The words “Demise” and “Resurrection” are clear contradictions in terms just as are the phrases “Kim Kardashian” and “Reality TV Actress.”  But that is exactly what Google unexpectedly ran into with its Google Health Initiative.  What started out as a seemingly hopeful Brand Extension into the “can’t miss” social media healthcare industry, which, let’s face it, is ripe with financial and growth opportunities for a savvy, behemoth company like Google, slowly morphed into that situation in high school when you bring your unbeatable 5-man hoops squad from the local Suburban Community Center into the big city to test its mettle against pick-up teams in the playground who leave no doubt as to the street smarts required to rule the game of basketball in the city streets, where the rims have no nets and even the little guys can jam the basketball.  Even your team’s leader, the tough, rebounding 6’10” Center with soft hands and a great shot gets painfully schooled by quicker Guards who aren’t nearly as tall or as talented but they understand the “hustle” of the game.  They “get” that winning is the only thing and participating with the better players on paper is useless without understanding the lay of the concrete courts.

Google Health had no idea that the profits hidden in all mainstream healthcare ventures lie in the gross inefficiencies hidden by the Health Insurers via Oil Cartel-like business practices with assistance from regulators who also benefit in one way or another.  These secret healthcare money-making practices and companies are guarded with such deep and formidable political cover that is only rivaled by the way in which Hollywood has convinced a global audience that Kim Kardashian is even a celebrity.  I think Google Health figured this out a little too late during the “Google Health 1.0” Initiative or somewhere around the 7th pick-up game of the day when even Ken Howard would have forced his “White Shadow” basketball team to pack it in to re-tool in order to fight another day. But “Coolidge” and “Salami” would live to come back another day to teach these playground players that a true “Team” with a well-executed and practiced plan can overcome even the biggest of odds.  After all, it was a TV Show which always ended with a message.

But who would have ever thought that with all its accomplishments on the web that Google would miscalculate a “David & Goliath” competition when they are actually “the David” and some Health Insurers “the Goliath”?  Sure, there’s more to Google Health’s recent demise but conceptually I think this is what Google learned and just like Coolidge and Salami, they will be back because how many other business situations with such big upsides will they be placed in the underdog role fighting for Right in an industry such as healthcare where their success is sorely needed to change the status quo and bring about meaningful healthcare reform?  I can’t think of any unless they decide to contribute to solving our national debt crisis.

Most medical professionals believe that all healthcare-related web initiatives are doomed to fail unless clinicians or other licensed medical personnel are a visible and significant part of the plan for roll-out, development and profitability.  This would seem to be an insurmountable barrier to enter the market for a company like Google Health which provided a Patient-Dedicated Service which stored and organized Medical Records. However, with the advent of “Health Care Social Media,” or “HCSM,” as it is frequently referred to as an acronym, something unique is developing on the web with healthcare involving Patients; and Patients only.  More specifically, as I learn more about HCSM, I think Chronic Patients like me yield a great deal of Influence in these healthcare web initiatives such that when a company as large, powerful and resourceful as Google gets flustered by not factoring this into their business plan and that miscalculation jeopardizes their entire healthcare initiative, this influential role of Patients in HCSM  needs to be examined and more carefully integrated into the business plan.

The fact is that Licensed Medical Professionals cannot yet participate in HCSM on a clinical individual Patient Care basis as their Licensure Boards, no matter how skilled, can’t keep up with the speed of Social Media.  This frustrating reality is applicable no matter how well intending these Doctors and Psychologists are with respect to branching out for the sake of being accessible for their Patients, and most are that selfless with what would be even more of a drain on their most precious of limited resources,namely, time.  As a result, they would leave themselves vulnerable to too many ethical, legal and moral cases of First Impression.  The smart ones heed the warnings of their attorneys and simply use HCSM to educate their Patients about new developments that affect their Patient Care and Patient populations.  Others use HCSM strictly for marketing purposes.  But some are also prematurely talking about ROI (i.e., “Return on Investment”) with respect to HCSM and thus trying to monetize HCSM before they even understand it.  However, as Apple Computer, Inc. taught us, we need to let the wine age a bit, the market define itself, then try to monetize it.

