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Archive for the ‘Google’ Category

Since its start in 2007, Chilmark Research has kept a fairly low profile as analyst firms go, focusing on a few discrete domains of healthcare IT (HIT). First there was patient and consumer engagement that led to the publication of our first report on Personal Health Records (PHRs). That first research effort led to a significant amount of consulting work and subsequently no reports published for broader market consumption until 2010. That year Chilmark research expanded into the mHealth domain, with the assistance of analyst Cora Sharma, and published the report: mHealth in the Enterprise.

In early 2011, Chilmark published what is arguably its most important, or certainly most popular body of research, a report on the Health Information Exchange (HIE) market. It was this report that clearly cemented Chilmark Research as a well-respected analyst firm providing unbiased, objective, and in-depth research on the domains it covers.

But there was a problem. By and large the vast majority of this work was done by one individual, myself, the founder of Chilmark Research. Over the course of 2011, particularly during the fall when a significant number of consulting assignments came in the door, I quickly came to the realization that I needed help. I was reaching burnout and the model needed to change.

What’s New:
In 2012, Chilmark Research is launching a subscription service called the Chilmark Advisory Service (CAS). This service will provide subscribers one of our annual market research reports (an updated HIE report is forthcoming, others in the works), a number of other content deliverables and direct access to Chilmark Research analysts for specific inquiries. More will be forthcoming regarding this service but encourage you to contact us directly (info @ chilmarkresearch dot com) if you wish to learn more immediately or schedule a meeting at HIMSS to discuss this service further.

Our research agenda for 2012 will look quite similar to our past work for we strongly believe these are the most important topics in healthcare IT today:

Patient & Consumer Engagement
Why it’s important: As the industry migrates to reimbursement models based on outcomes and providers take on more risk, it will become increasingly important to truly engage the patient and their loved ones as part of the care team. Also, in highly competitive markets, providers will be seeking new approaches to not only engage consumers, but build loyalty.

What we’ll be covering: Patient/consumer engagement and outreach strategies of both providers and payers including patient portals (Stage 2 meaningful use requirements are key market driver), telehealth, privacy & security (including consent management) and new models of care & outreach to not only improve consumer/patient satisfaction but improve outcomes.

mHealth
Why it’s important: No doubt about it, the growing ubiquity of smartphones and how they have become such an integral part of our lives (we store family pictures there, we record our expense reports on them, we answer emails, etc.) and an ever growing number of consumers are doing mobile searches to answer health-related questions. Couple this with near saturation of physician adoption of smartphones and the growing use of touchscreen tablets by providers, it is not too hard to imagine a future where mHealth becomes the touch-stone for provider-patient engagement.

What we’ll be covering: Primarily address consumer-centric and clinician-centric mHealth Apps, how the market is developing, what is being adopted and used and why, and lastly, what is the trajectory for this rapidly evolving, ever changing market.  Currently, we are in the midst of producing a report (ready by HIMSS’12) that takes a close look at mHealth Apps for provider-patient engagement.

Health Information Exchange
Why it’s important: The HIEs being put in place today are the fundamental infrastructure, “the pipes,” that will enable one, be it clinician or consumer, to create a true longitudinal, patient record which will lead to safer, more effective care (at least basic logic points to such). These pipes will also allow researchers, public health officials and others to perform advanced analytics on this clinical data that can lead to better, more effective and responsive care. Lastly, as we move to new outcomes-based reimbursement models, HIEs will become an absolute necessity for virtually all medium to large size healthcare organizations.

What we’ll be covering: As mentioned above, last year’s HIE Market Report put Chilmark Research firmly on the map as a firm providing unmatched coverage of this market. We have every intention of keeping that title. First off, we will be releasing an update of the HIE Market Report (target HIMSS’12 release date) with in-depth profiles of some 25 vendors. Second, we are launching a major research project in early February on end users’ experiences and future strategies for their HIE deployments. We have much more planned for this market, but that is a very good start!

How We’ll Do It:
As mentioned previously, I had some help, but not enough and certainly not enough to launch a major expansion of Chilmark Research. To address this issue I went out and found some incredibly bright young people (always believed in the adage, surround yourself with people smarter than you) to join Chilmark Research. They are:

The returning Cora Sharma who’s research use to be the mHealth domain but has now moved to Patient & Consumer Engagement Strategies & Tools.

