One more thing: Works for Apple, but killed Google Health

Google Health is dead.

There have been plenty of post-mortems as to why, ranging from the fact that it’s not social enough (uh … no), to the realization that only a minority of practices have electronic medical records, yet alone a patient portal that can incorporate PHRs like Google Health.

I’ll chip in with my own reason — it suffered from “one more thing” syndrome.

PHRs today aren’t seamlessly incorporated into a patient’s and doctor’s normal workflow.

Google Health required patients to take that extra step of entering a health and medical history themselves.  And most doctors could not automatically incorporate Google Health information into a format their EMRs could use.

Whatever takes extra steps isn’t likely to be adopted.

Google Health was off to a rocky start when it discovered how difficult it was to download insurance company-generated health claims into its database.  As e-Patient Dave DeBronkart noted, it’s often “garbage in, garbage out.”  And relying on patients to enter their own data doomed the service to niche status.  It’s no wonder that only 7% of patients use PHRs at all.

For doctors, there’s even less incentive.  Most have enough trouble transitioning to an EHR, let alone integrating it with Google Health.  It’s no wonder that not many were willing to take that extra step of doing so.

Dave Chase summarizes it best:

To understand the impact, I’ll exaggerate to make a point—your healthcare provider doesn’t care about you unless they can see the whites of your eyes. Why is that? Today’s flawed reimbursement scheme only compensates the healthcare provider for a face to face visit. It’s hard to fault the primary care physician who has been put on a hamster wheel of 30-40 appointments per day and can’t even give their practice away upon retirement (that was once their retirement plan) for not wanting to deal with their patients sending email or sharing information from their personal health record.

The failure to involve health care professionals is the biggest reason why Google Health failed. I hope people will begin to realize that nothing will change in health care unless physicians are on board 100%. Like it or not, doctors still wield tremendous influence over their patients, so for consumer health innovations to succeed, it needs to come through the doctor’s office.

“One more thing” works well for Steve Jobs and Apple when announcing new products. But when it comes to health technology, requiring physicians and patients to take any additional steps is a surefire recipe for failure.

Kevin Pho is an internal medicine physician and on the Board of Contributors at USA Today.  He is founder and editor of, also on FacebookTwitter, and LinkedIn.

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