But lest we not forget that we are mostly talking about Doctors here, so they are bound to make the same mistakes their arrogant and greedy record company executive brethren made when faced with the same apparent opportunities to which Recording Artists, and in this case, Patients, also lay claim.  Although, I sincerely hope not because the younger Doctors I have been privileged to meet in the various virtual HCSM functions I have “attended” are SO SHARP and seem SO DEDICATED to Patient Care and to realistically regulating the Health Insurers who operate within the Health Insurance Industry utilizing the same unconcerned community-minded approach as the Oil Cartels that I am doing all I can to help them play a vital role in the development and growth of HCSM (and thus the emergence and re-emergence of Patient Medical Record Organization and Storage Services like Google Health).

To understand why HCSM is strictly a Patient-Driven Medium, you need to know that the only constraint on Patients sharing information and experiences with one another in HCSM is their own respective Privacy tolerance levels.  Personally, I don’t mind the world knowing that I have the incurable and auto-immune illness, Crohn’s Disease, and as a result, I have been hospitalized over 200 times and operated on almost 20 times.  I even wrote a Book about it called “Confessions of a Professional Hospital Patient” with the hope that others could learn from me sharing my information, experiences and lessons learned as I thought THAT was the Medium to disseminate all that I had learned.  A Service like Google Health offered Patients a place to safely aggregate their medical information so that it could be accessed easily by Medical Facilities and Medical Professionals all over the world thus freeing up Chronic Patients to live their lives to the fullest and never having to worry that a skiing accident in some faraway land could wind up a medical disaster where they would have to explain their unique medical condition to Doctors who speak a different language.  Even more important, a Service like Google Health would breed confidence in this type of Chronic Patient so that he or she actually goes on that trip or relocates to another city for a great new job opportunity without fear of being separated from their medical records.

An increasing amount of Patients understand the possible, if not probable, privacy tradeoffs to sharing their information and experiences in exchange for the same about their present health problem.  When they do so, they are creating Virtual Patient “Communities” of Empowered and Informed Patients with shared illnesses, symptoms, medications, complications, side effects, etc. When these Informed Patients tap into this almost instantaneous database of empowerment and consult with their real-life Physicians, the interaction is quicker, it is less intimidating for the Patient, the Patient Care becomes more collaborative in nature, and the overall Consumer Transaction is both more efficient and cost effective.  Amazingly, not one Clinician or Licensed Medical Professional was involved with the foregoing explanation of how a Service like Google Health would help in the transformation of “Patient 1.0” into the new “Google Health Empowered & Informed Patient 2.0.”  Accordingly, while it would seem counter-intuitive that Clinicians need be present to lend authenticity to a web healthcare venture, HCSM says differently and it is this underestimation which hurt Google Health.  In essence, what Google Health lacked was a modern-day Grassroots Marketing Campaign by Patients touting how useful the Service is to Chronically Ill Patients, for example, who can now travel the world knowing that all of their medical records are in one place and they need not wait for standardized Electronic Medical Records (“EMRs”) to be adopted worldwide.  And these days, Grassroots Marketing is akin to Social Media and thus it is powered by technology so it won’t take long for other Patients to get this message and find benefits of their own in these types of Services. Then, amazingly, medical professionals will come on board because that is where their Consumer Patients are.  Remember, ROI?

Therefore, the only ones dominating the HCSM playing field are Patients sharing information and experiences with other Patients for the betterment of their own Treatment as well as for the betterment of overall Healthcare.  This Patient empowerment will have a trickle-down effect which will be the Game-Changer we have all been waiting for in healthcare.   It is not going to happen as a result of healthcare reform as our political party system won’t permit the necessary changes without the other side neutralizing the effectiveness of any positive reforms.  But there is precedent for this type of success involving counter-intuitive traditional Grassroots Marketing effectuating broad-sweeping industry changes and in all places and industries it was set by a band in the Music Industry called “The Grateful Dead.”  As a result, they are one of the top grossing concert acts of all-time and they did it “acoustically,” i.e., without Technology, just Grassroots Word-of-Mouth.   Think about the influence and power of Patients utilizing the jet stream-like growth of HCSM to publicize Services like Google Health.  For the first time in many years, healthcare would then become an industry as hip as the Mobile Phone or Computer industries and that will attract top-notch employee talent and it will strongly incentivize  Physicians and Hospitals to enter into local Provider Agreements with the demographically appropriate Patients in the Google Health-type Service.  On the face of it, it appears that by just having Patients advocating a “Google Health” type quality Service within HCSM and having that Service follow The Grateful Dead business model we Patients will help bring about the changes in healthcare we have sought for so long.   Who else but Patients should be doing this anyway?

