Online health records raise privacy worries

Searching the Internet for movies playing locally is just plain handy, but the idea of Googling your own medical records is raising privacy concerns.

Google, the California search-engine company, and the Cleveland Clinic — an Ohio medical institution with a reputation for quality care — recently announced they will collaborate on a pilot program to store patient records online.

The test program will allow 1,500 to 10,000 patient volunteers at the Cleveland Clinic to store certain records — information on prescriptions, allergies and laboratory test results — in a secure Google account. Patients will have passwords and only they will be able to access the medical records.

The idea is to allow patients to control their medical records. If they decide to change doctors or hospitals, they will be able to electronically transfer their Google records by themselves. Patients will be offered the service free.

"What we are trying to do is exchange information between isolated electronic medical systems and when we do that the patient gets a benefit," said Dr. C. Martin Davis, a Cleveland Clinic spokesman. "The patient is making the decision when information moves from one system to another."

But some privacy advocates wonder whether hackers will be able to access the Google medical records or whether the company will use them commercially. Google says it will not share or sell the data.

Many hospitals have been keeping — and improving — electronic patient records for a number of years. In some cases, both hospitals and patients' own physicians can access those computer records. Right now, patients can't move the records around electronically, but some doctors say that could happen in the future.

"We do have patient records that are electronic and that can be used so physicians can track data of their patients' care," said Dr. Joshua Kugler, chief medical officer of South Nassau Communities Hospital in Oceanside, N.Y.

Kugler said he supports the idea of patients accessing their records, saying they "need to be the drivers of their health-care information."

Still, Kugler questioned whether Google can ensure that only patients will access their own records. "I am concerned about the privacy issues," he said.

Building a network

At the North Shore-Long Island Jewish Health System, Dr. Barry Goetz is director of ambulatory clinical-information systems.

Goetz said the health network has spent "hundreds of millions of dollars" on a system that will eventually allow any of its hospitals to view records on care a patient has received at any of other hospitals.

Starting in June, North Shore will provide records on patients who have received care there available to hospitals across the system.

Initially, though, patients won't be able to move their information around as in the Google model.

Goetz said privacy is a concern. "There's a lot of questions with regard to shared medical information as to who should be the adjudicator of whether that information should be shared or not," he said.

Pam Dixon, executive director of the World Privacy Forum, says she's concerned the Health Insurance Portability and Accountability Act — which governs medical privacy — might not cover information stored on Google.

The World Privacy Forum is a San Diego not-for-profit public interest research group.

"The concern is we have the movement of data out of the health-care sector [the Cleveland Clinic] to a noncovered entity [Google]," Dixon said.

And what about the potential for using the information to attract revenues?

"We will not share nor will we sell users' information," said Google spokesman Gabriel Stricker. "We have no plans for ads."

Revenue producing?

It's unclear whether Google plans to make money on the medical-records program.

Stricker pointed to Google News, which attracts users but does not have ads that make money for the search engine. "When you create a good user experience, that's good for Google," Stricker said.

Strickler would not say whether Google has plans to expand the pilot program beyond the Cleveland Clinic in the future.

Arthur Caplan, a bioethicist at the University of Pennsylvania, urged caution with all electronic medical records.

"You're going to have to build a clear firewall that says this is off-limits for commercial use," Caplan said. "They have to be clear about who will use the records."