What About Google Health And Electronic Medical Records?

The New York Times has an article about Google and Microsoft and their approaches to healthcare. After reading that, I decided to read a Google Blog entry about their product managers' thoughts on healthcare. It seems that both large firms see a big opportunity here, especially Google. I must admit, I am biased towards Google based on having used their products and what I have read about their corporate culture. However, while generally a proponent of such technology, I wonder how serious privacy issues are in this arena.

Perhaps this is obvious, but I think applying IT to healthcare should be a national priority for a plethora of reasons. As a med student, I am trained to take a fairly routine history, which includes history of present illness, past medical/surgical history, drug allergies, current medications, family history, and social history. A lot of this information is constant over time and occasionally can be crucial for the patient's care. However, patients are not the best historians. They forget the names of their meds, they forget surgeries they've had, they forget even why they came in sometimes!

A health record that is owned by the patient can help remedy this. Imagine an international standard for a health record. I'll call it a "Portable Health Record" or PHR, for short. In digital format, your .phr file would contain all of this information in a standardized format. Viewers would help you easily access and understand the information, which you could update as necessary. The same would go for the physicians whom you would give access to. By having one standard format, if you ever move or switch physicians, your health record would stay intact, and your new physician would be familiar with how the information was stored. Simple, right?

However, privacy is a major issue that shatters this simple view. People would worry about insurance companies or others who may not have your best interests getting their hands on this information. Such information could be used to exclude patients from healthcare plans, or to target them for direct marketing. One can imagine even worse possibilities.

But, how realistic is this? I believe that with proper safeguards, such as data encryption and appropriate permissions systems, this risk is really just a straw man. We are already exposed in many ways, by using online banking and credit cards. While there are real risks involved with those activities, millions of such transactions occur everyday. As the Google article alludes to, if we can use IT to reduce medical error, I think from society's point of view, this benefit outweighs the risk/cost of exposing some to an invasion of privacy. Perhaps I feel that way since I have no personal experience with identity theft, but I think if people are responsible and the technology is developed appropriately, it will benefit patients, physicians, and society.

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