Google Defends Medical Records System

Google is responding to claims that its Google Health solution, which allows users to collect their medical information in an online account and then port it to their health care provider, has the potential to display inaccurate information.

The controversy that erupted earlier in April 2009 stemmed from the experience of kidney cancer survivor Dave deBronkart, who transferred his medical records from Beth Israel Deaconess Medical Center to Google Health. In the process, Google Health apparently took information from his billing records to incorrectly state that deBronkart suffered from a number of conditions, including chronic lung disease.

The culprit, as it turned out, was the billing codes and associated descriptions in those records.

“These descriptions, from the International Classification of Diseases (ICD-9), often do not accurately describe a patient because the right ICD-9 code may not exist,” Roni Zeiger, product manager for Google Health, wrote in a blog posting. “So the doctor or hospital administrator chooses something that is ‘close enough’ for billing purposes. In other cases, the assigned code is precisely what the doctor is trying to rule out, and if the patient turns out not to have that often scary diagnosis, it is still associated with their record.”

When Google Health replicated those billing codes, though, it also assigned deBronkart some phantom conditions.

“We’re also glad this happened,” Zeiger wrote, “because we and many others now better understand the limitations of certain types of health data and we are working with partners to improve the quality of the data before it gets to Google Health and our users.”

Nonetheless, he added, “We are more committed than ever to putting consumers in charge of their own health information.”

Zeiger apparently met with the CIO at Beth Israel, along with deBronkart and his physician; the hospital agreed to send only free text descriptions from doctors, as opposed to ICD-9 billing codes, to Google Health from this point forward. Those free text descriptions will be associated with a clinical coding system known as SNOMED-CT.

In addition, Zeiger promised to drill more fully into the overall issue of “data liquidity” to ensure that what reaches Google Health is of higher quality.

Google has been upgrading Google Health in recent months, reflecting a growing industry-wide push in health care IT. In March 2009, Google added functionality so users could share their medical records and personal health information with doctors and trusted contacts; it followed this by unveiling its participation in a pilot program with the CMS (Centers for Medicare & Medicaid Services) that would allow Medicare beneficiaries in Arizona and Utah to import their Medicare claims data into Google Health.

Competitors to Google Health include Microsoft’s HealthVault technology, which was incorporated this month into Mayo Clinic Health Manager, a personal health record service the Mayo Clinic will use to allow patients to monitor their conditions and share information with caregivers.

Users of the Mayo Clinic Health Manager will be able to store health information obtained from providers, upload data from home health devices and receive reminders about their care.