Web Based Personal Health Records: How much added value is there?
Google’s personal health record (PHR) is getting closer to becoming an on-line reality as it enters the pilot aspect of its development. Modern Healthcare recently provided an update to Google’s collaborative efforts with the Cleveland Clinic in the launching of the pilot program for the online PHR. The big story about this pilot is that Google is not providing any privacy protections as out lined by the Health Insurance Portability and Accountability Act of 1996, commonly referred to as HIPAA, during the pilot stage.
At the crux of the privacy issue is the lack of a signed business agreement between Google and the Cleveland Clinic. Both parties do have plans to sign such an agreement in the future though as the PHR program goes forward. Modern Healthcare did state that Google does have protections in place for now to ensure privacy, but those details were not apparent in the article. On a side bar, Microsoft Corp. has also developed its competing application called HealthVualt and is collaborating with the Mayo Clinic in a similar endeavor.
The idea behind these two PHR systems is to offer external provider (providers not associated with, in this case Cleveland Clinic) access to patient health records. Conceptually this will help providers who don’t have local access, where a patient may become ill or injured to obtain critical health information about a patient. Currently when one provider wants information about a patient they contact the patient’s primary hospital and have information faxed to them. It may be a little slower than getting on-line but it works.
Cleveland Clinic already uses an electronic health record system that allows many options for patients which include test scheduling, appointment management, and prescription renewal. Google’s PHR which is to be an extension of Cleveland’s MyChart program will not offer such services. The MyChart program also automatically notifies patients when certain routine testing should be done based on their medication profile or age. The example used related to women getting mammograms at a specific age, a prompting service put in the system.
In many instances technology has made our lives a bit more efficient and convenient. Technology has clearly exploded in the business world in terms of manufacturing. It was only a few years ago when we all had VCRs in our homes, then we went to DVDs, film cameras to digital cameras. No doubt technology has made a place for itself in today’s busy life. The question I have is this. When does technology stop adding value and becomes more of a liability?
Electronic health records (EHR) maintained within a healthcare organization (Hospital/Clinic) provides ease of access and facilitates the communication of information to multiple people that may need simultaneous access for decision making. This information is currently kept within the confines of the institution and public access does not exist.
The applications that Google and Microsoft Corp. are developing add a new dimension to the EHR that provides an unclear value. If we use the premise that most of us utilize the same hospital/clinic for our care on a regular basis, there doesn’t seem to be the need for a national PHR database such as Google’s or Microsoft’s. The majority of the time, when patients access the healthcare system they do it locally and historical healthcare information is readily available. The advent of an internet based PHR should cause some concern for security and privacy. Even with today’s technology, breaches in security and hacking occur at a seemly exponential level. Internet based PHRs will likely become a new target for hackers and crashers; infecting viruses, pulling information from one record and placing it in another. These and other security problems I think are all possible scenarios. How much added value is there with establishing such an internet based service? Are we opening ourselves up for exposure and asking Murphy to come and visit? From a cynical perspective are Google and Microsoft looking at this as nothing more than a way of increasing their market share for advertising dollars, or do they think this provides a real value to the healthcare system? Will healthcare organizations be charged for accessing patient information, and how will external providers gain access to PHRs? How will Google or Microsoft ensure the authenticity of a provider before granting access? I am not convinced.
About the Author
Mike Pringle is the creator of Mike’s ViewPoint, where he provides his perspective on various Healthcare issues. He has over 20 years of nursing experience working both domestically and internationally. Mike has a Bachelor’s Degree in Nursing and a Masters Degree in Public Administration with a healthcare emphasis. He specializes in both Emergency and Critical Care Nursing. Mike has held positions ranging from department staff and Nurse Manager to Executive positions.
Benjamin Wright responds:
Posted: February 24th, 2008 at 9:25 pm →
Maybe patients can use contract law to enhance the privacy of their health records. http://hack-igations.blogspot.com/2008/02/contracts-for-patient-privacy.html
Mike Pringle responds:
Posted: February 26th, 2008 at 12:56 pm →
Thanks for the comment Ben. Contract law could possibly work as you suggest. Unfortunately I can not speak intelligently about the intricacies of contract law to advocate its application or not. I still don’t know if this type of service that the two software giants are providing adds any real value to anyone’s medical record system. I enjoy the convenience that technology often offers, however at the same time I wonder if we get ahead of ourselves. One of my favorite sanity points regarding any decision making process is to always make this statement when it is not clear as to how to proceed. “Just because we can, doesn’t mean we should”. I can not help but feel that both Google’s and Microsoft’s PHR application falls into this category.