Google Health and HealthVault – why and when it matters and to whom

Bill Crounse 2007 04HealthBlog readers know that I seldom turn over space on this blog to guest experts.  HealthBlog is very personal, and I like to keep it that way.  However, I also know that HealthBlog is widely read around the world.  There are topics and information you might not come across if I didn’t steer you just a bit.  So today, I break with tradition and provide a re-post on a very timely subject – the shutdown of Google Health and what it means to the industry.  But before I share what my colleague, Sean Nolan, the chief technology officer for Microsoft HealthVault, had to say in his Family Health Guy post, I wanted to add a thought or two of my own on this topic.

Ever since the announcement last week that Google would be shutting down Google Health, the blogosphere has been abuzz with opinions on why this is happening and what it means to the industry.  David Chase wrote a piece saying it was about the money, and the fact that clinicians don’t get reimbursed for doing much of anything except seeing patients in person or doing procedures in a medical office.  He blamed our perverse reimbursement system for the demise of Google Health and perhaps Google’s failure to engage the clinical community.  I agree, that may have been a miss.  However, I’ll also lay blame with consumers themselves, or rather a insurance system (public and private) that has pretty much disconnected consumers from their healthcare and created a kind of entitlement mentality in the broad population. 

imageI’ve said it before and I’ll say it again.  One thing I learned as a practicing physician is that most people simply don’t think or care much about their health until they, or a loved one, don’t have it anymore. This is particularly true of young people. Furthermore, when it comes to any kind of medical service, educational program, wellness or disease management solution, etc., most people expect someone else (insurance) to pay.  They are very resistant to spending their own money on anything related to their health because they tend to believe that their employer, insurance company, or government program should pay.  The only exception is what I call health vanity products and solutions (plastic surgery, fitness, beauty products, nutritional supplements, etc.) because historically these haven’t been covered by insurance so the “entitlement” factor isn’t as engrained.

With health reform, accountable care organizations, a challenged economy, and state and federal debt one thing is certain.  More and more of the cost of healthcare is going to be passed along to consumers.  They will have much more skin in the game.  When that happens, they are more likely to see the incentives associated with staying well.  Perhaps they will also make better, more informed choices about their care.  It is also expected that provider incentives will change as we move away from “fee for service” models of care to something that makes more sense for keeping people healthy.

There are needed changes on both sides of this equation before services like Google Health and HealthVault can really take off.  It is perhaps unfortunate that Google Health didn’t have the executive support and patience to stay in the game.  Thankfully, Microsoft is in health for the long-term.  As evidence, let me now provide some thoughtful advice and guidance from my colleague, Sean Nolan


Yes, thanks – we’ve heard about Google Health

Seems like everybody on the web (or at least in our little Healthcare corner of it) has an opinion on the news that Google Health is shutting down. Just in case you’re thinking about sending me the link --- yes, I’ve heard. 🙂

First off --- sincere thanks to Aaron, Adam, Missy, Paul, Marc, Crutcher, Alan, Eric, Alfred, and all the others over at Google who built a great service and fought hard for the idea that the only way to really fix healthcare is to consumerize it. There will continue to be plenty of short-term debates about privacy, data ownership, standards, etc., but ultimately it’s inevitable --- we’ll get there, and Google Health moved the ball forward.

Second --- what does this mean for HealthVault? The “buzz” online ranges wildly, but the real and simple answer is: nothing. As I said a few months ago, HealthVault is a key piece of our overall approach:

HealthVault is a critical component in our broader project strategy --- which is to (1) connect care across the ecosystem, from the home to the clinic to the hospital to the research lab, and (2) do so in a way that includes and encourages innovation from as many different organizations as possible.

Solving only the consumer side isn’t enough --- that’s why we have Microsoft Amalga on the enterprise side. Our two platforms combine to enable the transformative all-up story: enabling clinical integrations like and Medplus, home monitoring programs with Kaiser, CCF and UMass, and so on.

Anyways, in case you were worried, HealthVault is indeed alive and kicking. Everybody here is seeing a real uptick in momentum --- our recent mobile (by the way, the iOS library was just released --- Android super-soon now!) and imaging announcements have kicked off a ton of new innovation, MU-based exchange is heating up with Direct and Blue Button, we have more and more HealthVault-connected patient portals coming online, Facebook authentication seems to be a big hit … all signs point to “awesome.”

Now we’re looking forward to providing an ongoing home for folks that have worked with Google Health in the past. Some specifics about how to do that:

1. How USERS can move their Google Health information to HealthVault

The great news here is that the Google team has been working with us to ensure that migration is as simple and painless as possible. Google is based on the CCR standard, and HealthVault has the ability to import CCR-based documents, so it’s a pretty straightforward deal.

Google has detailed instructions for moving your profile data into HealthVault here.

For now, the process involves downloading your Google information as a special file called a “CCR” and then uploading that file to HealthVault where we’ll incorporate it into a new record there. It might make sense to create your HealthVault account first at The one thing to note is that you’ll have to move your “Files” separately from the rest of your information. To do this, just save the files to your desktop and then re-upload them using the “Add” button on the HealthVault Documents page.

The really cool thing is that, within a week or so, Google is launching a “one click” (well ok, a few clicks) transfer of both the CCR information and files using the Direct project secure messaging protocol. As soon as that’s ready, they’ll have instructions on their own health pages, and I’ll post a note here on the blog as well.

2. How DEVELOPERS can migrate their Google Health solutions to HealthVault

HealthVault was created so that developers could build great applications --- there’s a ton of documentation and reference materials on our MSDN site. From there, you can also download our .NET SDK and be running a “hello world” application against our test site within just a few minutes. That’s a great way to get your head around the platform, but it doesn’t mean you have to use .NET to integrate with HealthVault. There are open source integration libraries for just about every platform around (did I mention iOS and WP7?). A quick search will get you there --- drop me a note if you don’t find the one you’re looking for.

If your application integrates with Google by sending and retrieving CCR documents, you’ll find that converting it to work with HealthVault should be pretty painless. We can accept CCR uploads as well; users have the option to extract the individual items out into their record and/or leave them as discrete documents. You can also use platform-provided transforms to fetch information in CCR form as well.

A more interactive application will likely require a bit more work --- but we’re here to help. For business stuff, our BD team at is the way to start. On the technical side, the HealthVault forums are monitored both by professional support staff and our engineering team. We’re always up for a quick discussion about how to approach a problem, so don’t be shy.

We’ve gotten used to saying “you can do that with HealthVault or Google Health” --- it’ll take a while to get used to being out there more or less on our own. But that’s OK; we’re confident in our direction and are having a great time working to change the world. Remember --- just keep swimming!


Thank you, Sean.  I couldn’t have said it better!


Bill Crounse, MD                Senior Director, Worldwide Health                   Microsoft

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