10 Reasons why Google Health failed

By: Brian Dolan | Jun 27, 2011        

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Google Health Shuts DownSince Google’s announcement on Friday, pundits have discussed the many possible reasons that Google Health failed. The best analyses of the demise of Google Health include this timeline by John Moore of Chilmark Research, this roundup from ReadWriteWeb, and some of the comments in these two TechCrunch articles.

This morning we parsed through the many comments, commentaries and pundit quotes found in these and other posts around the web to create this list of ten reasons why Google Health failed. This is not intended to serve as a definitive list, but it includes commentaries from a handful of current and former Microsoft healthcare executives, as well as other notable industry onlookers.

Why did Google Health Fail?

Google Health was not fun or social: Adam Bosworth, the original leader of Google Health and now founder at Keas, told TechCrunch TV a few weeks ago: “My sense is that neither [Google Health nor Microsoft HealthVault] are dramatically successful. In Google’s case, it’s partly because they haven’t really pushed to see what people would want. They basically offered a place to store data. Our data shows people don’t really want a place to store data, per se. They want to do something fun and engaging. If it’s not fun, if it’s not social, why would they do it? Yes, they want to be healthy, but they need more than that. They need the encouragement and even the pressure of friends. They need the constant pressure, constant reminders.” While not all healthcare services need to be fun, Bosworth’s insight is especially helpful since he helped found Google Health. Video

Google Health was not trustworthy: Same old “Google is actually evil” argument and should not be trusted with personal data, especially health data. Proponents of this reason believe consumers are not willing to trust corporations like Google or Microsoft with their personal health data. This group would likely disagree with Bosworth that Google Health wasn’t fun or social enough.

Google Health was too cumbersome to use: While the user interface for Google Health has received praise, the process for bringing data into Google Health wasn’t simple. Dr. Joseph Sucher explained the cumbersome nature of the process by highlighting three points in a comment on Dr. John Halamka’s Life as a Healthcare CIO blog: ”One, the patient doesn’t always get reliable information transferred to them. Two, many people simply don’t have the time or take the time needed to update the details of their healthcare. Three, the information complexity can become too unwieldy and complicated for most people to maintain on their own without professional input.”

Google Health did not involve doctors: GH was too bottom-up, according to at least one former Microsoft executive: Dave Chase, founder of Microsoft’s health business and now CEO at Avado, writes for TechCrunch: “As much as there’s a massive consumer-empowerment movement, in order to get ongoing and broad adoption of something in healthcare, one needs to lead with the clinicians. Take a look at ZocDoc, for example. They are having success with appointment scheduling by leading with doctors/dentists who then, in turn, bring in their patients. Without provider adoption first, they would have had limited success with consumers.”

It was hard for Google to partner with insurance companies: Matthew Holt, co-chair of the organization The Health 2.0 Network, told ReadWriteWeb: “Google became disappointed when they found out how hard it was to get insurance agencies to share their data voluntarily. They made some progress but not enough.”

It was too hard to overcome the current reimbursement barriers: This from former Microsoft exec Dave Chase again: “As much as we’d like to think it isn’t the case, the fundamental driver of most (not all) behavior in healthcare is the reimbursement scheme… To understand the impact, I’ll exaggerate to make a point—your healthcare provider doesn’t care about you unless they can see the whites of your eyes. Why is that? Today’s flawed reimbursement scheme only compensates the healthcare provider for a face to face visit.” I don’t understand this argument, but I suppose any failed health venture can be blamed at least indirectly on a backwards reimbursement system.

Google Health was poorly marketed: A common refrain in the comments of most Google Health coverage these past few days. How were consumers supposed to know Google Health existed? Did Google promote GH less than other Google services?

Google Health received poor C-level support: Dr. Bill Crounse, Senior Director of Worldwide Health at Microsoft, wrote in the comments of the TechCrunch article: “Yes, but it also failed because Sergey [Brin] and Larry [Page] never really supported it. Health isn’t a core competency at GOOG. Health is hard. It takes lots of time, money and partners to transform an industry.” When Page took over it was noted that he planned to cut services with low adoption.

