Thursday, October 18, 2007

Online health records, brought to you by Google or Microsoft

The idea of online health records is not surprising, but definitely not reassuring.

From Computerworld:

Less than two weeks after Microsoft Corp. announced plans to support online personal health information records, Google unveiled plans to follow suit.

Marissa Mayer, Google's vice president of search products and user experience, said Wednesday here at the Web 2.0 Summit that Google plans to support the "storage and movement" of people's health records.

...Google became interested in the personal health record market as it watched Hurricane Katrina take aim at the Gulf Coast and all the paper-based records stored in various medical offices and hospitals in the region. "In that moment, it was too late for us to mobilize," Mayer said. "It doesn't make sense to generate this volume of information on paper. It should be something that is digital. People should have control over their own records."

I'm definitely mixed about this. Your personal health records should be something you have access to, and probably even have copies of. Having a copy of x-rays, MRI images, and other objective data could be very useful information for your new health care provider. What worries me is the confidentiality of these records if they become hackable and findable on the internet, and all the fraud that this could propagate. Medicare fraud is already a pretty uncontrolled problem. NPR has a wonderful segment on this.

Here's what I found most striking about the article:

Medicare fraud has now become a favorite career path of many former drug dealers. The FBI has interviewed drug dealers and asked them why they're moving from cocaine to wheelchairs and walkers.

Why the Shift? Malcolm Sparrow of Harvard's Kennedy School of Government says former drug dealers give three reasons.

"There's more money, there's much less chance of being caught and if I do get caught, I'll be treated like a white-collar criminal, not like a drug dealer," Sparrow says. There's also a fourth reason: They're less likely to be killed in a drive-by shooting.

If there was some secure, untamperable way to have access to these records, it could definitely help the health care industry save money by not needing to run the same tests over and over every time a patient goes to a new provider. Of course, there would also need to be some way to guarantee this data does not get into the wrong hands, which is much harder to do. I hear about stolen laptops with employee or customer data almost daily. Fortunately, credit card numbers, bank accounts, and even social security numbers can be changed with effort. How much worse would it be if that laptop also contained your medical files?

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