Reactions to story from The New York Times

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  Google Health: Your Personal Online Health Record

  http://www.straightfromthedoc.com/50226711/google_health_you...
  82 days ago in Straightfromthedoc: Grand Rounds Issues I've Missed · No authority yet

  I'm not really jumping for joy that Google now has Google Health - offering your personal health record on the web. I mean...I am all for getting medical help and information online, but putting your own health record online. Who will do that? Google enters the field of personal health records with a leading online brand, deep pockets and a wealth of technical skills. In a two-month trial this year, the Cleveland Clinic found that its patients were eager to use the Google health records. The pilot project, limited to 1,600 patients, was quickly oversubscribed, said C. Martin Harris, the Cleveland Clinic's chief information officer. Dr. Harris also said that when the clinic's online health records, introduced in 2004, were linked to the Google record the clinic's records were used more frequently by patients. "It positioned our personal health record more into an activity that they use every day," Dr. Harris said. The Google record, he said, allows the user to send personal information, at the individual's discretion, into the clinic record or to pull information from the clinic records into the Google personal file. Okay, yeah. Admittedly, all that is really convenient. However I cannot help but think of it security-wise. After all, health records are sensitive information. I have no problems with clinics and hospitals having electronic medical records. But putting such information online? I don't know, I am just queasy with the whole idea - but I haven't checked this service yet, though I am a heavy user of most of Google's services. But then, that's just me. It all remains to be seen whether general consumers will bite it. ;-) Read more from The NY Times. [Photo Credit: Google Health] See full article. Related Entries: Health Care and Human Services Online Education - 01 February 2004 Google Medical Scrapbook——真正的Google Health？ - 08 七月 2006 Loyola and Concord to Offer Online Health Education MJ - 25 October 2007 Google Health gestartet - 20 Mai 2008 RFID Can Stop Your Heart... - 25 June 2008 Contents of this feed are a property of Creative Weblogging Limited and are protected by copyright laws. Violations will be prosecuted. Please email us if you'd like to use this feed for non-commercial activities at feeds - at - creative-weblogging.com.
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  PHRs - Miracle or Mayhem?

  http://blog.praxeon.com/2008/06/phrs---miracle.html
  142 days ago in Praxeon Blog · No authority yet

  You may have caught some of the recent press around personal health records or PHRs. Both Microsoft and most recently Google have entered the market of providing individuals the ability to enter their personal health information in an on-line medical record. And in the case of Google, individuals have the ability to import their medical records from pharmacies, labs, hospitals and insurers. (Full disclosure – MyDailyApple is a Google Health service). A lot of commentary on Microsoft HealthVault and Google Health has focused on the advantages of accessibility and patient control. The PHR allows the patient to take their medical records anywhere and provide access to anyone at anytime – since it’s all on line. The major disadvantage that has been mentioned revolves around issues of privacy and security. Do you trust Microsoft or Google to safeguard your medical information? I agree that accessibility and portability are major advantages of PHRs and that security is a major concern. But I think most commentaries have missed some of the other major advantages associated with an on-line PHR and some of the major pitfalls. For instance, from a patient perspective, consider some of the following additional advantages beyond portability and accessibility: 1. Now you can review your records to see how your doctor thinks. You can see their decision making, how thorough they are and what other diagnostic possibilities they are considering. 2. You can see if your physician is compliant with the latest guidelines regarding screening, testing and treatment. In short, as a patient, you can now get some insight into whether or not you are getting high quality care. But on the flip side, from a physician perspective, there are some serious concerns with opening up medical records so easily: 1. Does this expose physicians to additional liability? What if a patient finds something wrong in their medical record or an omission of care? 2. Can you imagine a HealthVault or Google Health service provided by lawyers – “We’ll see if there is evidence of negligence in your PHR and get the money you’re entitled to!” Okay – some of you might think I’m being a paranoid doctor. But seriously – I saw an ad on the TV asking women who had an emergency c-section to get immediate legal counsel. Bottom line: Are providers really going to rush to provide easy access to medical records to on-line PHRs if it means they might get sued? On-line PHRs contain the aura of another miracle for what ails the US healthcare system. And certainly, greater transparency, portability and accessibility or records and patient empowerment are all important goals – furthered to an extent by the PHR. But there could be problems – and a great deal of reticence beyond issues of patient privacy – before there is widespread adoption. Google Health and HealthVault are not going to be enough to fix the problems in US healthcare. It’s going to take a couple of additional “mini-revolutions” beyond on-line PHRs – like in areas of medical tort reform and malpractice; easily understood and validated quality measures; financial incentives towards prevention and wellness and not just disease treatment – till this patient starts to get better. Special thanks to my father – whose conversations with him helped shaped much of my thinking for this current blog.
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  Google Health

  http://rockaintdead.blogspot.com/2008/05/google-health.html
  178 days ago in Rock ain't dead - A negative view of this piece-of-shit world · Authority: 2

