With the Web service, called Google Health, consumers will be able to enter their own basic medical data and invite their doctors to electronically send information that would be stored by Google.
Google's initiative puts it in company with Internet rival Microsoft Corp. and Revolution Health Group LLC, led by America Online Inc. co-founder Steve Case, in launching sites for users to fill out and manage online profiles that are known as personal health records. The companies are seeking to get in on the ground floor as more health practitioners begin digitizing records. President Bush has called for most Americans to have access to electronic medical records by 2014, because of the potential to reduce health-care costs and prevent medical errors.
George Scriban, product manager, consumer health platform for Microsoft said that they are trying to create an industry and are humble in the face of how big this is."
So far, consumers have been slow to make use of services that allow them to set up personal health records, partly because of concerns about online privacy. Limiting the usefulness of these services, only a small percentage — 14% — of U.S. medical practices keep records electronically, according to the Department of Health and Human Services. The HHS is targeting 50% adoption by medical practitioners by 2014.
Personal health records contain basic data such as a consumer's name, address, phone numbers, insurance information, emergency contacts and employment information. Users also can enter what prescriptions they are taking, any allergies, their immunization records, family medical history, and information about their medical conditions and doctor visits.
Such records are meant to be a secure place for people to maintain their own health information or that of their family, separate from traditional files that are often kept by medical facilities. That way, users' health information isn't tethered to a particular doctor or hospital and can readily be given to other medical providers.
For example, if a patient with diabetes were rushed to an emergency room not affiliated with the primary physician, a relative or friend with access to the online personal health record could provide information to the new doctor about what medications and treatments the patient had been on. By contrast, if doctors had to wait for the records to be faxed over, they may in the meantime have to ask the patient to describe this information, or else just guess.
Big Challenges
But the online services face big challenges. To be effective, medical experts say the services must be able to compile information from different practices where someone has been a patient. What's more, many hospitals and other institutions that do have digitized records use different record-keeping technologies. So Google, Microsoft and Revolution Health must design their services to accept information from systems the medical practices use. While this isn't impossible, companies acknowledge that accepting all varieties of records will take time.
Landileigh Nelson, a 45-year-old administrator in Napa, Calif., says she considered creating a personal health record using the Microsoft service, called HealthVault, but decided against it because of concerns about online privacy. She says she uses Google's Gmail service and has received targeted advertisements based on what she types in her emails. She fears an online health record could similarly be accessed.
"I don't like the abilities that the world would have to access what's wrong with me," Ms. Nelson says.
Microsoft says all user data in HealthVault are kept private unless the user designates otherwise. Also, none of the data are used to tailor advertising or health-related search results to users, and the company doesn't keep records of searches for particular health topics performed on the site, Microsoft says.
Medical professionals also are concerned about online privacy. Andy Wiesenthal, associate executive director at the Permanente Federation, where he oversees electronic medical records for the Kaiser Permanente health plan, says he is uncomfortable with the notion that health data his organization provides could be used to sell advertising — even if it's with the patient's consent. He says that Kaiser Permanente is talking with Google, but that his organization won't share data about its members with Google until privacy and security questions are answered.
Indeed, patients setting up personal health records online may not be protected under federal privacy rules. Karen Bell, director of the Office of Health IT Adoption at the Department of Health and Human Services, says personal health records aren't subject to the privacy provision of the Health Insurance Portability and Accountability Act, which regulates the disclosure of personal health information and requires medical entities to ensure confidentially in the communication of private medical information.
'Absolute Cornerstones'
A Google spokesman said: "For us trust between Google and our users is one of the absolute cornerstones of our business. And we are absolutely committed to continuing that dedication in all of our efforts."
Google, best known for its Web search service, has been hinting at an expansion into health-related services since 2006. Last week, the company disclosed an online health-care project with Cleveland Clinic, a nonprofit medical center. Under the pilot program, patients can take their medical data stored in a Cleveland Clinic personal health record, and safely share it with an online Google health profile.
Revolution Health aims to make it easier for users to include doctors' official reports in a personal health record. Consumers or their doctors can fax a paper-based medical record to Revolution Health and within 24 hours the site will post an image of the record online.
Revolution Health's service is free, but to get a record to another doctor, users have to print it out and hand over the hard copy. With Microsoft's HealthVault, a consumer can identify which doctors can access the record online and which information to share.
HealthVault, launched in October, offers a number of personal health record options. One called icePHR from CapMed, a unit of Bio-Imaging Technologies Inc. that was an early developer of personal health records, allows users to designate specific information to be available to responders in case of an emergency. Users then print out instructions on how to access the record on a wallet-size emergency card. The service costs $10 a year per family.
Automatic Uploads
Another HealthVault option that is free to users creates charts and graphs based on measured information such as blood pressure or weight that can be automatically uploaded from compatible devices.
Microsoft says its goal is to get consumers to create connections with health entities and request information. The company is working with medical and fitness device manufacturers to get them connected to HealthVault as well as software companies that write applications for physicians to get them connected.
While technology companies sort out ways to link their systems with others, the medical community is working to set standards for personal health records. The National Alliance of Health Information Technology, an industry group, last week released a draft definition of the term "personal health record." Google, Microsoft and Revolution Health aren't members of the Alliance, although Jane Horowitz, the group's chief marketing officer, says she would welcome the tech giants.
