In an interview, Mr. Scriban said HealthVault, which is also free to consumers, tries to solve one of the most frustrating health issues for ordinary people: fragmentation. “Fragmentation of delivery of care has a lot to do with fragmentation of someone's health care identity. Everybody's health care identity is spread around in little slices in different sectors. The employer has some information, various doctors have others, hospitals and payers and pharmacies have still others. The ideal is to have all one's information, presentable and portable and useful to any and all providers,” Mr. Scriban said.
Essentially, HealthVault is a consumer-controlled hub for gathering and controlling information from various sectors of a person's “health care ecosystem.”
Mr. Scriban said that he understands that some physicians get nervous at the thought of patients in control of their own medical records. But he believes that systems like HealthVault and Google Health are really just systematizing what already happens informally.
“When a patient gets a referral from one doctor to another, it is really that patient who acts as an information transporter, telling the new doctor his or her medical history, medication use, and in some cases actually transferring paper records,” he said.
HealthVault tries to standardize, stabilize, and formalize that process, and Mr. Scriban contends that this will reduce errors, prevent loss of important information, eliminate redundancy, and give physicians a fuller picture of their patients' health. He added that HealthVault is being designed to interface with many different electronic medical records systems. He said that he hopes that as more patients create PHRs, more doctors will see the ultimate value in interconnectivity.
HealthVault and Google Health are similar in many respects.
“Both are backed by large companies with a lot of resources; [both companies] have looked at the same problem and arrived at similar conclusions. One conclusion is that you cannot revolutionize health care in one big step. The other is that the consumer is really the agent of change in all of this,” Mr. Scriban said.
Still, there are some differences. He stressed that Microsoft is primarily focused on enabling people to manage their health information, and less engaged in providing self-care tools, something that Google is pursuing.
Although it is natural to view the current landscape as a clash of the IT titans, Mr. Scriban thinks that view is overstated. “In the end, we're really glad that Google has joined us in attempting to deal with the problems of personal health information management. I don't think it's really a Google vs. Microsoft scenario. It's more like Google, Microsoft, and all of us who are involved in PHRs and EHRs versus paper!”
Google and Microsoft are engaged in lining up partners across the health care landscape, including insurers and managed care plans, information service providers, medical organizations, and patient advocacy groups.
Microsoft recently partnered with Kaiser Permanente, an integrated health plan with more than 8 million members, to test the transfer of data from Kaiser's personal health record into HealthVault. The pilot project, launched last month, is open to Kaiser's 159,000 employees. The idea is to combine the clinical data entered by Kaiser physicians, which are available in the Kaiser personal health record, with patient-entered health information and clinical information from providers outside of the Kaiser system.
“Providing new ways to manage their health online is one more way we can engage consumers in their care,” Anna-Lisa Silvestre, vice president of online services at Kaiser Permanente, said in a statement. “We believe that Microsoft HealthVault will be a valuable supplement to our expanding set of online features.”
Kaiser officials plan to reevaluate the pilot later in the year before expanding it to Kaiser members.
Google's Mr. Wiseman said it is particularly important to create alliances with health plans. “A lot of people won't use Google Health unless their health plans support it.” Google's other major focus is on consumer decision support tools.
Among Google Health's new partners is HealthGrades, the private company that has quietly emerged as the leader in online physician and hospital ratings. HealthGrades uses publicly available data on quality outcomes based on 32 standardized procedures and health conditions to grade physician and hospital performance. The ratings parameters are based on work done by the National Quality Forum.
“HealthGrades' mission is to guide Americans to better health care,” said Dr. Samantha Collier, chief medical officer of HealthGrades. “There are enormous gaps between what we know we could do and should do, and what actually happens in health care. There are vast gaps between the best and worst hospitals and clinics.”