When the locator loads, you many need to manually enter your location. Do so using the “Change Location” option:

After doing your search, a red needle icon shows where to get regular seasonal flu shots, a blue needle for the H1N1 vaccine or colored both ways if both are offered at a particular location (so many needles — don’t let your kids see this map before you go!):

Click on any of the icons, and you’ll be shown more information about that location:

A list along the left-hand side of the map also gives more details about a particular place and reflects all the locations on the map. Many of these are pharmacies, but Google says more locations will be added:

We’ve been working with HHS, the Centers for Disease Control and Prevention (CDC) and state and local health agencies to gather information on flu vaccine locations across the country, particularly for the H1N1 flu vaccine (both the nasal-spray vaccine and the shot). At the moment we have data for locations of flu vaccine directly from 20 states and counting. We are also continuing to add information from chain pharmacies and other providers in all 50 states; today, you’ll find results from chains such as Walgreens, CVS and PDX participants, such as Kmart, Duane Reade, WinnDixie and Giant Eagle.

Unfortunately, you can’t tell at-a-glance if a particular location is out of stock on flu vaccine. For example, in the map above, you can see H1N1 is said to be available near Fountain Valley. But according to the list, it’s out of stock:

It would be nice if the map could also reflect the availability status. Plus, I wish there was a way to share a map tailored to a particular location. Even when you’re signed in to Google and using the My Maps feature, it doesn’t seem possible to save a map for a particular ZIP code. Using the share options also just shares the generic URL, not one that will bring up a location-specific map.

The locator will also soon be added the the Flu.gov site from the US government and the American Lung Association’s flu site.

Google also maintains a Google Flu Trends site designed to help you spot where flu activity may be peaking.

Here is a screen capture of the OneBox result for Asthma:

As you can see, Google provides a quick definition of the condition and then gives you a link to either Google Health, Mayo Clinic, Medline Plus or WebMD. Note, not all of these links will be available for all health-related queries.

I asked Roni Zeiger, the product manager for Google Health, about monetization of Google Health. He told me it is about getting the answer as quickly as possible to the searcher. They have no current plans or even future plans to add ads to the Google Health property.

It’s part of a process that Google hopes will allow them to improve health-related search results plus perhaps build more trending tools like Google Flu.

“We’d like to do a better job of accurately estimating current levels of flu and extend that to other areas, and to do that, we need to understand better what people are searching for when they’re feeling sick,” said Dr. Roni Zeiger, a medical doctor and Google product manager overseeing the project.

Google will randomly select a small number of people, in the United States, beginning today and show them a simple Yes / No question at the bottom of searches relating to health issues. The experiment will run for at least the next few weeks.

For example, in a search for “headache,” those selected will see this:

The “Did you search because you or someone you know has a headache” question should fairly quickly help Google understand what percentage of people are conducting headache-related queries because they’re actually suffering one (or know someone suffering one), versus people who are just interested in the topic generally. Similar questions will come up for other illness-related queries, such as:

• Did you search because you or someone you know has ankle pain?
• Did you search because you or someone you know has post-nasal drip?
• Did you search because you or someone you know may be experiencing a reaction to poison ivy?
• Did you search because you or someone you know may have streptococcal pneumonia?
• Did you search because you or someone you know is taking ibuprofen?
• Did you search because you or someone you know may have an ear infection?

Assuming many people are suffering illnesses when they search for these queries, Google could conceivably shift its results to be more “cure” oriented.

How about future trend tools. Will we see a Google Chickenpox, somehow from all this data, down the line? Zeiger laughed about the name but didn’t dismiss the idea that other trending tools may emerge. But what those might be, exactly, he couldn’t say.

“The natural place to look is for other similar infectious diseases that have outbreaks. We’d like to try, but there’s isn’t something specific that we know is next, based on our current insights into health processes,” he said.

With Google Flu, Google correlates search data with reported outbreaks, to increase its confidence level. In cases where it lacks a correlating factor (are poison ivy cases even publicly reported?), understanding how many queries are really based on an actual illness over time might help with creating some future trending. But for the most part, this seems to have a much more immediate application as a way for Google to decide if certain results need more “cure” slanting.

How about privacy? Answer the question, and Google says that it is NOT associated with your Google Account, if you’re logged in. Instead, answers are linked to standard logged information like cookies and user IDs, which I feel are pretty anonymous. And these get destroyed in 9 to 18 months.

Still worried? Assuming you’re one of the few selected, just don’t answer the question. Google’s also blogged more about the program here, and there’s a FAQ here.