The former Washingtonian who has returned to his New England roots, Naveen Rao. Naveen’s research focus will be HIE & analytics/BI domains.

And last but certainly not least, my son, John Moore III who in addition to leading an mHealth start-up of his own, will be focusing his research efforts at Chilmark on, you guessed it – mHealth.

Brief bios on these three stellar additions to the Chilmark Research team are over in the “About” section of this website.

I do not hire readily (learned my lessons there long ago) and have been very judicious in choosing only those who show significant promise. I have no doubt in my mind that with some mentoring, these three have the chops to become some of the finest analysts in the industry and the credibility that Chilmark has established in the market will continue to grow.

Speaking on behalf of the Chilmark Research team, we look forward to continuing to provide this vitally important industry that impacts us all with the critical research that is needed to help guide it forward in the successful adoption and use of IT to truly improve healthcare delivery. Each of us are very passionate about this issue, it is a mission for us and through our research we intend to make a positive impact.

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A little over a week ago Google stated that it was putting a stake through the heart of their personal health platform (PHP) Google Health. We at Chilmark had been expecting this for some time, it was just a manner of when it would become official. Thus, we were somewhat taken aback by all the publicity surrounding this final chapter with our own post on the topic receiving well over 40 comments and link-backs (that may be a record – thanks everyone for contributing to the story). With the closing of Google Health, we postulated in that post that Microsoft really had no other worthy competitor that will challenge them to continuously make enhancements to HealthVault. We may have spoken prematurely.

Stepping in to take the place of Google, is none other than an ol’school EHR company (and one of the largest), Cerner, who provided their own commentary on the demise of Google Health and their future intentions. Last week we had the opportunity to talk with the Cerner Health and learn more about those intentions but before getting to that, some quick background.

Taking a different tack:
Cerner has been in the HIT business now for 31+ years having grown to one of the leading EHR vendors in the market. You’ll usually find their systems (EHR: Millenium) in large healthcare organizations. This sector of the EHR market is seeing fierce competition as Epic seems to pick up one win after another at the expense of others, including Cerner. While continuing to go head-to-head with Epic, it appears that Cerner has also chosen to take a different tack, adopting a philosophy of: if you can’t beat them straight up, change the rules of the game.

In this year’s Annual Report, co-founder and chairman Neal Patterson spoke of Cerner’s origins, its staying power in the market but most importantly, the desire to transpose Cerner from a “care company” to a “health company” stating his belief that

…the business of health may eventually become a bigger business than the business of care.

In conversations with several Cerner executives, it becomes pretty clear that this company is truly looking to remake itself into one that adopts an open approach to not only sharing information (Cerner was very instrumental in the Direct Project) but provides a foundational “network of services” to enable “communities of care.” Those communities can be within a city, a region, an employer or a State. On the HIE front, Cerner recently won the Missouri State contract (not too surprising, it is in their backyard) but Cerner is also looking to land additional multi-stakeholder, HIE contracts with their partner Certify Data Systems. Unlike virtually all other EHR-derived HIE solutions, Cerner’s is actually pretty open and can interface readily with any EHR provided the EHR uses common data standards (e.g., CCD, CCR, etc.). But what may be even more interesting then what they have done in the HIE market, is what Cerner intends to do in the broader consumer market.

Cerner Health:
Last year at Health 2.0 a couple of representatives of Cerner made a fairly simple but engaging presentation on some of the gaming concepts they were developing which reminded one of some of the earlier developments at what is now Humana’s defunct skunkworks, Crumple It Up. Though a bit gimmicky, the presentation caught one’s attention as it was certainly out of character for any EHR vendor, let alone one of the leaders.

Now, some nine months later Cerner announced its intention to take Cerner Health beyond what Google Health was (not too hard to do). The leadership team at Cerner Health graciously hosted a call with Chilmark Research to further discuss exactly what those intentions are which are outlined below:

Provide a wide range of health & wellness services for employers.
Cerner has been eating its own “dog food” for the past year using Cerner Health to promote health & wellness among their employees who to date have lost a combined 12 tons of fat (take that Biggest Loser). This weight loss program will be rolled-out across Cerner’s home town of Kansas City (employers, providers, etc.) in two weeks. Cerner Health will target a number of other health & wellness areas, with programs that include built-in incentives. Clearly, Cerner is targeting WebMD in the employer market, a market that has seen very few comprehensive solution suites and WebMD has been milking that market for a longtime and is vulnerable.

