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May 19, 2008 2:04 PM   Subscribe

Google Health launched today..

Mega-giant Google now offers a way for people to store their medical records and information all in one place online. It will help search for health-care providers and even remind you to take your medicine. They are also partnering with CVS to streamline the whole health process from being seen in a CVS clinic to renewing your prescriptions through Google. More about the service at the Google Health FAQ.
posted by pearlybob (79 comments total) 5 users marked this as a favorite

 
That is both cool and frightening.
posted by empath at 2:07 PM on May 19, 2008 [6 favorites]


For years I've been annoyed by the privacy geeks warbling on about the horrors of risking your medical records on line (long after everyone had all of their financial stuff on-line).

Now we can find out just how many people actually give a crap. Good news.
posted by tkolar at 2:08 PM on May 19, 2008


Yeah. No, wait. What about that is cool? It's just a plain old database full of incredibly sensitive information that no one should be trusting a private company with, and they've already figured out their first way to monetize it, more tk.
posted by Your Time Machine Sucks at 2:10 PM on May 19, 2008 [5 favorites]


That is both cool and frightening.

Yeah... I could see how it could be useful. For most people (I'm assuming) medical records are not something they can get access to easily, or would know how to use. Certainly thats the case for me. On the other hand, Google is already acquiring so much information on all of us, now our health records?

On the other hand, I'm not much of a medical consumer, this year I had to get reimbursed from my employer's "flex pay" system for some new contacts. That's about it.
posted by delmoi at 2:10 PM on May 19, 2008


How long until we need Google to remind us to wipe our asses?
posted by ColdChef at 2:12 PM on May 19, 2008 [3 favorites]


This could be useful, and seeing as it's all voluntary and inputted by the end user, the privacy issue might be overwrought. It's not hard to imagine that someone will not have a problem with listing their various meds they have to take for some kind of acute respiratory illness, but opt not to list their horrible festering genital sores or whatever.

Still, this is one area that I didn't expect that Google would go into.
posted by Burhanistan at 2:14 PM on May 19, 2008


ColdChef: you don't have Google calendar reminders for that?
posted by Burhanistan at 2:15 PM on May 19, 2008 [2 favorites]


The company that puts a never expiring tracking cookie on my browser wants to hold my medical records? No thanks.
posted by damn dirty ape at 2:16 PM on May 19, 2008


They don't really answer an important in their FAQ:

6. If it’s free, how does Google make money off Google Health?

Much like other Google products we offer, Google Health is free to anyone who uses it. There are no ads in Google Health. Our primary focus is providing a good user experience and meeting our users' needs.


Okay... yes but how does Google make money?
posted by amuseDetachment at 2:24 PM on May 19, 2008 [1 favorite]


Now we can find out just how many people actually give a crap. Good news.
posted by tkolar at 5:08 PM on May 19


I give a crap. Ever buy life insurance? Are those medical questions they ask you are all possible grounds for refusing to pay your benefit if they can show you didn't answer honestly. How long before they require you to disclose the contents of a site like this in your application? And before they deny paying benefits to someone who had one of these sites and didn't disclose it.

Financial information is different because it has always been available to purchasers as your credit report. Medical records weren't because doctors had confidentiality and patients never kept their own records. Now the patient is going to have a copy of their medical history that insurers are going to want to see, and google may even sell them the ability to double check whether or not you have one of these completed (even if google won't sell access to the contents of it).
posted by Pastabagel at 2:24 PM on May 19, 2008 [1 favorite]


Google is not a "covered entity" under the Health Insurance Portability and Accountability Act of 1996 and the regulations promulgated thereunder ("HIPAA"). As a result, HIPAA does not apply to the transmission of health information by Google to any third party.
posted by thewalledcity at 2:27 PM on May 19, 2008 [22 favorites]


Anyone who uses this is asking to be among America's growing ranks of the uninsured.
posted by Blazecock Pileon at 2:29 PM on May 19, 2008 [1 favorite]


"partnering with CVS.." this is key. If GH can partner with others it could be big. There is no consumer level central heath database right now, although many are trying. For example, walk into a pharmacy, sit down at a free bloodpressure kiosk, swipe a card or enter your ID, your BP is uploaded to the database where it is tracked and available to doctors. Do similar intergrations with other locations, providers and devices. It's a long road to make something like this work as it requires a lot of cross provider sharing of sensitive information but whoever pulls it off will be very successful.
posted by stbalbach at 2:29 PM on May 19, 2008


Yeah, I'll pass.
posted by disclaimer at 2:30 PM on May 19, 2008 [1 favorite]


Also, I note that 23andme was founded by the wife of one of Google's founders. For $999 and a cheek swab, 23andme which check your DNA for known genetic diseases among other things. You use this service, apply for insurance, die, the insurance company finds out you have this and didn't disclose it, it is a recipe for getting screwed.

