We’ve known for a few months now that the era of “Adult supervision” is over at Google and co-founder Larry Page is taking over the CEO role from Eric Schmidt.  The expectation is that Page will work to make the firm, now weighing in at some 24,000 employees, more nimble and startup-like.  The resulting reorganization may result in cuts to projects that he sees as unsuccessful, including Google Health.

While some commentators are already setting up a sort of media death watch for Google’s Personal Health Record (PHR) service, I’m not so sure.  My confidence comes not because of any indications from new CEO Larry Page, but because of his Google co-founder Sergei Brin.

Brin has been more public about his belief that massive stores of data, of the sort that Google is assembling with Google Health, can be part of the solutions to our long-term health challenges.  This becomes very personal for Brin who carries a gene that dramatically increases his chances of developing Parkinsons (Brin’s mother suffers from the disease and he gives himself 50-50 odds of acquiring it in the future).

Brin learned about his genetic risk through a company called 23andMe which offers low-cost gene mapping that comes with risk analyses and a community for connecting with others who have similar genetic markers.  The company was co-founded by Brin’s wife, Anne Wojcicki, and Google is an investor.

It’s a pattern of entwined interests that I think will be difficult to put aside.

Now this doesn’t negate the fact that Google Health has failed by most measures and certainly hasn’t changed the world in the ways its founders had hoped.  The mind ponders what Google could do to breathe some new life and energy into the project, making it worthy of continued attention?

• Add social components ala PatientsLikeMe – Google has had difficulty establishing itself in the social networking space.  There is growing evidence, however, that at least one set of health consumers are interested in using social outreach for support.  One example is the #WLMon (Weight Loss Mondays) hashtag on Twitter, where people publish their weekly weigh-in to the world to add peer pressure to their program.  Perhaps no platform has gone so far in this pursuit of transparency as PatientsLikeMe, where some users maintain incredibly detailed records about their health situation and can share them publicly.  And many of them do.
• Focus on niche disease groups ala PatientsLikeMe – Part of the success of PatientsLikeMe has been to target specific life-impacting chronic conditions such as ALS, HIV and depression.  This is in stark contrast to the Google Health strategy of pursuing the largest number of people including the generally healthy, or those whose conditions consume a lot of health care dollars, such as diabetes, but aren’t necessarily life-impacting for much of the course of the disease.  People who feel bad are more likely to make the effort to track and engage than those who feel generally healthy.
• Heck, just buy PatientsLikeMe.
• Buy 23andMe – This would perhaps be the most dramatic way to get serious about changing healthcare.  By acquiring the platform, promoting its services, and then integrating genetic information with PHR data on a large scale, they could truly bring new insights into the healthcare mix.
• Open the platform to developers – PHRs are great in theory, but they have two major failings.  The first is the need to get the data, which often requires a lot of manual entry on the part of the end-user.  Google deals with this to some degree by allowing the import of records using a Continuity of Care Record/Document (CCR/CCD).  As these become more commonly available, it will be far easier to push that information in and hence easier for consumers to use.  The more important challenge, though, is that health management tools should be an extension of the primary care relationship, not stand-alone gadgets.  If developers could incorporate Google Health’s capabilities into the patient portal experiences of provider organizations, as Microsoft’s HealthVault allows, they would be better positioned to promote clinical engagement which would help drive adoption.

While it’s no easy task to take Google Health to a level that will make it a relevant part of transformational change in healthcare, I also don’t think that Google’s quite ready to pull the plug.  That said, Page is known as unconventional and somewhat unpredictable.  Let’s just hope that the shock isn’t more than Google Health can handle.