Electronic medical records after Google Health’s failure
By Vineeta Vijayaraghavan and Clayton Christensen
The opinions expressed are their own.
It may seem that the viability of electronic health records looks dismal after the failure of Google Health, yet in integrated health systems around the country they have been implemented and utilized by patients. In Google’s failure we must see an opportunity to address the fragmentation of our healthcare system and take notice of those health systems that are offering innovative services that help provide better care at a lower cost.
Earlier this month, Google announced that it was closing down Google Health, its foray into personal health records, because it failed to find “a way to translate limited usage into widespread adoption in the daily health routines of millions of people.” Based on 30 years of research, we are firm believers that technology will enable disruptive innovations in healthcare – the types of innovations that will dramatically lower costs, increase quality and improve access to millions. But Google Health was doomed from the start. The obstacle standing in the way of its success was the massive fragmentation of our healthcare system, and its closure signifies the urgent need to integrate healthcare.
Google thinks big. With Google Health, it would have loved to solve the fundamental problems facing consumers – making it easier to schedule appointments and communicate with doctors, allowing patients to manage medications remotely, or even helping them avoid the doctor’s office entirely. Accomplishing these goals would have almost certainly inspired consumers to embrace electronic health records. But to do so, Google needed a fragmented maze of insurers, hospitals and medical groups to also share their data, requiring them to clear complex regulatory and privacy issues to complete the onerous process of bringing their own information online. These organizations do not have the right incentives in place to invest in such an effort, and so Google Health failed.
There is only one way to speed up the process of getting robust health records online, and that is integration. Over the last year, we closely studied seven integrated health delivery systems – which typically contain a medical group, an insurer and a hospital – and found that electronic health records are immensely popular with consumers enrolled in the systems because they solved their most urgent problems.
At one well-known system, HealthPartners in Minnesota, patients can access their online records to schedule an appointment and have all their files automatically available to a new specialist the patient might never have seen before. At Group Health Cooperative in Washington, when patients go in for a blood test, test results have often been emailed to them and added to their electronic health record before they even arrive home.
Even the Medicare population served by some Group Health physicians has embraced electronic health records, contrary to expectations. In fact, some physicians have seen a 50 percent drop in in-patient visits by Medicare patients while retaining the same satisfaction ratings and outcomes. If replicated widely, that result has astounding implications for lowering the cost of care across our healthcare system.
Integration is critical in creating high-value health records and encouraging usage. Physicians who are employed in integrated systems comply with inputting patient data, and are often compensated for time spent on email and phone visits. The insurer in an integrated system can aggregate information so that patients can view and pay bills from different specialists and hospitals in one online site. Most importantly, the entire organization invests money and staff time into making integration and technology work better for patients over time.
At HealthPartners, a dedicated team worked for a year to revise its online appointment scheduling system, reducing 800 appointment types to a few dozen. The team also reengineered physician workflow, ultimately bringing average wait times down from 17.8 days to 4.2 days, and enabling many patients to actually get an appointment on the same day they called.
If you want a better experience, find your way to an integrated system in your part of the country and see what the future could hold.