Facilitate population health management – address “communities of care.”
For some time now, employers and payers have been looking to better manage their populations to lower medical loss ratios (MLRs). Providers will be looking to do the same as they take on a greater share of the risk via new contracts (e.g. BCBS-MA’s Alternative Quality Care contract) and future Accountable Care Organizations (ACOs). Cerner Health intends to serve both employers and provider needs in this regard with “Health Graphs,” a conceptual analytics framework that combines multiple data streams to provide an accurate view of population health at the community level. The Health Graphs concept is still a bit fuzzy (as are most data analytics models to address this issue) but what we do like is the focus on communities. To be truly successful at addressing population health, one must operate from that community level. Cerner Health correctly perceives health as a community issue where within a given community, be it an employer, a hospital, a specific condition, a town, a region, etc., there are unique needs requiring a focused approach.

Provide a PHP with an ecosystem of third party apps and go direct to consumer.
Cerner Health will go head-to-head with HealthVault by offering a PHP with a published software development kit (SDK) for third party independent software vendors (ISVs) by year-end. This will enable an ecosystem of applications to potential sit on top of the Cerner Health stack. Currently, the SDK is undergoing testing with a limited set of beta ISVs to fully flush-out capabilities, documentation etc., before a broader roll-out. In addition to releasing the SDK at year-end, Cerner will also open the doors to any and all consumers/patients to store their personal health information (PHI) on the Cerner Health PHP. Similar to HealthVault, Cerner Health will support all leading data standards, Project Direct protocols, and certainly allow one to upload their Blue Button files to the PHP.

The big challenge for Cerner on the PHP front is soliciting ISVs to join. Many will perceive Cerner as a competitor to their own initiatives and one should not expect competing EHRs (Allscripts, eClinicalWorks, Epic, GE, Nextgen, etc.) to readily partner either. Where Cerner Health draws the lines of what it intends to take to market and what it will look to partners to provide remains unclear. In what is still a very immature market, this is not necessarily a bad thing but it will prove challenging for Cerner to build-out that ecosystem on the PHP without clearer articulation of intentions.

The Wrap:
Cerner’s entry into the health market is a bold move and hardly a slam-dunk. Reading between the lines, Cerner Health has an extremely broad charter that will likely bring it into competition with a wide range of vendors outside its traditional EHR haunts including Microsoft, Intuit and WebMD to the multitude of disease management firms and of course population health analytics firms such as Ingenix, Thomson Reuters, SAS and IBM. Have they bitten off more then they can chew? That’s a very real possibility. But one thing this company does have going for it is staying power and one would be foolish to discount them this early in what will be a very long race.

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Chilmark Research has not had a very good feeling about Google Health for well over a year now. Back in early May of this year we felt that Google had all but given up and had put Google Health in stasis. Today, Google made it official, Google Health has a little more than six months to live, then it will get the Kevorkian treatment with Larry Page administering the final lethal dose.

First yellow flag
Going back to the hey days of mid 2007, Google seemed to be chugging along quite nicely with its plans to enter the consumer health market. They had Adam Bosworth leading the team, excitement filled the air and then, seemingly out of nowhere, Bosworth up and quits. Google stumbled along under Marissa Mayer, but it just didn’t seem to have the same level of excitement. Microsoft, who was busy with their own consumer health play, HealthVault, seemingly wanted to jump the gun and have the limelight shine on them releasing HealthVault in October 2007. A premature launch as HealthVault was far from being ready for prime time – it was painful.

Yellow flag number two
Google went along at a methodic pace and finally unveiled Google Health at HIMSS’08 during Google CEO Eric Schmidt’s keynote presentation. (Google threw a great party that year at HIMSS, one of the better ones.) It was a limited beta release with Cleveland Clinic wherein they had hoped for 10,000 users, but far fewer actually signed on.