You want to keep track of your health info? Get a photocopy of your chart, and bring home all those carbon copies from the doctors office. Keep them in a nice paper file that your insurance beneficiaries can shred/burn/deny all knowledge of when the time comes.
posted by Pastabagel at 2:35 PM on May 19, 2008


No, no no no. I'm not telling google about my health issues. They already know about my fisting searches. Thats all they's getting. Jeeez
posted by Po0py at 2:36 PM on May 19, 2008 [5 favorites]


For all the people who think this is great: would you feel the same way if it was Microsoft doing this? How about if it was the federal government under the Bush administration?
posted by Pastabagel at 2:39 PM on May 19, 2008 [3 favorites]


I love me some google. I mean, I use it all, from gmail, to Docs, to Notebook, to Maps and Streetview, and don't even get me started on my love of Earth and Sky...

But I have to draw the line at this. I'm sure that there are good and compelling reasons to use something like this, and that the people who volunteer their information will undoubtedly appreciate some of the conveniences that the service has to offer.

But there are some limits on my relationship with this company. Financial and medical both cross that line.
posted by quin at 2:44 PM on May 19, 2008


It's not hard to imagine that someone will not have a problem with listing their various meds they have to take for some kind of acute respiratory illness, but opt not to list their horrible festering genital sores or whatever.

OK, but this thing basically has three uses: 1) convenient way to transmit your health records to care providers, 2) reminder service, 3) profit channel for Google. If you leave out the festering sores, it stops being useful for #1. If you include them, you have no way of knowing what that info will be used for over the long life of the database and the company. #2 just isn't that special if you have calendar software.

#3 is pretty much the reason that it's stupid to give this info to a private company; it's a moral hazard that they are going to be struggling with anew every time they have a bad quarter or change CEOs or someone writes an article predicting that the days of their stock flying high are over. Someday, hard is it is to imagine, Google could be in a death spiral and need to sell off assets to the highest bidder. I'm surprised that people would be open to this in a country where it's so easy to become an insurance pariah and job security is so frayed.
posted by Your Time Machine Sucks at 2:47 PM on May 19, 2008


You use this service, apply for insurance, die, the insurance company finds out you have this and didn't disclose it, it is a recipe for getting screwed.

If George Bush signs it, the Genetic Information Nondiscrimination Act passed nearly unanimously by the House and Senate would prevent this kind of action.
posted by Blazecock Pileon at 2:49 PM on May 19, 2008


Hmm. I'm a little worried when I think about how, after my mother had a stroke that caused ataxia, my google mail sidebar ads included ataxia therapy videos, even before the word appeared in any mail I sent or received.
posted by StickyCarpet at 2:49 PM on May 19, 2008 [1 favorite]


There is a privacy agreement that looks pretty good. The intention of this service is to make your life easier, not to be evil. In any case, anyone who thinks their health records are already private is not living in the 21st century.
posted by stbalbach at 2:51 PM on May 19, 2008


Am I the only one who doesn't care whether people know my medical history?

I mean, here: I've had two surgeries for inguinal hernias, I've had kidney stones several times, I take benazepril for high blood pressure and use metronidazole for rosacea, I have no known allergies, and I'm nearsighted.

What, exactly, are the Bad People going to do with that?
posted by greenie2600 at 2:54 PM on May 19, 2008


What, exactly, are the Bad People going to do with that?

Deny you insurance coverage unless you pay incredibly high premiums. And even then, they may opt to deny coverage for procedures based on a pre-existing condition.
posted by Blazecock Pileon at 2:57 PM on May 19, 2008


I don't understand why anyone would trust Google about anything. I use some of their services to greater or (mostly) lesser extents, but I have no love for the company, and anyone who thinks "do no evil" is anything but bullshit will eventually have a rude awakening.

Or, essentially, #3 from Your Time Machine Sucks.
posted by maxwelton at 3:00 PM on May 19, 2008


Oh, and another thing that worries me: I just experienced some major difficulties when, working in the field, I relied on a 4GB SanDisk memory stick I bought at RadioShack. Even when reformatted it, it still contained and loaded malware that kept sending my info to DoubleClick, and changing my drive letters, and installing dummy autoload CD drivers. Thanks for doing no harm, Google.
posted by StickyCarpet at 3:00 PM on May 19, 2008


Honest question right off the bat: What the hell is a "mega-giant?"
posted by CitrusFreak12 at 3:04 PM on May 19, 2008


greenie2600 : What, exactly, are the Bad People going to do with that?

