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Google Health Open Platform Is Great — Or Awful

Posted by timothy on Fri Jun 06, 2008 10:25 AM
from the now-that's-a-dialectic dept.
JackPowers writes "The Google Health APIs enable portable, standardized, open architecture, extensible personal health records, which is nice but boring if they're just used to manage the paperwork of the doctor/patient relationship. But once the data is set free, all kinds of Web 1.0, Web 2.0 and Web 3.0 apps are possible. This article looks ahead 10 years at Best Case Scenarios. A follow-up article lists the Worst Case Scenarios."
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  • by BadAnalogyGuy (945258) <BadAnalogyGuy@gmail.com> on Friday June 06 2008, @10:29AM (#23682627)
    No private company should be so entrenched in society that it would be impossible to survive without the service they provide. If I can't get a job without a Google Health "badge", then something somewhere has gone horribly wrong.

    This is already a big problem with credit companies becoming so pervasive. It's also bad enough that private companies are leading the American military around by the nose. But that pales in comparison to the actual, direct, and personal limits imposed by something like the system the article is talking about.
    • by Lumpy (12016) on Friday June 06 2008, @10:46AM (#23682815) Homepage
      It is already very wrong. many places pull your credit report for hiring. They throw away everyone below 680.

      Honestly this practice should be outlawed and companies that do so need to be fined heavily.

      also the fact taht your credit report is probably the MOST INNACURATE information you have on you and companies make decisions based on this horribly inaccurate data.

        • Re: (Score:3, Insightful)

          Nothing like being guilty until proven innocent is there?

          A criminal background check, ok, not a big deal for the most part and can save a company a lot of potential headaches and/or liability.

          A credit check though? What good does that do for a company? Actually, wouldn't most companies prefer employees with less than good credit ratings as they would likely be less able to leave the job?

          Piss test too you say. And why can't this be left to law enforcement? Pretty serious invasion of privacy, and if there's n
    • No private company should be so entrenched in society that it would be impossible to survive without the service they provide.

      Define impossible. My father in law doesn't have a credit rating. He lives in a rural area where most deals are done in cash. But he has to work harder and has a lower standard of living because of his choices.

      You have a right to compete in the job market. But you don't have a right for a job.
    • by niceone (992278) * on Friday June 06 2008, @11:08AM (#23683169) Journal
      Yes, especially as in 10 years time it will probably still be Google Health beta.
    • "But once the data is set free, all kinds of Web 1.0, Web 2.0 and Web 3.0 apps are possible." Newsflash ... it's not a bright idea to load up any of these online cloud databases with your personal medical records ... I mean, why the heck would I want to blab to Google (and hence, eventually the world) that I'm a herpes-infested schizophrenic ... no, you're not ... yes, I am ... no way! ... I told you to stop bothering me while I'm typing ...
    • by value_added (719364) on Friday June 06 2008, @11:47AM (#23683751)
      No private company should be so entrenched in society that it would be impossible to survive without the service they provide.

      An insightful comment if ever I read one, but I'm afraid you're a few generations late. As a society we gave up believing in government, institutions of power or authority, religeon, civic responsibility and most all notions of tradition, and adopted instead a belief in individuality and self-fullfilment. That doesn't leave us with much, does it?

      If the current trend continues and free market idealogues get to rule the day, we should expect to have everything from infrastructure to institutions ruled and run entirely by corporations (to the extent they don't already), and we'll all be working for Taco Bell or for The Brawndo Corporation.

      The situation can also be viewed political terms. A good portion of the electorate really does believe that government is evil, that government can't possibly do anything as efficiently or as cheaply as business, and that taxes infringe on their God given rights, but they're only too happy to let the Walmarts of the world take over provided they can maintain the illusion they've kept a few extra dollars in their own pockets.

      The people who complain about undue corporate influence on government probably don't notice that they've succumbed to those same influences in their own lives, but they might notice when there's nothing left to sell off, somebody else holds all the cards and those free-market choices they've been promised come up short.

