Google introduced Google Wave last week to much acclaim. Several aspects of the product have tremendous potential for patient-centered communication online. The question becomes will the developer community respond during the developer period by building applications that takes advantage of the live collaboration tool or will HIPAA considerations nip the potential of Google Wave in the bud for the Health IT community?

Google Wave is a tool that allows participants to edit and work on richly formatted text, documents and rich media in real-time. Google describes a wave as "part conversation and part document." Waves are like email and IM in one, with the ability to collaborate on pictures and other media thrown in. It's an ambitious attempt by Google to revolutionize real-time communication. Google has also released a draft protocol for evaluation by the develop community. In order to maximize adoption, Google has released open source, production-quality, reference implementation of the Google Wave client and server.

There are several potential uses for Google Wave in the healthcare context. The first, most powerful use is the ability of the health community to implement patient-centered communication. Doctors and patients are able to initiate communicate around a condition and all things related to the patient's condition are captured within a wavelet (individual conversations/collaborations). Things like MRI's and test results can be appended to a wave and doctors and specialists can collaborate through the wave. Since the communication is server-based, these conversations can be captured, secured, tagged, searched, etc.

There are several challenges to overcome in implementation. The first and foremost is patient privacy. Patient communications are subject to HIPAA regulations. According to Google, the wave server acts as a communication hub, storing operations and echoing them to clients which are connected and 'interested' in that wavelet. Wavelets may be federated, meaning that wavelet servers can exchange operations about wavelets amongst themselves. A sufficient security architecture would have to be deployed properly so communications can be secured and stored properly.

Another consideration is scale. For Google Wave to be truly useful, several provider types would need to be engaged on the platform. While it would be useful for doctors and patients to be engaged in communication on a wave, the tool becomes even more powerful when specialists, hospitals and labs can also participate in a wave since it can store the previous conversations and as test results, etc become available, these objects can be shared on a wave as well.

Google Wave has the capability to post a private reply to a specific wave participant on the string (which could be useful if the specialist wants to collaborate with another specialist without necessarily making that part of the collaboration public). Google Wave also has a "playback" function that allows a later participant to review how the wave was constructed to see how the conversation evolved.

Because waves are embeddable through Google's API, the first logical implementation would be through a patient portal. The potential application of Google Wave as a central communication and collaboration tool for telemedicine practices is clear. Google Wave can also be an important tool in implementing the medical home concept endorsed by the American Academy of Pediatrics (AAP), American Academy of Pediatrics (AAP), American College of Physicians (ACP), and the American Osteopathic Association (AOA). The concept centers around providing comprehensive primary care for children and adults. The medical home concept fosters an ongoing relationship with a personal physician trained to provide first contact, continuous and comprehensive care through all stages of the patient's life, including during acute care and chronic care conditions. In order for physicians to efficiently provide this type of care, they will require tools such as Google Wave to collaborate efficiently.

Update on Tuesday, September 29, 2009 at 3:10PM by HealthySpacesRx Editor

Google announced that it would release Google Wave to 100,000 beta testers on Sept. 30. Google has been working on stabilizing the platform and working out bugs since it announced the new product in May.

Update on Sunday, November 15, 2009 at 1:25PM by HealthySpacesRx Editor

It didn't take long for others to figure out the usefulness of using Google Wave and Google Health as a communication platform for health professionals. Check out the proof of concept that Ylabz put together on his site that demos a use case for communication between a doctor and a nurse.