After stumbles, Google's still betting on health care

After stumbles, Google's still betting on health care unknown

Karen DeSalvo, chief health officer at Google | John Shinkle/POLITICO

Google is betting its future on health care, but the company’s journey so far has been a little bumpy.

In 2021, three years after its creation, Google disbanded its health care division. The dissolution came after group leader David Feinberg left the company to become CEO of electronic health record company Cerner. Since then, Karen DeSalvo, a former Obama health official, has taken over and is managing staff distributed through various Google teams.

Under her watch, Google has optimized search and YouTube to better answer common health questions, updated its consumer health wearables to function more like medical devices and built artificial intelligence products to meet industry demands.

At times, the company has stumbled. In the pandemic’s early days, Google scrambled to address Covid health misinformation on YouTube. Then, after a Supreme Court decision overturned Roe v. Wade in 2022, research revealed that Google Maps was directing abortion seekers to anti-abortion pregnancy crisis centers.

Despite missteps, Google is pressing on in health care. DeSalvo chatted with Ruth at Google’s annual health event, The Checkup, about the company’s plans.

The interview has been edited for length and clarity.

What is one of your biggest priorities for Google in health care?

I’m very keen to see that this thing (she points to her Google phone) becomes a doctor in your pocket.

What are the things that we can enable in self-care? And then, what are the things that can support the caregiver? It’s related to: How do you access information, whether that’s on Search or YouTube, or have access to telehealth? So much that will happen just from a device that’s honestly pretty inexpensive and in the hands of a huge chunk of the planet.

People during the pandemic in America spoke loudly and clearly that they want more agency and control. People want to not have to be so reliant on the house of medicine to learn about their health.

Health care feels like a long-term play for Google. How big could it be?

It is a long-term play for us. And the reason it’s an important use case is because [on search] people are asking health questions. We’ve got to get it right. And we have got to help them on their journey. On our [wearables like Fitbit], people don’t just want to count steps. They want to make sure that they’re being healthier.

Cloud is [becoming] a trillion-dollar global industry. Thirty percent of the world’s data is health care.

In our ethos as Google is to co-build and partner. [An organization] had a problem to solve. We had technical people who could think about it with them and solve it. But then they can take it out and scale it. And that those things do take longer. But we are also getting faster. We’re learning how to do those with more rapidity. So it is a long-term play in the sense of we’re going to be in it.

You’ve hired the former FDA head of digital health, Bakul Patel, and you’ve been partnering with a lot of global health institutions like the World Health Organization on artificial intelligence that could screen for various conditions like tuberculosis or diabetic retinopathy. How does regulation factor into your strategy, not just in the U.S. but globally.

To get scale, we have to make sure that we’re doing it in a way [so] that it’s not just about endorsement. This opportunity that we forged more formally with the WHO during the pandemic has … really helped us say, look, there’s a backbone organization that can help us understand what the challenges are. Let’s not just make it a pandemic thing. Let’s figure out what we can do going forward.

St. Pete Beach, Fla. | Ben Leonard

This is where we explore the ideas and innovators shaping health care.

An emergency room in Florida erroneously charged a 4-year-old — not his parents — with a medical debt for care he never received. The hospital wouldn’t speak to the parents about the debt, because the claim was in their son’s name, and it got sent to collections. When journalists came knocking, the health system decided to clear the debt.

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Today on our Pulse Check podcast, host Megan Messerly talks with Alice Miranda Ollstein, who explains why the Biden administration is facing off with Democratic attorneys general in court over the FDA’s authority to place certain restrictions on abortion pills — and the potential implications for pharmacies dispensing the pills.

New research shows that telehealth opioid treatment reduced overdose deaths. | AP

Medication treatment for opioid use disorder via telehealth helped significantly reduce overdoses during the pandemic, though not as much as in-person treatment in either an office setting or a certified opioid treatment program, a study published today found.

The large study from CDC, CMS and NIH researchers in JAMA Psychiatry concluded that between September 2019 and February 2021:

• Telehealth patients had a 33 percent lower adjusted odds of fatal overdose.
• In-person patients had 38 percent lower odds of fatal overdose.
• Patients in certified opioid treatment programs had 59 percent lower odds of fatal overdose.
• 1 in 5 Medicare beneficiaries in the pandemic cohort received OUD-related telehealth services.
• 1 in 8 beneficiaries received medication treatment.

Researchers said the findings underscored the need to expand interventions in clinical settings.
Why it matters: The findings are a win for advocates of opioid treatment via telehealth; federal agencies allowed more virtual care during the pandemic when Covid-19 made in-person visits risky.

The findings come as the Drug Enforcement Administration considers public comments on a proposal that would make it more difficult to access buprenorphine, a controlled substance used to treat opioid addiction.

They also add to growing evidence that eased telehealth rules reduced overdoses amid the pandemic. However, a study in JAMA Network Open in January found that telehealth might not expand access to treatment, potentially because of the digital divide. Other research, though, has suggested that ending eased telemedicine rules could disrupt access to care for some groups.

The Energy and Commerce health subcommittee, chaired by Rep. Brett Guthrie (R-Ky.), held a hearing on price transparency. | Francis Chung/POLITICO

While most hospitals have started to comply with price transparency regulations, patients still aren’t benefiting. As a result, Congress is looking for advice on what to do next. On Tuesday, the House Energy and Commerce Committee held a subcommittee hearing on how to compel hospitals to share meaningful service pricing.

Price transparency rules aim to give patients pricing data on medical services so they can comparison shop, which should ultimately drive down prices. But health systems aren’t presenting the data in a way consumers can understand.

The No. 1 recommendation? Enforceable federal standards.

Witnesses — a mix of policy experts, health system operators and consumer tech companies — seemed to agree that to move forward on enforcement, the government would have to add specific legal requirements for how hospitals should publish prices for medical services.

“We’re seeing hospitals doing everything from not posting any pricing information to posting a price as a percentage of Medicare,” said witness Sophia Tripoli, head of healthcare Innovation at patient advocacy group Families USA. “For example, 120 percent of Medicare, which is meaningless for consumers.”

They want hospitals and health systems to be required to:

• Post all prices in dollars and cents
• Use standardized descriptions of medical services so patients can easily compare them across health systems.
• Format their pricing data in a way that can be easily read by patients and aggregated by third-party comparison tools.