Microsoft, Google Joust , Concur, On Health-Care Offerings
Appearing at the Mastermind Session at Everything Channel's Healthcare Summit in San Diego this week, Grad Conn, Microsoft Senior Director of Global Consumer Health Strategy in the Health Solutions Group, and Alfred Spector, Google Vice President of Research and Special Initiatives, fielded more than an hour of questions from both Gartner analysts and audience members regarding Microsoft HealthVault and Google Health.
Both Conn and Spector offered their fair share of both thorough and cagey explanations. Following are some of the questions they were asked along with their arguments and exchanges.
Q: What are the fundamental differences between the offerings?
"Neither one takes the data from your health record and uses that to tune-up a search," suggested Gartner vice president and distinguished analyst Wes Rishel. "Both have a very strong philosophy that this is the consumer's data. They have control over the data, to make it go away or make it never be there in terms of how they use the product. If there's a difference at all, it's under what circumstances?"
Spector first reiterated that the broader Google search advertising platform would not come into play in Google Health.
"The argument not to do it is that we're very interested in consumer acceptance," he explained. "With respect to Google's general search, that's a different world. It's a different kind of thing within the health environment, and it's an interesting question whether we made the right decision, but that's why we made it: getting consumer acceptance. We have no intention of [involving advertising] at this juncture."
"One of the 75,000-foot reasons to do this is the epidemiological research value in the data," Spector continued. "It must somehow be valuable over the long-term, where we knew drug 'x' affected person 'y' because of a certain set of of factors, and that [a person] could check for not just correlation but cause and effect. Down the road I think that'd be an incredible contribution to the world, but only when consumer acceptance is there. There is no reason to believe that your medical account would be the same as any other Google accounts."
Conn was more forthcoming in a technical sense about how Microsoft intends HealthVault to function.
"HealthVault is a software and services platform," he explained. "What we see ourselves doing is, we're plumbers—not Joe the Plumber, but plumbers that enable the construction of consumer engagement. We're really like PayPal—I mean, no one goes to PayPal to go shopping. PayPal enables transactions to occur but it's a subordinate brand; 97 percent of PayPal users have never actually been to PayPal.com. We see the primary brand [in HealthVault's case] as, for example, New York Presbyterian."
"It's not an example we think is better or worse than Google's, but Google's a bit more like Facebook: it's the entry point but also a platform that you can plug into," he added. "I think [people] see us as solving different kinds of problems."
Q: How will these platforms be profitable for Microsoft and Google?
"If I may be a bit crass," asked Gartner Managing Vice President Bob Booz, "how do you make money on this, and what happens if you don't?"
Spector maintained that advertising interests wouldn't come into play with Google Health; rather, Google views it as an overall extension of the brand.
"Google gets a large share of the search market," Spector explained. "We organize the world's information and make it universally acceptable and useful. There is an enormous amount of health-care data that is underorganized and underused—it's ripe for use in improving medical care. Our customers expect us to do this. We do this with a view that people will do more Google searching and enhance our overall brand. People go to Google more than anything else online before they see a physician."
Conn attempted to illustrate differences in the models.
"We're in a different spot; we look at ourselves as providing infrastructure," Conn said. "[Google] is more consumer-oriented; we're about getting the industry to build applications. [Microsoft CEO] Steve Ballmer has said that health-care is one of the top six bets for the company, and he doesn't make those [statements] unless there's a lot of money going into it. We've got so much traction among CDOs in the U.S. that it's unimaginable to me that it won't work. Emerging business models come out of being at the center of ecosystems. Another one is images. Both the systems could easily do it, and we haven't explored deeply right now."
The Gartner panel wasn't willing to let either industry giant off the hook.
"So let me see if I get this right: you're both saying health-care is a big deal, it's very information-intensive, and someday we'll be profitable?" asked Rishel, prompting chuckles and loud claps from the conference audience.
"I think we're doing better than the GM executives, at least!" cracked Spector. "No, getting electronic data organized and allowing the consumer to get involved, everyone must kind of believe in that. This has been Medical Informatics 101 for a very long time. It's good at the high level but no one gets sufficient benefit at the micro level—what's going to make this all valuable is specific value propositions. That's what's going to drive it."
"Steve has said that it's almost unnatural that the world's largest software company wouldn't be participating in health," Conn maintained. "Health is already a big business for us—a very profitable, significant segment. When we do make money on Amalga, which is our enteprise product, and HealthVault...well, when we break even on HealthVault I'm not going to share, but it's not a ridiculous number. The value it provides to join scattered parts of the ecosystem is huge."
Q: Are you actively committed to the CCD standard?
The ASTM/HL7 Continuity of Care Document (CCD) standard is the guts of interoperable document systems in health-care IT. Approved in 2007 as an ANSI Standard for electronic clinical document exchange, it essentially harmonizes its two separate predecessors—HL7 Clinical Document Architecture (CDA) and the XML-based ASTM Continuity of Care Record (CCR). CCD constrains data such that it can be read by humans or processed by an electronic medical record. Its proponents champion the fact that it has a small set of fixed XML tags to make it available in both HTML and PDF formats.
Translation? Ideally, there's more data that can be seen and easily accessed, and less room for interpretation or speculation.
"CCD is a very complicated standard," Spector said. "We're trying to talk with organizations to have the right profile for the right interoperability."
"We support both CCR and CCD," Conn explained. "But our stance is we're not here to set standards, we're here to support them. As new CCs emerge, we'll support those as well."
Are the offerings repositories for storing data or are Microsoft and Google providing services to be able to access information from disparate systems?
"Both Google and Microsoft store data and provide connectivity to share data," Spector said.
"We don't believe people care that much about storing data," Conn suggested. "There are lots of ways to do it. But people do want to share data. You have to store it, first, before you can share it."
Q: How are plans made for an individual who chooses to go to HealthVault, but then to Google Health, or vice versa? How do you manage patient records in both?
Conn was the first to suggest Microsoft was "ready to send data to Google any time."
"We'd like Google to operate the opposite way, too, but we're cool if they don't," he said. "It's kind of silly for us to create separate repositories. A lot of our partners are working for both of us."
"We will do this," Spector added. "There are somewhat interesting technical synchronization issues, but there's no reason Microsoft and Google can't work together on this."
"So you are in fact going to make nice with each other?" asked Booz during the session.
"We have this vision," Spector admitted. "We all believe, I think there's incredible value for both companies and for people."
"Besides," he added. "Plenty of time to fight about other things down the road."