*steals glasses*

*stands 20 feet away with a sign that reads "Ha Ha! You can't read this!*

Bwahahaha
posted by quin at 3:05 PM on May 19, 2008


Also, I note that 23andme was founded by the wife of one of Google's founders. For $999 and a cheek swab, 23andme which check your DNA for known genetic diseases among other things. You use this service, apply for insurance, die, the insurance company finds out you have this and didn't disclose it, it is a recipe for getting screwed.

Not only that, it could also be grounds for having your health insurance taken away, if you ever get sick (except in California, due to a recent court decision).

That way you not only get screwed, you get to live through it (for a while)
posted by delmoi at 3:06 PM on May 19, 2008


What, exactly, are the Bad People going to do with that?

Do you live in the United States? If so, insurance companies can use that information to deny you coverage, and boot you out of their program if it turns out you forgot to disclose any of it on an application -- even after paying for years if you get sick.

Yeah, it's a problem. But insurance companies have access to all that info anyway, so it doesn't matter that much if Google has it too.
posted by delmoi at 3:09 PM on May 19, 2008


How long until we need Google to remind us to wipe our asses?

Heh. Google has the Toto S300 in every washroom. Wiping your ass is a thing of the past.
posted by GuyZero at 3:09 PM on May 19, 2008


yes but how does Google make money?

By keeping its stock price artificially high through periodic announcements of new, non-profit-making "services" that consumers aren't clamoring for, then letting a gushing press do the rest.
posted by mediareport at 3:09 PM on May 19, 2008 [2 favorites]


What's the big deal? Doesn't Google already know all of our health problems from our search history?
what's with all these red spots on my arms should i get scared?

my foot hurts so bad after a car ran over it last night

gimme some ativan

+bleeding +forehead +"nail gun" +removal -"staple gun"

wisdom teeth extraction at home.com

kissing dogs is it dangerous?
posted by milkrate at 3:10 PM on May 19, 2008 [16 favorites]


What, exactly, are the Bad People going to do with that?
Deny you insurance coverage unless you pay incredibly high premiums. And even then, they may opt to deny coverage for procedures based on a pre-existing condition.


It's true. As an American you have a constitutional right to lie on insurance disclosure forms.
posted by tkolar at 3:13 PM on May 19, 2008 [2 favorites]


Now we can find out just how many people actually give a crap.

Google Toilet is still in Alpha Testing. Hang tough for a while, dude.
posted by jonmc at 3:13 PM on May 19, 2008


Okay... yes but how does Google make money?

Unlike the previous smart-ass answer, Google makes sufficiently large margins on the ad business that it can fund a number of unprofitable products with the hopes of making them profitable eventually.
posted by GuyZero at 3:14 PM on May 19, 2008


Milkrate makes a good point. You do a google search for say....festering, pussy, fanny zit and after you get your results, Google asks, "would you like to include this in your google health file?" Just like it does with calendar dates. Even if you say no, what will happen to the search? Is it tucked away somewhere in Google-land?
posted by pearlybob at 3:18 PM on May 19, 2008


>>What, exactly, are the Bad People going to do with that?
>Deny you insurance coverage unless you pay incredibly high premiums.


Here's a flash. When you apply for health insurance in the USA, the insurer asks you about your medical history in excruciating detail, with opt-outs for them in case you suddenly come down with AIDS, lie about pre-existing conditions, etc.

I'm not saying that putting more of our vital information in Google's hands isn't kind of creepy—it is. But I don't think this is why it's potentially problematic.
posted by adamrice at 3:23 PM on May 19, 2008


Wow, what a bunch of FUD in here.
Pastabagel, Microsoft is doing this, but they have a MUCH more intriguing answer to the same problem. They want to build a platform that allows for the transference of EMR's through their API/HealthVault.
Points:
1. Your medical records are anything but private in the USA. Unless you have never been insured.
2. You have almost no access to these medical records.
3. No one owns them or oversees them. They are out there, under no control, floating freely.
4. Most of us are really undereducated about our own health and see doctors with the expectation that they will know about us than we do.

A PHR/ patient portal solves 2-4 of these problems. Many might think that it is invasive, but again, the insurance companies, along with the credit agencies know all there is to know about your health through declaration and buying trends.

This is not so much an issue of not trusting such a system. This type of system is inevitable. Who do you trust to empower you to own your own health information. MSFT? Google? The Govt? An insurance company? You will have to pick as patient reimbursements will be done in tandem with submissions to your PHR.

In the end, the competition in the market place is already ratcheting up. Intel has a PHR that is far deeper reaching than GH and is being widely adopted through a employer opt-in protocol. Google, MSFT, and about a dozen smaller firms are all gunning for this as well.
posted by BrodieShadeTree at 3:37 PM on May 19, 2008


Okay... yes but how does Google make money?

