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Google to Begin Storing Patients' Health Records
Posted by
Soulskill
on Fri Feb 22, 2008 12:14 AM
from the meet-doctor-google dept.
from the meet-doctor-google dept.
mytrip writes with news that Google's health record archive is about to be tested with the assistance of the Cleveland Clinic. Thousands of patients (who must approve the transfer of information) will have access to everything from their medical histories to lab results through what Google considers a "logical extension" of their search engine. We discussed the planning of this system last year.
"Each health profile, including information about prescriptions, allergies and medical histories, will be protected by a password that's also required to use other Google services such as e-mail and personalized search tools. The health venture also will provide more fodder for privacy watchdogs who believe Google already knows too much about the interests and habits of its users as its computers log their search requests and store their e-mail discussions. Prodded by the criticism, Google last year introduced a new system that purges people's search records after 18 months. In a show of its privacy commitment, Google also successfully rebuffed the U.S. Justice Department's demand to examine millions of its users' search requests in a court battle two years ago."
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Great... (Score:5, Funny)
Re:Great... (Score:5, Informative)
Microsoft's HealthVault came out several months ago, and has more partnerships than Google.
http://www.healthvault.com/ [healthvault.com]
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Re:Great... (Score:5, Funny)
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Re:Great... (Score:5, Interesting)
If anything, Microsoft is ahead in the game of press releases, but certainly not in a functioning and useful Electronic Health Records system.
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Re:Great... (Score:5, Funny)
Just think how useful this could be for your doctor. No more tedious working out what to prescribe you. Just type the diagnosis into your google page, refresh, and adsense will immediately deliver links to drugs that are just the job!!
And you get paid for the click-thrus! It's a win-win scenario and almost worth being ill for!
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Cleveland Clinic (Score:5, Insightful)
It's Cleveland Clinic, and it's pretty much in every major city. So there are more people affected then just in Cleveland.
Re:Cleveland Clinic (Score:5, Informative)
Over my dead body? Ha! Not even then!
Fortunately, this sort of activity is illegal in Canada (PIPEDA [privcom.gc.ca]), so I for one won't ever have to welcome your google overlords.
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Re:Cleveland Clinic (Score:5, Interesting)
It only makes sense for a trusted third party (with technical expertise) to hold onto this data. Personally, I trust a government (state or federal) or non-profit program with community oversight to a for-profit corporation for this. Others may simply not want any digital health records, just like some folks don't want to have online access to their bank account.
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Re:Cleveland Clinic (Score:5, Informative)
"This sort of activity is illegal" (currently)
Google's marketing argument to a government is likely to include the idea that Google are using its own computers, so it saves the government money, while still giving the government control. The small print however, is that a marketing company would have direct access to everyone's details and they will do data mining on it.
Google's "do no harm" PR smoke screen marketing theme is sounding more hollow, every new move Google makes. Their goal is to become some kind of marketing version of Big Brother, but with the total knowledge they are building up, they will also have immense political power as well. Google data mine everything they have. They are not holding medical records for free. They will do some data mining on them.
Each new chess move of Google reminds me of the saying "The road to hell is paved with good intentions". Google is becoming Big Brother. Yet few people seem to be able to see its slowly happening.
This Hospital data move is like Googles Knol idea, its yet another facet of their move towards Big Brother
http://science.slashdot.org/comments.pl?sid=389296&cid=21697432 [slashdot.org]
and as for trusting marketing people
http://science.slashdot.org/comments.pl?sid=448546&cid=22377974 [slashdot.org]
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Is it scary yet? (Score:5, Insightful)
But when you associate my email, calendar, documents, health info and who knows what's next, I start to wonder if that might not be too many eggs in one basket?
And if you are like me, your handle/username/login is the same across many sites.
Double-edged sword (Score:5, Interesting)
Re:Double-edged sword (Score:5, Insightful)
The trouble is that I don't want anyone else to have it. We have technology that can go anywhere with us. You can carry a key fob that will hold it all etc. More to the point, you can carry a key fob with better security than a password with you to access, and allow access for updates by those of your choosing.
