Google to Begin Storing Patients' Health Records 214
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."
Great... (Score:5, Funny)
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Sorry to hear about your problem; even more sorry to hear that it's on the record.
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]
Re:Great... (Score:5, Funny)
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!
Re:Google VS Microsoft (Score:4, Insightful)
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At the very least, Microsoft's Live Hotmail doesn't scan your email like Gmail does. Google's policy on privacy is questionable at best. The minute Microsoft starts scanning my email to target me with ads, I'll quit defending them.
Microsoft's security division dwarfs that of Google's. In the past year, was Live Hotmail any less secure than Gmail? Microsoft has its faults too, but so does every company, including Goo
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You use Hotmail for a example, I'll use MSN.
Google defends your privacy strongly. MSN will hand over anything the government asks for with no reason.
Wonderful privacy eh?
A machine reading my email, not for information gathering but to target ads is fine.
Its a very straight forward process and your privacy cannot really be compromised in any way because of it.
I do pay $50 a year for a premium Gmail account.
I do it for the other features though like domain support and not the lack of a
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At least Google doesn't delete your file attachments [hubpages.com] for no reason.
At least Google censor web links [adiumx.com] you send to your friends.
Who gives a crap if a machine reads my email?!! It's going through the intertubes, EVERYONE can read my email unless I encrypt it.
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Gmail loses attachments [liewcf.com]
Gmail loses all mail [ehmac.ca]
Censorship by Google [wikipedia.org]
Again, a lot of mistakes that Google does get swept under the rug, because they're Google. Meanwhile, any mistake that Microsoft does gets put in the spotlight.
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More to the point, no company should be trusted with that kind of personal information. Not Google. Not Microsoft. No one.
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Not only has Microsoft attempted such a thing, but they've succeeded and already have a working version. [healthvault.com] Its Google that's playing catch-up here, not Microsoft.
To be fair, though, I wouldn't like either company to be snooping around in my health records.
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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In short, I trust Google about as much as Microsoft when it comes to making profits on this. And will the cost associated with it trickle down to patients? Probably.
Re:Cleveland Clinic (Score:4, Insightful)
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.
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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You know, you're right. Its like the "how to boil a frog" analogy. Time to switch default search engines ...
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My medical data is mine. Not any health-care providers ... they have absolutely zero right to share it with any business entity, and the law backs me up on it.
We don't need slippery slopes. There are already too many people w
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For now ...
Just look at the history of the Social Security Number - it was supposed to be used ONLY for Social Security ... now what? Its used as an ID almost everywhere.
And I dumped my gmail account over a year ago - and today (because of creeping big-brotherism) I've changed my search engine as well.
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.
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Granted, you can have more than one identity, but generally I think people like having single handles. It lets you build a reputation across multiple sites.
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Personally, I think "Identity 2.0" is a solution in search o
HIPAA compliance? (Score:4, Interesting)
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Also, change the password of that one "critical" service regularily.
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Anonymous Coward?
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[ Reply to This
Well your username is certainly very prevalent on most of the sites I visit.
I wonder how you find the time!
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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Seriously, what's the secrecy here?
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It's called looking at the big picture, not using a trivial example to attempt to trivialize the whole issue.
Re:Double-edged sword (Score:4, Insightful)
Abortion
Substance abuse
Domestic violence counseling
Prescriptions for drugs associated with a disease that has a bad stigma
And those are just a few examples of what people would want protected. I'm pretty sure that you would not want people to know that you are seeing a doctor about impotence? right? Perhaps you don't really want people to know that you are color blind or deaf in one ear. Maybe you are embarrassed if people know you have herpes.
Perhaps you don't want people finding out that your kids have been treated for sexual abuse (the record probably won't say it wasn't you that committed the abuse).
There are way more things that you don't want people to know than things you do. Hardly anyone goes to the doctor for something good.
But, if you want to tell the world that you have warts on your 1 inch penis, go ahead... we won't stop you.
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Quant, call it a night (Score:2)
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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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As long as the details of all hospital and doctors that use these services are effectively sell you details for free data storage are publicly and clearly displayed across the internet so th
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If the government has it (Score:2)
If the government has it, the governments get it.
If the governments get it, the corporations get it.
If the corporations get it, the mafias get it.
If the mafias get it, the rich and powerful own it.
No information is secure because powerful/rich individuals can access anything stored anywhere on earth. Just because the governments can hold the information, doesn't mean there aren't moles and terrorist cells in the US government who will sneak the information out and sell it to terrorist groups. And of course
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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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I'm not sure they are legal as proof anyway - I know that my daughter's day care won't accept it, and I have to have the doctor fill out a separate form.
Re:Double-edged sword (Score:4, Interesting)
Same as with tax records, really: Not every paper solution is automatically non-fragile.
