That’s quite an ambitious question. It’s a sentiment I’ve heard over and over from people who think that Google or Apple could enter healthcare and finally make the software a joy. However, what prompted the title of this article was Alvin Rajkomar, MD, Product Manager at Google Health who shared this as Google’s ambition in healthcare.
Alvin shared Google’s goal to “restore the joy of caregiving” in a video which showed the first demo of a Google Health product. Check it out below:
I have to admit that this is the closest I’ve seen to a big tech company putting together something that’s starting to look like an EHR. Props to Google for having this ambition. However, this demo falls flat on so many levels that it’s still hard to take serious. Plus, it doesn’t address the real underlying challenges that make clinician burnout a reality today.
The most glaring thing for me with the above demo is that it largely focuses on viewing EHR data as opposed to data entry. While there are certainly challenging nuances to viewing EHR data today, most of the “joy” is sucked out of healthcare thanks to data entry, not viewing data. Certainly, Google’s demo asserts that they can more effectively access and display data across multiple organizations which we all know would be great. However, it doesn’t share a compelling case for how they’ve really solved the healthcare interoperability problem. Remember that the problem is not a technical one, but a business one. Does a slicker interface do anything to solve the business problem here? Not even close.
All of this said, I do find some of the elements they demo as a step forward in what EHR vendors are doing to display various EHR data. I think I’ve seen almost every feature they showed in the video in various EHR software, but no doubt those features aren’t evenly distributed across all EHR software. I don’t know how many times I’ve talked to an EHR user who says, “Why can’t my EHR do [insert XYZ function]?” My internal response is to think of an EHR who has that feature. It’s pretty rare that I don’t know of one that does that missing function. However, letting them know it’s possible only angers them more.
The one exception that Google likely does better than EHR vendors is image recognition and searching for keywords within images and other data. Many EHR vendors do search documents and most scanners have some sort of OCR technology that can be applied to scanned documents. However, it’s fair to say that Google does this better than the other EHR and scanner technologies out there. Plus, we can give them credit that their search abilities will be better as well.
This begs the question, are these features enough to make a compelling case for the Google Health interface over EHR interfaces? Plus, what’s to keep EHR vendors from seeing these demo features and incorporating them into future releases of their EHR? No doubt the Google demo is clean and well done. However, it’s so simplified, it’s hard to really see it as more than just some cool features that an EHR vendor should consider incorporating if they haven’t already. Reminds me a lot of an EHR salesperson doing their well trained EHR demo to healthcare organizations. It always looks polished and beautiful with the perfect patient responses and data. A stark contrast from the realities of a clinician’s day to day.
Even if we were to assert that Google had created a better EHR like view of all of a patient’s health information, it still leaves off the most cumbersome part of an EHR: data entry. The video does demonstrate Google’s use of SmartText that you’ll be familiar with if you use Gmail or other Google applications. A cool feature and one that I personally enjoy in Gmail. However, it provides incremental typing improvements at best. Basically, Google does nothing to address the clinical documentation overhead that really is killing the “joy” clinicians had with patient care.
My best guess is that Google is making a big bet on Ambient Clinical technology that is going to hopefully replace the clinician documentation requirements. We’ve reported previously on Google and Stanford’s efforts to create a “Digital Scribe” to replace the human alternative and even self-aware rooms which track patients and update providers. If you take the view that ambient clinical technology will replace the documentation efforts, then there’s no need for Google to address the data entry burden in their interface. That’s a pretty big bet to make, but may be what they’re thinking by just focusing on the interface needed to access the data.
What’s also interesting is that this demo seems to be a very physician centric demo. I’m sure the nurses feel left out. Let alone the lab, pharmacy, radiology, etc. Lots of patient facing questions as well. Not the least of which is whether patients want their data shared between all their providers like is being demoed. Most do, but some don’t. What’s Google’s model for that?
All in all, I think it’s great that Google is putting this out there. I can see how their designs and their approach will inspire better design and some great new features in EHR software. It may even illustrate an opportunity to have their software embedded in EHR software. It’s not too hard to imagine Google providing an API to EHR vendors that takes care of the document scanning, OCR, indexing, and search functions from within today’s EHR software. That would be a cool product and feature. However, that certainly feels like it falls well short of Google’s ambitions in healthcare.
Will Google be able to “Restore the Joy of Caregiving”? That feels like a massive stretch given what they’re showing in this initial demo. However, I think it’s great that Google is trying. The more smart minds we have innovating and pushing the boundaries of what’s possible and the conventions of healthcare as we know it the better. Just don’t cancel your EHR contract yet.