Yes, Google will make it convenient, but we need to do more about the security of it both in access to it, and what happens to it while stored somewhere other than in our homes. The mobile devices that we carry around, ordinary telephones, and other simple items make 2 part authentication easy (well easier) than you think. We should be using them.
Additionally, we already have rules about sharing health-care information. Lets use those laws, not make more, to ensure the integrity of that privacy.
Anyone here who thinks that their privacy is safe because their health care information is not yet stored by Google is completely mistaken. It's very easy to get your health care information from the current system through human error, and social engineering.
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Re:Double-edged sword (Score:5, Insightful)
I suppose it all comes back to things being run by human nature, and sooner or later you'll have to make a deal with the devil and give him his due; increased convince (eventually to the point that it will be impossible to function without it) for a decreased amount of privacy. In theory your SSN is only related to taxes; in practice you can't get through life easily without giving it to every Tom, Dick, and Harry.
Security by obscurity might be the only measure of protection we have, but that's not terribly comforting when someone *thinks* you did something wrong, or when someone *gets* your data (though google seems much better at protecting data than most banks and governments).
On the plus side it might be nice to see spam for drugs that you can actually use, compared to everyone getting offers to increase penis size with drugs to keep it up for hours.
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Re:Double-edged sword (Score:5, Insightful)
Meanwhile, we in stone-age Europe usually receive little booklets at our birth and whenever a doctor immunizes us, he enters a stamp plus some info there. Same as with voting machines, really: not everything is in need for a fragile high-tech solution.
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Password Protected? (Score:4, Insightful)
"a clinic" in Cleveland? (Score:5, Insightful)
there are others doing this already (Score:5, Insightful)
I chose not to participate, because the provider was new and unknown to me. I don't think I would want to use Google, because they ARE known to me.
I'll just keep asking for copies of records when I visit a doctor, and keep them in my filing cabinet.
Do I get access to my own records? (Score:5, Insightful)
Can I log in and see everything myself? And can I see the list of everyone who ever accessed my records? If not, it's no good.
Future Killer App (Score:5, Funny)
For the privacy worriers... (Score:5, Insightful)
This is a very big step up from what you now have. I worked for some time in the client-server programming department of a health care organization with 20,000+ employees, on projects ranging from inventory management to patient records to corporate salaries. This company did much better than most, and I can tell you that your privacy is not terribly secure.
When you're dealing with a situation which requires thousands of people (doctors and nurses) immediate access to your records, from anywhere in the organization (spannint numerous states), even if you ruled out network security, system security, etc., the possibilities for social engineering are absolutely ENORMOUS. And more than that, with that many employees, it's simply a given that some of them will misuse their power. Just within my friends who work for the company, I know of a very good number of times when information of others was accessed, used, or disseminated for personal use or amusement. Never anything nefarious, but still, not only unethical, but against the law as well.
Google has a much better idea of how to warehouse data, manage access to it, and audit usage and access than any of the individual health care companies out there. They may not be perfect, but they'll probably do a whole lot better than what we/you have now.
Re:For the privacy worriers... (Score:5, Informative)
The idea of HIPPA securing medical data can be considered a sense of false security. Companies must show they are making a reasonable amount of effort to secure PHI. Making a reasonable amount of effort does not mean the information is very secure.
In my opinion HIPPA does not ensure the privacy of an individual's health information very much but merely gives everyone a false sense of privacy.
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Here's some medical records privacy horror stories (Score:5, Informative)
http://www.post-gazette.com/pg/06362/749444-114.stm [post-gazette.com]
WSJ, 26 Dec 2006, Medical dilemma: spread of records stirs patient fears of privacy erosion; Ms. Galvin's insurer studies psychotherapist's notes; a dispute over the rules; complaint tally hits 23,896, Theo Francis.
(My notes, for people who are too lazy to even click on the link:)
In 1996, after her fiance died suddenly, Patricia Galvin left New York for San Francisco and was hired by Heller Ehrman LLP.
