Coronavirus in Context: The Google Response to COVID-19

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You're watching Coronavirus in Context. I'm Dr. John Whyte, chief medical officer at WebMD. Joining me today is Dr. David Feinberg. He's the vice president of Google Health. And Bob Brisco, he's the CEO of WebMD and Internet Brands. Gentlemen, thanks for joining me.

Great to be here. Thank you.

David, I want to start with a quote that you gave a while back, where you said, "I believe Google is already a health company. It's been in the company's DNA from the start." What did you mean by that?

Well, first of all, thanks for having me and for getting all this great information out that you do at WebMD. You know, I've been a practicing physician for 30 years. And, uh, in those first 10 years-- and I say this tongue in cheek-- I knew everything. And the patients didn't know what was going on. And then Search came, right. And when Search came, which has been out for 20 years, people have been able to get medical information. And it's leveled the relationship between the doctor and the patient. And we certainly still have work to do to make sure that our information is authoritative and that we get rid of misinformation. So there's still work for us to do.

But fundamentally, Google Search, I think, has changed the doctor-patient relationship dramatically.

And Bob, you and I have been talking about the lack of good information out there, at times, especially when we're trying to find data on prevalence, the condition. Um, I wanted to get Bob Brisco's thoughts on how do we make sure, uh, we're getting the best information for consumers?

COVID's moving so quickly in the world, trying to get all the researchers, all the doctors, trying to get hands around what's going on with it. And I think Search has been an important way to get at that, unearthing of papers, looking at different data sets.

And I think in a connected world where we're all trying to get to the same data set, it's allowing us to go faster. It's just not fast enough, given how quickly this disease has been moving. David, what are-- what are-- what are your-- what's your perspective on that issue of the role of Google in helping the-- to get the information to the right people.

Well, I mean, our mission is to organize the world's information, make it helpful and useful and accessible. And I would say at this time in our history, there's such urgency for us to get that right. You know, we've launched, um, an SOS [? pad ?] on our Google homepage. It's the first time we've done that for a health condition.

In the past, we did it for natural disasters-- completely curated page, no advertisements, you know, and links to authoritative bodies, like CDC or WHO, or those appropriate bodies in other parts of the world-- you know, multiple languages, 50 different countries, um, to get that authoritative information out. But we thought we could do so much more, right. So our mobility report, for example, is showing public health folks how well social distancing is actually taking place. Probably our only really good treatment right now for this disorder is social distancing. I mean, I'm excited about the hope around vaccines and treatments. But really we needed to separate people.

And so how are we doing in keeping people away from retail? Uh, how are we doing in keeping people away from the park or toward the park, et cetera? So we're really proud that we launched our social mobility that's been used now in 130 countries. It's in daily briefings of multiple governments about how to-- for-- to allow them to kind of change and adjust their policy. Again, I wish we could go faster.

David, you recently announced with-- with Apple, I believe, an initiative around contact tracing and that sort of thing. Would-- would you mind sharing with us what you all are doing on this dimension?

Yeah. I'm really proud because we think that the solution here is going to be one of partnership, so happy to partner with, uh, Apple. But what we heard were governments and researchers saying to us, we think contract tracing will be incredibly helpful in getting people back to work, back to life, OK. So taking that problem, we thought we could help collaboratively with Apple.

We-- we-- we launched what will be, I think, next week, and then ultimately not even an app, but just on the phone, an ability for public health officials to create apps if that-- in such that if they want to use contact tracing. And individuals have volunteered to be in it. We've put the Bluetooth technology together such that with those permissions, you and I-- if we're within six feet of each other for more than 15 minutes, and then over the next two weeks you count all the people I've come in contact with-- if any of them become positive, I'll get notified, not of the individual, but I'll get notified that I've been in contact with somebody who's now positive.

So that's the technology we-- we put together. Um, we wouldn't have done this if we couldn't put that kind of privacy first in security, central to design. And that's why it's opt-in and why we're saying, you know, people can look at the technology, et cetera. But really what we're trying to do is create a, uh, a digital way to do contact tracing so public health officials that are stretched have this at their fingertips.

We think it's only a piece of the solution, right. I think testing is important. That's why [? we're ?] launched all the locations where testing is. Uh, it's going to be clear, key to figure out, do these antibodies work? Are they protective, et cetera, the same with the medications? So not that this is a silver bullet, but a foundation to allow public health folks to think more digitally about contact tracing.

And that's a lot in helping the public health community. But you're also working in helping consumers. And you've been talking about a pilot of virtual care anytime, anywhere, where it's the ability to add next to Search, perhaps, an urgent care center or some other type of immediate care, including pricing. That's fairly new for Google. Is that right?

