Google Goes to the Doc's Office

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"What Martin [Harris] has done is revolutionary," says Wallace of the National Alliance for Health Information Technology. "It may not be the perfect solution, but it is a better solution than we have now." Over time, more information can be added, and more patients and doctors will be able to access the records. And if the pilot program works, Google intends to roll out a comparable service for the general public.

One payoff: cutting health-care costs. "There's a real potential to affect the slope of the health-care cost curve," Harris says. "I believe this kind of exchange is the way we will get the total value out of an electronic medical record."

Projects like the one started by Cleveland and Google could also have big implications for business. Companies want employees to take greater charge of their health care. Experts say employees can do a better job of that by gaining control over—and access to—records, and that they'll get a leg up, technology-wise, from the participation of such players as Google and Microsoft (MSFT). "I think Google is spectacular on this," Wallace says. "Health care is a mainstream issue, and getting the purveyors of information involved in this is a brilliant step."

What's In It for Google?

How the e-health program plays out for Google is less clear. Mountain View (Calif.)-based Google is not the first high-tech giant to dip a toe into health care. Microsoft, for example, launched a health records and information service, HealthVault, in October (BusinessWeek.com, 10/4/07). The company has more than 100 partners including the Mayo Clinic, a nonprofit medical practice and large online health-information network, and hopes to use its large health software business to help bring new players on board.

On Feb. 20, the company released source code to help outside organizations and developers integrate their information and build programs around the HealthVault platform. "We think that we are the best health search out there, and we think more and more we are going to convince people of that," Sean Nolan, HealthVault's chief architect.

Being late to the game has hurt Google in the past. The company's finance site, launched May, 2006, has failed to gain much traction. It ranks 16th in the business information category of Hitwise, a company that measures Web traffic. Yahoo's (YHOO) much older finance site has remained No. 1 for much of the past three years. Similarly, Google's payment service Google Checkout (BusinessWeek.com, 7/10/06), launched in June, 2006, has failed to grab market share from eBay's (EBAY) leading payments service, PayPal .

Thorny Privacy Issues

When it comes to online health information, the obvious prize is the estimated $500 million to $1 billion health search advertising. Google won't admit to aiming for that market, though, and those familiar with the project suggest revenue could come from other sources. "They aren't wedded to advertising," Wallace says. "Their attitude is that this is such a nascent area, they can play around for a while and find a way to make huge amounts of money." It's not yet clear how that might happen. "The unanswered question is what is the business model that justifies the investment of these big players," says David Lansky, senior director of the health program at the John and Mary R. Markle Foundation, a nonprofit dedicated to improving information technology in health care.

One worry is that the companies might be tempted to sell personal information. While strict laws govern patient privacy at hospitals and health-care providers, "there is no federal regulation of what these middle-layer players can do with your data," Lansky explains. And while consumers might trust Google or Microsoft now, what might happen in years or decades? "This is deeply personal information that is being collected about you and your family," says Jeff Chester, executive director of the Center for Digital Democracy. "There is unease about marketers being able to access that vast range of information."

Carey is a senior correspondent for BusinessWeek in Washington . Holahan is a writer for BusinessWeek.com in New York .