- Power to discover â€“from whom and where to get help
- Power to own oneâ€™s own data â€” with complete control of how it is used. This he characterized as an â€œinalienable rightâ€
- The right to choice:
- of provider
- of insurer
- of treatment â€“in partnership with physicians. If the physician sees their patient as a â€œpartnerâ€ rather than a â€œpuppetâ€ it makes all the difference in the world in how the patient is treated
- The power of privacy â€“meaning the consumer can decide what to disclose to whom, and whether to withhold information without having a large red X for â€œmeds not disclosedâ€ appear on their chart
If consumers had all these rights, they would engage in the power of action to make better choices, though Bosworth freely offered that he doesnâ€™t have the magic bullet.
Bosworth made a couple of other interesting assertions:
- That the technical challenges involved in getting data into consumers hands are not hard to overcome
- That once consumers understand whatâ€™s really going on theyâ€™ll rebel against being exposed throughout their lives to the threat of bankruptcy from medical expenses and will put the burden back on the government or others
I asked Bosworth whether he felt consumers had a role in determining their diagnosis â€“in partnership with their physiciansâ€“ as well as their treatment. His answer: â€œsort of.â€ He doesnâ€™t want to see patients play at being doctors but he recognizes that physicians exhibit diagnosis bias and that consumers want a â€œbreadthwise searchâ€ to see a long list of things they may or may not have so they can rule out the scary ones.
Those looking for details of the forthcoming Google Health offering were probably disappointed but not surprised that Adam didnâ€™t reveal much. But hereâ€™s what I picked up in trying to read between the lines:
- Google wants to include in their PHR transaction data between physicians and health plans, physicians and PBMs, labs and physicians and so on. They are not planning to rely on feeds from physician EHRs to do this â€“Bosworth made a point of pegging EHR adoption outside the hospital at <10% though I think heâ€™s understating the truthâ€“ but to try to plug directly into the payment streams
- Google is trying to lay the groundwork to have HIPAA overturned, and short of that would like to educate providers and patients about how to get at their information even within the constraints of current laws. Theyâ€™d like to see consumers have the ability to review and challenge their records as is the case with credit bureau information
- In keeping with the Google philosophy, Google Health is likely to be a â€œsimple, sloppy solutionâ€
And a final tip for those wanting to work with Google: he seems to like medical experts whoâ€™ve written books.