      Google, I think, is doing what any business does, and that's fulfulling an unmet need and making or trying to make a profit in doing so. The question is why we're not doing it ourselves?
    • We already have HL7 [hl7.org]. Providers have the ability to exchange and consolidate your medical records directly and to provide electronic copies for the patient to physically retain to personally bring by sneakernet between their providers without the need for a proxy. The vast majority of people don't have that many medical providers, nor do they change them very often. It is neither necessary nor desirable to have a company like Google aggregate the records. Its only strength is in being the *only* repository,

        • See: http://www.hhs.gov/ocr/hipaa [hhs.gov]

          Centralizing that information takes away control from us as individuals.

          I specifically stated that your medical records themselves would not be centralized and that your consent to release would be required and would further fall under the clinical discretion of each of your medical providers.

          The only thing I was suggesting is that for emergency purposes, it would be possible to quickly locate records sources that you have explicitly authorized. Whether or not any particular
      • by JCSoRocks (1142053) on Friday June 06 2008, @10:42AM (#23682763)
        That's the very point the OP was making. The credit companies are already ridiculous. Not, "yay credit companies! it's totally ok that they can ruin your life!"
        • by Hijacked Public (999535) on Friday June 06 2008, @10:54AM (#23682935)
          Healthcare companies can already ruin your life, literally and figuratively. If one of their people incorrectly transcribes 1 character of your personal info your insurance company will deny the $35,000 invoice they send and it will fall entirely on you to sory out. That same transcription error can result in your new doctor not getting your medical records from your old doctor, who probably doesn't have a complete set anyway because to get them you'd have to put in a request from every single medical provider you've ever visited.

          It doesn't have to be this way. I'm usually a big free market believer, but I'm also a vet who has been through the VA healthcare system (unfortunately named VistA). Here [fredtrotter.com] is a good piece that mentions the VA's system and how it is being used by an FOSS project to get some of this under control.

          I don't particularly like Google, but I like the US healthcare system even less.
          • Re: (Score:3, Insightful)

            The UK is working on a massive centralized database of health records called NPfIT [ieee.org]. Aside from all the typical delays and cost overruns [ieee.org] of deploying a massive new IT system, there is widespread concern [4ni.co.uk] about privacy among citizens. It will be very interesting (and easy) for Americans to sit back and watch how it pans out. I have an in-law who was fired from a nice hospital job for unauthorized access of patient records (she was showing a friend hoping to get hired on how they file things), which showed m
          • Re: (Score:3, Insightful)

            You have some false logic in your security description. When you talk about how it would be easier to steal data from the office server rather than from Google you are grossly misunderstanding the threat. What are the odds that someone is going to even target that private practice? How much do you think they would even get if they do get in? I would even go so far as to say that the average individual worthy of specific targeting typically gets healthcare from slightly larger and more advanced organizat
      • ... In some areas, having bad credit will prevent you from getting a job. What's the difference ...

        You can do something about bad credit. Most health problems are outwith your control (cancer, car accident, genetic problems ...)

  • Awful? (Score:3, Funny)

    by sm62704 (957197) on Friday June 06 2008, @10:34AM (#23682671) Journal
    Considering that the site's about peoples' insides, shouldn't that be "offal"?
  • by LighterShadeOfBlack (1011407) on Friday June 06 2008, @10:34AM (#23682677) Homepage
    Just what we need, more bullshit for buzzword fetishists.
    • Seriously.

      What, everyone gets bingo too fast on their Web 2.0 bingo cards [0bingo.com] so the next version of bingo cards needs new entries and thus is Web 3.0?
    • by Otter (3800) on Friday June 06 2008, @10:51AM (#23682891) Journal
      I'm just relieved to hear that Web 4.0 is more than 10 years away...
    • If I hear some MBA start saying this I'll either stab myself in the eye with a pen or just one-up him and tell him that Web 3.0 is garbage and we should really be working toward the Web 5.0 initiative. Either way, should be a good time.
    • by dhj (110274) * on Friday June 06 2008, @11:57AM (#23683881)
      Web 3.0? F that. iWeb 2009 Enterprise Edition is just around the corner. It will make Web 2.0 and Web 3.0 look like buzzwords from the 1990s. The the major feature enhancements of iWeb 2009 Enterprise Edition are:

      A synergistic development model.
      Grassroots support.
      Enterprise level uptime and support (obviously).

      This technology promises to create a paradigm shift in the way we think about web services.
  • This is one of the most (potentially abused) systems I can forsee. I really don't think losing our privacy where medical records are concerned is going to help society. this just stinks. google should be ashamed.
    • by ColdWetDog (752185) * on Friday June 06 2008, @10:42AM (#23682767) Homepage

      This is one of the most (potentially abused) systems I can forsee. I really don't think losing our privacy where medical records are concerned is going to help society. this just stinks. google should be ashamed.

