Who's tracking your health? Paging Dr. Internet

IVOR TOSSELL, The Globe and Mail, May 23, 2008 [posted here with permission of the author]

Google, pursuing its strategy of monetizing omniscience, has launched a product that will track every bit of your health information. Everyone together now: Yikes!

Called Google Health, it seems destined to exacerbate the pent-up fears that underlie our increasing reliance on massive technology corporations. But the scariest thing about Google Health is how useful it looks like it will be. It's an oasis of sanity in the madness of health-care record-keeping that we know and loathe. But will its Googliness be enough to keep people away?

Following in the footsteps of other companies - including Microsoft, which launched a competing product called "HealthVault" - Google Health made its debut this week in the United States, though Canadians weren't barred from signing up.

The site offers a handful of linked services. First and foremost, it wants to be a storehouse for health information, everything from the names of conditions to the nitty-gritty of test results, including blood tests and imaging results. Users can input this information in one of two ways: They can plug it in by hand or by choosing options from Google's exhaustive lists, from "Aarskog syndrome" to "zits." But American users who signed up also discovered that Google Health not only lets them punch in their own test results, but import information directly from the handful of health-care networks and pharmacies that have partnered with them.

The service is simple and elegant, but more to the point, it highlights a glaring need. Too many of us are trapped in a nightmare where our medical records are scattered across the offices of every clinic and surgeon we've ever visited, instead of one central location.

Referrals are accompanied by faxed wads of paper, which may or may not contain all the relevant information, and occasionally get lost in the shuffle. Patients have become used to starting from scratch with every new physician they see, sometimes needlessly duplicating tests.

The ramifications for quality of care are enormous, and in emergency situations, digital record-keeping can go from convenience to life-saver. The upshot of the present systems is that if you want to guarantee that results will be there when they're needed, it's best to keep copies for yourself - which is something the system discourages, too.

That's not to say that things aren't improving. A patchwork of digital-record initiatives have sprung up across the country, though many of them work in isolation. Many clinics and hospital networks, for instance, do keep electronic medical records, but don't freely share them with other providers on account of privacy concerns.

Most promising of all, Alberta and Prince Edward Island already have province-wide electronic record-keeping systems that store records centrally for each patient, giving them the same kind of one-stop access to their records that Google is offering.

According to Richard Alvarez, executive director of Canadian Health Infoway, a non-profit organization that's spearheading the drive for electronic records in Canada, the rest of the country should follow suit over the next couple of years.

Even if government steps up to the plate, however, private services like Microsoft's and Google's will still be around. In fact, Infoway is working with them to see that their products will be able to talk to the systems that are being built in Canada.

The question is whether Canadians - who have never had a huge fondness for privately delivered health care - will entrust their most sensitive secrets to a company that's made a fortune by selling ads on cat videos.

In time, we might. Rather than being rendered obsolete by province-wide electronic systems, the likes of Google Health could remain a useful complement.

As Alvarez suggests, snowbirds might find it useful for keeping their health information together when they travel beyond their province's borders. And Google Health does things that austere government systems might not, like link to extensive reference pages that detail various medical conditions.

By the same token, Google's servers are located in the United States, and as such are subject to the Patriot Act, which can see data handed over to the authorities. (Though the idea that U.S. authorities might actually wait for legal sanction before intercepting data seems increasingly quaint.) And, as American observers have pointed out, Google claims that it isn't subject to the U.S. laws that regulate the handling of health records.

All of which will likely give a lot of people pause before spilling their guts to Google's servers. But in time, others might realize that online privacy has always been a bit of a mirage, especially where Google is involved.

Anyone who's spent a morning searching Google for a health concern has already told that company what they've got - or worse, what they think they've got. And it's been shown that an anonymous user's identity can easily be deduced from what they search for.

Google Health, then, is a test of how comfortable we are confronting the reality of omniscient, inscrutable databases. Odds are, Dr. Internet already has your chart. Will you own up to it?