Sunday, March 02, 2008

Battle Royale in PHRs

A lot of buzz lately around Google's and Microsoft's PHRs. John Halamka's blog (and Paul Levy's cross-linked entry) talk about Google's PHR -- these two guys get so many hits on their blogs that whatever they talk about is buzz, by definition.

Meanwhile, at HIMSS Microsoft announced the creation of a fund (the Be Well Fund) to spur ideas for integrating information into their HealthVault PHR. They plan on funding about 20 initiatives ("new and innovative scenarios") at about $150K apiece. A pretty clever way of getting the juices flowing on this issue if you ask me, especially since the biggest obstacle to getting real market traction is cracking the nut on connecting gazillions of disparate hospital and physician office legacy systems. HealthVault also had a full-page ad for the fund on the back page of Saturday's Wall Street Journal (you can only see the ad in the print edition).

Meanwhile, not much has been heard from RevolutionHealth, Steve Case's much ballyhooed entry into health care. I've got to think that they don't stand a chance now that Microsoft and Google are on the scene. From what I've seen of RevolutionHealth, it's more patient education than a PHR, and that segment is pretty crowded already.

It's been about 6 months since Aetna's Ron Williams called Microsoft's and Google's entrees "vaporware", and despite more concrete offerings now, there's still a fair amount of grousing that Google, in particular, should "just launch it already!"

I'm actually sympathetic with their instinct to move slowly. The health care sector is tougher than any market either Microsoft or Google has faced to date -- highly complicated subject area, fragmented supply- and demand-side, unsophisticated users (on both the supply- and demand-side), and potential for high liability exposure (privacy, misrepresentation of medical information, etc) with not much tolerance for error.

Neither Google nor Microsoft lacks for hubris, though, and in the end, that could be their undoing. At every conference I've seen them at they've both presented themselves as the white knights who are going to "change the paradigm" and "use disruptive technology" to unleash "demand-side pull-through" -- so much jingoism that it would make any 1st year business school student blush. Yet, their value proposition to patients is very tenuous, at best, because so little clinical data is electronically accessible at present. Couple that with the lofty, self-generated expectations they've created, and you've got the potential for one or both suffering a large public failure.

I hope not. I want health IT to mature to a point where they and other leading edge consumer-oriented companies like Apple and Sony and Panasonic can enter the space with customer-facing applications that just work -- no fuss, no muss. I just worry that they may be ahead of their time and if they fail now, it might be years before they're willing to come back.....


John said...

I applaud the efforts of Microsoft and Google and any other entity that is looking to change the healthcare system as it stands today.

What bugs me about this post is the seemingly holier than thou attitude, in that we healthcare veterans really know what's going on and you upstarts don;t have a clue. Well, they may not be "White Knights" but they will give consumers more control, if consumers decide to take it and that my friend strikes fear into the traditional healthcare establishment. Just look at the AMA screaming about retail clinics, and now this post.

Written by Micky Tripathi said...

Hi John

Sorry you mistook my comments to be "holier than thou". As I said in this post and in previous ones, I want them to succeed and I'd be delighted if they turned out to be the "disruptive technology" that helps make health care delivery better value-for-money than it is today. As my blog clearly says, my fear isn't that they'll succeed, it's that they'll fail. I appreciate your comments and your frustration, even if they are aimed at the wrong target.....