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The motivation for high-tech solutions is
a) high-tech is cheap enough now that at scale, it could actually be cheaper than printing booklets and buying ink and stamps
and more importantly
b) people have too much information for paper storage and organization to be as practical as it once was. It would only take a couple years to fill up an entire drawer of a filing cab
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It's a waste of time. (Score:2)
Too late, the black market always has it. (Score:2)
1. If the government has the information, the black market has it.
2. The black market can simply buy the information from the people who work in the hospital.
The lesson? No information which is stored in plaintext anywhere on earth is secure. As long as a pair of eyes can see it, whoever owns that pair of eyes, can capture and sell whatever information. It's already too late.
Password Protected? (Score:4, Insightful)
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"a clinic" in Cleveland? (Score:5, Insightful)
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Re:"a clinic" in Cleveland? (Score:4, Insightful)
If that is the case, then they really blew it with todays headlines. That McCain piece is about the most unsubstantiated news un-worthy gossip I've seen in a while. If the Obama campaign touches that one, he loses my vote.
I would be surprised if he does (Score:2)
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.
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The full solution (Score:4, Insightful)
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So on Monday you go see Dr Smith, who writes you for 120 x 10mg doses. Then you just erase Dr Smith's note from your record, and on Tuesday go see the good Dr Mendez, who writes for 80 x 10mg doses. Then delete again and go to see t
Future Killer App (Score:5, Funny)
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World Privacy Forum (Score:2, Informative)
They discuss how PHR vendors may not be covered by HIPAA nor patient/provider confidentiality laws (esp subpoenas.)
They particularly note that PHR vendors that also provide email services have a lot of data that can be easily linked together (...and to you.)
I'd really like to see this sort of thing work, but am cautious.
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.
In fact (Score:3, Interesting)
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Please explain how "health data" has "enough info" to "allow the run on the bank". And for the readers who have no idea how to read crazy, please also explain what you mean by this fragmented poor english.
kthxbye.
Re:In fact (Score:4, Insightful)
Many of the Health data systems are built on Windows and built poorly. The security that everybody thinks is there, really is not. 25-15 years ago, I worked at various medical facilities including Metpath/corning, BlueCross/Blueshield (just at time of going private), and IBM/Kaiser (worked on the system that was in there for over a decade). I am aware of a at least a few of the systems that currently exists. From talking to a few others that still work in the industry, I know that security STILL is not taken as serious as it should be. Hippa has made changes, but from what I understand more of trying to control who sees what, and not as much on the computer. The health system is NOT just your patient info. Most of the systems contain your insurance and ultimately has loads of information on your checking and/or CC (assuming that you are not visiting a money only doc). All somebody has to do is hack these systems to obtain information. They then build up a DB and use it to attack in one clean shot, or chose the option of quietly and methodically taking the money.
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
How much access? (Score:4, Interesting)
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National Security Letters? (Score:2, Interesting)
So all this talk about Google standing up to protect user data from the US Administration is as true and verifiable as their motto itself ("Don't be evil").
"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.i'm in ur... (Score:2, Funny)
Sorry, I just couldn't resist.
Privacy Ammendment (Score:4, Interesting)
As a professor of Constitutional law at the University of Chicago, he should be abundantly aware of how fragile our right to privacy is in this country, being that it's an inferred right that rests only on precedent.
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Potential for research? (Score:3, Interesting)
As a poster above noted, finding a way to query the data is a problem. Finding ways to anonymize patient information is a problem(how many elements of medical history does it take to identify a human?) But in the end, if google were subsidizing my health care, I just might say do whatever the fuck you want with my charts!
Which brings this back to one of the question of the century: When will the consumer own it's own data? Today this might be a service Google looks to sell as "You pay us to data warehouse your medical records", but tomorrow it might be "You pay us to mine the data warehouse that we've established."
Are the inconsistencies of patients chart data too much of an obstacle to overcome? I'd hate to think that Google is just doing this as a form of Web 2.0 SAS, 'pay me to do what you used to do yourself' service. I've always imagined that Google figures, if they get enough data in one place, something magical will happen. Medical research of millions or hundreds of millions of patient histories seems like it could be magical.
I want my medical records... (Score:2)
...but I don't necessarily want to store them at Google or any other 3rd party vendor, unless Congress amends HIPPA to cover them. I'd rather have the option of carrying my records around on an encrypted USB or other portable device. That would mean getting health care providers to use common file formats and standard forms. Not holding my breath.
I wanted to something similar with my pets. Put their vet records on a little memory stick card I could put in a special holder in their collar. Treatment h
Employers (Score:4, Insightful)
Highly volatile (Score:3, Informative)
Google already compromised? (Score:2)
Re:Not Mine (Score:5, Informative)
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The REAL issue is that HIPAA has no teeth. No one has yet really had a judgment entered against them on a HIPAA privacy violation that I am aware of, and
Re:Not Mine (Score:5, Informative)
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If you don't like it, don't use it. This isn't a mandated thing by any means.
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Re:I for one welcome our new informational overlor (Score:2)
Unlike the USA, where they are free to collect any information and not say who they are going to sell it to.
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