But Google isn’t the only one in the electronic health records and “health search” game. So is Microsoft. There are scores of others in the segment, as well as billions spent annually in advertising. Despite the money and involvement of companies like Microsoft and Google, digitizing the nation’s health records and getting millions of people to use online tools to manage their health histories seemed an almost insurmountable goal in early 2008.

Then came the election of Barack Obama.

As part of its economic recovery program, the Obama Administration has proposed a multi-billion dollar effort to upgrade the US health care system by making all health records electronic within five years. The idea is that over time it saves money, delivers efficiencies, helps improve the quality of healthcare and overall costs in the system will decline. That effort has given Google Health, Microsoft Health Vault and others a major hypothetical boost. But major challenges remain.

According to a story in the NY Times, two separate medical journal articles identify a range of problems and obstacles to achievement of the Obama Administration’s goal:

Two articles, to be published on Thursday in the New England Journal of Medicine, point to the formidable obstacles to achieving the policy goal of not only installing electronic health records, but also using them to improve care and curb costs.

One article reports that only 9 percent of the nation’s hospitals have electronic health records, based on a survey of nearly 3,000 hospitals . . .

In a second article in the journal, two experts in health information technology at Children’s Hospital Boston assert that spending billions of dollars of federal funds to stimulate the adoption of existing forms of health record software would be a costly policy mistake.

The second article advocates development of an open software platform rather than working within the existing records framework. It’s not clear to me how open-source software would affect Google or Microsoft’s health-related ambitions — probably not significantly.

Billions are literally at stake in answering these questions, however.

Eventually there will be an electronic database of health records in the US. That will certainly yield public and private health benefits as well as cost savings to the system. (Privacy and policy issues preventing abuse will have to be addressed as part of the effort.)

The big unknown is how long it will realistically take to develop that system and whether, if it takes many years, Google or Microsoft will have the patience to wait that long.

First, “Share This Profile” is an email-based tool that lets you give someone else online access to a Google Health profile. Privacy and security are obvious concerns here, and Google says these safeguards are in place:

• the access link you send will only work in connection with the email address of the person you send it to; your profile can’t be accessed if the link is forwarded to someone else
• the link expires after 30 days
• the recipient can only view your health profile, not edit it
• the recipient can only see the profile you’ve shared, not any others in your account
• you can turn off sharing at any time
• you can always see who has access to your profile

The second tool is for offline sharing; it’s a new print feature that creates a wallet-sized hard copy of your profile that shows your blood type, medications, conditions, and treatments.

Just as Microsoft didn’t anticipate the rise of search and search advertising and Google didn’t anticipate Facebook, it’s possible that something as yet unknown could displace traditional search’s (and Google’s) centrality in the internet experience. Citing her blog post on the future of search, the UK publication TechRadar uses an interview with Marissa Mayer as an occasion to discuss the issue and the future of Google more generally.

Beyond universal search, Mayer emphasizes personalization, social search and location awareness as important elements of search’s evolution. She also points to Google’s “cloud computing” efforts and data storage as significant for Google’s future. As an aside, Google Health — specifically electronic Health Profiles, which is one of those efforts — will potentially get a big boost from the new Obama Administration, which wants to aggressively digitize heath records.

In the near term, Mayer also suggests some new interface changes will be coming this year:

Mayer reveals that the team has been evolving the interface design and user experience of the rich media-heavy search results since the launch in May 2007 and that we’ll see the fruits of this experimentation in the coming months.

The article paraphrases Mayer, saying that “while search is 90 per cent solved, the last 10 per cent will take decades to complete.” I would argue by contrast that search is about 50 percent solved and that it won’t necessarily take decades to see significant changes and improvements. Mobile will be an increasing influence on search for one thing, and that will play out in the next five years.

Location awareness in particular is much closer than the article implies. I agree with Mayer that personalization and being able to tap into social networks are two important, undeveloped areas in search. However, personalization and Google’s potential approach to “social search” are in hypothetical conflict.

Regarding “social search,” Google is inclined to incorporate anonymous, aggregated user data to influence search results; but users are likely to be interested not in the anonymous “crowd,” but in what their networks and friends have to say about things. That partly accounts for the rise of social networks. And, in some ways, “search” and “social networks” are opposites.

Google’s acquisition of mobile services Zingku and the Twitter-like Jaiku provide potential tools for the “network search” scenario. Google also owns Orkut, which has gained usage over the past year. (Google also bought DodgeBall a few years ago but doesn’t seem to be doing anything with it.) The challenge here is integrating these tools and services potentially with one another and search in an elegant way. A reader of my personal blog Screenwerk also predicted that Google will buy Twitter in the coming year. (Facebook has tried already and will likely try again.)

