Information Technology Reference
In-Depth Information
ETHICAL AND
SOCIETAL ISSUES
The United States federal government is pushing for most
Americans to have their medical records stored in electronic form
by 2014. Electronic health record (EHR) systems store patient
records in a central database that can be accessed by many
physicians at more than one location. Such a system eliminates
problems caused by duplicate records at different physician
offices, avoids having to fill out a new patient history with each new
physician visited by the patient, and reduces errors made by incor-
rectly deciphering handwritten notes and prescriptions. Electronic
records can make for a better and healthier world. However, the
cost of moving to electronic systems is prohibitive, especially for
small medical practices. At this point, only ten percent of small
medical offices and five percent of solo practitioners have moved to
EHR systems.
Although the government is introducing financial incentives
to encourage physicians to use EHR systems, some big
companies that aren't typically associated with healthcare
are becoming involved—particularly Microsoft and Google.
Approximately 52 percent of adults look to the Web when seeking
health advice. Google and Microsoft believe that they can better
assist health consumers by providing them with a robust tool
for managing their health records. Microsoft's tool is named
HealthVault, while Google's is named Google Health. The compa-
nies see their EHR systems as a solution to the government's
problem for finding a low-cost records system designed for both
physicians and patients.
John D. Halamka, a doctor and CIO of the Harvard Medical
School, thinks systems in which the patient manages the informa-
tion, such as those proposed by Microsoft and Google, are the inevi-
table future. “Patients will ultimately be the stewards of their own
information,” Halamka stated. “In the future, healthcare will be a
much more collaborative process between patients and doctors.”
Google agrees that patients should be in charge. A statement
at Google Health's welcome page reads, “At Google, we feel
patients should be in charge of their health information, and they
should be able to grant their healthcare providers, family mem-
bers, or whomever they choose, access to this information. Google
Health was developed to meet this need.”
But just how private and secure will our medical records be
when stored in Web-accessible databases, protected only by one
password? Privacy and security concerns are raised both by corpo-
rate access to private records by Microsoft and Google and out-
sider access by hackers. It is likely that both companies will use
automated systems to target advertising at individuals based on
medical records, just as Google's Gmail places ads next to e-mail
messages based on the message contents. Unauthorized users
might also be able to access records stored on a network that
billions of users around the world use.
Another problem that complicates Google and Microsoft's
involvement is that third-party medical record services are not cov-
ered by the Health Insurance Portability and Accountability Act
(HIPAA). HIPAA provides strict standards for keeping medical
records private. If a patient chooses to use Microsoft or Google to
store medical records, those records would no longer be protected
by the standards imposed by HIPAA in its current form.
As in similar cases, patients should weigh the costs in terms of
privacy and security against the benefits of convenience and data
reliability. Meanwhile, the software vendors need to work to build
higher levels of security, privacy assurances, and customer trust.
Discussion Questions
1.
Why does the U.S. federal government want to move
health records to electronic systems?
2.
What benefits and risks are offered by Web-based health
records management systems like Google Health?
Critical Thinking Questions
1.
How might Google and Microsoft reassure users about the
privacy and security issues posed in this sidebar?
2.
Would you consider registering for Google Health? Why or
why not?
Sources:
Lohr, Steve, “Google and Microsoft Look to Change Health Care,”
New York Times, August 14, 2007,
www.nytimes.com/2007/08/14/technology/
14healthnet.html,
AP Staff, “Google ventures into health records biz,”
CNN.com, February 21, 2008,
www.cnn.com/2008/TECH/02/21/
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