ICare

Healthy debate on electronic health records

By Steve Johnson

Mercury News
Article Launched: 10/31/2008 07:00:00 PM PDT

Backed by both presidential candidates, Silicon Valley tech giants and
other companies are leading an effort to create electronic health
records containing data about your most intimate health conditions —
from your bunions and bad back to your chronic hemorrhoids and
psychiatric history — so the information can be easily shared with
doctors, insurers and others.

Proponents of electronic health records believe they can dramatically
cut medical costs and lessen the likelihood of patients being
improperly treated. As a result, voluntary programs to test the
concept recently have been launched by major corporations, from
Silicon Valley tech titans Google and Intel to Microsoft.

But despite assurances the records will be kept confidential and
patients will control who sees them, consumer advocates fear the trend
will lead to widespread privacy violations and relentless marketing by
hucksters misusing the data.

"Increasingly, consumers will be receiving an array of pitches and
promotions and product offerings based on very sophisticated
analytical assessments of their health information," said Jeff
Chester, executive director of the Center for Digital Democracy. "This
is an area rife with problems."

Saying the paper records used by most doctors are inefficient, waste
money and make it hard for health professionals to exchange vital
information about patients, President Bush in 2004 ordered the federal
government to begin planning
for the nationwide adoption of electronic health records. And that
goal is being enthusiastically pushed by his would-be successors.

Computerizing such records makes sense "instead of you filling out
forms in triplicate when you go to the hospital, that will reduce
medical errors and reduce costs," said Barack Obama during the
candidate's second debate Oct. 7.

"Let's put health records online," replied John McCain.

Major corporations are promoting the concept, as well.

In May, Google set up an area on its Web site, dubbed Google Health,
where people can place their health records and share the information
with doctors and others. Patients now can exchange health data with
only a few doctors participating with Google Health, but Google plans
to broaden its record-sharing features.

Not to be outdone, Microsoft in June announced a deal to let Kaiser
Permanente's 159,000 employees store their medical data on Microsoft's
HealthVault site. Late last month, Microsoft unveiled a similar
arrangement for patients covered by insurer Aetna.

In addition, Santa Clara computer-chip maker Intel has teamed with
several large companies, including Applied Materials, Wal-Mart and
Pitney Bowes, to create an independent Web-based entity, called
Dossia, where the companies' employees can manage their health data.

The services are free for patients and the companies involved insist
they're not in it for the money.

"None of us are approaching this because we think we can create a new
product line," said Colin Evans, an Intel manager who is Dossia's
chief executive, insisting Intel's interest is to help improve its
workers' health.

"Most doctors keep their data on paper. That's dangerous. If doctors
can't exchange information or have an incomplete view of the patients
because they don't have the records," he said, it can have serious
consequences and has even led to some patients' deaths.

As Microsoft has promised, Google won't pepper patients with unwanted
ads, said Dr. Roni Zeiger, product manager for Google Health. Instead,
he added, the Internet search giant believes it can benefit indirectly
by providing a vital consumer service.

"We think that when people are signed in to applications they trust
and appreciate, they will tend to use other Google products,"
including Google's main search site, which does have ads.

So far, just 13 percent of U.S. doctors use some computerized records
and 4 percent do so extensively, according to a New England Journal of
Medicine national survey of nearly 3,000 physicians in July. But if
the adoption of such records becomes widespread, it could open up a
huge business opportunity. Research firm Kalorama Information
estimates the annual market for products related to such systems could
hit $4 billion by 2015.

Much of the equipment needed to link the network would have to be
powered by computer chips, for example, a potential big plus for
Intel. Google also might be able to charge businesses such as
weight-loss services to put their nutritional or other medical tips on
Google Health, said Andrew Rocklin, a health expert at Diamond
Management & Technology Consultants in Chicago.

But the concept has run into resistance.

Of 1,003 Americans surveyed two years ago by the New York-based Markle
Foundation, which promotes new communication technologies, 77 percent
suspected their information could get into the hands of marketers and
80 percent feared they could be exposed to identify theft and fraud.

Those worries are warranted, consumer advocates say. "One of the
ongoing concerns I think with both Microsoft and Google is these
business models are constantly in flux," said Marc Rotenberg,
executive director of the Electronic Privacy Information Center in
Washington. "They may say today there is no advertising. Once they are
in possession of the medical data, they can change the business
model."

Recent medical-data breaches also have contributed to the misgivings.
In April, federal prosecutors in New York charged a former hospital
employee with improperly accessing nearly 50,000 computerized health
records of patients so he could sell the information to others.

Contact Steve Johnson at sjohnson@mercurynews.com or (408) 920-5043.