Google (among other companies including Aetna and Microsoft) spent millions of dollars on the development of a model to move human health care toward a portable health record. This move is only possible because of open communication standards that are available in human medicine. Conversely, in veterinary medicine, we have few standards and are sinking further and further into a morass of proprietary methods of practice management integration. If this trend is allowed to continue, it will be difficult to move toward open standards much less a portable health record in the future.

An introduction to Google Health and online data repositories and and how they  could benefit veterinary medicine.

Google health is a Google service that give patients a place to store all of their health information online (a.k.a. in the Cloud).  This health information can be retrieved from any computer and, therefore, be made available to other hospitals and doctors. Although not without its critics, Google Health and similar services will ultimately facilitate patient control of their health record and holds the potential to improve the overall quality of healthcare.

To get an idea of how Google Health may help you (you are a human patient aren’t you) in the future:

• All of your health records will be online and available for future reference. What medication did I take? What vaccinations do I have/need?
• Create web links with information about disease disorders in your medical record. Create links to your doctors office.
  
• Give an early warning of medication interactions (prescribed by one doctor) that you might have forgotten to mention (to another doctors)
• move that information to new hospitals: no more filling out information every time you go to the doctor
• allow future physicians to have access to the medical records to offer a complete overview of  your  health status.
• researchers could (theoretically) use this information to perform research studies.  
• It is even possible that all imaging and lab studies could be stored in one place for future reference
  
  

It is critically important to understand that information sent to Google health is not entered manually. Rather, hospitals that utilize the Google health portal upload patient information (at the patients request) to the service through an automated interface (more on this later).

A similar endeavor in veterinary medicine would be of tremendous value.  In addition to the benefits to your client that Google Health offers, a  third party "cloud based" data repository could open up other opportunities for informaton transfer that could revolutionize the way we practice veterinary medicine. Consider these possibilities:

• What if you could send a referral to a veterinary hospital with a single click of the mouse and all patient records (including lab results and images) were sent immediately and then downloaded into the referral hospitals patient database?
• What if your referral reports and updates from a referral hospital could be downloaded directly into your practice management software as soon as they were available (similar to how some labs and practice management software work today)?
• What if teleradiology and lab reports could be sent directly back to your practice management software regardless of which teleradiology service or lab service you use?
• What is practice management vendors could use this interface to help you migrate information in and our of your practice managment database? 

Unfortunately, a lack of funding, cooperation, call from veterinarians, and initiative among practice management vendors, lab services, and teleradiology providers is preventing the development of a similar service in veterinary medicine. 

Open standards – why Google Health is possible in the first place

Google Health is made possible because there are open standards that can be used by practice management vendors and Google that will allow for the free and open transmission of patient data. Google health utilizes a subset of the CCR (continuity of care) standard for data interchange.

Without open standards, an endeavor such as Google Health is not possible. Google has huge resources but building proprietary bridges with every human hospital and every doctors office in order to connect with them would not be practical or possible.

Nonetheless, the impractical and impossible is what will be necessary in veterinary medicine because there is no significant movement toward the adoption or implementation of open standards in veterinary medicine that all vendors can use to transfer information in and out of practice managment software programs. 

In general, veterinary practice management software is a proprietary affaire and, with the exception of a few select cases, there is little use of open standards.  This situation is unlikely to change. According to John Moore, consultant with Chilmark Research (http://chilmarkresearch.com/) "it is up to veterinarians purchasing software to demand that vendors demonstrate interoperability and adoption of open standards. There is little motivation for vendors to do this. It actually works against their business model." 

Bottom Line: Veterinary medicine must curb the development of short sighted, proprietary “integrated” platforms and move toward the adoption of open standards. This will allow the profession to  implement effective integrated practice management solutions that create efficiency in the veterinary hospital and improve patient care.  This will require commitment and coordination between industry, the private sector, and veterinary governing bodes such as the AVMA and AAHA.

The trend toward open standards and integration will not happen until practice managment and lab services vendors hear the call from veterinarians for this type of functionality. 

NOTE: this is a very simplifed introduction to open standards and Google Health. There is significant competition on the human side between vendors seeking to offer a cloud based patient data repository. Google has also used a modified version of CCR wich has been described as a perversion of opepen standards.  Perhaps the only thing worse than a lack of standards is competing standards.