There are a range of emerging mobile services (i.e., Mosio, kgb’s Texperts, ChaCha) that, to varying degrees, allow mobile users to tap human networks for real-time “answers” or “recommendations” on the go. These are substitutes for traditional search. In a very basic way, so is text messaging.

(Beyond mobile, TV screens represent another frontier for search, and another challenge that may “evolve” search in interesting directions. That’s fodder for another post.)

The rise of the mobile internet is forcing search to be more precise rather than simply serving up a list of potential links for subsequent investigation. And personalization may well help in that effort. But more generally, search needs to remove noise and redundancy, in my opinion. Why, when I look for a restaurant or a business location for example, am I subjected to 15 links from competing sources for essentially the same information? That’s another topic for yet another post.

On her own future Mayer impliedly denies rumors that she’s about to leave Google as ValleyWag had suggested. TechRadar quotes Mayer:

“I’m a geek and Google is a great place for geeks,” she says. “I really love my job because I get to work on new problems and have new challenges each day. I’m currently working on our Geo products, Google Book Search and Google Health. They’re all things I’m excited to be part of.”

Just a couple weeks ago, I reported on a Microsoft investigation of cyberchondria, when inaccurate medical information online makes actual health problems worse. On Friday, Dilbert cartoon creator Scott Adams shared a different point of view, telling blog readers how Google helped him find treatment for a speech defect known as Spasmodic Dysphonia.

More specifically, Adams was using Google Alerts to get information about the condition. Google notified him of an “obscure medical publication” that wrote about Spasmodic Dysphonia. He took the information to his own doctor, was referred from there to other doctors, and eventually had successful surgery to fix the voice defect.

“I never would have found that path without Google Alerts,” Adams writes.

But is his story representative of what typically happens when we use the Internet to search for medical information? The Microsoft paper released last month explained that using the Internet to diagnose health problems can make the problem worse than it really is:

“… the Web has the potential to increase the anxieties of people who have little or no medical training, especially when Web search is employed as a diagnostic procedure. We use the term cyberchondria to refer to the unfounded escalation of concerns about common symptomatology, based on the review of search results and literature on the Web.”

About 30% of people in the Microsoft study experience “heightened anxiety” because of what they learn online after doing a web search about medical conditions. But Adams says he’s used the Internet — “Dr. Google” as he calls it — “dozens of times to diagnose various minor medical problems, or to find out what things are dangerous or not.” And he poses some interesting questions about how well the Internet could diagnose non-emergency medical problems, both common and uncommon:

“With the uncommon problems, such as my spasmodic dysphonia, I have to wonder if Google (or WebMD, etc.) can do a better job than a doctor, if not now then maybe in the near future. If you could call up videos of people with identical symptoms, couldn’t you diagnose most of your own problems?

For example, are you any worse than your doctor at looking at High Definition pictures of a skin problem and comparing it to your own skin problem?

My guess is that the Internet could equal your doctor in diagnosing uncommon problems. WebMD for example asks a bunch of diagnostic questions and narrows down your symptoms just as a doctor would. That system will only improve over time.

Adams goes on to wonder about using an online database to handle prescriptions, with pharmacist oversight built-in. Something like that may already be included in government discussions of a national health database; I don’t follow the details enough to know for sure if it is or not.

Ultimately, it’s an interesting discussion. Adams’ concept of “Dr. Google” doesn’t seem too outlandish, but — to borrow a common medical analogy — four out of five doctors would probably disagree.

According to the article:

The partnership, announced Monday, will begin with a pilot project open to Kaiser’s 156,000 employees, which will run until November. If successful, the product linking Kaiser’s patient information with Microsoft’s Health Vault personal health-record service will be offered to Kaiser’s 8.7 million members in nine states and the District of Columbia.

Kaiser reportedly selected Microsoft because the two entities shared a similar document format vs. Google: Continuity of Care Document, or CCD vs. Google’s Continuity of Care Record, or CCR. Kaiser was reportedly also impressed by Microsoft’s handling of privacy and data security issues.

The fight for partnerships with health insurance carriers is not unlike these toolbar and default search deals that Google and Microsoft compete for. However, consumers will ultimately be given a range of choices about which records system to use. But the competition and ultimately the combined push by Google and Microsoft promoting adoption of online personal health records will accelerate the mainstreaming of such a system.

