1. Consumers, for the most part, just weren't interested or didn't even know what a personal e-health record is.
Despite all the attention e-health records have been getting from healthcare providers since the HITECH Act was passed in 2009, consumers are still pretty oblivious to offerings that allow them to electronically compile and manage their health data. In fact, an IDC Health Insights online survey of 1,199 consumers earlier this year found that only about 7% of respondents reported ever having used a PHR. The leading reason for consumers not using a PHR? About half said they haven't been exposed to the idea of using a PHR. In a similar survey done by IDC five years ago, 52% gave the same reason for not using a PHR. Not exactly progress.
2. Consumers who are aware of PHRs tend to use physician, hospital, and even health-plan portals to keep track of their records.
That's because, unlike Google Health and many other consumer-oriented PHRs, the bulk of the patient's key data--like test results--is already available in the record, supplied by the provider or health plan. Also, unless patients have a chronic or serious health issue, they only use personal health records very sporadically. By the time many healthy patients have another occasion to use a PHR after it's been set up, they probably have forgotten they even started a record and can't be bothered.
In fact, of consumers that have tried PHRs and stopped using them, 15.9% said they didn't want to spend time entering their data and 22% didn't see value in doing so, according to the recent IDC survey.
3. Lack of provider relationships and other data sources.
There weren't enough third-party sources allowing patient data to be imported to Google Health, with the exception of a handful of big name providers, including Cleveland Clinic and Beth Israel Deaconess Medical Center in Boston, and some more recent partners, like University of Pittsburgh Medical Center and Sharp Healthcare, as well as a few large national pharmacy chains like CVS and related partners like SureScripts. Google Health also lacked relationships with big labs so consumers weren't able to access their test results, which is one of the key attractions that often get patients using PHRs.
"One of the key insights we've developed over time is that in PHRs, connections to providers, and having an open platform" to support the import of data from multiple sources and applications, including medical devices, is "vitally important," Nate McLemore, general manager of business development and policy in Microsoft's Health Solutions Group, said in an interview with InformationWeek Healthcare. Microsoft's PHR platform HealthVault currently has about 300 third-party applications, including about 10% of which "also supported Google Health," he said.
4. Google lacked other communication and convenience features that patients look for when dealing with their health information electronically.
That includes secure messaging with healthcare providers and being able to schedule appointments. Both those capabilities are typically found in provider portals offering PHRs.
In recent months, Google Health had shifted gears a bit with its services and third-party relationships, hoping to make the site easier to use and more appealing to fitness buffs. That included new tools to let consumers monitor and record their daily physical activity, as well as help patients with chronic conditions like high blood pressure track their health-related goals. That required Google Health to forge relationships with makers of wearable health device makers. Apparently those new capabilities didn't exactly attract the masses, either.
5. Privacy and security concerns by consumers, whether warranted or not.
While Google officials said they didn't hear many concerns about privacy from consumers, fears about security and suspicion by some patients about whether Google Health had ulterior motives for collecting their health data was undoubtedly a factor that stopped some from using Google Health--or any online service for that matter--to store their personal health information.
"We all have our irrational fears," said Lynne Dunbrack, IDC Health Insights program director in an interview with InformationWeek Healthcare. "And some consumers undoubtedly had fears that their health information would show up in a Google search."
If Google had had more patience with patients (and doctors) getting comfortable with online e-health records, and had addressed some of its major weaknesses, the service might've become much healthier (pun intended).
By the way, Google just introduced a social networking service to compete with Facebook. Does that mean Facebook is working on a PHR? Probably not. However, Microsoft recently added capabilities to allow users to log into their HealthVault accounts using their Facebook credentials. I suppose that's one way to entice consumers into using a PHR.
The Healthcare IT Leadership Forum is a day-long venue where senior IT leaders in healthcare come together to discuss how they're using technology to improve clinical care. It happens in New York City on July 12. Find out more.