Google Health had no advertising opportunity: In the comments section of the TechCrunch article, Gabor Fari, the Director of Life Sciences Solutions at Microsoft, wrote that he believed the lack of advertising potential was what brought GH down: “I guess you can’t sell advertising to patients whose records you handle after all. They finally concluded that, so they are moving on,” he wrote.

Google Health was not useful to consumers: Ultimately, I think John Moore of Chilmark Research hits on the biggest reason of all: It didn’t solve any pressing problems for consumers. “Can it help them better manage their health and/or the health of a loved one? Will it help them make appointments? Will it saved them money on their health insurance bill, their next doctor visit? Can it help them automatically get a prescription refill? These are the basics that the vast majority of consumers want addressed first, and Google Health was unable to deliver on any of these.”

What else — why, do you believe, did Google Health fail? Do any of these ten reasons miss the mark?

  • HughesB

    I’d add just one more reason – ignorant hubris.  Just because you have a bunch of  smart, successful, tech-savvy people does not mean that you know how to even begin fixing the most complex and intractable industry on the planet.  Google is just one more business model casualty in a long line of bloody roadkill on the “healthcare reform” highway.  It ain’t as easy as it looks, folks.  Just ask Steve Case… 

  • MobiHealthNews

    @Hughes, what was Google specifically “ignorant” of? How can others learn from “ignorant hubris”? That doesn’t seem constructive to me.

  • HughesB

    Sorry, Brian, happy to be more specific.  What Google was ignorant of from the get-go is all of the difficulties involved in attacking the health records space. What others can learn is that healthcare is horrifically complex, and even a shot at success depends first upon understanding those complexities. In following Google Health from launch it was very apparent that they did not understand them. You’ve outlined a lot of them in your article — security/trust issues, the need to be provider versus portal centric, and most importantly the fee-for-service reimbursement system.  As you indicated that you did not understand Dave Chase’s point about the latter issue, I’ll explain.  The only PHR that will work is one in which the patient/consumer does not need to do much manual input and maintenance. For that to happen providers, PBM’s, payors, etc. all need to help populate the record electronically and automatically.  For them to do that, there needs to be a DIRECT financial reward , but our current system does not provide that.  And consumers, who have become accustomed to getting everything in healthcare for “free,” will NEVER pay for a PHR.

  • http://blogs.forbes.com/danmunro/ Dan Munro

    Lot’s of angst over this – and I’m struggling as to why. Revolution Health folded theirs in Jan 2010 – and no one really blinked. Steve Case managed to pivot/sell the assets – so I don’t think he lost too much – but it definitely wasn’t the success he was targeting (for himself or the PHR category). Google’s failure – and the PHR category more generally is pretty basic/easy. There is/was no compelling consumer value – at scale. That’s hard to get to when a product (any product) is free. Because of their size – GOOG was able to keep the cost of delivery low – but that’s never zero – even for them. So – how long do you run a business unit in the red before saying enough? I guess it’s about 16 quarters.

    Some of this is also true with Healthvault (which I’ve heard has 6-figure adoption #’s – but conveniently avoids any press or discussion around actual numbers). Where MSFT’s PHR is different – and they as a company are different – is that they can (and do) sell Healthvault to other countries (where a single payer model supports a CAL). Here in the U.S. – it’s more of a channel strategy that helps support a broader focus (and revenue stream) around provider-centric healthcare solutions (Amalga, expreSSO, etc…). MSFT also has a very rich history and strong commitment to the healthcare industry – going back to the days when MS-HUG was a standalone entity (Bill would often keynote the annual event). I was at one of those where he demo’d our software. At the time – we were pioneering the use of XML (the smaller offspring of SGML) specifically in healthcare (Baylor Health).

    The VA’s solution is impressive at scale – but let’s not compare public consumer needs with a military demographic that get’s fully subsidized healthcare. All that really says is that a centralized EHR (with individual access) has value at scale (assuming it’s free). Same with KP – which can also dictate use as a very large IDN (basically walled-garden). KP’s adoption % are impressive – but probably closer to 50% – not 100% (and there aren’t really any long term usage studies – mostly just initial access).