Three yellow flags and counting
Google Health was formally released to the public in May 2008. It was an elegant solution, very Google-like, obviously, with easy navigation, uncluttered screen, simple to understand, simple to use. Like their competitors to the north, Google had signed on a number of partners to create a health ecosystem of services/apps that a consumer could leverage to assist in managing their health and wellness. But there were also a few problems, the biggest one being that Google only supported a bastardized version (they modified it) of the Continuity of Care Record (CCR) standard thereby limiting what a consumer could actually import into their Google Health account. So despite having a blue ribbon advisory board, Google Health seemed to not want to fully connect to the healthcare community, the doctors, the hospitals, etc. – the ones holding the data! Google also struggled to sign-on additional partners to create a richer ecosystem and were way behind Microsoft in importing biometric data..

A bouquet of yellow flags
And as one observed Google Health in the ensuing years, one got the sense, that is if you were observant, that the Google Health team of engineers was very small and the leadership at the top of Google Health was a revolving door. Without consistent leadership, without a sufficiently large team and without the business development folks to strike partnerships, Google began struggling for legitimacy in less then a year. And now, by January 1, 2012, Google Health will go into the dustbin of the consumer health movement joining the likes of Revolution Health (at least Google didn’t waste as much money as Steve Case did) and a host of others.

Lessons Learned and Implications:

Healthcare is a tough market in and of itself and the consumer health market is even tougher. There is a paucity of consumer health information in structured, machine computable format. Maybe in a few years once we get doctors comfortable using EHRs and readily sharing records with their patients that may change, but that is still a few years out.

Few consumers are interested in a digital filing cabinet for their records. What they are interested in is what that data can do for them. Can it help them better manage their health and/or the health of a loved one? Will it help them make appointments? Will it saved them money on their health insurance bill, their next doctor visit? Can it help them automatically get a prescription refill? These are the basics that the vast majority of consumers want addressed first and Google Health was unable to deliver on any of these.

Without a worthy competitor, will Microsoft no longer feel the need to further invest in enhancements and features for HealthVault? Will Microsoft reassign those engineers elsewhere and basically put HealthVault in its own form of stasis? It’s not like HealthVault has been a screaming success in the market and Microsoft has some major work to do on Amalga to improve its own track-record there. Also, since Microsoft is no longer under the protective wing of R&D and now in Microsoft Business Solutions (MBS), thus it now has clear sales targets to reach and a more restrictive P&L. Don’t be too surprised if HealthVault goes into its own quiet period for the next 18-24 months. The only thing that may change our opinion is Microsoft’s success overseas with HealthVault.

Engaging the consumer/patient most often begins at the doctor’s office. If you do not get the physician(s) involved, actively promoting the patient to use such tools as Google Health and likewise do the hard work of creating value for the physician it may be nearly impossible to gain real traction. WebMD takes a slightly different approach, getting employers to actively promote (most often through incentives) to employees to use WebMD. But again, it takes someone advocating on your behalf. Google thought that if they built it, consumers would come on their own to Google Health. Sorry Google that was a gross mis-calculation, one may even call it arrogant.

Who ya’ gonna trust. There is still a significant portion of the populace that is reluctant to trust Google, Microsoft or just about anyone else up there in the Internet Cloud with such personal information as their health records. The reality of privacy and security of health records is far more nuanced and a consumer’s records may actually be safer in Google Health or HealthVault but that is another conversation. Bottom-line, consumers remain quite wary of putting their records into these types of services which hinders adoption.

Though we saw it coming, it is still a sad day to see the passing of Google Health. May she Rest in Peace.

Addendum:
Sean Nolan, Chief Architect at MSFT has some words of his own on the demise of Google Health as well as clear instructions on how to export your Google Health data to HealthVault. Worth the read.

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About a year ago we posted a piece that basically summed up Google Health as on its death bed. Google, of course was quick to defend itself saying that Google Health was very much alive and well. We even had a long conversation with the senior leadership of Google Health who told us they were taking Google Health in a new direction, had been doing a significant rebuild of the underlying architecture which culminated in a “new” Google Health which had far greater focus on health and wellness. They even went so far, in very uncharacteristic fashion to give adoption numbers. Granted, those adoption numbers were only those from users of the Android App CardioNet, but hey, it was something.

