September 23, 2008

Doctor on the net

If you are like me, the first place you probably go for a 'medical diagnosis' is Google. But it won't surprise you to know that there are now many web sites devoted to health and well being. It's also critical therefore to know where to look and who to trust on the Internet. As well as plenty of competition for your eyeballs, both Google and Microsoft have also recently launched portals that allow you to save your personal medical history on secure web pages.

At the top of the list for informative sites is WebMD. Rated as the 23rd of '25 Sites We Can't Live Without' by Time magazine, WebMD 'blends award-winning expertise in medicine, journalism, health communication' to provide a rich and informative experience. A related site, gets content from '70 U.S. Board Certified Physicians' and has built a reputation online for being trustworthy and reliable.

Another site, Revolution Health ( has similar content to both WebMD and MedicineNet but also lets users create a 'My Revolution' page - a personal space where users can keep track of their own medical records, access support network and contribute to website content.

But the real battle in the online health space is just heating up with the recent launch of two competing products from Google and Microsoft that let users take charge of their own medical records - think Facebook, but with your medical information. Both companies offer almost identical products - not surprising given that the two heavyweights lock horns in other areas like search and productivity apps too.

According to Google, Google Health 'allows users to store and manage all of your health information in one central place.' Like other Google products, Google Health is completely free, and can be accessed by anybody with a Google login. The Microsoft equivalent, called Healthvault also lets users store health information in one central place on the web, but additionally acts as a 'hub of a network of Web sites, personal health devices and other services that you can use to help manage your health.' Microsoft envisage that devices, like heart rate and blood pressure monitors may in the future be able to transmit data to Healthvault, as an example.

Of the two sites, only Google Health is available to use in Australia. I logged in with my regular gmail address and setup my account easily. In typical Google fashion, the site is laid out plainly and logically. As a test, I entered my knee reconstruction under the 'procedure' section. Google Health let me select the procedure from an extensive list. I was then able to add additional detail like the dates of the operation to the procedure record. Google Health also lets you create multiple profiles under the one login, so, for example, you can track the health record of multiple family members.
But usability concerns are largely irrelevant in this discussion. The proverbial 'elephant in the room' is data security; who do you trust with your precious medical information?

According to Peter Garcia-Webb, Chair of the AMA's Expert Advisory Committee on Information Technology, The AMA 'supports individuals taking responsibility for their own health through the use of an online health record portal.' However, the AMA would 'prefer to see a national electronic health record implemented', but maintains that the 'use of online health portals could be a stepping-stone towards a national electronic health record.' Because both solutions are hosted in the US, Garcia-Webb also warns that 'online repositories in the US are not subject to the security laws that apply to other electronic records, leaving personal health information open to misuse or exploitation.'

While security concerns are important there's also the issue of data portability. If users invest the time building an online health profile in Google, data should be easily portable between competing sites. While both sites are encouraging developers to build applications both use a different language and are therefore incompatible.

Nevertheless, with demand for these services growing quickly (Google's pilot was limited to 1600 patients and was quickly oversubscribed, according to C. Martin Harris, the Cleveland Clinic’s chief information officer, involved in the project) it may be a case, like in other online situations, that whomever builds a critical mass of users first comes to define the industry standard, and ultimately controls your personal health records.