      Unless this is mandated by somebody or other, you're free to post or not post whatever you want on Google health.

      That's fine, but it does severely limit the usefulness of the product. As a physician, I'm not going to be inclined to spend much time looking at a highly edited version of somebody's medical history. There is a reason we ask for records from doctors or hospitals. It's far too easy to simply edit out the uncomfortable bits of your life. That of course, is perfectly within your rights, but my job is too look at the whole history, not bits and pieces.

      I don't see this as taking off much in the professional sector - it may be popular in the direct-to-consumer advertising space (which is why I cynically suspect it exists), but it's too limited to be much use professionally. Not useless, but very limited.

      The truly scary part is that the "10 worst" scenarios are much more likely to come true that the "10 best".

      • If you are indeed a physician, where are you? I ask because here in the US there is absolutely no wau any physician I've ever met would take the time to read my entire medical history, because there is no way an insurance company would pay them to do it.

        I've seen large parts of mine and most of seems worthless to me. Lots of redundancy, lots of unreadable scratching. Medications and treatments that didn't work but contain no follow up that would communicate that.

        And I'm not very old and I've been in relativ
        • by Quadraginta (902985) on Friday June 06 2008, @11:24AM (#23683425)
          You're thinking that it takes a physician the same time to read through your history and pluck out the important stuff that it would take you, a complete amateur with nearly zero understanding of how medicine works.

          That's as logical as thinking that it would take Linus Torvalds as long to understand a kernel patch as J. Random User who's never coded a line in his life. Or that your car mechanic needs to carefully listen to every sound your jalopy makes to know whether it needs a valve job. Or that the conductor of the Los Angeles Philharmonic would have to get out a tuning fork and go carefully around to listen to each of his 150 musicians to know whether the orchestra is playing in tune.
        • by ColdWetDog (752185) * on Friday June 06 2008, @11:31AM (#23683539) Homepage

          If you are indeed a physician, where are you? I ask because here in the US there is absolutely no wau any physician I've ever met would take the time to read my entire medical history, because there is no way an insurance company would pay them to do it.

          I'm in Alaska, come up and visit. Bring your harpoon....

          "Taking the time to read your entire medical history" may or may not be particularly relevant. If you are young and healthy without significant ongoing issues, it may be perfectly unnecessary. I likely don't care about the details of your tonsilectomy at age 6 (I might, however, if you had a significant anesthetic reaction).

          But you bring up a good point that's generally obfuscated in these debates: You may not want every detail of a person's medical history at any given time. Sometimes you do. Having to wade through tons of extraneous detail makes it easy to miss important tidbits. Getting a 200 page printout from a 6 day hospitalization with everything including the janitor's notes doesn't help me much. Putting that in machine readable format helps me maybe a bit. What we don't have is an underlying, consistent framework for electronic medical records that's used by everyone and has the capability to organize a huge amount of information into a generally usable format.

          There are baby steps out there, but it's a huge chicken and egg problem for the field. I personally see the digitalization of medical records happening *very* slowly - over the next 20 years or so. And that's a feature, not a bug folks. There are absolutely huge societal issues to be dealt with before we give some uber-governmental department the holy grail of databases. I'd rather have the current fragmented system then allow every government and corporate entity start data mining for whatever purpose of the week they feel important (or profitable).

            • by ColdWetDog (752185) * on Friday June 06 2008, @12:39PM (#23684469) Homepage

              I'd like it if an ambulance crew could pull my records up in some protable terminal and see "Allergic to Sulfa" in a prominent position.

              No ambulance in the world is going to give you an antibiotic. They're going to wait until they get to the ER and let the doc decide. Even if I, for some reason, decide that I'm giving you a drug you subsequently decide to have an anaphylactic reaction to it, well, that's why I have steroids and endotracheal tubes. If you're that sick we ask you the AMPLE history (Allergies, Medications, Past (Medical History), Last Meal, Event. If we can't get it out of you, well, then your likely sick enough to be run through some rather standardized stabilization protocols until we figure out just what you manage to do to yourself. Usually, it's readily apparent. If it's really complicated, it's likely that you are stable enough for the docs and staff to work through the problem bit by bit.