Beginning in late March 2011, we started hearing the rumors of the impending demise of Google Health once again (is this becoming some sort of annual thing with Google Health?). We waited a few weeks to see if the rumors would die down, they did not. We put a call into Google Health to set up a briefing, get an update. Response back was slow (one yellow flag). When they did get back to us, they said it will be at least a couple of weeks (two yellow flags). Next, our Google contact told us by email that they were going to hand Chilmark’s inquiry off to Google’s PR department (screaming dark orange flag). And now today, we received an email from one of Google Health’s most visible spokespersons, Missy Krasner that she is leaving Google.

There is now no doubt in our mind that the Google Health development team has been dis-banded and Google Health has been placed in a cryogenic state until the moribund consumer adoption of such tools comes to life. It would be far to big a PR nightmare for Google to completely pull the plug on Google Health as they have done in the past with other less then stellar launches. No, they’ll put an engineer or two on Google Health to keep it up and running but don’t expect anything new out of Google Health for at least the next 5 years. This baby is frozen.

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Ok, before I even begin, let me put it right out there: I’ve been using Apple products since I first got my hands on one of those cute little Mac SEs in the late 80’s having given up my spanking, brand new Compaq 386 with 64kb of RAM and a dual 3.5 & 5.25 floppy drives to a post doc at MIT who traded me the Compaq, which he needed to finish his thesis, for his Mac. I never looked back. I will attempt to keep that bias in check in this post.

Tomorrow, Apple will formally release the iPad 2, a device that has seen extremely strong adoption in the healthcare sector and even one of the HIT industry’s leading spoke persons, John Halamka of Boston’s Beth Israel Deaconess Hospital (he’s also Harvard Med School’s CIO) spoke to the applicability of the iPad in the healthcare enterprise in the formal iPad 2 announcement last week.

The iPad 2 release is happening while most other touch tablet vendors including HP, RIM, Cisco and those building Android-based devices struggle to get their Gen 1 versions into the market. Of these other vendors, only Android-based devices are available today, including among others the Samsung Galaxy and the Motorola Xoom.

But it is not so much the new features in the iPad 2 (e.g., lighter weight, faster processor, two cameras, etc.) that will continue to make the iPad the go to device for physicians and healthcare enterprises, it is the process by which Apple vets and approves Apps that are available in the App Store. Apple imposes what at times for many App developers is an arduous and at times capricious approach to approving Apps. This approval process is in stark contrast of the one for Android, which is based on an open, free market model letting the market decide as to which Apps will succeed and which will not.

Virtually any patriotic, flag-waving American will say Hoorah, the free market rules. Of course a lot of App developers are saying the same thing and have riled against the Apple process since the first iPhone release back in 2007. But the free market, even here in America is truly not free. We have put laws and regulations in place, be they environmental, public health, etc. to protect the broader public good. Apple has done much the same for its App Store insuring that those Apps which are approved are unlikely to cause harm, which on a mobile device is usually the release of personal information such as passwords, credit card information, etc.

Unfortunately, the same can not be said for the Android OS and its marketplace of Apps. There have been numerous reported cases of malware Apps in the Android Market that most often are not removed until after thousands of users have had their personal information compromised. The latest occurred a little over a week ago when Google removed 21 malware Apps from the marketplace and then proceeded to remove about 30 more.

In the healthcare enterprise market, where very sensitive patient information is gathered and shared for improving the quality and efficiency of care delivered, touch tablets are seen as an ideal form factor for the ever on the move clinician who is looking to access the latest patient information at the point-of-care. Therefore, as clinicians increasingly demand access to such information via their touch tablet device, healthcare IT executives will increasingly seek to insure that the devices used are truly secure. Google’s continuing struggles to keep its Android Market free of malware will prevent devices using this OS from seeing greater adoption in the healthcare enterprise. This will allow Apple to continue to put distance between itself and other touch tablet competitors in this increasingly lucrative market.

Addendum:
Jared Sinclair, an ICU nurse in Nashville TN, has a similar view on the topic,

 

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Activity is really heating up here at Chilmark Research.  But all that activity is making it difficult to follow all of the changes that are taking place in the market.  Let me correct that, not so hard to follow, extremely hard to find the time to write about within the context of these posts.  Thus, a change is needed.

