For all of the explosion of technology prowess we’ve enjoyed in the past decade or so, there have been very few tech companies that have truly changed healthcare, Dr. David Feinberg told me. Sure, tools have digitized our paper records or streamlined the process of communicating with your doctor. “But I actually think there’s only one example of where tech really did fundamentally change healthcare, and that’s Google Search.”
For the past couple of years, Feinberg has served as head of Google Health, but he’s not even touting his own product. He’s talking about pure search: the empty box and flashing cursor that puts a wealth of medical information—and some misinformation—at your fingertips.
Feinberg joined me recently on A Second Opinion podcast. Like my own, his career path has led him away from the exam room, even as he continues to work with the patient in mind. He began his medical career as a child psychologist, then transitioned into administration as president and chief executive officer of Geisinger, and he now leads Google Health, which brings together a team from across Google and Alphabet—he won’t say exactly how many on his team, only “high hundreds”—to use AI, product expertise, and hardware to take on big healthcare challenges.
Feinberg insists that the Google Health opportunity, for him, is yet another chance to treat the same patients he saw decades ago. He remembers two specific cases: a young man and his father, early in the boy’s schizophrenia diagnosis and a third-grade girl with suicidal thoughts. Those cases, Feinberg told me, encapsulate the problems facing American healthcare: first, how do we deliver health information that patients and their families can understand and use, and second, how do we ensure that patients get timely care when they need it most.
“I don’t know that my career has changed much,” he said. “I’m still trying to help those two patients.” And he believes that Google Health is uniquely positioned to do so.
This isn’t the first time Google has ventured into health, Feinberg is quick to point out. About 10 years ago Google tried consolidating health records for patients on phones. But what the current version of Google Health is trying to do, he said, “is really trying to add to what Google has already been successful at,” he explained. “Google is serious about healthcare, and it’s very mission-driven around making sure we’re building products that are transparent, that are clear, that help people.”
Because the truth is, we all use Google as our first line medical consult—myself included! Before an ER visit, 70% of people do a Google search on their symptoms or condition. In mental health, patients will start conducting Google searches months before they’ll talk to their partners or care providers about what’s worrying them.
“We are where people start their healthcare journey,” Feinberg said. “And we’re open 24/7.”
Google’s strength, he told me, is ordering large amounts of information, searching it, and delivering authoritative, structured results. In fact, he said that Google Search sees billions of searches each day and healthcare makes up a big percentage of those queries.
During the Covid-19 pandemic, Google Health has partnered with trusted authorities like the Mayo Clinic in the U.S. and the National Health Service in the U.K. to deliver a panel of curated data on the Covid-19 pandemic, the latest public health recommendations from CDC and the WHO, and symptom checkers. The aim is to deliver authoritative and accurate information.
“We’re trying to make it very easy to go from information discovery into action,” he explained.
But Feinberg’s goal is to move Google Health beyond just safe search. For instance, he described a partnership with Ascension, one of the largest private healthcare systems in the United States, to recreate the Google Search experience for doctors and nurses within the health system’s own patient records in a secure way.
“At this point, I’d still call it pilot, but we have live patient data with doctors and we think—likely—we’ll be able to improve care for people. They won’t get tests they’ve already had because the doc couldn’t find it. They won’t get asked questions they’ve been asked 100 times because that information will be available. We hope that it’ll lead not only to better quality care, but more time with your doctor,” he told me.
He also raved about the possibilities of computer vision in healthcare. “When we apply computer vision to something in healthcare, it’s just a matter of time before we achieve specialty-level care.” Computer vision mammography can decrease false positives and false negatives by 5% and 9% respectively, he said. In dermatology, computer vision tools can increase the accuracy of the primary care physician from about 50% to about 90%.
“If you think of rural America, where there’s no dermatologist, the nurse practitioner can use our tool to help diagnose derm conditions,” he said.
These are the kinds of tools Feinberg predicts will come alongside physicians, public health officers, and individuals, ensuring better care. In fact, during the Covid-19 pandemic, Google Health has released some 200 new tools that go beyond search to truly improve health for people all over the globe.
“I’m so proud of our team. Like everyone else, the pandemic caused people to have to work from home, and care for their kids, and be nervous about food and all of that stuff. Despite the difficult situation, I think we really did step up,” Feinberg said.
Among the new tools: Covid-19 screening tools that connected people with care and helped them navigate their own insurance landscape; community mobility reports that helped public health officials see how social distancing orders were being followed (with complete privacy for individuals); opt-in tools to alert individuals if they have been exposed to Covid-19 in a public setting, and pandemic trackers and prediction tools based on local symptom search.
And for all of these tools, Feinberg is convinced that the pairing of Google’s innovative engineering with insiders’ perspectives on medicine has delivered value.
“Google felt it was important to have that healthcare voice in this particular area because it’s rather complex,” he said, explaining his role as an MD among Google’s engineers. “We’ve really married a very, very strong clinical team alongside our product and engineer folks, so nothing gets turned on until everybody has signed off.” That process has come with its share of growing pains, he admits, but also “huge progress.”
“For me having practiced medicine for 30 years—and I’m not really with a tech background—I’m positive now after a couple of years at Google, that our technology can save lives,” Feinberg told me. He is convinced that Google’s technology—applied in partnership with healthcare systems—will help doctors and nurses deliver better care. But he also understands the trust required. “If people don’t trust us—the docs, the regulators, the patients, the families, the communities—this world class technology, that I’m convinced will save lives, will sit on the shelf.”
David Feinberg, MD, MBA joined me on A Second Opinion podcast for Monday, March 1. For more of Dr. Feinberg’s insights on innovation at Google, the balance between medicine and engineering at Google Health, and the aspect of the pandemic he finds particularly frightening, see Episode 114 of A Second Opinion on Apple Podcasts, Spotify or YouTube.