Google Health opens, sparks privacy woes

After a year and half of development, Google's online filing cabinet for personal medical records is open to the public, giving users instant electronic access to their health histories, while reigniting privacy concerns.

Called Google Health, the service lets users link information from a handful of pharmacies and care providers, with plans to add many more. The Internet search giant is the latest entrant in the growing field of companies offering personal health records on the Web. Their ranks range from longtime online health services such as WebMD to the software powerhouse Microsoft to start-ups such as Revolution Health.

The companies all hope to capitalize on the trend of consumers increasingly seeking health information online, and the potential of Internet tools to help them manage their own health care and medical spending.

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. Google Health differentiates itself from the pack through its user interface and features such as the public availability of its application program interface, or API, said Marissa Mayer, the Google executive overseeing the service.

More than two dozen companies and institutions announced that they are partners with Google Health, including Walgreens, CVS, the American Heart Association, Quest Diagnostics, Beth Israel Deaconess Medical Center and the Cleveland Clinic.

Mary Adams, 45, a Cleveland Clinic patient who participated in the Google Health pilot, said that she was initially concerned about the privacy of her medical information. Still, she felt safe enough to enroll and has been using the service for six months, linking it with an online health management tool from the Cleveland Clinic and adding information on prescriptions and doctors to her online profile.

The service, still a non-final ''beta'' version, does not include ads. Besides importing records from providers, users can enhance their password-protected profiles with details such as allergies and medications, they can search for doctors and they can locate Web-based health-related tools. The health venture provides fodder for privacy watchdogs who believe Google already has access to too much about the interests and habits of its users in its logs of search requests and its vaults of e-mail archives.

Pam Dixon, executive director of the World Privacy Forum, said services such as Google Health are troublesome because they aren'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.

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, Dixon said. During a webcast earlier this week, Mayer said users' health information is stored at Google's ''highest level of security.'' Mayer said in an interview with The Associated Press that users' health information will not show up in search results.

Utah company is participating: A Utah company is one of 14 businesses and organizations that are part of the offerings of Google Health. MediConnect Global of South Jordan offers to retrieve medical records for Google Health users and to identify information from them to be placed in their profiles.

MediConnect will digitize the records from health care providers identified by customers. Customers will be able to access their records online or download them to their own computers. "MediConnect's medical record retrieval service allows people to have access to information from their personal health history from anywhere in the world at anytime," said Amy Rees Anderson, company CEO. The company charges a fee of $98 for up to 100 pages and 10 cents per page for additional records, said Cory Maloy, director of communications. The company complies with the federal health privacy law, he said.



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Online Health Info System Is Unveiled by Microsoft: Privacy and Security top list of concerns.

Microsoft Corporation has released a new software product and free Web-based platform that allows individuals to collect, store, and share their electronic medical records. HealthVault is intended to allow people to access their medical records through any device, regardless of the health care provider or insurer. Microsoft has also developed HealthVault Search, a new Internet search engine that helps people find answers to health questions, learn more about topics important to them, confidentially store information they discover, and act on that knowledge to improve their health and wellness.
HealthVault Search also intuitively organizes relevant online health content, allowing people to refine Internet searches to more efficiently find information.

Empowers Consumers
Experts say technology can play a key role in helping solve the problem of "health care fragmentation," the dividing up of a single patient's providers and records between several organizations and locations, and can empower consumers by giving them more control over, and information about, their health care.

"A system like HealthVault can help put patients in control of their own health care by putting information and access directly in their hands, instead of forcing them to go through various intermediaries," said Jeff Emanuel, research fellow for health care policy at The Heartland Institute and managing editor of Health Care News.

"A functional market must be based on empowerment of the consumer, and the health care market is no different," Emanuel said. "Telemedicine and health care technology allow consumers to control their own treatment and records, thereby giving them a stronger hand in their care."

Security Measures
While developing HealthVault, Microsoft consulted privacy advocates, such as the Coalition for Patient Privacy, along with online security experts. HealthVault keeps a log of each time a record is written, changed, or read, which means users can view an audit trail in their personal HealthVault account at any time. Microsoft's HealthVault systems and databases are safeguarded with extra precautions, such as isolating data center traffic on a virtually separate network, and keeping servers in physically separate, locked cabinets. All data traffic to and from HealthVault and its solution providers is encrypted. The system's backup data are also encrypted, and its transportation is logged every time a record is accessed, uploaded, or downloaded.

Privacy Concerns
Not everybody feels confident about Microsoft's ability--or intent--to protect patient privacy. Some analysts point to the system's privacy policy as a sign it is still vulnerable to the targeted disclosure of private information. The policy says, in part:"Microsoft may access and/or disclose your personal information if we believe such action is necessary to: (a) comply with the law or legal process served on Microsoft; (b) protect and defend the rights or property of Microsoft (including the enforcement of our agreements); or (c) act in urgent circumstances to protect the personal safety and welfare of users of Microsoft services or members of the public" (emphasis added).
"Privacy concerns are consistently shown to be one of the public's biggest worries as health care moves toward a digital future," said Emanuel. "Microsoft's reservation of the right to disclose personal medical information if company officers see such a disclosure as being in the company's best interest is worrisome.

