Mr. Google comes to Washington

From my post on the World Health Care Blog, which was picked up by the Wall Street Journal's Health Blog

Google’s Adam Bosworth told the standing room crowd that came to have breakfast with him this morning that since he was in DC it was appropriate to “talk about rights,”rather than products. He enumerated a variety of rights (he also used the word “powers”) consumers should have:

• Power to discover –from whom and where to get help
• Power to own one’s own data — with complete control of how it is used. This he characterized as an “inalienable right”
• The right to choice:
  • of provider
  • of insurer
  • of treatment –in partnership with physicians. If the physician sees their patient as a “partner” rather than a “puppet” it makes all the difference in the world in how the patient is treated
• The power of privacy –meaning the consumer can decide what to disclose to whom, and whether to withhold information without having a large red X for “meds not disclosed” 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 doesn’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 what’s really going on they’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 –in partnership with their physicians– as well as their treatment. His answer: “sort of.” He doesn’t want to see patients play at being doctors but he recognizes that physicians exhibit diagnosis bias and that consumers want a “breadthwise search” 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 didn’t reveal much. But here’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 –Bosworth made a point of pegging EHR adoption outside the hospital at <10% though I think he’s understating the truth– 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. They’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 “simple, sloppy solution”

And a final tip for those wanting to work with Google: he seems to like medical experts who’ve written books.