Postscript from Greg: There’s tremendous value in Google Health for consumers. I haven’t compared it to its various competitors, however. There is, in the beginning, some fairly heavy lifting involved in getting the personalized information and health records online, which includes registrations on multiple sites. Some consumers may be frustrated by this and it may initially dampen adoption somewhat, although there is a service that will retrieve paper health records and put them on a CD for users.

This is one of those situations where consumers have to actually use the system to recognize its true value. However, there’s also lots of valuable content on the site. That may acclimate consumers to Google Health and help feel comfortable using it in advance of uploading the full profiles and health records.

Immediately questions of privacy, trust, and security arise. Indeed, trust is a huge issue here. “Do you trust Google?” becomes a fundamental question. The company has said the records are safe and more secure than Google’s own search logs. Marissa Mayer yesterday also told me that the records could be completely erased if consumers wanted to do so.

I believe all the aspirations and company statements about Google seeking to help consumers control their health records and making healthcare more efficient. The potential issues with Google Health aren’t really about Google Health itself. They’re about the larger healthcare system in the US, which makes profitability the paramount consideration and quality patient care a distant second.

While I’m not holding my breath, I hope there will be reform in the US healthcare system over the next several years that will help enable people to use products like Google Health without fear or concern about whether the data could get out or who might try and use it against them.

Google’s Marissa May wrote the Google Blog post this morning on the service. There’s also coverage in the Wall Street Journal.

Microsoft and Revolution Health, among a few less well-known others, offer personal health profiles online, and it’s fairly clear that this is the direction that the entire healthcare industry is moving. But here’s what Google’s Marissa Mayer says “sets Google Health apart”:

• Privacy and security
• Google’s platform approach, which will make it interoperable with third party services and providers
• Portability of the data
• Google’s user focus

Specifically on the most important of these issues (privacy and security), Mayer says:

Due to the sensitive and personal nature of the data that will be stored in Google Health, we need to conduct our health service with the same privacy, security, and integrity users have come to expect in all our services. Google Health will protect the privacy of your health information by giving you complete control over your data. We won’t sell or share your data without your explicit permission. Our privacy policy and practices have been developed in thoughtful collaboration with experts from the Google Health Advisory Council.

Those who think Google does a good job with data privacy and security will likely be satisfied with these assurances, but cynics and skeptics will not. My concern is not that Google will make every effort to protect user data, but that unscrupulous third parties will try and get at it: private litigants, would-be employers, and US insurance carriers trying to minimize their exposure.

There’s also the question, which Mayer doesn’t address in her post, about advertising. Google is not likely to exploit any of this personal health data for advertising purposes. Google recognizes how foolish and potentially damaging that would be to its relationship with consumers. However, many skeptics see this as one of Google’s motivations in creating Health.

Then, on a mundane level, there’s the question of getting doctors and third party institutions to use the service. I have had personal experience in spending almost two hours filling out a detailed health profile online, only to be told later that I had to provide the same information again on paper forms in the doctor’s office because they “didn’t use” that part of the online system.

Here’s a screenshot of the Google Health interface:

Online health profiles make tremendous sense from a number of points of view and may even be able to save lives in some circumstances by giving doctors access to complete patient health information when they’re not able to (e.g., the emergency room). However, there are myriad privacy/legal issues and larger challenges that have to be resolved, independent of Google or Microsoft, before consumers can fully trust that their records are going to be protected against unauthorized access or abuse.

Postscript:

I spoke briefly with Marissa Mayer this morning and asked her to discuss and address some of the questions and issues I raised above.

On the question of getting third parties (i.e., doctors) to participate with and use the system:

Mayer said that Google Health will be working with doctors, hospitals, pharmacies and others to encourage them to use the system (including uploading existing health records from those third parties). She said that over time she expects more and more doctors, clinics, and hospitals to use the system.

On the question of advertising:

Mayer said that Google will not sell any personal consumer information. She did say, however, that pages that aren’t part of the consumer health profile – information pages in Health that offer general discussions of topics (e.g., diabetes) – would potentially feature ads. This is no different than other ad-supported health sites. But on the question of whether any marketing messages would be tailored to individuals based on their health histories or behavior, Mayer said that was speculative but that under any such scenario, Google would not do so without explicit consumer permission (”opt-in”).

On the question of data security:

Mayer said, “We think we’ve built a system that is resistant to hacking” and brings a level of security and protection that is comparable to what Google provides to sensitive data like email and consumer credit card information (in Checkout). On the question of third parties gaining improper or unauthorized access to consumer health data, Mayer said that Google was bound to comply with local laws but reiterated Google’s commitment to protect the data.