  Google Health permite a al usuario ingresar información sobre su salud, tanto enfermedades que sufre y medicaciones recetadas; permite buscar información médica relacionada, y hasta compartir dicha información con su médico de cabecera. Toda la información puede ser ingresada en forma manual por el usuario, o si el usuario reside en Estados Unidos, puede importar dicha información directamente desde el sistema de información de su obra social. Google ofrece este servicio sin cargo alguno, y por el momento libre de la barra de publicidades relacionadas AdSense. Según algunos diarios como el NYTimes, Google tiene un gran número de clientes relacionados con la industria de la salud, por lo que no creo que vaya a pasar mucho tiempo antes que este nuevo servicio sea también alcanzado por la publicidad orientada al contenido que usualmente nos muestran todas las páginas relacionadas con el buscador. Con este nuevo servicio, Google suma información sobre nuestra salud a nuestro perfil de usuario, nuestra información financiera, nuestras fotos, nuestras casas, nuestras calles, nuestros amigos y nuestras redes sociales, demostrando que el Gran Hermano no necesariamente es un concepto gubernamental, aunque éste diga no hacer un mal uso de nuestra información. Teniendo toda esta información, no va a extrañarme el día que uno pueda combinar Google Health con Street View de Google Maps para encontrar a alguien con riñones saludables, mientras a éste le aparece en su página de información médica un banner ofreciendo bañeras o bolsas de hielo en ocasión. Estoy escuchando 'Asshole', por Gene Simmons. Cheers :-P You think that you're so cool That you're nobody's fool But you've got a personality (yeah) Just like a bucket full of pee How does it feel To be a real... Asshole You're such a creep You look like a sheep (ba-baah)... Asshole You know you've got no shame And you've got such a stupid name And one day you'll finally shut your trap 'Cause you are the cream of the crap Asshole... Asshole... You're such an asshole... You always look like an idiot This may be news for you You are the king of all stupidness Maybe I'm an asshole too Maybe I'm an asshole too Just like you You're such an asshole... You're such an asshole... Maybe I'm an asshole too Maybe I'm an asshole too Etiquetas: News, Things I wonder
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  Googlification vs picklification (if you see what I mean)

  http://bowblog.com/2008/06/03/googlification-vs-picklificati...
  182 days ago in bowblog · Authority: 36

  Before I get my teeth into the BBC Trust’s service review (I feel obliged to sooner or later) I enjoyed the collision of cultures (or contrast of cultures I guess) evident in two announcements made last week. In the first one Google announced that the company’s personal health platform thingie Google Health now works with medical records systems at various US hospitals (they started in Cleveland). Obviously this is just another step in the advancing Googlification of Everything but it’s also interesting because of the way it contrasts with the second announcement, which was from mega-government IT contractor Fujitsu (which used to be ICL) that they’ve got into a terrible pickle and have finally had enough of the vast and (by the sound of it) out-of-control government IT disaster-in-the-making that is the NHS medical records system. The former (Google and the hospitals) says: use light-weight, consumer-grade tools, put control in the hands of users and not administrators and concentrate on incremental methods, standards and interoperability. The latter (the £12 Billion NHS system) says: build grim, centralised and monolothic systems on a military-industrial scale, exclude open, incremental or agile methods because of your 1950s risk model and hope for the best. So the big question is: how many of these epic, national-scale contracting disasters do we need to see before we change our approach and try building important national systems by assembling existing code and services in a smart, non-dogmatic way? My guess: at least another ten years. Contractors (BT In particular) are queuing up to replace Fujitsu in the NHS job because the money is just vast. A real web 2.0 type approach to the project would cost 10% of the bid price for the whole thing and would get dozens of executives fired. In the meantime, I think everyone involved (at the NHS and Fujitsu at least) should read this fascinating presentation about the re-engineering of the BBC’s online identity system from Brendan Quinn and Ben Smith (thanks to Jem Stone for the link). To quote: 1. Each project must have a clear customer and a real benefit 2. Don’t repeat yourself 3. Be as simple as possible 4. Be as open as possible 5. Start simple, then iterate 6. Don’t optimise prematurely… 7. …but build to scale 8. Test often 9. Evolve 10. Let it die If the BBC, which is a pretty big institution—although I’ll acknowledge it’s an order of magnitude smaller than the NHS—can build like this then the NHS could too. I wonder if there is any radical thinking of this sort going on there or is it life in the bunker for all concerned?
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  Google Health goes live

  http://www.tonetek.co.uk/blog/google-health-goes-live/641/
  189 days ago in SEO, SEM, Internet News, Comment, Observations and Reviews from Tonetek Blog · Authority: 3