              Yes, rapid access to medical information can be important and very occasionally life saving (but likely not). But Google Health isn't going to work for this. If you are unfortunate to have a serious medical condition, a small laminated paper with your doctor's name, brief past history, medication and allergies and maybe an old EKG shrunk down would do wonders. Stick in in your wallet. We always check that looking for cash, checks and your insurance card....

  • by DragonWriter (970822) on Friday June 06 2008, @10:36AM (#23682695)

    Web 1.0, Web 2.0 and Web 3.0 apps are possible


    Web 3.0? That's just silly.
  • Oh Hell (Score:5, Funny)

    by Target Practice (79470) on Friday June 06 2008, @10:37AM (#23682711)
    Web 3.0? What is that supposed to be? A LAMP application hooked up to a cage of weasels?
  • The ideas are cool (Score:5, Insightful)

    by Oxy the moron (770724) on Friday June 06 2008, @10:38AM (#23682719)

    But that doesn't mean they're good. Diet monitoring? Try this [freshmeat.net], or any other free web service that does it *without* needing your medical history. Fitness Monitoring? Doesn't Wii Fit do this? How about a simple spreadsheet? Travel? Is it that hard to look at The Weather Channel [weather.com] before you leave?

    Honestly, this just sounds like candy-coating a terrible idea so that people will buy into it. None of the ideas on that page are lacking a non-Google implementation assuming you're not too lazy to do some footwork.

    Then again, if you are too lazy, maybe whatever ill effects you receive from using Google's service are deserved...

  • by Rob T Firefly (844560) on Friday June 06 2008, @10:40AM (#23682747) Homepage Journal
    Well then, I'm happy - or sad for them.
  • worst case scenario? (Score:5, Interesting)

    by Red Flayer (890720) on Friday June 06 2008, @10:46AM (#23682823) Journal
    From the worst case scenarios:

    PUBLIC HEALTH

    Anonymized Google Health data is mined by Pleasantville public health officials to chart wellness patterns and develop health policy. Government commissions use the stats as the basis for regulating smoking, trans-fats, sugar and alcohol. Households with strong wellness metrics are eligible for tax rebates.
    Sounds like a good idea to me. People with unhealthy lifestyles cost communities and bigger units (states, federal govt) a lot of money in emergency services, medicare costs, etc. I welcome the idea that those with healthy lifestyles shouldn't be subsidizing those with unhealthy lifestyles. Plus, there is then an obvious economic incentive to become healthier.

    Seems like a win-win to me.
    • You missed the part where they dispatch the T-888 to the guy who ate the hamburger.
    • I welcome the idea that those with healthy lifestyles shouldn't be subsidizing those with unhealthy lifestyles. Plus, there is then an obvious economic incentive to become healthier.

      Maybe I'm just naive, but it seems to me that the *only* way to prevent healthy people from having to subsidize unhealthy people is to (1) allow health care providers to refuse to treat unhealthy people, AND (2) make everybody pay for their own health care. Anything less than that will involve some hidden subsidization via taxes, etc. (Please note I'm not saying I think it should work that way, just that subsidization is always going to be part of health care).

      Also, sometimes bad health has nothing to do

    • Re: (Score:3, Interesting)

      And from the best case scenarios:

      SCHOOL RECORDS
      The Turner Twins' immunization records are forwarded to their school each September. Throughout the year, their schoolmates' anonymized records are linked to the school to keep track of ear infections, strep throat, lice and sports injuries. Schools publish aggregate wellness data to attract new students, and education watchdogs lobby for funding based on overall student health indices.

      School funding based on how often the children get ill? No, thanks.

      INSURANCE
      Trader Ted shops for insurance by selectively releasing his Google Health record on-line. He pays for regular care through a Health Savings Account, but health insurance companies bid for his catastrophic coverage based on his authenticated medical history, diet and exercise records.

      No mention of what happens to someone with a disease though.

    • I welcome the idea that those with healthy lifestyles shouldn't be subsidizing those with unhealthy lifestyles
      You should drop your health insurance then. Or at least get into an HDHP.

      Or go to work for a drug company, or a healthcare provider. They see an economic incentive in keeping people in poor health.
    • by grassy_knoll (412409) on Friday June 06 2008, @11:14AM (#23683251) Homepage
      What's next? Only approved food may be sold? Perhaps any non-vegan food is subject to confiscation and the owners subject to arrest?