Volume.
posted by Civil_Disobedient at 3:39 PM on May 19, 2008 [1 favorite]


A large database, holding lots of sensitive private records?

Ah, of course. Although I suspect Google may do a much better job of holding onto the data...

Yes, I know, NHS records haven't been lost. Yet. Still, at least with the incentive of being able to sell records on, Google will want to preserve them, and not lose them to possible competitors. No profit in that...
posted by djgh at 4:37 PM on May 19, 2008


HIPAA-Google Health comparison chart
posted by Rhaomi at 5:07 PM on May 19, 2008 [2 favorites]


The New England Journal recently had a very nice, impartial review of these things, which they call Personally Controlled Online Health Data.

Personally, I think this is probably a Good Thing, though I would never underestimate the unrestrained evil of the private health insurance industry in the U.S. Wonderful things are possible if there is a universal standard for rapid transfer of health information and if this catches on there is the potential to save billions of dollars by not repeating work, by being alerted early to a patient's pertinent medical history, or even by simply not having to manage a thick paper chart for every patient in the office of every doctor they see.

The privacy issues, the denial of care issues, all of this has to be dealt with and I certainly wouldn't put *my* information in a place were I can't control it right now, but from a physician's perspective, it is nice to finally see some movement in terms of information management. You wouldn't believe how far behind we are.
posted by Slarty Bartfast at 5:12 PM on May 19, 2008 [2 favorites]


Unlike the previous smart-ass answer

If that was directed at me, I assure you it wasn't a smart-ass answer. Creating a steady stream of new products that get media attention and keep Google in the news as an innovator - even an innovator of products that no one is really asking for - is a strategy Google is definitely using to keep its stock price high. I didn't make that up; it's something you see mentioned in the business press all the time.
posted by mediareport at 5:24 PM on May 19, 2008


If that was directed at me, I assure you it wasn't a smart-ass answer. Creating a steady stream of new products that get media attention and keep Google in the news as an innovator - even an innovator of products that no one is really asking for - is a strategy Google is definitely using to keep its stock price high. I didn't make that up; it's something you see mentioned in the business press all the time.

I grant that it's not a smart-ass answer, at all, but "keeping its stock price artificially high" isn't the same thing as "mak(ing) money." You could, I guess, say that the high stock price makes the shareholders money while it rises, but as far as making money for the corporate entity, well, the mechanism is a bit more complicated (add-ons drive press, which drives traffic, which drives clicks and views, which drives ad revenue) than your glib comment suggests.
posted by Kwantsar at 5:32 PM on May 19, 2008


The company makes absolutely no money from its stock price - employees may get a bonus, the founders' net worth is derived from their stock holdings, but the $16B of annual revenue comes from sales of advertising and has absolutely nothing to do with Google's stock price. Unless your position is that Google has invented a way to convert pure hype into a net positive cash flow of $2.5B annually. Which is somewhere between smart-ass and wrong.
posted by GuyZero at 5:36 PM on May 19, 2008


More health care innovation that doesn't do anything to actually provide care to anybody.

This isn't available in Canada, which is fine, because there is no use for it.
posted by ethnomethodologist at 5:52 PM on May 19, 2008 [1 favorite]


Oh, and another thing that worries me: I just experienced some major difficulties when, working in the field, I relied on a 4GB SanDisk memory stick I bought at RadioShack. Even when reformatted it, it still contained and loaded malware that kept sending my info to DoubleClick, and changing my drive letters, and installing dummy autoload CD drivers. Thanks for doing no harm, Google.

I take it DoubleClick wouldn't have pulled this kind of stunt before the acquisition? Or is Google not cleaning up DoubleClick's act fast enough? Me, I'd give them a little latitude, given that the stick was probably manufactured before March.
posted by yath at 5:55 PM on May 19, 2008


To those who say "You should never give a private entity this information," consider:

1) You are giving your money to a private entity.
2) Many hospitals are for-profit entities, and they already have much of this information.

I believe that the future of companies like Google and Microsoft includes the idea of "a bank for your data" just that way that Wells Fargo et al are a bank for your money. Who you give your data to will be a similar decision as who you give your money to: someone with reliability, safety, good customer service, etc.
posted by CheeseDigestsAll at 6:04 PM on May 19, 2008


I'm curious: Those of you who are against this, how many of you are using Gmail?
posted by Brandon Blatcher at 6:26 PM on May 19, 2008


*starts working on ways in which letters in "Google" total 666*
posted by ZenMasterThis at 6:27 PM on May 19, 2008


As someone who lives in a country with free, but ocassionally inefficient healthcare, I'd love a service like this. Due to a minor book-keeping error by an A&E triage nurse, my lungs collapsed five times before I had the operation to fix them, which should have happened after the third lung collapse. It would've been quite handy to have Google email me an alert when it noticed I'd hit the criteria for an op but hadn't been booked in. That and it'd be cool to be able to check what my blood group is/allergies I've forgotten about/etc. on my 'phone while at the doctors. Just in case of further book-keeping errors.

