Google, Microsoft pushing for electronic medical records

The ER doctor stares at the unconscious stranger on his table. He has never seen this patient. He has never seen this patient’s records.

He cannot know the patient is allergic to the medicine he’s about to inject.

This scenario, more than any other, illustrates why individuals should consider using one of the new services that let patients keep their own medical records online.

Google Health, Microsoft HealthVault and others still have serious shortcomings. They lack obvious features. They can be hard to use. They worry privacy advocates.

But even now, as their creators devise a new product category on the fly, these services can do much for users, even those who never make an unexpected trip to the emergency room.

In theory, records follow patients from doctor to doctor. In practice, studies show, they make it less than half the time.

Even when one doctor refers a patient to another, the records often stay put. About a fifth of all tests that doctors order duplicate tests ordered by other doctors.

“Critical information is falling through the cracks. It makes patients suffer and pushes costs up,” said Roni Zeiger, project manager for Google Health.

“Even when doctors have complete records, computers can help make sense of them. A graph that charts patient weight and blood pressure over five years conveys more information more quickly than a huge file of handwritten notes.”

For all that personal health records can help doctors, their real goal is to help patients help themselves.

Users who enter nothing but the most basic information – their age – get warnings when they reach milestone birthdays that require tests such as prostate or breast exams.

The more information that users provide, the more these systems can help them.

Users who type their medications into Google Health get warnings about potential interactions. Users who tell the system their vaccination history get messages when they need boosters.

System designers hope to make it easy for users to provide the system with detailed information.

Even now, HealthVault works with 10 different medical devices, such as blood pressure and blood sugar monitors.

Patients just plug the devices into their computers and the information zips into their accounts.

“We’re not building these devices at Microsoft. We’ve made HealthVault an open platform so anyone can make compatible equipment,” said Grad Conn, senior director of Microsoft’s health solutions marketing.

“We’ve also made it easy for customers to see what works with HealthVault. We have a logo that gets stamped on compatible products.”

Both Google and Microsoft are inviting other companies and organizations to develop products and services that work with their health portals.

Indeed, both companies need many more partners to attract broad use.

The most important partners will be organizations that handle patient records: hospitals, medical practices, pharmacies, insurers and government agencies.

If Google and Microsoft can get these groups to put medical records in the proper electronic formats, users will be able to import all their data with the click of a button.

If not, users will have to get copies of paper records and enter everything by hand, as they generally do now.

Partnerships with doctors, pharmacies and the rest would also enable users to manage appointments, schedule drug pickups, make claims and otherwise control their medical lives.

Other potentially valuable partners include the many organizations that store data about doctor and hospital quality.

Such partnerships would let users see awards, complaints, lawsuits and other vital information. The addition of user reviews would make health platforms the medical equivalent of the Zagat restaurant surveys.

“Both Google Health and Microsoft HealthVault already do interesting things, but it’s going to take a lot of years to add the features and win the acceptance that will make them mainstream products,” said David Merritt, project director at the Center for Health Transformation in Washington.

Nearly everyone agrees with Mr. Merritt that years will pass before most Americans store complete medical records online.

Congress will probably need to pass privacy laws that specify the proper use of electronic medical records. Users will need to become comfortable with the idea. The systems will need to become easier because no one expects users to type in all their records.

“Think about how long it took for electronic banking to seem normal and then multiply a few times over because medicine is more complex and way more conservative,” Mr. Merritt said. “That said, when these systems finally do win wide acceptance, they are going to extend millions of lives.”