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Scott Shreeve, MD

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I'm the CEO of Crossover Health, a patient-centered, membership-based medical group that is redesigning the practice, delivery, and experience of health care. We offer urgent, primary, and online care to our members who can access our technology platform, practice model, and provider network from anywhere and anytime to optimize their health. Email Me



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Getting Giga Over Google (Again)

Giga (gĭg ‘ə) n.

  1. Metric prefix denoting multiplication by 109 or 1,000,000,000.
  2. In measuring the capacity of computer disks and RAM, equivalent to X 230 or 1,073,741,824.
  3. In California surf slang for something that is totally gnarlatious.

OK . . . enough already . . . regarding Google, Micro$oft, Privacy, and for sure Deborah Peel. It is a tiresome, circular circus of announcements, concerns from pundits, and hang wringing by the neighsaying yes-crowd (or the “no” crowd as the case may be). The bottom line is that the big boys have been circling this arena for a long time, and after smelling blood all those years, they have decided to take their first bites. While the remoras fight over the irrelevant table scraps, these first bits dig into the whale of a health care problem that we are facing. I for one, think it is pretty cool.

Having watched the inevitable Microsoft vs. Google war taking shape for several years, I find it interesting that a major skirmish line is being drawn in the health care sector. With the recent announcement of Amalga, which as the name implies, is a culmination of several recent acquisitions, Microsoft is fulfilling their promise made last year during the keynote that they are “going to fully apply” all their resources into solving the health care IT problem. Building on that pledge, Microsoft has upped the ante with their still recent HealthVault announcement, and subsequent and surprising announcement that they are going to “open source” their framework, release API’s specifications, and even fund startup projects as part of their Be Well fund.

All of this is prelude, of course, to the real battle which will be in search. We have already seen the troop level increase” with Microsoft’s hostile take over attempt of Yahoo. Get ready for the oncoming battle of the bulge . . . but we can let that simmer because it is “game on” in the health care battle right now. Google vs. Microsoft in PHR right now in prime time. Let’s get ready to ruuuuuuuuuuummmble!

My prediction: Google by a long shot. A really long, interconnected, collaborative, collective intelligence, networked kind of aggregated intelligence kind of a shot.

Look, Microsoft is an application company. As such, they have dominated the computing industry hand over foot for two decades (which could be considered centuries in other industries). Microsoft placed an incredibly profitable bet back in the early 80’s when they understood that by controlling the commodity operating system, they could control all the proprietary applications that would eventually be built. Controlling the applications meant that they could control the dollar flow, the upgrade cycle, and the proverbial versioning game. Ruthlessly, profitably, and in near monopolistic fashion.

However, just as they were late to the internet, they are late to another form of sea change within computing: the NETWORK. I have written about networks frequently recently, having only really understood their potential within the last six months. Sun was rightthe network has become the computer (O’Reilly rocks – this was written in 2000!). No longer do I need applications, in fact, I don’t even care about the applications because I they all reside on the network somewhere. I don’t have any version issues, storage issues, configuration issues – I plug and play; anytime, anywhere. This is incredibly powerful paradigm.

This whole PHR thing sets up an interesting contrast for the larger issue of who would I trust with my health data. Let me start with a few general comparisons in terms of my perceptions in working with these two companies (as it relates to how I think each would manage my personal health information):




Trust Check

Branding Check

Ease of Use Check

Speed to Market Check

Next Order Thinking Check

Make My Life Simpler


My personal analysis of the metrics that matter to me in assessing which platform I would be willing to use for my personal health information.

So after all the hype about the Google PHR, I was actually able to see it and test drive it out yesteday at HIMSS. Congratulation to Roni Zeigler, Missy Krasner, and even Marissa Mayer (who still has not responded to me) for getting this out under extreme market “interest”. The Google PHR has the expected simple but intuitive interface, does exactly what you would expect in terms of functionality with the screen shots you have seen, and with all the seamless integration you would expect: G-mail, Google Calendar, Google Maps, Google Search, Google Alerts, Google Reader, etc. There is medication alerts, built in medical conditions, demographic information, and care coordinator contacts lists. It is currently missing ability to upload images/documents, import laboratory feeds, and several other essential features/functionality. However, as with everything else Google has ever done, you know it is coming in the constant iterations that will inevitably flow.