In a country that requires health insurance, and where the health insurance companies seem to have the motto 'be really, really evil', probably not a good idea.
posted by jack_mo at 6:32 PM on May 19, 2008 [1 favorite]


Thanks for the post pearlybob. I can only add that this whole thing is voluntary and if it helps patients with their bookeeping, it's great. My concern is that, among patients I see, the ones who really take a vested desire to improve their health, well, they keep immaculate records of what has happened to them and what drugs they are taking. They are able to do it using old-fashioned filing and word processing -- that does not have a online or privacy worrying component. It's the patients who a service like this one might really help -- the disorganized, the ones who sort of hope nothing happens and that their doctor has stuff in order (a precarious notion in the world of changing insurances and the ability of a doctor to drop you if she or he does not want to take your insurance), that a service like this one could really help. Unfortunately, a component of why they need help is your socio-economic, psychological pathologies all combined into one. And, I'm not sure how many of such people are online or let alone have email. (A percentage of such patients are on fixed incomes from disability and it does not leave much to pay the ISP). So, for the people it can really help I'm not sure how self maintained electronic medical records are going to be the solution.

A lot of medical innovation comes out, and has been said, it gives benefits but at enormous costs -- like a medicine that is newer, more expensive and claims to do something that 40 year old medicines have been doing well keeping people alive to 105 anyways. This one innovation could reduce costs at least.

At last, has google really been successful in their non-search related/ad-related revenue stream. Do people use their calender so much? Or, rather, how many people and online stores have bought into google checkout? I would think their non-core business record has not been stellar so I can't see this offering as really changing how medical information is kept.

Btw, from a quick perusing, it's freaking impressive though. I wish my hospital's medical information access used a format like this one. They did their homework at least.
posted by skepticallypleased at 7:16 PM on May 19, 2008


It almost looks like Google is taking a punt on there being a shake-up in the US health-insurance laws in the near-to-middle future.
posted by Ritchie at 8:13 PM on May 19, 2008


Depending on who you ask and how you define them, the bureaucratic costs of health care represent up a third of all the money spent in the industry every year. Temp at a hospital and tell me this isn't so. Google can certainly reduce some bureaucratic costs for some doctors, theoretically translating into better care for you and less money spent on paper shuffling. I still won't trust them unless I know what kind of encryption they're using to store my data but if they are successful and you do not disclose your information to google insurance companies might assume that you have something to hide.

Frankly, I see a massive class action lawsuit in Google's future.
posted by christhelongtimelurker at 8:27 PM on May 19, 2008


Thanks but no.
posted by zouhair at 8:34 PM on May 19, 2008


Brandon Blatcher: "I'm curious: Those of you who are against this, how many of you are using Gmail?"

There is a difference between using Gmail and divulging information about my micropenis.
posted by zouhair at 8:36 PM on May 19, 2008 [1 favorite]


This isn't available in Canada, which is fine, because there is no use for it.

It's kind of available in Canada. My pharmacy keeps my information in a big ol' database. As long as I go to one of their chain stores, I can fill my prescriptions OTC and can examine my medical history. And my province is keeping some amount of information on me, because I present a "Care Card" at the doctor's office or drop-in clinic. And they both keep a file folder on me. My extended medicare prescriber is in on the loop in some fashion, too; surely some of the services are billed to them instead of paid out-of-pocket.

Where it really does differ from the Google system is that none of them are permitted to share that information with others, while Google has a disclaimer about disclosing to third parties.
posted by five fresh fish at 8:37 PM on May 19, 2008


What are the risks to people who aren't subject to the horrific USA health care / insurance system? Given a better (ie universal) health care system, there'd be no need to hide this information, no?
posted by rokusan at 8:56 PM on May 19, 2008


Google has the Toto S300 in every washroom.

I'm still using Number 2.0.
posted by lukemeister at 9:45 PM on May 19, 2008


Disclaimer: I work in healthcare.

So many misconceptions, and people wonder why healthcare in America is 20 years behind the times technologically.

Most of you already have ALL of your health information stored, accessed, and data-mined daily by the most evil corporations in the entire nation: health insurance companies. They know about every doctor you see, every surgery you have, and every diagnosis you've been given.