"Security of information should be a primary focus in technological endeavors such as these," Emanuel continued. "Despite the best of intentions, lapses in security can occur, and information can be inadvertently released. Purposely disclosing personal health information is far worse than that.
"Regardless of the reasons for disclosure, the results of such a violation of privacy can be devastating," Emanuel said.

Published In: Health Care News | June 1, 2008 | The Heartland Institute

Microsoft launched the beta version of HealthVault in October 2007. The site was officially launched this February, and in April it was opened up for wider use. Click here to learn how Microsoft® HealthVault™ helps Physicians and hospitals better connect with patients.

INDUSTRY LEADERS FORM TASK FORCE TO ALIGN ON ELECTRONIC HEALTH RECORD STANDARDS

May 1, 2008 - Focused on the acceleration of electronic health records, industry leaders from Canada Health Infoway (Infoway), Canadian Healthcare Information Technology Trade Association (CHITTA, the Health Division of Information Technology Association of Canada (ITAC)), and the Association of Health Technology Industry (AITS) announced today they have formed a task force to accelerate and promote the transition to a new set of pan-Canadian health information technology standards.

The task force will collaboratively work to promote the adoption of pan-Canadian standards, especially with point of service systems, by engaging clinicians, health care providers and vendors. Involving these stakeholders will support the planning required to ensure the interoperable electronic health record (iEHR) is leveraged and the adoption of pan-Canadian standards is accelerated.

"Time and again, we have seen the success of industries like the financial and consumer sectors drive faster end-user adoption through the implementation of standards," said Dennis Giokas, Chief Technology Officer, Canada Health Infoway. "With the aligned direction of our industry partners we can now work collaboratively to accelerate the deployment and use of these interoperability standards for the benefit of Canadians and the Canadian health care system."

Common standards are an integral element of, and a key requirement for, the establishment of a pan-Canadian interoperable electronic health record. Significant cost savings and quality improvements are achieved when custom integration is eliminated. Patients, clinicians and health service delivery organizations all benefit when data can be reliably shared across health care systems.

"We have been building health care systems using industry standards for over 20 years. Achieving full adoption of the pan-Canadian standards, and realizing the benefit of Canada's health infrastructure investments, is a multi-year journey until new products emerge and legacy systems are retired," said Brendan Seaton, President, CHITTA, the Health Division of Information Technology Association of Canada (ITAC).

"Health information systems tend to be stable, so we will see a period where both existing and new standards are supported. We look forward to collaborating with health providers and Canada Health Infoway on developing solutions for this transition."

To enable the successful deployment of interoperable electronic health record solutions, the organizations support the use of: HL7 and DICOM for messaging, LOINC® and SNOMED CT® for terminologies, HL7's Clinical Document Architecture (CDA) for documents, HL7's Clinical Context Object Workgroup (CCOW) specification for clinical context management, as well as the pan-Canadian interoperability profiles.

"The transition to common, pan-Canadian standards allows us to achieve the highest quality in an interoperable electronic health record system. As an industry we are starting to see market demand for these new standards, and our members are making commitments to meet that demand. Success will come when we work together on this very complex challenge," said Daniel Laplante, Executive Director, AITS. Canada is a strong contributor to the global acceleration of EHR standards through its unique collaboration model.

Launched in 2006, the Standards Collaborative provides coordination, implementation, support, education, conformance and maintenance of electronic health record standards in Canada. One third of its members are representatives from health information technology companies.

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About Infoway
Infoway is an independent, not-for-profit organization funded by the Federal government. Infoway jointly invests with every province and territory to accelerate the development and adoption of electronic health record projects in Canada. Fully respecting patient confidentiality, these secure systems will provide clinicians and patients with the information they need to better support safe care decisions and manage their own health. Accessing this vital information quickly will help foster a more modern and sustainable health care system for all Canadians.

About CHITTA
CHITTA, the Canadian Health Information Technology Trade Association, is the Health Division of ITAC, the Information Technology Association of Canada. CHITTA represents more than 120 companies across Canada that provide information and communications technology (ICT) products and services to the health sector. CHITTA represents the Industry to governments and health care decision-makers for the purposes of building a strong and sustainable health ICT industry in Canada, promoting investment in health ICT, and ensuring the interoperability of health ICT systems.

About AITS
Created in 1987 and representing over 100 members, the Association of health technologies industry's (AITS) mission is to stimulate the development of the health technologies industry and to promote its economic and social value. AITS is a meeting place for exchanges between partners on domestic and foreign markets.