While most people are aware of the privacy problems in the Patriot Act, few outside the geek world seem worried about a major danger to people’s privacy in non governmental areas.

An article on Webware pointed out that Google is planning to work with the Cleveland Clinic to put the patient’s medical records on line.

Between 1,500 and 10,000 patients at the Cleveland, Ohio, facility will participate in the project’s test run, volunteering to have their medical records transferred to their Google accounts. The hospital already keeps electronic records for over 100,000 patients in an internal system called MyChart, but when those personal health records, or PHRs, are shared with Google, patients will be able to use them outside of the Cleveland Clinic. Included in the data will be prescription information, medical histories, and details about conditions and allergies..

This has resulted in a discussion on various geek websites.

Eric Zeman at InformationWeek thinks it is a good idea:

I recently had to switch physicians. The one I left had the coolest techno set-up ever. It included a complete electronic system…
My new physician, by comparison, is no more advanced than the doctors I saw as a kid. None of my previous information was transferred. A complete history had to be taken all over again and everything stored in gigantic paper filing cabinets. The technology is there to prevent this. Why not use it?

In contrast, this article on ComputerWorld worries a lot more about privacy. Their expert points out that, unlike medical records at a clinic, by releasing and posting your records to a third party, your records may not be covered by HIPAA. For example, this means that it would be easy for lawyers to subpoena the records. And since few people actually read the “release” forms, it is possible that the records could be used for research or commercial purposes.
HIPAA is the law passed 12 years ago that scared doctors and nurses so much that for awhile people complained they couldn’t find out how their mom in ICU was over the telephone. Anyone releasing information to the wrong person was and is threatened with a huge fine and time in jail. But by signing a paper releasing your record to an outside party, your records will no longer be covered by that law.

But over at Slashdot, the discussion of people who actually work in computers is even more interesting. Various tech experts remind us that only a big company or the government has the expertise to carry such a database, and that even small doctor’s offices/HMO’s that use medical records can’t guarantee there won’t be someone snooping into your record out of curiosity. Finally, one geek reminds us that many people just won’t want their records on line at all. Period.

As a doctor, I left practice before our Federal Clinic change over to electronic records, so I don’t have “hands on” experience. However, what worries me is that there will be so much information on the record that the small clues to an illness will be missed.

A lot of medicine is an art, not a science, and although all the machines will help us diagnose things that fifty years ago we often missed, there is still room for a kind hand and a quiet talk in the office with someone who is hurting.

And that part of medicine can’t be easily computerized.


Nancy Reyes is a retired physician living in the rural Philippines. Her website is Finest Kind Clinic and Fishmarket.

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