Recently launched Google Health, which allows you to store and manage all your health information online, is just the latest sign that the healthcare sector is carving out its own space in the Web 2.0 revolution. Health 2.0 has its own flavor of user-generated content, wikis, blogs, mashups, and wireless options that come with cellphones and PDAs. Autonomy is a key driver of this dramatic change. In the process, traditional health paradigms are turned on their heads.
Google Health allows individuals to build their own health profiles online, entering health conditions, medication, allergies, lab results, etc. Users can even create multiple profiles for family members or others they care for, and import medical records from participating hospitals and pharmacies. Participants can find trusted information on diseases and conditions of interest to them and learn about possible medication interactions and other topics to talk with their doctors about. In a word, you would have autonomy, everywhere.
Assistance is also provided with reminders to take medications (the virtual pill box) and with finding physicians and hospitals matched to the individual's needs. The system allows patients to keep their doctors up to date on what is happening with them. It incorporates automatic notification of potential drug interactions, eliminates the need to repeatedly fill out the same paperwork when visiting new physicians, and avoids unnecessary repetition of lab tests.
The launching of Google Health follows an initiative earlier this year by healthcare insurer Aetna, which announced a new service to help people manage their own health records online. Aetna's personalized online medical information service, called SmartSource, draws upon a patient's own medical history to help answer questions about symptoms and treatment. The company plans to gradually introduce the free service nationwide to its customers beginning in August.
So what could Google Health accomplish? The immediate goal is to improve health, provide proper treatment, and prevent future disease. Ultimately, it allows individuals to be responsible for their own health and for interaction with healthcare providers and insurers. It therefore makes sense that they should have ready access to their own medical records, X-rays, and lab tests. People should be able to transfer their health records in readily understandable form to other health providers and other insurers -- and know that the records are accurate and complete.
Google Health is a potentially very powerful and useful resource. But it also shares vulnerability with other online resources and has privacy advocates warning about the dangers of inadvertent release of personal information. Google servers are at the top of the list of IP addresses infected with malware, so there are other risks to think about as well. Google says the servers used for Google Health will be more secure than the other servers it uses.
It is the unsafe aspects of computing at the moment that make Google Health risky. Unless we reach the point where computing is essentially risk free, accidental dissemination of private health records to the wrong parties will always be a possibility, and the potential downsides of Google Health will remain.
— Kim Solez, MD, Director of NKF cyberNephrology at the University of Alberta
These are great points, Kim. In actuality though, there are more serious breaches of confidentiality in the current paper medical records and open exposure to anyone without controls or need to know. HIPAA put restraints on all patient information, both paper and electronic, that anyone creating patient records has to comply with.
Both Google and Microsoft are HIPAA compliant. I believe that Google's health record moves the right direction in giving the control of information and disclosure to the patient, which now owns the medical record..
The incentives to move physicians and hospitals toward making great use of the electronic medical record is probably a good thing assuming privacy is maintained. It is hard to judge the exact effect of this part of the legislation until the structural details of the privacy provisions are finalized.
Doctors tend to be a conservative group resistant to change and health care costs are an alarmingly large part of the overall budget. If privacy and security issues can be addressed effectively, then having more medical data in electronic form is obviously a good thing as it will make analysis and innovation easier.
With the stimilus bill having pass senate this afternoon, some worrying portions of the bill is now beginning to surface with regards to electronic health records. It's seems there is an overt government manipulation behind this move to make electronic health records for all patients.
There is nothing bad about the primary goal behind Google Health project, but the main issues related to online security need to be solved before the project come to fulfilment. What guarantee do we have to make sure that servers used for Google Health will be more secure than the other servers it uses? Who is the accredited authority who can testify that there are "less security problems" with Google Health servers than with its other servers? Health information is very sensitive and given the online security issues, it is indeed very risky to put ones health information in a world wide online system.
The Google Health entusiasts and users must be aware of the potential threats they will be facing with the service. Google has been partnering with some hospitals such as the Cleveland Clinic that is allowing "1,500 to 10,000 of its patients to sync up their records with Google’s nascent Internet-based personal-health-records system" said David P. Hamilton in his article Google Health’s Cleveland pilot program — and the nagging questions it doesn’t come close to answering. This is to enable them "to take their medical records with them wherever they go and be able to easily access and manage their own health information". David said that if patients are "free to selectively share their medical information, or even edit or delete it", people might chose to hide or minimize some embarrassing information and they might mislead their doctors. Consequently, other doctors might not trust medical records presented by patients and the goal of the Google Health servive might not be achieved.
Hi Paul, The fact of being sick can make one very angry, and so one finds some very inflammatory, off-the-wall, biased and inaccurate essays written on medical topics. It is probably best to avoid taking sites like your large font reference too seriously no matter how colorful their language may be, but stick instead to reasoned discourse. I know personally some of the people mentioned in that article and it is very disturbing to see how untrue the characterizations are.
The relationship of Google Health to HealthVault is explained here. Fred Trotter has a good discussion of the HIPAA issues.
It's with great delight to hear that many sectors are now embracing Web 2.0 technologies but we obviously should be worried when major players like Google and Microsoft are being sympathetic to us when it comes to health records. Are they just trying to extend their Ad space or provide a portal for third parties to easily access our health records? Google has sided with regimes like communist china and what guarantee do we have that they will not connive with major insurance companies to breach our medical recorsd?
How secure should health data be? IT people talk about the increased security that would come from a trinary code. The poor man's secure trinary code is doing what online payroll sites do: employ a three component authentication for access, with the three components disseminated in three different ways. It would make sense if access to one's general Google account did not provide access to Google Health, another additional password or ID component would be needed for that. The security of health information is as important as the security of a payroll; it should be protected in a similar fashion.
The concept of risk free computing is intriguing. It is not an impossible goal. Suppose there were no viruses, no spambots, no effective hacking, and that there was completely secure encryption of confidential data so it could not be misused, and easy accuracy checking. This would have dramatic effects on our use of computers in the work place and make something like Google Health practical.
It is worth pondering what Stephen Hawking wrote about computer viruses: "I think it says something about human nature that the only form of life we have created so far is purely destructive. We've created life in our own image."
The standoff that exists at the moment between virus writers and those making software to combat viruses is very like the standoff that exists between disease and efforts to cure and prevent it. It is logical to think that at some point man/womankind will win both battles eliminating most computer virus threats and other online risks, and conquering major human disease.
One way to deal with the destructive aspect of the computer life we have created is to look at reformating its design. The architecture of the individual computer as well as the architecture of linked computers (the landscape of the Internet) could be re-designed in such a way that computer disease as we know it becomes irrelevant. A computer architecture that eliminates the threat of viruses would allow us to maximize the benefits of the Internet without limiting our autonomy.
An analogy can be made between computer architecture and human architecture, and by extension computer disease and human disease. The architecture of the human for the purpose of this analogy is the gene. It is controversial because of the way it threatens the essence of humanness, but geneticists are looking at prevention of disease by redesigning our genetic structure, our architecture. This could, theoretically, also result in a substantial increase in our autonomy.
Regardless of how we get there we can think of moving toward risk free computing and risk free living in tandem.
Suddenly in such a risk free environment your work computer would really be yours, you would have complete administrative control over it (why not?) and would be able to install programs and make changes just as readily as on your home computer. But even more importantly you would have control over your own health and there would be very few threats to it.
In a word you would have autonomy, everywhere. And live a really long time with a very interesting life.
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