This post was co-authored by Rich Whalley, an associate at CBT Advisors.
What could Google do if it had access to everyone’s health data?
You’re probably already thinking a few things:
1. There’s no way I’m giving Google my personal health data.
2. Didn’t Google already try to do this with Google Health?
3. Won’t this take the “don’t” out of Google’s “don’t be evil” motto?
But bear with us. Imagine a healthcare system 10 years in the future that would make Obama proud.
I go to the doctor and find out that I’m at risk for developing type II diabetes and need to craft an effective set of measures to minimize my risk. I find out that there are multiple recommended approaches, including preventative medicines. We log in to my Google+ health data page and go through the extensive record of my diet, lifestyle, and exercise data, as well as my genome. From this, we determine how my response is likely to compare to that of the average person at risk for diabetes.
Even if Obamacare is ultimately upheld, it’s hard to imagine that the government alone is capable of unifying and analyzing all this data through the implementation of electronic health records. A better solution may come from the private sector, where all the necessary tools are already developed. As we know from Wikipedia, the most comprehensive, cost-effective data sets often come from user-generated data.
In comparison to Wikipedia, and Google+, Google Health was never positioned to gain a large enough user base. Google Health also lacked the right social tools to become popular enough to generate anything like “big data.” Google+, by contrast, will likely gain mass adoption because of the Gmail user-base and Google’s recent moves in the smart phone space. Google’s core strengths—aggregate data analytics, Web app and smartphone integration—give it the inside track to become the ultimate user-generated health resource.
But how to proceed? Letting it grow organically might ultimately lead to a flop the way it did with Google Health. Instead, we have a few suggestions to take on and neutralize the privacy issue and grow via a clever acquisition. That way, Google can realize its full potential as a neutral data gatherer and let its users benefit from the analysis
1. Take the “evil” out of data acquisition
Google has been in trouble in the past with privacy, and some view Google as an evil entity trying to take over the world by gaining and analyzing information on its users. Why would anyone want to give Google access to personal health details? There will always be a small group of people vehemently against sharing personal details with Google, but in our view the benefits outweigh the risks. Just as with Wikipedia, those who input the data will not be the only ones to share the benefits. We believe that sharing personal health information can be done in a responsible way, and people will be happy to help build resources and contribute to studies that prove beneficial and essential for healthcare and medicine. HIPAA (The Health Insurance Portability and Accountability Act of 1996) will offer further protections.
2. Set up a personal health page for Google+ users
We propose that Google integrate a personal health record page into the Google+ platform. Here, users could privately—repeat: privately—enter data about medications, conditions, and various other health metrics. Even if individual personal health pages were filled less than completely, a user base of hundreds of millions could lead to meaningful trends. Users may find benefit by becoming better informed about their health, but that may not be enough. Users may also want a piece of the new revenue streams created when Google provides these trends and data sets to pharma, academia, healthcare providers and, dare we say, insurance companies.
Health data could potentially be user-authorized to be privately shared with doctors and family through the Google+ platform. Users could also access support from focused groups of peers, a more valuable resource than the most encyclopedic search. As discussed in the epilogue of the recent, nearly-up-to-the-minute history of Google, In the Plex by Steven Levy, Google realizes it needs more than search algorithms to fall back on as it takes on Facebook.
3. Leverage the power of user-submitted data
Google may be able to aid with Phase IV studies and recruitment, given the potential for data aggregation and a user base exceeding that of large healthcare providers such as Kaiser Permanente. Phase IV studies gather information on patient response to already-marketed therapies, such as Biogen Idec’s highly efficacious multiple sclerosis drug Tysabri. In a small subset of patients, Tysabri causes deadly brain infection called multifocal leukoencephalopathy (PML). Biogen Idec is conducting a 5-year, 5,000-person Phase IV study to figure out ways to predict those at risk for infection.
Recently, user-submitted data from the network made its way into a groundbreaking study published in Nature Biotechnology that refuted the use of lithium as an effective therapy for Lou Gehrig’s Disease (ALS). PatientsLikeMe, an online health social network and personal health resource, sees this study as only the beginning.
By creating a portal for personal diagnostic and biometric data, Google can start to follow in the footsteps of PatientsLikeMe. Say a patient on Warfarin is using a Google+ enabled blood pressure monitor. The data from the blood pressure monitor could be tagged with certain information from the personalized health record, anonymized and sent to a central database for correlative analysis. The PatientsLikeMe website (screenshot below) shows user-reported data on the efficacy of Gabapentin for treating various symptoms. Now imagine predicting efficacy of therapies by finding correlations with genomic data: a personalized medicine revolution, fueled by the patients themselves.
4. Acquire PatientsLikeMe
Google+ could benefit from a framework to allow patients to gain insight into their own health through data analytics on aggregate data. PatientsLikeMe has already done the legwork in developing novel health analytics tools and a huge and growing dataset. A PatientsLikeMe acquisition would ensure that Google would hit the ground running; new users would already have access to insightful health information.
In April, 2011, PatientsLikeMe opened its site to all comers, healthy or not. Now over 1000 diseases are represented there. But we think that the lack of incentive for adoption by healthy people will make it tough for the site to keep expanding its user base at high rates. If the platform is integrated into Google+, the number of users could grow to an astonishing level. Assuming that Google+ gains a user base of millions of people, aggregate data on basic biometrics could allow very interesting trends to emerge. If only 0.1% of Google users take advantage of the platform, that would make it much larger than PatientsLikeMe is today.
We suspect that when Google Health went dark, its engineers did not lose their jobs. Instead, they may have been integrated into a project with much bigger ambitions, namely Google+. Google’s large user base provides the key to allow platforms like PatientsLikeMe to expand further than they could have otherwise, and thereby provide greater benefit to patients and doctors alike.
At last year’s Partners HealthCare Personalized Medicine Conference at Harvard Medical School, we still remember a resounding frustration in the air that there was no way to turn personalized medicine and healthcare into a concerted effort between physicians, healthcare providers, patients, government, pharma, biotech, insurance and academia. A user-driven, shared data platform could bring it all together, and Google may be able to show the way forward.
Rich Whalley (firstname.lastname@example.org) is an associate at CBT Advisors, a boutique consulting firm in Cambridge, MA. Rich graduated from MIT in 2010 with a Bachelor of Science in Chemistry.
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