  Google announced that its online filing cabinet for medical records would become open the public today, following a preview of the service in February. Called Google Health, it lets users build a personal health profile, import records from care providers and pharmacies, research diseases, and locate hospitals, doctors and online medical services. Similar existing offerings include Revolution Health, backed by AOL co-founder Steve Case and Microsoft Corp.’s HealthVault. Marissa Mayer, Google Search Product Vice President, told the New York Times that Google Health differentiates itself from the pack through its user interface and the public availability of its application program interface, or API, allowing users to create tools such as web site widgets in order to enhance searches. The Mountain View-based search engine views its expansion into health records management as a logical move forward due to the millions of requests it receives daily from people trying to find information about illnesses, injuries and recommended treatments. The health venture provides fodder for privacy watchdogs who believe Google already has too much information about the habits and interests of its users in its logs of search requests and vaults of e-mail archives. One of the most contentious aspects of Google Health is that it isn’t covered by the Health Insurance Portability and Accountability Act, or HIPAA. Passed in 1996, HIPAA set strict standards for the security of medical records. Among other things, the law requires anyone seeking a patient’s records by subpoena to notify the patient and give the patient an opportunity to fight the request By transferring records to an external service, patients could unwittingly make it easier for the government, a legal adversary or a marketing concern to obtain private information. ”We are in uncharted territory here. A privacy policy, I don’t think, is enough to protect what needs to be protected in a doctor-patient record,” Pam Dixon, Executive Director of the World Privacy Forum told the New York Times. However, in an interview with The Associated Press, Mayer assured users that Google will not aggregate their health information across services, meaning activity on the health service will not show up in search results. In addition, Google’s official blog maintains that the most important aspect of the health offering is consumer empowerment, allowing users to collect, store, and manage their own medical records online. Digg This! | Save to del.icio.us | Reddit | Submit to Netscape | Google Bookmark This | Furl This | Add to Yahoo MyWeb 2 | Contact bigmouthmedia
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  PHRs, EHRs, privacy, functionality, and what the future might hold

  http://healthblawg.typepad.com/healthblawg/2008/05/phrs-ehrs...
  193 days ago in HealthBlawg · Authority: 58

  I had the opportunity to give an informal talk at a NEHIMSS gathering earlier this week.  It was a perfect storm: Google Health finally went live on Monday (and now I am the last blogger to blog about it), and a local institution has been involved as one of the first cohort of providers and others that can deliver patient records to Google Health should a patient choose to make that happen.  The patient privacy advocacy community is all fired up about the potential privacy issues brought to the fore not only by PHRs, but also by EHRs and by components of those systems, and related systems, that are being further defined these days at various levels -- consider, for example, the e-prescribing regs issued recently by CMS (see related press release and e-prescribing page), as well as the overarching Wired for Health Care Quality Act.  Letters have been written, reports issued.  Senate sponsors have apparently agreed to make some changes to the Wired Act, though some observers wonder if Ted Kennedy's health issues will derail action on the bill.  Not all advocates are satistfied, and there is another bill (known by its clever acronym, TRUST) wending its way through Congress as well.  Other observers believe that the privacy issues are so significant, and the opportunity to share EHR data with those who need it (i.e., other clinicians) is just around the corner, that the consumer-facing PHR business model is in serious trouble.  The Commonwealth Fund got into the act, too, releasing a report on a number of EHR implementations and the measurable benefits that accrue from their use. We had an interesting discussion about the benefits and burdens associated with PHR and EHR systems -- from evidence-based medicine built on appropriately-blinded secondary use of data, to better patient management through tracking of the filling of e-prescriptions.  While there are a lot of regulatory initiatives out there to promote EHRs and e-prescribing, the government is not mandating their use. Instead, it seems to be in the business of establishing standards (if you adopt such a system it must have certain features and be interoperable with other systems.  It is ceding the field to payors, who are likely to continue to mandate being wired as a condition of provider network participation. Back to the question of regulation:  HIPAA seems to have left some gaping holes through which Microsoft's HealthVault and Google Health may pass.  Those companies say that their privacy policies are more stringent than HIPAA and Google has said recently that serving ads on Google Health is not in the cards.  The problem with relying on these statementsis simply that they are voluntary policies adopted by businesses that may change them over time.  Other related parts of the health care information economy are similarly untouched by HIPAA.  This raises the perennial issue of the regulator: how do we regulate what is not covered by law?  This, in turn, raises a philosophical question about the nature of regulation, and the degree of specificity that is needed in a statutory or regulatory scheme.  (The more specific, the shorter the shelf life.)  Check out a fascinating discussion of rules-based regulation vs. principles-based regulation in a recent issue of The New Yorker.  While the magazine column is focused on US Treasury regulations (do we prevent another Enron or Bear Stearns debacle only by writing rules that would have limited specifically what Enron and Bear Stearns did, after the fact?), its points are generalizable to other regulated industries:  Why not establish broad principles (as many EU countries do) that allow for broad discretion on the part of regulators?  For example, financial statement disclosure need not be one-size-fits all.  Let's give regulators the tools to prevent the next debacle before we even know exactly what it will look like, instead of always fighting the last war.  One argument against the principles-based approach: if one believes an Administration to be unprincipled (or to have the wrong principles), then one cannot blithely grant broader discretion to the regulators.  It will be interesting to see whether the principles-based approach to rulemaking gains traction in other federal agencies. -- David Harlow

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