The (for-profit) pharmacy you go to has a record of every drug you've ever taken, including the ones you pay cash for to hide from a spouse, parent, employer, or insurance.

The doctor you see is likely a member of a for-profit LLC or PLLC, or employed by a for profit hospital, or just an independent practitioner who has to pay the light bill and put food on the table.

The hospital you go to is likely for-profit to some degree (even "not for profit" hospitals are for profit, meaning they have to have positive cash flow to remain open).

Your lab specimens are tested by another for-profit company.

Your pathology results are probably read by a for-profit path lab.

Then consider all the other possibilities. Your claim was probably sent electronically from your doctor to the insurance, likely through a 3rd party called a clearinghouse, which process millions of claims per month. Millions upon millions of nice tidy compact pieces of information telling what is wrong with you and what was done to you, where, and by who. That claim was generated in your doctor's office by a software program created by a for-profit company. Your doctor might use an EMR, which is another piece of software written by another for profit company. These programs likely interface together, and may interface with a nearby hospital, probably interface with your pharmacy, and are now being interfaced directly with insurance payors (real time adjudication).

Privacy in healthcare in America is an oxymoron.

If you have a serious illness, there are likely to be 6-10 for-profit entities that know all about it, and have forevermore linked it to you in a swirling sea of databases.

With all that considered, letting Google know you take Allegra is probably not that big of a deal.

For those of you fretting over pre-existing conditions, if there were ever a concern over a pre-existing, the insurance company would simply ask for records from your doctor, or previous doctor, (who must archive their medical records even after you stop seeing them, BTW) and establish pretty quickly if it were pre-existing or not.

The insurance companies have access to your medical records DIRECTLY FROM YOUR DOCTOR. They don't need Google for that. Never have, never will.
posted by Ynoxas at 9:51 PM on May 19, 2008 [6 favorites]


What I think is interesting about this is that Healtheon and WebMD have been trying to do this for what, 10 years? Michael Lewis's book, The New New Thing is about Jim Clark trying to shop this concept around. But if it's just another tab in your Google Account, everybody is like, hey, why not?

When you've already entered my mutual funds and stocks in a portfolio in Google Finance, when you write letters to your mistress in Gmail and put reminders to sleep with her in Google Calendar along with directions to the motel linked through Google Maps and have pictures of her in a private album in Picasa Web Albums, when you read erotic Saved By The Bell fan fiction in your Google Reader through RSS feeds, this is really just a hop skip away.
posted by bertrandom at 10:06 PM on May 19, 2008


Here's the ironic part: the only thing Google wants to do with your personal data is organize it for you so that they can run ads down the side while you access it. If you can come up with a different monetization strategy, drop Larry & Sergey a note. So far that's all the Google brain trust has come up with.
posted by GuyZero at 11:13 PM on May 19, 2008


I think it was Scott McNealy (Sun CEO) who said several years ago: "You have no privacy. Get over it."

And I think he was pretty much on target.

When you really, really think about it, does it REALLY matter if your health records are seen by others? First of all, 99.99% of all people DON'T CARE about your health records. Second of all, why do you care about the .01% who DO have an interest in your health records? If someone is that interested in learning that you had a sore throat in May 2005, or had a boil lanced in September 1999, or take Pepcid AC for occasional indigestion -- well, sounds like that person needs to get a life.

I can understand - I think - extremely rare cases, but overall, this just seems to be a non-issue. ESPECIALLY since it's voluntary.
posted by davidmsc at 11:36 PM on May 19, 2008


Freaky, and yeah, I'll pass too.
posted by Raynyn at 12:29 AM on May 20, 2008


Actually, I would much rather see something like this run by the federal government, where privacy restrictions could be relaxed in appropriate circumstances.

Access to health history for providers is very important-- potentially life or death. Many people seem to think that when you go to the hospital, everybody already knows your health history. It's not the case; there are some tricks to discovering history, but they're pretty limited.

Let me give some real life examples. These are all patients I have worked with:

1) Patient comes in with history of dementia and altered mental status-- not a good historian. Doctor orders MRI to rule out stroke. The MRI needs to happen soon, but there are some absolute contraindications to MRI, and available family is unsure of patient's health history. (In this case, x-ray films show that the patient has had a pacemaker placed, and the MRI is canceled. Some contraindications do not show up on films.)

2) Patient comes in for rule-out stroke, reports history of anxiety and heavy home benzodiazepene (anti-anxiety med) use. Benzo withdrawal is potentially dangerous, and the drugs are continued in the hospital. Over the course of the stay, the patient becomes increasingly somnolent. Patient's pharmacy is contacted, and it is discovered that the patient has grossly overstated her dosages. (Patient was fine, by the way; stroke was ruled out, patient recovered from the benzo overdose, and went home when she discovered we wouldn't give her any more drugs.)