Occasionally, rather than write an in-depth post on a single topic/action that occurred, we’ll write one that addresses a number of activities that have happened in a given market/technology sector that we follow.  This is not to say that any one of these activities doesn’t deserve its own in-depth review, it’s just a matter of having the time.

Over the last couple of weeks or so, several things have happened in the PHR (or our preferred term, PHP – personal health platform) market that are note worthy:

Google Health releases update to their PHP. The update, which Chilmark wrote about previously, refocuses the Google Health platform from one that was predominantly focused on sickness to one focused on health.  In very un-Google like fashion, Google even shared some user numbers stating that over 50K users had signed up to the service via a soft-launch on the Android mobile app, CardioTrainer.

Epic releases the iPhone app, MyChart. Epic, who is literally steamrolling the competition in EHR installs for large hospitals has created an iPhone app for their tethered PHR, MyChart. Leveraging all the bells & whistles of MyChart (e.g., appt scheduling, reminders, Rx refill requests, records viewing, etc.) this looks like a pretty slick app and if I was in California and a Kaiser-Permanente member, you can bet that I would have this app on my iPhone. Nice job Epic.

Now if only other EHR vendors could get off their duffs and actually create a PHR that consumers would want to use. Sadly, today this just does not seem to be a focus of the vast majority of EHR vendors and their PHR offerings stink.

HealthVault finally joins Continua. There has been a lot of he said-she said with regards to the ongoing reasons as to why Microsoft, for a number of years, refused to join the medical device consortium Continua.  Chilmark has even chided Microsoft for its policy towards Continua, even if Microsoft had a valid point that Continua simply would not move fast enough (Continua members are still painfully slow in releasing Continua compliant devices). Well, that is all in the past now as earlier this week Microsoft made a “soft announcement” that is has signed on to Continua. No reason to break open the champagne just yet, but it is a promising sign that consumers will have more freedom of choice when they walk into that Best Buy Health kiosk to buy their next home, biometric monitoring device to load data up to their HealthVault account.

Next week, Chilmark will be in San Francisco to attend many of the activities occurring during Health Innovation Week.  We’ll do our best to keep you apprised of what we learn and see, but encourage you to also follow the twitter stream.  My personal twitter name is: @john_chilmark.

Wish all an enjoyable fall weekend.

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Google Health has seemingly been stuck in neutral almost from the start.  Despite the fanfare of Google’s Eric Schmidt speaking at the big industry confab, HIMSS a couple of years back, an initial beta release with healthcare partner Cleveland Clinic and a host of partners announced once the service was opened to the public in May 2008, Google Health just has not seemed to live up to its promise. Chilmark has looked on with dismay as follow-on announcements and updates from Google Health were modest at best and not nearly as compelling as Google’s chief competitor in this market, Microsoft and its corresponding HealthVault.  Most recently we began to hear rumors that Google had all but given up on Google Health, something that did not come as a surprise, but was not a welcomed rumor here at Chilmark for markets need competitors to drive innovation.  If Google pulled out, what was to become of HealthVault or any other such service?

Thus, when Google contacted Chilmark last week to schedule a briefing in advance of a major announcement, we were somewhat surprised and welcomed the opportunity.  Yesterday, we had that thorough briefing and Chilmark is delighted to report that Google Health is still in the game having made a number of significant changes to its platform.

Moving to Health & Wellness

Today, Google is announcing a complete rebuild of Google Health with a new user interface (UI) a refocusing on health & wellness and signing on additional partners and data providers.  Google told Chilmark that the new UI is based upon significant user feedback and a number of usability studies that they have performed over the last several months. Rather than a fairly static UI (the previous version), the new UI takes advantage of common portal technologies that allow the consumer to create a personalized dashboard presenting information that is most pertinent to a consumer’s specific health and wellness interests and needs.  So rather then focusing on common, basic PHR-type functions, e.g., view immunization records, med lists, procedures and the like, the new UI focuses on the tracking of  health and wellness metrics. This is not unlike what Microsoft is attempting to do with MSN Health and their health widgets that subsequently link into a consumer’s HealthVault account, though first impressions lead us to give a slight edge to Google Health’s new UI for tracking health metrics.

