While details are thin, here’s a first pass at comparing and contrasting Google Health (GH) and Microsoft HealthVault (HV). Overall, there are many common features, some differences, and many common challenges between these two platforms.
A High Level Comparison
Google Health and Microsoft HealthVault Personal Health Information (PHI) Platforms
There’s still not much information available about the specifics of GH, although they did release sketchy information on the Official Google Blog. I’ll comment on a few of the particulars.
Both are patient controlled — data is released only with patient permission.
Both GH and HV make claims of data portability. This is in contrast to the “tethered” model of many personal health records (PHRs) being offered today by employers, health plans, and care providers; in a tethered model, PHI is not portable — if you leave a health plan or employer, or if you get care outside the provider’s system — your data does not follow you.
Both have adopted broad technical standards to facilitate interoperabilty of PHI (e.g., the HL7 CDA Continuity of Care Document and the ASTM Continuity of Care Record). Thus, it should be possible to exchange your PHI between GH and HV, and among other parties that have adopted similar standards. When? can I move all my PHI? will data exchange be easy or require 32 steps? — these questions can’t be answered yet.
Thus, the market for PHI should look much more like the market for fax machines than the market for high definition DVD players. Fax machines of different brands can exchange information — but they compete on features, price, ease of use, etc. At this point I don’t foresee a standards battle-to-the-death such as the one that occurred between Sony Blu-ray and Toshiba HD DVD.
GH and HV also will compete on many other levels — applications, 3rd party complementors, user friendliness, etc.
HOWEVER, While GH and HV will compete, at this stage of evolution they are should be far more collaborative than competitive. Using Clay Christensen’s terminology, the primary competition is non-consumption — people will need to learn about why their PHI is important and how to use a PHR.
The common goal for both GH and HV is to build the size of the network for PHI. The total value of the network is dependent on reaching a tipping point and creating a network effect; the value of the network grows exponentially based on the number of users, thus growing the overall size of the market is a win-win.
Both are platforms. Platform models and platform strategy are almost unheard of in health care, but there’s extensive experience from other industries. See e.g., The Elements of Platform Leadership, MITSloan Management Review, Spring 2002 or Platform Networks—Core Concepts, MIT Center for Digital Business, June 2007 (warning: not easy reads, but very helpful to understand platforms).
Both GH’s and HV’s long-term revenue model is unclear. Neither Google nor MS have been very specific about their long-term plans for monetizing their offerings. I think this is smart as it’s very early and we don’t know what will and won’t work; they have many options. Both seem to recognize that there is tremendous value to be created in this type of collaborative network, yet both seem unclear about the best ways to do so.
Finally, both GH and HV appear to be extremely sensitive to privacy/security issues. Both claim that they will not use PHI to create targeted ads, but there are many disbelievers Here’s a cynical but representative comment from the TechCrunch blog:
“Your search for cra sincaunre yielded 0 results. Since we can see from your medical records that you have dyslexia, perhaps you meant _car insurance_?”
Out of the box, GH is a PHI platform and a PHR. HV is a PHI platform, not a PHR. (had enough initials?)
GH seems much more B2C focused. HV seems more focused on developing B2B partnerships with their 3rd party complementors taking on the responsibility of developing applications and signing up users.
Thus, HV seems more dependent on its complementors for ultimate success. If the partners build good applications and attract a lot of patients, HV can flourish. If the partners sit on their hands, HV might have to rethink whether it wants to build and market more applications on its own. While GH also will allow 3rd party complementors to build applications, GH seems more inclined also to build apps on its own. Details here are particularly thin, so watch this over time.
GH seems more intent to develop mechanisms to automate gathering and updating of PHI from other parties in the health care system — hospitals, doctors, health plans, labs, etc. While there is nothing to preclude HV from doing similarly in the future, I believe MS will have have more channel conflict issues because MS already does substantial business with health care organizations. GH will probably be less concerned about using more strong-armed tactics to obtain data on patients’ behalf. Again, the HV model seems to pass this responsibility on to complementors for now.
Some Common Challenges
Gaining consumer trust — avoiding a fatal mistake of a PR disaster through a security breach or violation of confidentiality (real or perceived)
Using carrots and/or sticks in working with complementors?
Using carrots and/or sticks in trying to extract data from health care incumbents?
Growing the overall size of the network.
Adding useful applications, whether from GH or HV themselves, or with 3rd party complementors.
Bottom line: more similarities than differences. It’s early. The platforms are flexible and will evolve…stay tuned.
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Tags: ASTM, EHRs/PHRs, Google Health, health plan, HealthVault, hospital, network effect, personal health information, platform, portability, privacy, strategy