3) Patient is admitted unresponsive, possible brain mass. Patient is do-not-resuscitate and has a power of attorney, a person who can make decisions about her health care. POA is contacted in order to gain information about how much treatment patient should receive-- potentially unpleasant procedures, or comfort care only. However, the POA also had a recent stroke, and is unable to advise. (Unpleasant procedures were performed.)

I also want to point out how easy it would be to gather health information through social engineering-- I do it all the time, although maybe it doesn't count since it's part of my job. Pharmacists don't hesitate to list medications to me. Family opens up. Nursing homes fax me records. All on the assumption that I am who I say I am. (Caller ID probably helps, but it's easy enough to spoof. Next time you're in the hospital, try this trick: pick up a phone and call your pharmacy, pretending to be medical staff, and ask for a list of your medications.)
posted by nathan v at 12:54 AM on May 20, 2008 [1 favorite]


Not sure about any of you, but I'm finding this incredibly fun. I've only made my way through A, B, E, and N but currently I have both Avian influenza and Bird flu, Elbow Pain, Eye Cancer, a Neck lump, and a Nosebleed.
posted by ageispolis at 4:13 AM on May 20, 2008


I probably won't use Google Health at this time, because I am not good about remembering to record information in the online calendar, let alone another new gadget that is probably there to try and sell me something, even if only through more ads. It is a good idea to list all your meds on a piece of paper or a note card to keep in your wallet in case of an ER visit, tho'. I know someone who ran into problems with getting prescriptions from 3 different docs and the meds didn't mix well (some things slip by pharmacists). Now keeps it all on a 3x5 notecard, and all meds are kept in a large tupperware container to take to the ER. Family members can just slap the lid on and give to the EMT's. Every new med has to be approved by the primary care doc now.

If I ever get any major physical issues, I'll write them down and put it in my wallet for the ER doc like my friend. You can also program your cellphone for ICE numbers so docs/EMTs can call the appropriate person in case of emergency if you're not cognizant.

I don't see a huge benefit of using an online system unless I were traveling and had to get to the info via the 'net. Then again, I am not on any meds so I don't have to get prescriptions filled. Maybe some people will like the ease of ordering this way.
posted by Marie Mon Dieu at 4:45 AM on May 20, 2008


What is in Google Health user's medical record: "patient, 22, complained of eye tic". What is in Google's database:

Google health, 2008: "patient, 22, complained of eye tic"
Google search, 2010: "ellis island" "passenger manifest" goldschmied
Google search, 2015: "parkinson's disease" "ashkenazi jews"

There is no need to discriminate on the basis of the applicant's genes, you only have to find a reason to deny coverage (or not hire, or not marry, or...) based on your fairly-purchased data-mine of the user's own possible correlation of their genes and their symptom. If you can't think of a lot of other non-positive variations on this premise, you haven't heard some of the ideas which come out of marketing people at tech companies in department meetings, that make all the geeks' jaws drop as they turn a paler shade of pale and try to explain why "that would be a pretty big violation of user trust".

This isn't just "waah, Google is collecting private information", it's "Google is collecting private information on a number of different axes which are more than the sum of their parts when they are all correlated, will also tend to attract data on individuals who have not chosen to use the service, and any separation of those axes within the company is a figment of the imagination of the user."

If they really don't want to be evil, they should avoid concentrating so many kinds of data without really compelling reasons for doing so, when they know perfectly well that the later iterations of their company might have very different leadership and values and that the data is likely never going away.

I think the big problem here is that in the US and the UK, people have somehow decided that privacy isn't possible, despite all the other countries with functioning privacy laws (nope, my health information is really and truly private, and you have the right to desire that yours becomes private again). This is a good example of why "there's no such thing as privacy" is largely a self-fulfilling prophecy.

If doctors, nurses and carers recognize that access to correct and full records affects quality of care, they should be howling for a single non-profit centralized database solution to be developed by their affiliation groups or hospital networks, because quality of care is 100% of their job. 100% of Google's job as a publicly-traded company is serving their shareholders.
posted by Your Time Machine Sucks at 5:38 AM on May 20, 2008


the $16B of annual revenue comes from sales of advertising and has absolutely nothing to do with Google's stock price

Fair enough, it *was* glib to conflate the two. But the media strategy is real enough.
posted by mediareport at 6:38 AM on May 20, 2008


What is in Google's database...

Google anonymizes search logs after 18 months. If you're logged in to their system it will correlate your searches to your user account (see Google Web History) but otherwise it only sees an IP address which is not really granular enough to correlate searches together.

you only have to find a reason to deny coverage...

