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More on Google and the Cleveland Clinic

For a start, as I said in my last post  and many times, and at least one of these commenters has written at length, the benefits of sharing health data in clinical situations massively outweigh the risk. So that should be the focus of the discussion.

I am NOT saying that there shouldn’t be privacy protections and there is no reason in my mind why, for all HIPAA’s flaws, it cannot be extended to PHR providers as covered entities.

However, as far as I can tell nothing that is happening here violates HIPAA. Showing you keyword based advertising may not to everyone’s taste, but it does not mean your private health data is being transferred to anyone. And presumably your data will only end up in these services if you give them permission to accept it, which will include consent to provide whatever services and advertising you’ll see.

And that’s assuming that either company does advertising based on records rather than search terms (which is Google make that 98% of their money).

But exactly where are Microsoft and Google suggesting that they’re going to be selling private identified data? Nowhere. Microsoft has bent over backwards to demonstrate that they have no intention of allowing themselves or anyone else to access your health records without permission. And Google will likely do the same when it announces its plans officially.

And of course if you’re paranoid about your health records being
with them, I’m sure someone else has a solution that you’ll like
instead, or you can be free to not use any solution.

And as for consumer reaction? Dmitriy really needs to begin to
understand what shapes consumer opinion and action. It’s what gets
written in the press. And if reporters consistently concentrate on
irrelevancies and miss the bigger picture, that consumer opinion will
take a while to get to the right opinion on the important issues. (Did
you notice the Iraq war, Dmitriy?)

And if Dmitriy thinks I’m promoting this simply for my personal
gain, and that there’s no benefit to better, more controlled sharing of
health information using Google, Microsoft or any other vendor as a
vehicle….well I’m not sure a shake is enough.

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become a game testerCnada Goose ParkasAndreKaryonSavvyDoc Recent comment authors
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become a game tester
Guest

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Cnada Goose Parkas
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Cnada Goose Parkas
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Andre
Guest
Andre

I can’t begin to tell you what a nightmare it was to have surgery with this guy. From his inept office to University hospitals billing, the whole experience was awful. I should have used Cleveland Clinic. First, his staff overbooks his surgeries. After waiting in a hospital bed for 8 hours, he greets me politely, then informs me he is way behind because I arrived at the incorrect time. I tell him that I arrived 15 minutes before the time that was shown on the letter from his office and offer to retrieve it for him. He declines the offer,… Read more »

Karyon
Guest

What Google and Microsoft are doing is vaporware. This issue about privacy is also overblown. I think Google and Microsoft have a very short term memory because WebMD tried this last decade and failed. What makes this different? In my opinion it is the same stuff.
The only way healthcare will be changed is from the inside out, not from the outside in.

SavvyDoc
Guest

Patient Privacy issues are seriously overblown. The information has little to no value to an outsider other than for the purposes of gossip (see the incidents at UCLA medical center as an example). This is not financial information, which if obtained by an outsider can ruin your life. With the advent of on-line banking the security measures are in place for IT tools like google health to be implemented safely.
http://savvydoc.wordpress.com/2008/03/24/savvydoc-make-easy-appointments-online/

Paul Griffiths, CEO of MedTouch
Guest

Most hospitals are still struggling to connect the dots and collect everything that happens inside their walls, never mind deal with information a patient may have. So while both of these applications might help the physician/patient face-to-face interaction become a more informed experience, they don’t do much to address the operational failure in healthcare of how data is distributed in a system.

Gunther Eysenbach
Guest

As to your quote “Showing you keyword based advertising may not to everyone’s taste, but it does not mean your private health data is being transferred to anyone”. Well, I hate to say it, but if you actually combine a EHR/PHR with context-triggered ads, it is more than a matter of taste, in fact, you are leaving the door wide open to trick people into releasing their data (why? see the blog entry cited below). Fortunately, Google Health will NOT put any ads into Google Health (or so they say), but other online PHR vendors may. See: Eysenbach, Gunther. Online… Read more »

Matthew Dillingham
Guest

However, as far as I can tell nothing that is happening here violates HIPAA. Showing you keyword based advertising may not to everyone’s taste, but it does not mean your private health data is being transferred to anyone. And presumably your data will only end up in these services if you give them permission to accept it, which will include consent to provide whatever services and advertising you’ll see. I agree. The Internet is completely voluntary, you do not have to post your information or have an e-mail account. As with anything new and worth trying there is a little… Read more »

Benjamin Wright
Guest

To address the privacy fears associated with Google health records, patients might post legal terms and conditions in their records. http://hack-igations.blogspot.com/2008/02/contracts-for-patient-privacy.html

Matias
Guest
Matias

Should i move out of the US? this is crazy

jd
Guest
jd

tcoyote, to think that a PHR must be a “chilly data archive” is a narrow view. If by definition a PHR is only an inert record, especially one in which you have to enter the data yourself, then sure, it’s a turkey. A better way to think about it is as the record of medical information designed for use by the patient and controlled by the patient. It is useful to the extent that it is populated more or less automatically with the person’s complete clinical and claims record, organized in a way that makes sense, shareable with others (such… Read more »

tcoyote
Guest
tcoyote

Matthew, there are a lot of exciting things going on in healthcare IT right now- the Internet based claims systems like AthenaHealth and Availity, Subimo (now a part of WebMD), the intelligent voice response companies, social networking sites for physicians and patients, the ferment around RPM and the stunning advances in imaging (which, now digital, is absolutely IT), plus a lot of the stuff I don’t even know about but would learn about if I could come to your 2.0 Conference. It’s just that the PHR isn’t one of them. It’s a turkey. It’s already made one dive into the… Read more »

gjudd
Guest
gjudd

tcoyote wrote “I don’t think any of these commercial PHR’s are going anywhere, not only because of privacy concerns but because they do not fill a felt personal need of most consumers.” You’ve touched on a blindingly obvious – thus invariably ignored – fact of healthcare and healthcare spending: most people, most of the time, are not in need of ‘data-intensive’ care. The care requirements of most people, most of the time, do not require data management capabilities of any sophistication surpassing a contact management application. Worse, the discussion of PHR/EMR pros/cons frequently seems to assume a ‘record’ that is… Read more »

Matthew Holt
Guest

tcoyote, you conflate two different things. Are PHRs trustworthy? and are they filling a need? As JD explains at excellent length in his comment, it’s the second that matters not the first. And it’s the second issue that we should be talking about not the first. If the second becomes true, then the privacy issue will take care of itself.
And as for foolish optimism about the future potential of IT in health care, well at least I’m not the first commentator accused of that. I vaguely remember criticism of a certain book on the topic before http://content.healthaffairs.org/cgi/reprint/23/2/276.pdf