      Maybe we can ban alcohol nationally, since that worked so well last time.

      Oh, I know. Mandatory exercise. Not running fast enough? Well, attack dogs are cheaper that what you're costing medicare, so enough with your rights.

      The idea the economics of health care must trump individual rights leads to complete regulation and control of everyone's lives as a "cost saving measure". It's totalitarianism.

      But I suspect you know that, since your sig line seems to indicate you're trolling.. if so, well done.
    • by Quadraginta (902985) on Friday June 06 2008, @11:14AM (#23683253)
      You think? Hmmm. How about someone in government realizes that AIDS costs the public treasury a huge amount of money, so they start penalizing a gay lifestyle? Or being unmarried, which shortens up your life? Or amusing yourself rock-climbing or bicycle racing, which are more dangerous than going to the gym and riding a stationary bicycle to nowhere?

      More plausibly, how about someone in government thinks that lifestyle X is bad for you, and starts handing out tax penalties and rebates accordingly -- but he's wrong. Not like we've ever had any health fads that turned out to be nonsense, right? And no government bureaucrat would dream of making decisions when he doesn't really have enough information to make a good one, right?
    • i'm afraid its not that simple. your comment seems to have overlooked some of the other factors that contribute to health, such as; lead, asbestos, and other types of industrial pollution.

      this system that you consider a 'win-win' is actually a more tightly controlled authoritarian system than the one in which you currently live. the only practical advantage here would be for the HMOs and insurance companies. they would be better able to price coverage.

      i don't think it would require a great deal of imaginati
    • by InvisblePinkUnicorn (1126837) on Friday June 06 2008, @11:31AM (#23683535)
      "Seems like a win-win to me."

      As long as you are on the enforcement end, and not on the end being forced to give up all of your rights as a rational being, everything will always look win-win.
  • In Other News (Score:3, Interesting)

    by had3l (814482) on Friday June 06 2008, @10:51AM (#23682893)
    Scientists are baffled by the realization that most things that matter are either Good - Or Bad.
  • by WamBam (1275048) on Friday June 06 2008, @11:13AM (#23683245)
    As someone who deals with paper medical records all day, I welcome standardized electronic medical records. Not only would e-records be portable, they would also allow for greater continuity of care between healthcare providers. Obviously, security is an issue and I'd like to see more measures taken to ensure that our medical records are protected. As for the possibility of these records raising insurance premiums I think the best way around this is to create a national healthcare plan. I would think that in countries where there is national healthcare services, electronic medical records would be of great benefit since it's inevitable that such a large beaucratic undertaking would need centralized patient information. I would take issue with basing rates on people with healthier lifestyles. There are many in this country that aren't living healther lifestyles due to socio-economic factors. People that live in in poorer areas don't always have access to proper healthcare, are often not educated in the ways of maintaining health and don't have access to nutritional foods.
  • by D Ninja (825055) on Friday June 06 2008, @11:33AM (#23683567)
    From the "Good Things" article...

    Ready to take their relationship to the next level, lovers Romeo and Juliet share STD status reports through their Google Health accounts. If things get serious, they'll open up their entire files to each other and compare genetic data when contemplating children.
    This doesn't seem like such a great thing to me. Here's the scenario I see...

    Romeo and Juliet share STD data. They are both clean (or so the record says). Great. They can now enjoy sex with each other.

    Then, over time, they decide that this relationship is really a great thing and they want to start looking into marriage. They get married. Everybody is happy.

    Now that they're married (because nobody would be stupid enough to share this type of data BEFORE marriage...would they?), they share their genetic information with each other as they are talking about children. But, what's this?! Juliet sees that Romeo has a high propensity for Down Syndrome (or any other "disease" - take your pick). Well, this isn't good.

    So, instead, Juliet decides to get a divorce and go on her merry way.

    The End
    • Re: (Score:3, Insightful)

      The same as web 2.0, which is the same as web 1.0 was. It's yuppie buzztalk for the clueless by people who miss the dotcom bubble.

      Web 1.0 was "It's a series of tubes."

      Web 2.0 is "It's a cloud."

      Web 3.0 will be "It's pixie dust and fairie magic".