PHR Model At Turning Point

So,  Google is going through some internal upheaval as co-founder Larry Page prepares to take over the reigns as CEO.  According to an piece appearing in today’s Wall Street Journal, Page is aggressively reviewing existing projects and is likely to take an axe to those that don’t seem to be working. Does it surprise any of you that one of the programs facing cutbacks may be Google Health and its faltering PHR?

As HIT expert Shahid Shah notes, Google has created some decent PHR technology — but despite having a vast reach and rich resources, hasn’t figured out how to grow its user community.  Even with its massive bank account, I’m not surprised to see that it hasn’t turned healthcare into a major income source. Google just isn’t that great at going outside of its box.

Then, consider that Microsoft doesn’t seem to be pushing Health Vault very hard these days, and you’ve got to wonder whether the whole “massive tech company builds PHR” thing can possibly work.   Yes, I realize I might get flamed by Microsoft execs saying this, but let’s get real here.  Microsoft isn’t great at connecting to markets it doesn’t monopolize either.

Oh the other hand, evidence is mounting that PHRs may be popular when driven by a provider and its own EMR.  Perhaps the highest-profile example of this may be Kaiser Permanente’s EMR/PHR ecosystem.  Its “My Health Manager” PHR system is closely integrated with its Epic EMR installation and now has millions of users.

Why is Kaiser succeeding at generating PHR interest where Google has failed? It’s largely because rather than offering a mixed bag of apps and options, as tech vendors have been doing, My Health Manager allows patients to securely exchange messages with physicians, refill prescriptions, review test results and schedule medical appointments.  Patients aren’t being asked to become updater and curator of their medical information, but rather, to use it. This just makes sense.

As I see it, the whole notion of a PHR as a freestanding app is basically circling the drain.  Realistically, patients have little incentive to interact with their health data unless it has some immediate impact on their lives.  An EMR/PHR combination, on the other hand, has tremendous potential, as it connects patients to both their providers and their health data effectively.  If I were Microsoft or Google, I’d just throw in the towel at this point.


About the author

Anne Zieger

Anne Zieger

Anne Zieger is a healthcare journalist who has written about the industry for 30 years. Her work has appeared in all of the leading healthcare industry publications, and she's served as editor in chief of several healthcare B2B sites.


  • You are right John; it has to be tied to EHR and there has to be a need for the consumer to use it, at least in the initial phase. Only then there will be a traction.
    Alternatively, Google and MS can join hands with EHR vendors; but you and I know – these are giants and will not be able to come down to the level of EHR Vendors to work with them on a one on one basis.

  • Australia is aboutbto embark on a large scale PHR project, with the government offering a Personally Controlled Electronic Healtn Record for all Australians from July 2012.
    Whilst not tethered it will allow care providers to send summary information to the record, and individuals will have the ability to add notes as well.
    This may be the largest implementation of a PHR in the world, with some $400 Million in government funding.
    I believe it will help transform some of the current models of healthcare delivery as individuals start to take a more active role in their own healthcare, starting first with ther data, but ultimately playing a greater ole in their own care.

    Watch down under some good stuff happening he.

  • Anthony,
    Just so you know, this was actually written by Katherine and not me. For future reference, you can see who’s writing which articles at the top below the title.

    I’m personally not quite ready to throw the towel in on PHR. I’m just still waiting for the killer feature that drives most of the adoption. I won’t be surprised if that comes from a PHR vendor other than Google and Microsoft.

    That sounds like an interesting PHR in Australia. Do you have a unique identifier in Australia that can be used with the information? That’s one major thing holding the US back. We have the social security number, but we don’t want to use it since it’s used for financial stuff. We don’t have a health ID.

  • Re: “Google just isn’t that great at going outside of its box.”

    IMHO, that’s because they’re so hung up on hiring someone who knows “how to survive in a blender if they were only the size of a nickle” rather than embracing diversity and balancing their edgy, off-beat thinkers with more conventional wisdom.

    For example, Healthcare and PHRs, one area where they are not achieving their full potential, does not really benefit from the type of hackish intelligence that would make another Google initiative succeed.


  • Privacy is an issue with Google Health. I signed up to see what it offers and keep up with the technology. When I saw this in their Terms of Service:
    Google is not a “covered entity” under the Health Insurance Portability and Accountability Act of 1996 and the regulations promulgated thereunder (“HIPAA”).
    That was it; I wasn’t entering any private or personal data under those conditions. Some day that info may haunt me in the form of denied insurance coverage, etc.

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