Well, that was clearly on our roadmap. Uh, we were going to launch it for a urinary tract infection, um, because that's one of the-- of the disorders that could, in certain cases, with digital triaging, could be treated appropriately without getting people to go to ER. So that was our thinking pre-COVID.

When COVID came, we shifted to more of a COVID focus, but it's the same piece. It's the same thinking about, um, our user's journey. When they come to WebMD, when they come to Google, they're looking for information.

We want to take them into action and help them in their journey. So we've put up, uh, national telemedicine providers when you're looking locally, as well as local. So we really wanted to create both of those systems with the transparency in pricing, so folks can make a decision if that's how they want to approach their care.

Um, you know, we've been at this a long time in health care. And there's just been this slight move up around telemedicine, you know, 1%, 1.2%. And it was always good to come, and then COVID happened.

And I don't think we moved up the curve. I think we've shifted curves, right. We're in a whole new place. And a lot of the physicians that I'm speaking with that were reluctant, they now see it as fantastic, and they're engaged in doing it.

And for patients, I think, post-COVID, people are going to say, wait, you mean to tell me I could have got that treatment virtually? And now I have to drive, wait in the waiting room, and check in 20 minutes with the doc? It's a four-hour round trip. Why can't we do it how we did it then?

So I think we've dawned a new day where telemedicine, which is not right for everything, but for a lot of things can replace going to a brick and mortar.

We're-- we're seeing the same amongst, um-- we serve over 100,000 health care professional practices in the United States. And we have, um, about 5 million Medscape members globally. And to build on David's theme, I would say, in the last two months, we've seen the equivalent of the prior five to seven years of telemedicine adoption. It's-- it's remarkable how fast this is moving now.

And I would say, now that we're on this new curve, we're going to continue to see even more adoption, right. And people start thinking about it. And how can we check your vitals through the video? And-- and more and more will be able to be done because you can't do hands-on. But can we use sensors in a way to make even more of those office visits virtual?

David, do you think that quality of care ultimately improves because of the adoption of these technologies?

Well, I think quality of care, uh, improves when you get rid of unneeded variation. Uh, I think that that-- that is-- there-- certainly, there's times where variation makes sense. But there's clearly not. And I think the best way to get at that variation, I think it has to be physician and clinically led. But it has to be informed by data.

So if we're doing visits through telemedicine, uh, or even just [INAUDIBLE] charged, it's fantastic because now we have digital information that we can go look at and say-- now we're-- we just published a paper that, you know, we can, uh, basically avoid medication errors by telling a doctor, having looked at electronic health records, hey, this is an unusual medicine to prescribe at this time, right. It's kind of a nudge.

Like, well, only 1 out of whatever, 10,000 people will be doing it right now. Are you sure you want to do it? That, to me, is one, preventing errors, preventing mistakes, but also getting at decreasing the variation, so we know when we're making a variation that we're doing it intentionally.

In the patient side of that, there's so much variability in adherence. And it strikes me that the digital tools that are now getting adopted at a much more rapid rate, allow us to really improve adherence practices in ways we couldn't before. Do--

I would say, that's certainly my hope. But the jury's still out. I mean, we have not seen fundamental changes. I mean, I-- I got my Fitbit on, and I like to exercise. And if you took this away from me, I'm still going to work out tomorrow. And if I were really, really ill, multiple chronic conditions, I don't think you can manage me from a watch, right.

But what about engaging the unengageable? What about all those other people? And that, to me, we got to see if the wearables and other coaching and interactions can take prediabetics to no longer being prediabetics, instead of becoming diabetic. So how do we engage the unengageable? And I think the consumer wearable nudges could be very healthy-- helpful-- if in keeping the almost healthy, healthy, would be a great goal.

That's really well-said. And my mind was going also to how much breakage we typically see in the health care system. 1/3 of prescriptions never get filled because of, um, latency or concerns, or concerns about side effects, or economic issues.

And if we know where these outages are happening in adherence plans, both in the Dx and Rx side, it strikes me, knowledge is power. And the health care professionals then know where and when to engage better than they did before.

That's exactly what we're trying to do. We're trying to say that, um, with privacy and trust with your doctor, can we give them a view to all of your records in a very useful way, so they're not doing multiple clicks to find it? And-- and figure out what's going on with you? And then as a consumer, can we help guide you in a more transparent, convenient way to get the quality care that you need? So that's exactly what we're trying to do.

Thank you both for joining me. And thank you for watching Coronavirus in Context. I'm Dr. John Whyte.