Google Health: Great idea, but scary as all get out

Google has launched its personal health portal, Google Health. It's a clear and straightforward hub where users can store their medical information, and look up information on conditions and medications relevant to them. See the video for the pitch from product manager Roni Zeiger, a physician who left his practice to run this project (although he still keeps his hand in, as it were, by doing urgent care medicine on weekends).

Google Health is an important initiative, if only because it shows users how completely broken medical record-keeping is right now. But this product comes with a warning label.

The good

If you want to track all the drugs you've been prescribed (and the ones you self-prescribe), all the medical diagnoses you've received, all the lab results done on you, it's a clean place to record that information. It does smart things with the data, too: if you look up drug that has a dangerous interaction with one that's already in your profile, Google Health will alert you.

Hardly anyone, of course, actually has all their medical records at hand, nor the time or expertise to enter in everything in their file accurately. The idea with Google Health is that you get the data from your medical providers--your doctors, your pharmacy, and your lab. Google has a few relationships with diagnostic (lab) companies, some pharmacies, and a few medical centers. But at the moment, chances are that your family physician is not in the system.

But assuming they get there, once you pull in your data, you'll be able to annotate or add to it as you wish. (But not modify it.) When you head off to another doctor or hospital, you can then give them your complete online record, saving time, money (in duplicated lab tests), and potentially your life (if there's data in there about prior conditions, allergies, etc.). This is exactly what a medical record is supposed to do for you already, but the portability of medical data has never been very good; Google is trying to fix that.

You'll also be able to push your medical data to services that analyze it for you. For example, there's a heart attack risk calculator from the American Heart Association, and pill-taking reminder service.

The platform is somewhat open: there's an API that developers can write to use the medical data that users open up to them. Zeiger joked with me that the "When am I going to die?" button will be added within days.

So what's not to love?

The worry

In a word: privacy. Google VP Marissa Mayer told a crowd of reporters that the health data is stored on new super-hardened servers. That's all well and good, but access to Google Health is via your standard Gmail/Google login, and plenty of people (like me until an hour ago) have old or weak passwords on their accounts. User security on this product is the weak link.

More importantly is the relationship of online medical records to the elephant in the room: the insurance industry. Your insurance carrier likely holds more medical data about you than your doctor (whether it's accurate is another story). I do not expect that the carriers will open up their databases to consumers, since that would enable a level of scrutiny on bills that the companies so far have been able to brush off. It's telling that no insurance companies or HMOs are partners with Google on this project.

My bigger concern is that insurance carriers will begin to give financial benefits to patients and client companies if they allow data to go the other way: if patients grant carriers access to their online medical records. In the guise of keeping patients safe, that makes sense. But giving insurance companies access to detailed health profiles on all their clients also lets them mine the data, carve out small insurance groups, and selectively apply elevated rates to people who, through no fault of their own, are at greater risk of requiring insurance company payouts. I would not be surprised to see rate premiums lowered for people or groups who gave the carriers access to their data. But heed my warning on this: it's a trap.

Yes, I sound paranoid. But I think it's fair to say that consumers and health insurance companies have long been locked in an adversarial relationship in the U.S., and that the carriers will find a way to use the Google Health data to increase their profitability foremost. We can hold out hope that in doing so they also increase the level of patient care, but I wouldn't count on it.

Unproven results

I'm in favor of any product that helps patients understand health care in general and their own situation in particular, and Google Health is a great step in that direction. But due to the divisive economics of health care in our country, I can see this remedy having some nasty side effects.

See also: Microsoft HealthVault.