Google Health brings in a new dimension to the ever growing search for finding a solution for storage, management and distribution of Electronic Medical Records (EMR).

Until so far the onus of managing a health record was the responsibility of the care provider or hospital. But now with Google Health patients would be able to access, organize and manage their health records. It allows the patient to gather this information from participating hospitals, physicians, and pharmacies and store them at a single place and also provides them with the capability to share this information with different physicians and hospitals. The success of such as system depends on the interoperability between the disparate applications used by Care Providers, Hospitals, Pharmacies and Payers.

Health Information Exchanges (HIE) and Regional Health Information Organizations (RHIO) attempts to do the same thing. Many hospitals have successfully implemented or are in the process of implementing such a system.

In one of the hospitals networks I was involved with, there were many challenges in implementing such a system.

a)      To begin with, the basic patient information was distributed among these hospitals, and quite often the same patient would have visited multiple hospitals, hence there could be duplicate patient information. Creating a unified Master Patient Index (MPI) using such data was a project in itself. After this a Record Locator Service had to be created to query and identify a patient using a deterministic or a probabilistic match using one or several patient variables such as SSN, driver’s license number, DofB, address, or any other demographic profile that uniquely identifies a patient.

b)      Once this was done, there was a challenge of physician authentication to access this data. Since the data was stored in different hospitals, and each hospital had their own user authentication system, a SSO solution was necessary to eliminate multiple logins.

c)      After this there was a challenge of identifying which physician gets to see what patient data. How could Lab ordering and Lab data or electronic prescription and fulfillment data be automatically associated with patient? And how can physicians communicate between themselves securely and use this data meaningfully in their diagnosis?

d)     Finally how to make this model scalable, beyond a few hospitals who participate in a regional alliance - RHIO ultimately was purely based on asynchronous messaging using a common protocol. The HL7 standards provide a good framework and XML formats for common data exchange.

If Google Health is able to fulfill all of the above functional capabilities, including building a larger network and is able to rope in more Care Providers, Hospitals, Payers and Patients, then it has the potential to revolutionize the Health Industry by providing a common framework for storage and exchange of health data, and possibly an alternative to RHIO and HIE.