Hello there, vRad blog readers. This is Samir Shah, M.D. typing, one of the vRad teleradiologists and one of the Medical Executive Committee members. Welcome to my hopefully thought provoking first post! My mother always told me I was opinionated, so here goes!
Google’s PHR Should Have Reprieve
Sadly, Google’s experiment with a PHR, or Personal Health Record, is going bye-bye. Google recently announced that they were shutting down this bold experiment in empowering the average person with control over their medical records, and were retiring the service indefinitely due to lack of widespread adoption. In my humble opinion, it’s a sad day for everyone that Google couldn’t give the service a reprieve – after all, Star Trek, the original series was canceled by NBC after two seasons, and only lasted one more before being canceled again. It didn’t become a cult hit until it was in reruns. Sometimes, as history has shown us time and time again, it can take a while for a good idea to catch on.Google Health
Right on Google’s website, the description of Google Health is stated with clarity — it’s a user’s way of storing health data. It is not a way of storing health data on behalf of health providers and it is not regulated by HIPAA.
Google Health Isn’t Farfetched
What if Google Health had become an invaluable resource in setting up a nationwide health data repository? It’s not so far-fetched…would anyone 15 years ago have thought that most people would check their emails on their cellular telephones? Would most people think 15 years ago that the lowly Apple computer could completely revolutionize the entire music industry… and a lowly search engine company could topple Microsoft in the world of computer technology?
Google surprised me with its timidity. After all, it was not many years ago that AOL, Hotmail, and Yahoo! were the dominant players in search and e-mail. Google was up to the challenge. Who else could have taken on the iPhone and stand a chance at success? The visionaries at this company have a track record of supplanting the usual orthodoxy. Right now, it seems that the crux of the argument against Google Health’s widespread adoption, is the slippery slope argument of the storage of the data itself on the cloud computing system, and its supposed vulnerability as a safe place to keep patient data.
Ramifications of Google Health
But, if Google Health had somehow caught on…what could the ramifications have been? What if, in a few years, every doctor would automatically check a patient’s Google Health account when admitting him or her, for let’s say, gastric bypass surgery. What if every intern could automatically check the account (with permission from the patient) with an admit from the ER. Oh, why Mr. Jones, that CT scan of the abdomen and pelvis from 2 years ago while you were on vacation while fishing in Colorado is on your Google Health account! Looks like you already have an IVC filter in place!
Google Health as an EHR Substitute
Certainly, Google Health is not analogous to a real electronic health record (EHR) – it’s the user controlling what is put in there, and it can even be handwritten. So it’s not a real medical record at all. But if it became a robust system, it could be a very good substitute. Remember, we are still in the process of advancing from archaic handwritten patient charts in 2011. For example, since HIPAA gives patients a right to obtain a copy of their medical records, what if some future technology made that as easy to do as clicking a button on a website…or perhaps it would automatically download to an individual’s Google Health account if that user so chose it to be that way.
Google Health Benefits
Now, a patient has a copy of the CT report (and maybe images in the future – the patient owns his x-rays too) that he had done at UCSF, then he had lithotripsy a week later at Kaiser, then he had another follow up CT at Stanford. Later he saw a kidney specialist in New York, and that specialist had access to all of this data. Think about it—right now the specialist in New York would probably not have the time or energy to obtain those reports – with the time zone issues, the bureaucracy, etc.…or if he did, he would have hit multiple HIPAA roadblocks. Now, it’s as easy as the patient pulling up a website for the doctor. I would argue that it would reduce costs (no need for another CT), improve care, and reduce medical errors…just imagine!