Google Health is Frightening

That's right. Google wants to host your medical records. Last week they announced a partnership with a clinic in Cleveland, OH. Now they're talking more about the product itself. Here's the scoop from Google Blog:

• Platform - One of the most exciting and innovative parts of Google Health is our platform strategy. We're assembling a directory of third-party services that interoperate with Google Health. Right now, this means you'll be able to automatically import information such as your doctors' records, your prescription history, and your test results into Google Health in order to easily access and and control your data. Later, this platform strategy will mean that you will be able to interact with services and tools easily, and will be able to do things like schedule appointments, refill prescriptions, and start using new wellness tools.

• Portability - Our Internet presence ultimately means that through Google Health, you will be able to have access and control over your health data from anywhere. Through the Cleveland Clinic pilot, we have already found great use-cases in which, for example, people spend 6 months of the year in Ohio, and 6 months of the year in Florida or Arizona, and will now be able to move their health data between their various health providers seamlessly and with total control. Previously, this would have required carrying paper records back and forth. With Google Health, the user can simply import the data from each medical facility and then choose to share it with the other facilities. It's advances in data portability like this that we think can really make a difference in the quality of healthcare. The clearer and more comprehensive the information regarding your health becomes, the better your care will be.

I'll be clear. I like Google. I think they mean well. They've got a ton of smart people there. On the other hand, the idea that my medical records are stored somewhere central, indexed and made available to anyone who can get access to the machine (as opposed to my doctor keeping his own records and sharing them when I tell him to) goes completely counter to my sense of privacy. Some things are best kept difficult. Sharing confidential records of any short should be one of them. To be honest, I think anything you want to keep secret or confidential should be on paper. My doctor, who is a pretty young, tech-savvy individual, uses a tablet PC to take his charts, and he's been kind enough to print his notes and stick them in a paper file.

Why do I ask him to do this when I don't have anything to hide? When there is no paper, there is no paper trail. If I know that only my doctor has my records, if they show up anywhere else, I have a pretty good idea of where they came from. If they're hosted on Google's machines, I have no idea who is doing what with my data.

Would this extend to mental health records? Imagine if you went to a therapist, marriage counselor, rehab, whatever, and those notes and records were online for "easy access." I want it to be a total pain in the neck for anyone to get them. I want it to be difficult for me to get them sent to anyone.

I switched Dentists this year. To transfer my charts and X-Rays, I had to call my old dentist, have them fax my new dentist a release form, which I signed in their presence, which they faxed back to my old dentist, who put my charts and X-Rays in a tracked, signed for FedEx envelope. It took some time and it was annoying, but my privacy was protected. Remember, there are many medical conditions that are illegal to disclose in the U.S. Imagine if a misplaced setting on this Google Health inadvertantly released people's genetic records or HIV status? I wonder what Andrew Sullivan, the Internet's favorite HIV+ pundit has to say about this.

People's medical records contain all kinds of things that are nobody's business but their own. Any doctor or hospital that would outsource their record-keeping, which is one of the most important things that a doctor can do for a patient (keep a good chart), is abdicating their responsibility and calls into question whether they value convenience over ethics. The doctor-patient relationship, including medical records, has long been considered sacrosanct. For a company like Google to actually want to offer this as a service says more about their arrogance than the system itself does about their capacity to innovate, and for any doctor or hospital to buy or use it would, to me, be a violation of trust.

There are those in Washington and around the country (Paul Krugman is one) who believe that electronic, portable charts are the key to universal health care. Krugman regular cites the Veterans Administration as an example, since they use some electronic records. The big difference is a) they keep it in-house, and b) they are a single organization. If I wanted to send my VA records to a private doctor, I would have to jump through way more hoops than just telling Google it's OK...and I should have to. Hillary Clinton regularly throws out "e-charts" as the solution to all our problems, and more centralization of records was a big part of her failed 1993 "Hillarycare" plan that she is so loathe to discuss now.

This should not be easy.

Google should be commended for trying to simplify health care record keeping, but this is an arena where they should keep their mitts off. If they want to sell a "black box" turnkey solution for internal record keeping, go for it, but I will still insist on paper. Host my records for me? Go away.