Last two years brought unprecedented interest in Personal Health Records (PHRs). Started in healthcare industry outlets the excitement crossed over into traditional media and the expectations are high.
Over the last year I have written a few pieces about the new PHR platforms from Microsoft and Google, outlining some of the challenges they need to address to achieve adoption and viability, which you can find here:
Recent update from Microsoft deserves another look:
First of all, I would encourage you to check out the announcement by Sean Nolan, the Chief Architect of HealthVault, outlining a product tour for new users as well as the commentary by John Moore of Chilmark Research.
John and Sean have a great overview of the new HealthVault features, which I believe are on the right track to increase product usability. Improvements to login are especially welcome, as the strong focus on privacy and security comes at the usability cost. As a user, I remember my frustrations with having to change my Windows Live password to the acceptable level of strength. Support for Open ID is helpful, though this might only be a start.
Microsoft is clearly committed to investing in the platform and is working with industry partners who are developing 3rd party applications. The billion dollar question however still remains the same: Do consumers and providers care enough about PHR to actively participate?
What do we need to look at? Metrics, metrics and metrics!
The grand visions of PHR for every consumer accessible by every physician have been around since nineties and have not changed that much. Despite a truly novel approach by Microsoft and Google of treating PHR as a platform, these platforms will be worth only as much as the number of people using them. Using them ACTIVELY and not just registering for an account and forgetting about the service. Engagement requires more than usability (which is simply the price of entry). The platform along with its applications must provide ongoing value.
Neither Microsoft nor Google published any consumer usage data
This might be forgivable given the early stage of their PHR platforms. But on the other hand, HealthVault has been around for a year and Google Health is nearing half-a-year milestone. While the products have been launched to the public, the main focus of both Microsoft and Google seems to have been recruiting industry partners. But still, if consumer adoption is strong, why not brag about it?
I would go out on a limb and say that PHR experience (of any kind) is still not close to being interested and compelling to John Q. Public. In the absence of official data, we have to go by anecdotes. Fortunately, the recent piece in Modern Healthcare has the key factoid from John Halamka, CIO at CareGroup Health System—parent of Beth Israel Deaconess Medical Center (BIDMC):
Still, PHRs aren’t attractive to everyone, even those partial to Google, such as the young and healthy, Halamka says. But they are of high value to providers such as himself, an emergency room physician. “Often I’m flying blind,” he says. “I would hope that a PHR would help.”
The key to Google Health’s success is making sure that users don’t have to input information themselves, but rather be able to access critical data at the click of a mouse. For instance, 40,000 patients at Beth Israel Deaconess have PHRs, but only 42 patients have added any information to those files, Halamka says.
That only 1 in a 1000 patients who bothered to enroll for PHR would care to take any action upon it speaks volumes about viability of a personally-managed health record. After all, the media attention around the concept has been huge and BIDMC, Google and Microsoft went out of their way to promote these programs. Unfortunately we are still stuck in the experimentation phase.
But what about all these huge PHR market projections?
Be careful who you listen to and how you interpret the data! While we keep hearing about huge (and valid) numbers of people who "search for health information" and "visit health websites", PHRs and many other consumer-directed tools require a lot more commitment than just looking for health info. So while the hundreds of millions of health searchers are real, few of them engage further.
The opportunity for PHR platforms still exists. The question is whether it will take one, five or ten years to bear fruit.
UPDATE: Microsoft demonstrates they understand the need to nurture new "PHR killer apps", in their recent partnership announcement with Scripps, Navigenics and Affymetrix to collaborate on personalized genomics.