In terms of brief background on The Grateful Dead, while other bands saw touring and playing live concerts as an expensive and never-ending personal-demon filled global road trip experience that only served to market their latest albums/CDs, The Grateful Dead turned that business model on its head and instead built up their live concerts into their primary revenue-generating vehicle.  Therefore, their investment in encouraging fans to tape concerts and share them with one another created unique commodities such that if they played 300 different concerts in a given year then they had 300 Unique Products for that year. They also redefined “Community” as not just a “Place” but more as a destination where a fan could meet other fans and partake in experiences they both enjoyed and this included the purchasing of Grateful Dead Merchandise, another huge revenue-source. The “Suits” (i.e., the record company executives who always think they know best how to market an artist’s music) were concerned that encouraging the free swapping of live Grateful Dead concerts would cannibalize Grateful Dead album/cd sales but they completely missed what was really happening.  The Grateful Dead were sharing their music with the world in effect telling fans, “Check it out.  That is what we sound like when you come to see us play Live.  Stay in touch with us and when we come to your town, tell all your  friends, then come out and watch us play.  Better yet, come along for the ride and you can experience that sound in cites all over the world and you’ll be hanging out with people just like yourself who also enjoy how they feel when they listen to our music.”  A “Suit” can’t communicate all that in a Marketing Campaign.  Only a FAN CAN DO THAT, just like only a Patient can truly promote the benefits of a Service like Google Health.

Therein lies the rub, as they say, with Google Health, because the value of that Service to Patients is almost limitless and there are various Physician Practice and Hospital Provider Integrations possible within the demographically desirable Google Health EMR-like database (but, of course, only with the Patient’s prior consent).  Therefore, Google Health needs to get its Patient-Consumers to tout its Service so that it gets picked up by the powerful HCSM “winds of change” and becomes the norm for Patients whose most effective tool against the barrage of medical paperwork, appeals, prior authorizations, submission of claims, appeal of claims, etc. is Organization.  Unfortunately, in the most recent “Patient 1.0” version of Google Health they measured their progress and charted their course by the more traditional standards, and did not invest enough time and they undervalued the use of Patients as Testimonial Marketers.  At the same time, again by utilizing the “same old, same old,” they also overestimated the acceptance of, and participation in, the Service by medical practices as if that were some touchstone of success.  Remember, HCSM is a Patient-Driven Medium so catering to the Physician crowd instead of the Patient population is like going through the Oscar “Best Actress” eligibility rules with Kim Kardasian.  There is some cosmic rationale to that conversation, and she’s gorgeous so there’s that, but unless she marries a guy named “Oscar,” she will never utter that word when discussing business and her career.  (To Ms. Kardashian’s credit, she is a VERY bright business woman who also knows this and she knows exactly who her audience is and thus who she must cater to. Services like Google Health who tap into HCSM must do the same.   Physicians and Hospitals will follow in due time.)

It took the banking industry a long time to gain widespread internet acceptance such that busy people now pay their bills on line routinely.  So now with the internet being an integral part of everyday life and HCSM being an insulated Patient-Driven movement, all a Service like Google Health has to do is re-launch with the street smarts Coolidge and Salami learned from their foray into the city playgrounds playing hoops and start a Patient Grassroots campaign run through HCSM.  Once challenged by a formidable opponent as dominate as Google, the political and regulatory hassles of hiding the aforementioned gross inefficiencies in its healthcare insurance business will outweigh the financial gain guaranteed by operating as De Facto Oil Cartels and this will make these Oil Cartel-like Health Insurers blink.  That’s why we need a company the size of “Google” to get into this industry as the Government will never be a viable player due to the ever-present potential for political influence. Once HCSM exposes these gross inefficiencies through Patent Communities and Empowered Patients, which incidentally are as closely guarded by these Health Insurer/De Facto Oil Cartels as that of the acting talents of Kim Kardashian,  that’s when Hospitals and Physicians will get fully in the Game and THEN Services like Google Health will be the NORM and our Healthcare System will be truly Reformed.