Google Health and the PHR: Do Consumers Care?

Google Health’s unveiling last week and Microsoft’s HealthVault launch last October
are important milestones in the evolution of Health 2.0. Both of these heavyweights have the resources and potential to improve the health consumer’s customer experience. I have followed the active (and important) conversations about privacy concerns, HIPAA, and Google Health’s terms of service, which are well represented by Erik Schonfeld’s post on Techcrunch and Larry Dignan’s post on ZDnet. And I read with interest Google’s rapid response offered by Google Senior Product Counsel Mark Yang.

What’s missing from all of these conversations is the elephant in the room: Do consumers really care about having online personal health records?

Current evidence suggests that less than 3 percent of health consumers
maintain a PHR online, according to Lynne Dunbrack, program director at
Health Industry Insights, who commented in a recent interview. It
reminded me of the post on The Health Care Blog a couple of years ago,
PHRs, EMRs, and pretty much useless surveys.

And while Google trotted out some great enterprise partners last week
for its announcement, I didn’t hear any consumer voices or testimonials
on how Google Health will fulfill an unmet need. To me, PHRs and
electronic medical records remain an industry-driven vision, not
a consumer-driven one — focused on efficiency and reducing costs. It
seems we’ve lost sight of whether the consumer really desires and is
willing to participate in these services. What are the circumstances
for using a PHR and do the benefits outweigh the perceived risks?

Google Health does seem simple, straightforward, and easy to use,
albeit with some major holes in content and functionality that I
imagine will be filled over time. However, I struggle to see how it’s
creating value for the average health consumer. Yes, data portability
is important in some sense and does add a level of control for the
consumer, but how much work is required by the user to create this
asset? And how important is data portability to the consumer?  We all
remember the predictions of the paperless office. The “paperless
record” feels like this decade’s version of the “paperless office.”

The best news around this announcement is the upcoming Google API that
will allow others to create applications on this platform. There are
myriad privacy and security issues with data moving from Google to
third parties. For example, I’m not sure what personal health info was
sent to Daily Apple when I signed up for their widget, nor am I fully
aware or comfortable with Daily Apple’s privacy and security. But
despite this, I think the API holds the most promise for consumers.

The bottom line, for me, is that Google Health feels like a good,
incremental step toward putting more control in the hands of the health
consumer. People should have more information about their next
treatment or medication than they do about their next book or
automobile. Without a clearly delineated consumer benefit, however,
this is a platform waiting for a killer app.

Keith Schorsch is the founder and CEO of Trusera.com, a social health Web site.

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Dr Robert Carl ParisienHardyPeter DurksonAnneLifeSensor Weblog Recent comment authors
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Dr Robert Carl Parisien
Dr Robert Carl Parisien

Dr Robert Carl Parisien says: I visited the google health care blog site and was tremendously disappointed. Its badly organized and difficult to use.


PHR system is premature because the industry has not yet agreed on a single PHR definition and many stakeholders are currently experimenting with various models, policies, and procedures. In short, there are no generally agreed-upon best practices to reference at this time.


Many PHR products are currently being offered to consumers, but a single definition of a PHR has yet to emerge.In addition to important medical information such as test results and treatments, a PHR can include diet and exercise logs. At the same time, it is important that consumers clearly understand that a PHR is separate from and does not replace the legal medical record of any provider.

Peter Durkson

Aloha, Thank you for these very enlightening posts! We’re mapping a Connecting Care system for Maui and Hawaii and you’ve provided us with very helpful ideas. We would add that people who want to age in place and their caregivers are also potential “consumers” of PHRs which are designed to connect with EMRs and personal digital health monitors at home. Our challenge has been to get PHR/EMR/RPM companies to get past product myopia and start building those “cathedrals” articulated so well by Joe Coughlin at the MIT AgeLab. Do any of your readers know of anybody trying to aggregate and… Read more »


Google Health–Blue Cross Blue Shield of Massachusetts just made a big announcement about a new agreement with Google Health. As a healthcare consumer (currently a BCBS member) and someone who understands how customer relationships should be developed, continue to be baffled that the consumer is once again left out of the equation. BCBS offers a member self-service program on their website. I have used the program this year and it’s been an interesting experience. I’ve called my providers’ billing departments and BCBS to ask questions about the claim details I’m seeing online and the response I get is, “why are… Read more »