This is an issue with the insurance system, not with data privacy. You seem to be saying that privacy is important so that people are able to lie to insurance companies to get insurance. How about a system where everyone gets medical coverage regardless of their health? I manage to turn every thread around here into a discussion of a single-payer health care system, but what you're describing is really not a privacy issue.
posted by GuyZero at 8:37 AM on May 20, 2008


Nope, I said that the complete medical record might pass but the insurer might look at the extended data-mined profile for risk management, and that they might not be the only parties with an interest in it. And I think I've been pretty clear that I don't think the current Google is going to do monstrous things with that profile, but that the problem is that the Google you give it to now isn't the Google who is going to own it for the life of the data.
posted by Your Time Machine Sucks at 8:49 AM on May 20, 2008


But my point is that regardless of how evil Google gets, who cares how they mine it as long as you're insured? What'd the downside of doing broad, data-driven epidemiological studies using data in something like Google health? In Canada and most of Europe you can have a dozen genetic conditions and then go catch herpes and you'll still get medical treatment.I can email my search logs for my self-amputation fetish to my Canadian doctor and all he'll do is tell me it's a bad idea. If I then come in missing an arm he's not going to turn me away. It's an issue of healthcare availability, not privacy.
posted by GuyZero at 9:43 AM on May 20, 2008


I keep all my health records in a battered notebook which I put under my mattress. Along with my retirement account, which is in dubloons.
posted by krinklyfig at 10:32 AM on May 20, 2008


What'd the downside of doing broad, data-driven epidemiological studies using data in something like Google health?

Who wouldn't want to improve standards of living through rational analysis of the health of a population?

However, if Google merges with or even buys another company -- and with its cash, that event is easily likely over the next ten years -- that's enough to allow them to change their privacy policy and monetize your private data without your consent. And because insurance companies -- and not citizens -- dictate health care policy in the United States, those same insurance companies will most assuredly bid for access of that very attractive dataset once it is available.

Google has already made deals with pharmacies, so the existence of some kind of business model is a given. Their privacy policy already allows them to work with vendors to market healthcare products to you with or without your consent.

It's a question of who that data belongs to, over the lifetimes of the entities involved. Once you digitize your health history and give it to them, Google and its future incarnations more or less own that data in perpetuity. Because Google is not bound by HIPAA regulations, there's no assurance, beyond the public image of trust that Google maintains, that your private health history will not change hands over your lifetime.

Until legislators recognize the human right to universal and unfettered access to healthcare in the United States, subscribing to this service is a pretty bad idea.
posted by Blazecock Pileon at 10:34 AM on May 20, 2008


Hunh. I used to think the U.S. healthcare system was better, but these days I've really been starting to wonder, from this article and others I've read in the last year or two.

The wait for a lumbar discectomy is currently about 6 weeks in British Columbia, and that's after you see the neurologist for a consult, which takes around 10 weeks. But all in all, I think the out of pocket cost for the surgery was about $100 for the night in a private room. Four-person wards are covered by BC Medical, which is free for seniors and about $1200 a year for a family of four.
posted by illiad at 11:13 AM on May 20, 2008


GuyZero writes "If you're logged in to their system it will correlate your searches to your user account (see Google Web History) but otherwise it only sees an IP address which is not really granular enough to correlate searches together."

Unless you subpoena the ISP and correlate the IP address to a user within a given time frame.
posted by krinklyfig at 11:42 AM on May 20, 2008


It's an issue of healthcare availability, not privacy.

I could type out a good long list of all of the entities besides insurers whom I wouldn't like to see datamining the correlated health records, web search and email activity of an individual, but is it really necessary? The issue is that for someone born right now, their data is probably going to persist for their entire life. So the bet isn't that Google continues to not be evil for the next little while, but that it continues to not be evil, or never has to sell their servers in a firesale, or never has a lasting security breach, or is never mass-data-looted under duress by the government, for decades. Historically, how many tech companies even make it 10 years? Unless there are laws protecting a right to privacy with serious sanctions for violators, there is no reason other than "don't be evil" not to exploit that info. It might turn out fine, but realistically, the odds of that degree of faith being warranted over an individual's entire lifetime aren't fabulous.
posted by Your Time Machine Sucks at 1:41 PM on May 20, 2008


Oh, in case this needs saying, I also think it's a healthcare issue. I think this product derives its value for Google from the fact that both healthcare and privacy rights have gone down the rabbit hole in the US at the moment, and that it won't fly legally in the mainland EU, or seem useful to anyone living somewhere with a relatively organized healthcare system.
posted by Your Time Machine Sucks at 2:32 PM on May 20, 2008


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