A particularly nice feature in the new Google Health is the consumer’s ability to choose from a number of pre-configured wellness tracking metrics such as blood pressure, caloric intake, exercise, weight, etc.  Once a given metric is chosen, the user can set personal goals and track and trend results over time.  There is also the ability to add notes to particular readings, thereby keeping a personal journal of what may have led to specific results. And if one cannot find a specific health metric they would like to track, the new platform provides one the ability to create their own, for example the one in the figure below to measure coffee consumption. Nice touch Google.

On the partnership front, Google is also announcing partnerships with healthcare organizations Lucille Packard Children’s Hospital, UPMC and Sharp Healthcare and has added some additional pharmacy chains such as Hannaford and Food Lion among others.  On the device side, Google has the young Massachusetts start-up fitbit (novel pedometer that can also monitor sleep patterns) and the WiFi scale company, Withings.  On the mobile front, Google has added what they say is the most popular personal trainer Android app, CardioTrainer and mPHR solution provider ZipHealth (full disclosure, I’m an advisor to the creators of ZipHealth, Applied Research Works) which has one of the better mPHR apps in the market.

If any metric is a sign of pent-up consumer demand for what Google Health will now offer it may be CardioTrainer. In our call yesterday, the new head of Google Health, Aaron Brown stated that they did a soft launch of CardioTrainer on Google Health by just putting a simple upload button in CardioTrainer that would move exercise data to a Google Health account.  In two weeks, over 50K users have uploaded their data to Google Health. Pretty incredible.

Challenges Remain

Chilmark is delighted with what Google has done with Google Health.  The new interface and focus takes Google Health in a new direction, one that focuses on the far larger segment of the market, those that are not sick and want to keep it that way through health and wellness activities.  Today, within the employer market, there is a major transition occurring with employers focusing less on disease management and looking towards health and wellness solutions that keep their employees healthy, productive and out of the hospital. Google may be able to capitalize on this trend provided it strikes the right partnership deals with those entities that currently serve the employer market (payers and third party administrators).  Chilmark will not be holding its breath though as to date, Google has not had much success in the enterprise market for virtually any of its services.

And that is one of many challenges Google will continue to face in this market.

First, how will Google readily engage the broad populace to use Google Health?  Google has struggled in the enterprise market, regardless of sector, and will likewise struggle in health as well, be it payers, providers or employers. Without these entities encouraging consumers to use Google Health (especially providers as consumers have the greatest trust in them), Google Health will continue to face significant challenges in gaining broad adoption and use of its platform.  But as the previous example of CardioTrainer points out, Google may have a card up its sleeve in gaining traction by going directly to the consumer through its partners, but it will need far more partners than it has today to make this happen.

Second, the work that Google has done to re-architect the interface and focus on wellness, particularly the tracking and trending of biometric or self-entered data is a step in the right direction, but Google has not been aggressive enough in signing on device manufacturers that can automatically dump biometric data into a consumer’s Google health account.  Yes, Google is a member of the Continua Alliance but Continua and its members have been moving painfully slow in bringing consumer-centric devices to market. HealthVault, with its Connection Center, is leaps and bounds beyond where Google is today and where Google needs to be to truly support its new health and wellness tracking capabilities.  Google’s ability to attract and retain new partners across the spectrum of health and wellness will be pivotal to long-term success.

Third, Google has chosen not to update its support of standards and remains dedicated to its modified version of CCR.  While CCR is indeed a standard that has seen some uptake in the market, Chilmark is seeing most large healthcare enterprises devoting their energies to the support of the CCD standard.  In our conversation with Google yesterday we mentioned this issue and Google stated that they are hoping the VA/CMS Blue Button initiative will take hold and provide a new mechanism by which consumers retrieve their healthcare data and upload it to Google Health.  The Blue Button is far from a done deal and has its fair share of challenges as well. Google is taking quite a risk here and would be better off swallowing the CCD pill.

In closing, Chilmark is quite excited to see what Google has done with their floundering Google Health.  They have truly hit the reset button, have a new team in place and are refocusing their efforts on a broader spectrum of the market.  These are welcomed changes and it is our hope that with this new focus, this new energy, Google will begin to show the promise that we at Chilmark have always had for this company to help consumers better manage their health.

Addendum:
9/24/10 – Earlier this week, I was interviewed by SearchHealthIT.com. They have created a podcast of that interview that provides further “color” to the Google Health Reset story.

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