Google Health Chief Outlines Multi-Pronged Plan to Improve Healthcare

// By Jim Samuel //

How Google plans to use technology to improve patients’ lives around the world

As technology giants Google, Amazon, Microsoft, and others forge ahead with plans to improve healthcare, many in the industry are wondering just what they plan to do and how they plan to do it.

David Feinberg, MD, vice president of Google Health and former president and CEO of Geisinger in Pennsylvania, discussed Google’s plans during an interview session at the 2020 StartUp Health Festival in San Francisco in January. The festival is an annual gathering of more than 2,000 healthcare innovators and startup founders.

Google Health was created about a year ago to bring together different product areas within Google into a single unit. Feinberg says he is the only product lead at Google who is not an engineer. “They needed somebody who knew healthcare,” he explains. “There was an understanding that this is not simply a technological fix like Gmail.”

David Feinberg, MD, vice president of Google Health (left), discusses Google Health’s plans with Howard Krein, MD, PhD, chief medical officer of Startup Health (right).

According to Feinberg, Google Health plans to use its search technology, its data analytics ability, and its artificial intelligence capabilities to improve healthcare on multiple fronts.

“This was an opportunity to really improve people’s lives around the world,” says Feinberg, a psychiatrist by training, adding that he took the job after Google assured him that patients who use Google services would “be treated as if they are our patients.”

Quality and Authority Are Key to Google’s Success

Google already plays a significant role in healthcare for millions of people around the world, says Feinberg, explaining that 80 percent of the people who visit an emergency room (ER) complete a Google search within two weeks of that visit. “When you get a new diagnosis, you go to Google,” he says.

That’s why improving the accuracy and quality of information people get through a Google search is important.

“What we have to do, on the consumer piece in particular, is make sure the information is better,” says Feinberg, referring to articles and other medical references Google presents to users when they search for health and medical information on the search engine.

“We have to get the dangerous stuff off and make sure the quackery stuff is five or six pages down” in the search results Google presents, explains Feinberg. “We need to create an ecosystem that has more authoritative information so that when you go to Google, you get three things you should bring in to discuss with your doctor, not send you off on a wild goose chase.”

Finding EHR Data Can Be More Like a Google Search

Any clinician who has tried to find a specific piece of patient data in an electronic health records (EHR) system knows how difficult that can be. But what if searching for data in an EHR were as simple as a Google search?

That was the question that led to Google’s recent but controversial partnership with Ascension Health. That partnership, which drew scrutiny from the media and government officials, came after Ascension asked Google to help it better organize patient data at two of its hospitals.

The technology giant went to work and when the project was finished, doctors and nurses at the two hospitals could search their patient’s record using the familiar Google search bar.

“As a practicing physician, if you go into these health systems, it’s like finding a needle in a haystack to try to find a piece of information,” Feinberg says. “We brought the Google technology of search and created a unified platform for doctors and nurses at two hospitals to search their patient’s individual record.”

Feinberg says that despite the negative media coverage of its work with Ascension, he remains “super proud” of what the company accomplished and that there was no intent or ability to use data for any other purpose.

“All we did was organize the record. We just put it in a way that is searchable,” he says. “We think organizing records where doctors are now free to spend time talking to patients so they don’t repeat the test that they can’t find is actually really powerful.”

While Google’s search technology may appear to be revolutionary in healthcare, it is commonplace in other industries and applications around the world. Feinberg says, “It’s amazing when you are in healthcare and you see it. People outside of healthcare, they’re like, ‘Wait a minute, that’s how everything works.’ It’s not that way in healthcare.”

Much of the concern among the media and government authorities over Google’s deal with Ascension centered on the ability of Google and its employees to access patient data. Feinberg says that patient data from Ascension is encrypted before it even reaches Google’s cloud storage, and remains encrypted while it is there. Ascension Health, like many health systems, stores data in the cloud and has chosen Google’s Cloud Platform.

“There may be times when some Google employees are exposed to some patient information,” Feinberg acknowledges. To do that, those Google employees have been trained in HIPAA compliance, and Google has a business associate agreement in place with Ascension.

Using Machine Learning for Diagnostic and Predictive Healthcare

Google Health is also working to use its machine learning capabilities to help doctors improve the accuracy of diagnostic imaging, as well as provide predictive diagnostics that can help clinicians prevent disease among their patients.

One example is Google’s success with using machine learning to accurately read mammograms. “We just published an article in Nature earlier this year on our mammography work,” says Feinberg. In that work, Google compared the results of machine learning on mammograms to the work of doctors from six academic medical centers in the United States.

“We also gave the doctors those women’s previous mammograms, access to the electronic health record, genetic information, and in some cases, they had MRIs of the breast. We just had the day’s mammography,” explains Feinberg.

The results showed that Google’s technology achieved a 9 percent decrease in false positives and a 5 percent decrease in false negatives. In the United States, he says, over a 10-year period, 50 percent of women will have a false positive reading of a mammogram. In addition, there were also cases in which a doctor said a woman’s mammogram looked normal, but Google was able to detect Stage 1 cancer.

Feinberg says Google’s technology is not intended to replace doctors but instead to help them provide better care for patients. “The docs made mistakes. The computer made mistakes. The best results are the combo of doctors and technology,” he says.

Google technology is not limited to mammography. The company is now performing diabetic retinopathy screening in Thailand and India and is outperforming ophthalmologists there. Among the capabilities of Google’s retinopathy screening system, Feinberg says, are its ability to detect hemoglobin A1C levels, blood pressure, cardiovascular risk factors, and risk factors for cognitive issues like Alzheimer’s.

“When you combine the retina picture with EHR information, with genetic information, you have even better ways to improve diagnostic accuracy,” Feinberg says. “There’s magic in those pixels.”

Google is also working to help physicians predict the onset of disease. A Google team in London, for example, developed an app that monitors a patient’s creatinine levels. Creatinine levels are a measure of kidney function so when a patient’s levels go up, the app sends clinicians a warning to check on the patient.

Feinberg reports that in the United Kingdom, the app took the time of diagnosing acute kidney injury from four hours to 14 minutes, decreased the cost of care by 17 percent, and that 30 percent fewer patients experienced cardiac arrest.

Making It All Work

Feinberg says that no matter how good the technology, the key to gaining acceptance in healthcare is trust. Earning that trust means working directly with clinicians and caregivers, including doctors, nurses, social workers, and people who are caring for their own families at home.

“We have to make it easy for all these people to become super caregivers. We have to act in a humble way. We have to act in a caring way,” he says, adding that Google is “focused on understanding what people need.”

Google Health’s goal is to make life better for people around the world. “The power is unbelievable in how we can improve the lives of billions of people,” Feinberg concludes.

Jim Samuel is a writer who has extensive experience working in the healthcare industry. He is based in Philadelphia and has worked for some of the nation’s largest healthcare corporations as well as regional health systems. Email him at jim@jwsamuel.com.