Google Plays Doctor

Peter JonesInformation Ecology

And Microsoft also wants your health records as well. The New York Times reports on the NEJM article warning about the entrants of mega-players GOOG and MSFT as purveyors of your private healthcare information. These are not altruistic enterprises – they have to turn a profit on this somehow. So it does make one wonder about their product strategy – will Google flash consumer health ads at you while you review your meds and shots? Will Microsoft create a new Health Passport ID to qualify your access to your medical records on their servers? So, who will the early adopters be?

There are so many questions –  Have you actually tried to locate and consolidate your medical records? Unless you’re a veteran and on VistA, have you noticed they are paper? So, will Google scan them for you as well?  What happens to your records if you leave the country or die? What if laws change and you don’t know about it? Can your doctor get to your online records, and will they have to have a separate ID for all their patients?  Why can’t people just put all their records on a flash drive, that gets updated at the doctor’s office, and then keep it physically with them – and a backup on the laptop? What’s the real value-add of the big players here?

The NEJM authors consider the trend toward personal health records a positive development for personal responsibility for healthcare:

Despite their warnings, Dr. Mandl and Dr. Kohane are enthusiastic about the potential benefits of Web-based personal health records, including a patient population of better-informed, more personally responsible health consumers.

“In very short order, a few large companies could hold larger patient databases than any clinical research center anywhere,” Dr. Mandl said in an interview.

But the authors see a need for safeguards, suggesting a mixture of federal regulation — perhaps extending HIPAA to online patient record hosts — contract relationships, certification standards and consumer education programs.

Today you’ll see almost 200K Google hits on “personal health record.” The growth in this “space” in one year has been truly amazing. Remember that Microsoft bought Medstory a year ago, (and there’s been no news from them since). However, if the US had a national healthcare system (or even statewide systems), a feature of patient and cost management would be your access to personal versions of electronic health records, such as those available on the aforementioned VistA system. Your tax dollars already built VistA and it is a public domain application. Veterans already have personal eHealth records through My Health eVet (such a bad brand name, but you get the idea). In this area, government and veterans are at the leading edge, and not consumers.

Information services providers might consider the “records aftermarket,” rather than records access –  helping consumers make sense of their health records. The medical records themselves are used as intra-practice documentation, and are not easily readable by patients or family members. Perhaps this is the direction the big players want to go, but there’s a lot of gray area in the reading and interpretation of medical tests, procedure, physician orders and notes, etc.  Doing this well is an editorial process – currently services such as Medstory do a good job getting you to qualified information, but the level of difficulty of interpretation and sensemaking remains daunting.