In 2000, Galvin began psychotherapy sessions at Stanford Hospital & Clinics with clinical psychologist Rachel Manber, who discussed her problems at work, her fiance's death, and her relationships with family, friends and co-workers. Manber assured Galvin that her notes would be confidential.
"I would never have engaged in psychotherapy with her if she did not promise me these notes were under lock and key."
In 2001, Galvin was rear-ended at a red light and suffered 4 herniated disks, which worsened.
In 2003, she applied for long-term disability. Her employer's carrier, UnumProvident Corp., said it would deny her claim unless she signed a release.
Manber assured Galvin her therapy notes would not be turned over. 3 months later, Unum denied her claim, because of psychotherapy notes about "working on a case" and a job interview in New York, which, Unum said, showed she was able to work. Galvin says they misinterpreted the notes.
In 2004, Galvin sued Manber, Stanford and Unum for malpractice and invasion of privacy, under California law. Galvin said "my most private thoughts, my personal tragedies, secrets about other people" were exposed.
In 2005, Galvin learned that Stanford had scanned Manber's notes into its system, making them part of her basic medical record. Stanford sent this file to Unum and the other driver.
Stanford said that "psychotherapy notes that are kept together with the patient's other medical records are not defined as 'psychotherapy notes' under HIPAA." It would be "impracticable" to keep them separate.
The health-care industry is scanning documents into electronic record systems. HIPAA gives psychotherapy notes special protection, but not when mixed in with general medical records.
Peter Swire, law professor, Ohio State U., explains why they wrote the rule giving confidentiality only to separate psychotherapy notes.
Stanford refused to separate her psychotherapy notes from other medical records. "Any time anybody asks for my medical records, my psychotherapy notes are going to be turned over."
In 2006, DHHS rejected Galvan's HIPAA complaint. From Apr-Nov 2003, DHHS had 23,896 privacy complaints, but hasn't taken any action. HIPAA exceptions allow release in connection with "payment" or "health-care operations."
Galvan, 51, is representing herself, because she couldn't find a California attorney with privacy experience.
Deborah Peel, Austin TX, psychiatrist and head of Patient Privacy Rights, says, "How many women want somebody to know whether they are on birth control?"
http://online.wsj.com/article/SB116709136139859229.html [wsj.com]
NYT, 26 Dec 2006, Costs of a crisis: Diabetics confront a tangle of workplace laws, N.R. Kleinfield.
Some companies fire diabetics for ostensible safety reasons, even though there's no evidence that they're unsafe. Courts nationwide have split on whether diabetes is a disability under the test that a "major life activity" is "substantially limited".
John Steigauf, 47, was a truck mechanic for United Parcel Service, but UPS put him on leave because of his diabetes. UPS claimed his blood sugar might plummet while he tested a truck, causing an accident, and he couldn't get an interstate commercial driver's license with insulin-dependent diabe
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"Searching" structured data is hard! (Score:5, Informative)
Google has done a great job in searching raw free-text data. However, healthcare data is a different beast. The sheer number of datatypes is mind-boggling -- the number of different labs, drug classes, diseases etc that can get coded in patient records runs in to millions. So over the years healthcare databases have been constructed differently - they follow an EAV [yale.edu] (Entity Attribute Value) representation, which means that the patient databases are generally just ONE BIG TABLE! Here is the database schema used at New York Presby. Schema [columbia.edu] - all past 20 years patient data is stored in one table! oh yeah.. DB2 Baby!
Essentially all data/knowledge complexity is present in the Ontology/Terminology (such as SNOMED or LOINC) and the patient data itself instantiates from these.
Also doing NLP over medical notes is a difficult problem requiring years of tuning and domain knowledge to construct one -- which again is so specific to a given institution or region that it just does not work elsewhere.
It would be interesting to see what *real* innovations Google brings on the table.Re:Not Mine (Score:5, Informative)
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Re:Not Mine (Score:5, Informative)
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