What an easy, and natural extension, to incorporate my personal health information to an the same entity that already manages the rest of my life. While this has some potential scary undertones, it is far scarier to me to think of the folks in Redmon managing my data and my life in this way. Microsofts bad behavior over the years, the unnecessary bullying, open taunting, stifling of innovation, orientation toward control, and focus on the proprietary, is going to return to haunt them in a very big, and very unfortunate way.

Think about the above for just a minute . . . nearly my entire productive professional life is being managed by Google. On a remote network. For free. Whoa.

So while the hype dust still needs to settle, I remain Giga over Google’s health care prospects.

5 comments on “Getting Giga Over Google (Again)

  1. DrBonis says:

    People is really sensible to the confidentiality of their medical data. It is critical information.

    The danger with Google Health and HealthVault is that somebody in the future crack their security systems.

    Also the fact about a private company getting data about your health must concern us.

    There is an alternative,, designed by the doctor that described the first case of Wiiitis, its philosophy is based on total anonymous users. A smart mechanism allows the store of clinical record without asking you any personal data (not even your email).

    Confidentiality is in such a way assured.

  2. scottshreeve says:

    Run this statement through your same perspective:

    “The danger with Wells Fargo and Bank of America on line banking efforts is that somebody will crack their security in the future. The fact that they are a private company getting data about your finances must concern us. ”

    The privacy argument as a rate limiting factor in my mind is non-sensical. I feel confident that WF/BofA have completed abstracted that as a concern of mine. In addition, this argument should be muted by the fact that more than 50M US Citizens currently use online banking, and 50% of those use it every week. It is the killer app of the internet and our familiarity, comfort, and even confidence in security measures should translate well with health care data.

    Clearly, we need to be cautious, but I am more than optimistic that financial services has blazed an very wide path that health care services can follow in these areas.

    Unclear on how Keyose security provides me any additional comfort through the use of non personal log in information. Send me some more information regarding it please and would be happy to check it out.

  3. John says:

    Scott, in full agreement with you on the privacy issue and find it more of a red herring and a stinky one at that thrown out there by the press because frankly, they do not know how to talk about the deeper issues that pertain to consumer control of their medical records.

    But I do disagree with your overall analysis of Google vs. Microsoft and like you, I use Google to run a lot of the operations of my small, but growing operations. Google is a great platform!

    Google has some real attributes that Microsoft is still struggling to adopt without cannibalizing its core business. In consumer healthcare though, MS is starting with a clean slate and we are far from seeing this whole story completely play out. Hell, we don’t even know how it will begin as there are a number of ways/business models that these two 800 pound gorillas may deploy in this sector for this sector is still very, VERY young.

    And each of them will struggle with getting that all important digital data in some automatic fashion to populate a consumer’s health record. This digital data, when you can even find it, is sorely lacking and more sorely stored within provider practices. How these two companies crack that nut will be interesting to watch. BTW, I have asked both of them about this issue and would argue that MS is well ahead of Google on tackling this critical issue.

    These are just a some issues and I haven’t even started on Dossia, HIEs, RHIOs and health banks, which throws a whole other angle to this story.

    Bottom-line, we have a very long ways to go and it is far too early to begin picking winners or for that matter, who is in the best position to win.

    As an FYI, did my own review over at and like you will continue to follow this closely as it is EXTREMELY interesting and it WILL have a major impact on healthcare that even in our broadest imaginations, I do not think we can yet fully grasp.

  4. John,

    Thanks for your comments. Please see my most recent post: “Microsoft Aims for the Clouds”

    I think you are onto something.

    The whole Microsoft thing is about to go non-linear.

    Late to the ‘net, late to the cloud . . . but deeper pockets than anyone in our galaxy.

    Monkey boy about to go whole hog open source . . . is it freezing somewhere?

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