    Dossia is struggling for cash (currently in fundraising mode) because they’re not profitable after 5 years of development/deployment. That’s with 10 really big member companies including Intel (with their own Venture arm) and WalMart. Last I read – there were only 6 of the 10 member companies deployed.

    Open Source may well be the solution here – but it too has a cost – even if the software itself is free. Servers, bandwidth, consumer support, engineering integration – are all very real $’s (and big ones at consumer scale).

    The value of a standalone PHR has not been proven – in spite of multiple large attempts. Where it has succeeded – MSFT, KP, VA – it is because the underlying healthcare costs are significantly lower or fully subsidized (or with MSFT – revenue is available in many directions – both direct and indirectly).

    Google’s failure – and Revolution Health before it – highlight the biggest consumer deterrent of all – personal risk. That risk has always included interoperability (read Chilmark’s post – The Tale of Two Medical Records from March: http://bit.ly/gRAN7X ). It just needs to include vendor commitment. When the vendor is also the healthcare delivery network – voila! Just don’t plan to move outside of that network!

    To John’s point at Chilmark Research.  What we don’t have – and need to get to – is a Collaborative Health Record.  The fastest mechanism for getting to a CHR isn’t through building out new networks – or through large (or small) software vendors – it’s single-payer.  I know that’s blasphemy – but there – I said it ;-)

  • Anon

    I found it useful as a place to have medical records/treatments recorded. How else was I to remember when that last vaccination was? The graphs showing changes in lab test were useful. I’m a Google user in many applications and yet I was unaware of Google Health until recently. There was no promotion to people in my position – the patient so, of course, there was no demand.

  • Neil Versel

    Actually, I agree on the hubris part. I blogged about it on my own site last week and may have more in a future MobiHealthNews commentary. http://www.meaningfulhitnews.com/2011/06/24/rip-google-health-doomed-to-fail-from-the-start/

  • Daniel

    Great article Brian, here is a bit more as well on the subject:
    http://blog.drchrono.com/2011/06/29/why-did-google-health-fail/

  • http://mi2.org Health Innovation

    Just to add one more piece to the discussion – There were lots of human factors elements missing… Simple fixes (one example of many) like switching the way meds are listed… Docs & nurses might be familiar with alphabetical lists of meds or listing by class of medication, but not patients.  Patients tend to list meds by time of day they take them.

    1. Marketing  2. Human factors  3. Trust

    You have to reach me (marketing). I have to trust you when you do (trust).  And once I take the plunge, it better be easy to use & forgiving/mistake tolerant (human factors).

  • Pingback: mPHR app switches from Google to HealthVault | mobihealthnews

  • How To Relieve

    and why Google Health will continue the service through January 1, 2012?

  • Guest

    test

  • http://www.wmmedcomm.com/ Wendy

    I disagree with one theory, the one where Dave Chase suggests targeting the doctor instead of the patient would have given GH a better chance to succeed. 

    I’ve been first a journalist and then a marketing consultant in health communications for over 20 years and can tell you GH probably would have failed faster if targeted towards doctors. I was in the audience when WebMD launched; those of us who’d been watching the growth of the Internet and pending Y2K in health care knew it wouldn’t work, since doctors weren’t using computers by and large and weren’t going to refurbish their offices with this major investment in hardware, software, and training.  WebMD recognized this: they said they were GIVING AWAY computers to a certain number of docs who signed on first. 

    Not a nibble. If the company hadn’t swiftly changed focus towards consumers, they would have died.

    There are times when direct-to-consumer is definitely your approach…and this should have been one of them. But with all the other obstacles listed here–lack of exec support, poor marketing, impossible insurance issues, misunderstanding their demographics–and who knows what else, there was no way for the system to succeed.

  • Adamsives

    G’day cobbers. I also believe that from my observations that Google Health relied upon Google making many many deals with many many health service providers. The  headache wouldn’t have been worth it.

    They also seemed to lack any governmental involvement (beside the obvious legal and regulatory compliances). Perhaps they would have had better luck if there were government mandatesincentives in the requirements gathering phase to ease provider engagement