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Second Opinion: June 13, 2008: Electronic Medical Records New technologies that enable individuals to manage their medical records online have drawn widespread attention from both the medical community and policymakers. The new services, which give individuals the option of sharing their records with doctors and other providers, have been widely acclaimed as an innovation that will both help patients to become better educated health care consumers and reduce medical errors by health care providers. Skeptics, however, remain concerned about the privacy and security risks inherent in keeping personal records online and argue that the risks will limit use of the services. We sent the following news story, Google
offers online medical records service (San Francisco Chronicle,
5/20/08), to leading health care scholars and asked them whether the potential
risks are worth the benefits provided by this new technology. This edition of our expert panel includes:
"The consumer has not traditionally been the center from which health reform efforts are focused and health information has not traditionally been accessible to consumers, yet this information is critical—particularly when it comes to improving overall wellness. Microsoft's HealthVault platform provides consumers with access to hundreds of health related services and devices - from personal health records to blood pressure monitors. Patients finally have a way to manage their health and health information (collecting, storing and sharing information) and treating health conditions like diabetes or high blood pressure in real time is possible. With regard to consumer demand, a Wall Street Journal/Harris Interactive
Health care poll conducted last November revealed that 91% of survey respondents
want access to their own electronic medical record (EMR) and 60% indicated
that the benefits of EMR's outweigh the privacy risks. Additionally, Microsoft
has helped to alleviate consumer privacy concerns with their strict privacy
protections combined with putting the consumer in the driver seat—allowing
consumers to update records and permit access by others." —John
Engler is the President and CEO of the National Association of
Manufacturers. He served as the Governor of Michigan from 1991 until 2003.
* * *
"Like it or not, health records are going to move online: the value of having records available to authorized providers anytime and anywhere will outweigh the very real privacy issues. If you have to pick somebody to store your records—and you probably will—you could do much worse than Google or Microsoft. Both companies have the resources and know-how to protect your data, and both have enormous incentives to be seen as responsible stewards of private information. The weak link in the security chain won't be Google or Microsoft, it will be you or your doctor." —Edward
W. Felten, PhD, is a Professor of Computer Science and Public
Affairs at Princeton University and is the founding Director of Princeton's
Center for Information Technology Policy. His popular blog, freedom-to-tinker.com,
is widely read for its commentary on technology, law, and policy. * * *
"The work of Microsoft and Google around on-line personal health records is very promising. It is encouraging to see these and other industry leaders like Availity take a prominent role particularly in the absence of decisive leadership from Washington. Privacy concerns are very legitimate. Leaked personal health data is far more embarrassing and potentially damaging than say credit information. The move toward on-line record-keeping will happen. But it will be a long-term migration that will accelerate as more patients feel comfortable with the efficiency, access, and privacy. Patients should and will determine that pace." —Jim
Frogue is the chief liaison to state policy projects at the Center
for Health Transformation. He has served three Members of Congress, most
recently as Legislative Director for Congresswoman Kay Granger of Texas.
He previously spent two years as the health care policy analyst at the
Heritage Foundation. * * *
"There is a tremendous opportunity for online personal health records (PHRs) to improve healthcare in the United States. Innovations in medical information technology initially focused on electronic medical record systems for physicians and other medical professionals in healthcare settings. However, in the past few years spurred by the American Health Information Community (AHIC), a public-private partnership to advance health information technology, large companies have leaped forward to develop solutions for consumers, not just medical professionals. Successes of the Departments of Defense and Veterans Affairs, and Kaiser Permanente, have shown that providers and consumers can be connected via technology to appropriately move medical information between parties to streamline care and improve access. I recall a conversation three years ago with Bill Gates and Microsoft leaders about what we had accomplished in the Military Health System. Not surprising soon afterward Microsoft was making a major investment in PHRs with plans to be a market leader. Are there privacy risks with PHRs? Yes, but they are manageable. Further,
they are far outweighed by the benefits in cost and quality and the sheer
desire of most people to have more control over their health records and
the way they receive care. Within 10 years most Americans will have their
own online personal health record and it will be an indispensible part
of their care." —William Winkenwerder, Jr., MD, is Chairman of the The Winkenwerder Company LLC and a Senior Advisor to Deloitte Consulting and Deloitte Center for Health Solutions. Previously, Winkenwerder served as the Assistant Secretary of Defense for Health Affairs in the U.S. Department of Defense from September 2001 until April 2007.
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