I think the recent New York Time's article entitled Google and Microsoft Look to Change Health Care missed the bigger picture. The article talks about other Internet companies (like WebMD), but it does not make any mention of the Federal Government's involvement in this arena.
In particular is the Nationwide Health Information Network (NHIN) which was initiated by an executive order in April 2004:
The Nationwide Health Information Network (NHIN) is the critical portion of the health IT agenda intended to provide a secure, nationwide, interoperable health information infrastructure that will connect providers, consumers, and others involved in supporting health and healthcare. The NHIN will enable health information to follow the consumer, be available for clinical decision making, and support appropriate use of healthcare information beyond direct patient care so as to improve health.
At the end of May NHIN published four prototype architectures. The proposals are standards-based, use decentralized databases and services ('network of networks'), and try to incorporate existing healthcare information systems. The companies involved were Accenture, CSC/Connecting for Health, IBM, and Northrop Grumman.
It seems to me that Google and Microsoft are using their proprietary technologies to try to achieve the same goals as NHIN. One of the major differences of course is transparency. Everything that NHIN does is open to public scrutiny whereas GOOG/MSFT have their own market research programs and keep their strategies (for making money) close to the vest.
Besides ensuring privacy, I would argue that one of the key components for creating a successful NHIN is interoperability. Even with "standards" like HL7 and DICOM being available, IMHO the current state of the Electronic Health/Medical Records industry is total chaos. Just like GOOG/MSFT are creating their own islands of knowledge, there are a lot of other vendors (84 listed on Yahoo! Directory) doing the same. As a medical device developer trying to interface with customer EMR systems, we're faced with having to provide essentially unique solutions to (what seems like) just about every customer. If that's the reality down here in the trenches, a NHIN is most likely a very long way off.
In a related item, there are some screen shoots from the future Google Health service (codenamed "Weaver") here.
Update: Dr. Bill Crounse at the HealthBlog also has some thoughts about the NYT article: Doctor Google and Doctor Microsoft; if not them, who?
Bob,
You wrote “It seems to me that Google and Microsoft are using their proprietary technologies to try to achieve the same goals as NHIN.”
I would like to draw your readers’ attention to two different initiatives that clearly show how we are closely aligned with the goals of NHIN, how we embrace world-class open standards in the healthcare industry, and what we are doing to improve patient safety through the design of a standardized (common) user-interface for clinical systems.
See http://blogs.msdn.com/healthblog/archive/2006/11/22/the-connected-health-framework-a-service-oriented-architecture-for-health-it.aspx for information on our vendor agnostic Connected Health Framework and Architectural Design Blueprint.
See http://blogs.msdn.com/healthblog/archive/2007/07/13/a-common-user-interface-to-clinical-systems-making-it-real.aspx for information about our work with the National Health Service on the design of a common user interface.
Bill Crounse, MD
Worldwide Health Director
Microsoft
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I work as a medical device developer (engineer) and can see how useful some sort of central health database could be for physicians and patients alike. It looks like Google’s version of the network would allow patients to alter their own records? That being the case, how do you avoid the “Wikipedia” challenge of allowing incorrect information to be added?
Aaron