You clearly don’t just eat at restaurants other restaurants recommend, even though you might take it into account. Now admittedly there is a difference here. When it comes to food, you know what you like and the worst that can happen is you don’t like it. But when it comes to your health you may not know what is best, and you can’t necessarily tell if we’re getting the best possible care. Still, here is a common situation: You’ve been diagnosed. Your primary care physician and you have discussed it and it is clear that you need a specialist and your doctor has referred you to one, but you’re wondering how you know who is the best out there for you. How do you know whether they cover your insurance? How do you find them? Today, often you just take your doctor’s referral.
Normally there are lots of doctors who could treat or diagnose you. And in point of fact there is a lot of information about doctors floating around in the ether. Where they went to school is known. Whether they are board certified is known. What is their specialty is known. CMS (Medicare) and insurance companies actually know how many procedures of various types most doctors regularly perform. And this turns out to matter. There is an excellent book out called Complications by Atul Gawande discussing a lot of these matters, but in particular the book notes that practice really does make perfect.
But how do you know who is well seasoned? Do you always judge who to take care of you by how long they’ve been in practice? What does “best” really mean? This is a hard question. Mortality rates, for example, may not be a good indicator. Some specialists only treat the patients that others can’t handle, and so, naturally, even though they are the best in the world, their rates might not be the best. Sometimes your choice may be dictated by other considerations. If there are two possible specialists, one is a man and the other is a woman, then sometimes people care about that.
It isn’t clear how we can best help. We don’t want to inadvertently steer you away from a brilliant doctor just because his or her mortality rate appears too high. What do you think, and what would you like to see made available on the web when you are searching for doctors?
Summary
At the end of the day, all these questions are about how you find the information you need. They are deceptively simple. If they were about restaurants, they would be trivial. But they are actually matters of life and death in the extreme and quality of life in the common case. In short, they matter profoundly.
I’d like to say that we have all the answers. But we don’t. Mostly, at the moment, what we have is questions and we’d love to hear from you.
Update: New contact link.
Thoughts on health care, continued
As I indicated in my post last week, I've been interested in the issue of health care and health information for a while. I just spoke at a conference about some of the challenges in the health care system that we at Google want to tackle. The conference, called Connecting Americans to Their Health Care, is a gathering focused on how consumers are transforming health care through the use of personal health technologies.
This speech will give you some insight into the problems that we believe need our attention. There are, of course, other challenges in health care that we plan to work on, and we'll share more information with you about the solutions we're trying to develop as this work advances.
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