Beth Israel halts sending insurance data to Google

Hospital admits 'mistake' as flaws in practice found

By Lisa Wangsness
Globe Staff / April 18, 2009
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WASHINGTON - Beth Israel Deaconess Medical Center's top technology executive acknowledged yesterday it was "a mistake" to send insurance claims data to Google Health as a way of summarizing patients' medical histories and discontinued the practice as of yesterday.

Beth Israel is one of many hospitals and insurers that send claims data to Google Health's "personal health records," which let people keep all their records of medications, allergies, and illnesses in a single file that is easily accessible over the Internet.

But as the Globe reported last week, claims data is prone to inaccuracies, particularly for patients with complex health problems. When Dave deBronkart, a 59-year-old kidney cancer survivor from Nashua, tried to move his Beth Israel records into his Google Health file recently, the list of conditions in his new Google record included serious diagnoses he had never received from his doctors, such as the spread of his cancer to his brain or spine and an aortic aneurysm. Dates were also missing or wrong.

Such inaccuracies could lead to medical errors if doctors make decisions based on bad information, medical technology specialists say.

Beth Israel will now send Google lists of patients' medical problems from clinical records, said Dr. John Halamka, Beth Israel's chief information officer, who spoke at length with deBronkart, his doctor, Daniel Z. Sands, and Google officials about deBronkart's case this week.

"It's clear from our discussions that sharing billing data with patients is unreliable for clinical history, and it was a mistake to do that," Halamka wrote on his blog ( yesterday morning.

Google Health directed questions to Dr. Roni Zeiger, a product manager for the company, who wrote in an e-mail to the Globe that Google would continue to let each of its partners determine the best way to send patient records to Google. He said they would work together to improve the quality of the information.

"I am certain that Dave and others like him will continue to teach us what's broken and what can be done better," the e-mail said. "Our job is to listen and improve Google Health based on what users teach us."

Insurers require clinicians to provide a coded diagnosis to justify reimbursement for every visit, test, and procedure. The coding language is not always precise enough to describe a patient's actual problem. Doctors also sometimes provide insurers with the code for the very disease they hope a test or procedure will rule out.

Google Health likes its clinical partners to send lists of each patient's problems in a coded format so the website can refer patients to additional information about their conditions using links to other medical websites.

Halamka said Google will immediately be able to provide links to websites with additional disease information for about 70 percent of the medical terms in the hospital's clinical records, which are written in a mix of free text and the hospital's own diagnostic coding language. He said the hospital is working with the National Library of Medicine on devising a way to codify the free text terms.

Halamka, who served on Google Health's advisory council last year, said he and Google officials discussed the pros and cons of sending Google administrative data before Beth Israel became one of Google's first partners last May. The thinking then, he said, was that on balance, the claims data would be helpful to most patients. "You try things, you then revise, and now we're revising," he said.

DeBronkart said yesterday he was "thrilled" that Beth Israel and Google had listened to his concerns and responded to them.

"This is a new era of participatory medicine," he said.