The EMR, or Electronic Medical Record, is a major thrust in the new Obama Budget. It comes as no surprise then that Google, its executives being major Obama supporters, have positioned Google Health as a major player in this new Market.
The first Figure depicts the current structure of Google Health. It has the patients Health Record, allows for Importing medical data, connects to online health information and then allows for finding physicians.
I have tried out the Health Record and frankly any first year Medical Student would probably fail their course on history taking with what is available any any physician worth their salt would most likely go elsewhere. But this is a start. It is cumbersome with all the manual entries. This it is even more complicated for the physician.
The Record contains the demographic data, conditions and history, procedures performed, test results, immunizations. It does not permit ready comparison of HbA1C for example to monitor Type 2 Diabetes or ESR or CA 125 or a wide variety of tests which a physician wants to see change readily. It also lacks any multimedia ability to incorporate CAT, MRI, pathology slides, and ultrasounds.
The import of medical records is attractive since it allows the patient to import lab tests say from Quest or records from your hospital or from other sources. It is a patient oriented system and functions well for a cumbersome initial attempt.
The medical records can be imported, copies, shared, converted and thus have a potential for wide accessibility. The problem again is that they are so rudimentary that they are virtually useless in any real medical environment. They also lack any Evidence Based Medicine inputs which we believe will be critical. They also seem at this stage to lack pharmaceutical interaction and of course there is no pricing or costs information, thus billing and awareness of costs is totally lacking.
The final chart below shows the details of the medical record we have discussed above.
Finally, one wonders of this is a Trojan Horse for the EMR push that is in the new Budget. Clearly Google has the technology and political connections. It seems to lack the "business side" of the equation however. It lacks what Vint Cerf and Bob Kahn assembled in the days of the Internet's beginning, an IETF type organization, an entity of involved practitioners. That, in our opinion, is an essential and critical element in getting this effort moving and accepted. It must have that ground up effort.
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