LifeSensor Weblog

“You may wonder if I am neutral about this topic, given my job and role in the company, and I will answer that blogging is not meant for neutral people anyway. I surely see the challenges but, above all, I see the huge potential of Web based PHRs (or should we call them iPHRs? … “

The meaning of … PHR (weblog.lifesensor.com)

A. Sethi
A. Sethi

Correct. I asked my family what they would do with a PHR. Silence. Consumers don’t care. But Health 2.0 can’t care that they don’t care. Sometimes, just sometimes, consumers don’t know what they want, or need. Like a PHR. And, more than a few of the endless apps being developed at Health 2.0 start-ups are going to need the data behind a PHR (hopefully in a portable construct, like CCR). Ask the average consumer about Transunion, Experian, or Equifax, and you might get the same reaction as you do for the PHR. Duh? Do consumers really care about either? Not… Read more »


I say YES. Great deal. I have kids…my records…I want to access them easily/it keeps Doctors in check, they have to keep up on their files.

Neal Linkon
Neal Linkon

I agree with Reed, not necessarily about the McKesson product, but the patient-perceived value of PHRs in general. When I was at Aurora Health Care in Wisconsin, we offered a highly functional patient portal that included a full PHR. About 2,500 new people sign up for the portal every month, hundreds communicate with their doctor and request appointments, and thousands pay their bills. Only a handful take advantage of the PHR capabilities. Until and unless a more exciting and compelling case can be made for PHRs, most consumers are going to yawn.


The PHR market seems to be evolving with multiple providers. Credibility, commitment, and a sound business plan as well as customer support are critical issues, much like EMRs.
CCHIT certification and interoperability may also play a critical role, for importing data into an EMR.
The big question is will consumers be comfortable with trusting their personal health information to a corporation whose primary business model is advertising, search, maps and other diverse applications?
Healthtrain Express


In my opinion consumers want “actionable” products that have meaningful impact on their day to day lives. Products that can help them deal with issues that impact their time and their money. Checking symptoms and figuring out what to do about them is far and away the #1 reason consumers go online for health. As a result, products that can answer questions like “should I see the doctor?” “When?”, “Where should I go for care?” are what consumers want and need. The resulting data from these products, stored in a PHR or anywhere else are simply a by product of… Read more »

Keith Schorsch

Great discussion, all. Appreciate many of the points made here and wanted to respond to a few comments as well. First, John from Chilmark makes some interesting points about the value of PHR, Kaiser’s 30% penetration, and “what if” we could extrapolate that level of adoption nationally. Whether you call current PHR penetration at 3% or 6-8% penetration as John claims, it’s a huge jump to 30%. I don’t think you can effectively use Kaiser as an example of what’s possible as it leads to overly aggressive conclusions. Kaiser is a very unique case in that it controls its provider… Read more »

Henry Albrecht

Keith, good discussion starter. Killer apps are those that solve problems. The bad/good news is that there are really big health-related problems that need to be solved… for the country, for health plans, for health systems, for employers and for people. One disconnect is that people (consumers, employees, grandma…) do not think of themselves as lipid counts, LDL cholesterol levels, family histories of cancer, hospital visits, test results, claims, etc… They are people and (whether actively in the healthcare system or not) care about things like how they feel, how they interact with others, how stressed they are, how fast… Read more »

Dr Julio Bonis

I agree with you. I am a family doctor from Spain who leads a PHR project: keyose.com I believe that PHR will become really valuable tools for patients. But not the way Google-Microsoft and the big ones are visioning. From my point of view the current systems are thought in terms of saving costs. They have a solution (technology) and are searching a problem. They are searching the problems in the wrong side of the equation: doctors and healthcare organizations. We need to ask the questions to the patients: what is relevant to you? how can I solve this problem?…… Read more »


Yeah, yeah the consumer is really important here and it really is a big unknown if consumers will adopt either Google Health or Microsoft HealthVault in large numbers in the forseeable future. What is going to be fascinating to watch is the flurry of parternships and annoucements that are taking place though over the next 12-18 months. See what kind of local flavors this takes on and if partners are willing to go with both Microsoft and Google. For example, Google Health has already signed up Beth Israel and BIDPO. Now they signed BC BS of Massachusetts who dominates the… Read more »