Technology — Constructive Medicine 2.0

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The Times They Are A-Changin’

Bob Dylan

Come gather ’round people
Wherever you roam
And admit that the waters
Around you have grown
And accept it that soon
You’ll be drenched to the bone.
If your time to you
Is worth savin’
Then you better start swimmin’
Or you’ll sink like a stone
For the times they are a-changin’.

…………..

One of main barrier for widespread use of Personal Health Record has been privacy.Many potential users of PHR are concerned about Privacy of their health information.
People fear that online use of PHR will result in loss of privacy and can have potential serious ill-effects.While some of these concerns are justified as Health is an intensively personal subject although it is a Universal right.

But what does privacy mean in 21st Century.We need to look in what others mean by privacy.

Privacy no longer can mean anonymity, says Donald Kerr, the principal deputy director of national intelligence. Instead, it should mean that government and businesses properly safeguard people’s private communications and financial information.

Millions of people in this country _ particularly young people _ already have surrendered anonymity to social networking sites such as MySpace and Facebook, and to Internet commerce. These sites reveal to the public, government and corporations what was once closely guarded information, like personal statistics and credit card numbers.

“Those two generations younger than we are have a very different idea of what is essential privacy, what they would wish to protect about their lives and affairs. And so, it’s not for us to inflict one size fits all,” said Kerr, 68. “Protecting anonymity isn’t a fight that can be won. Anyone that’s typed in their name on Google understands that.”

“Our job now is to engage in a productive debate, which focuses on privacy as a component of appropriate levels of security and public safety,” Kerr said. “I think all of us have to really take stock of what we already are willing to give up, in terms of anonymity, but (also) what safeguards we want in place to be sure that giving that doesn’t empty our bank account or do something equally bad elsewhere.”

Kurt Opsahl, a senior staff lawyer with the Electronic Frontier Foundation, an advocacy group that defends online free speech, privacy and intellectual property rights, said Kerr’s argument ignores both privacy laws and American history.

“Anonymity has been important since the Federalist Papers were written under pseudonyms,” Opsahl said. “The government has tremendous power: the police power, the ability to arrest, to detain, to take away rights. Tying together that someone has spoken out on an issue with their identity is a far more dangerous thing if it is the government that is trying to tie it together.”

Opsahl also said Kerr ignores the distinction between sacrificing protection from an intrusive government and voluntarily disclosing information in exchange for a service.

Additional Info

But as the debate over privacy continues.Personal health record privacy issues also needs to be carefully assessed in these changing times.

In a recent Wall Street Journal Online/Harris Interactive Healthcare Poll:

One key concept is that patients would have control over an Internet-based medical record and they would decide with whom and when to share that information. But, as when banking or shopping first went online, there have been issues of privacy concerns regarding healthcare data as well. As things become more common though, these concerns tend to wane, evidenced by a 10-point drop this year (from 61% in 2006 to 51%) in those who say electronic records make it difficult to ensure privacy. When it comes to other online medical services, three-fourths of adults feel that patients should be able to schedule an appointment with their physician via email or the Internet (77%) and communicate with their physician via email (75%). These online applications are big first steps in overcoming privacy concerns.

More adults (60%) feel that the benefits outweigh the privacy risks than those who do not (40%). Majorities agree that electronic medical records could reduce healthcare costs (55%), decrease medical errors (63%), and reduce redundant tests (67%) – similar to 2006 results. Even more (74%) believe that patients could receive better care if doctors and researchers were able to share information more easily.

Personal Health Record are now definitively a part of the lexicon of modern health care.

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The recent surge in activities around Personal Health Record business sector has been burgeoning.After the planned entry of Google Health by Google ,which was anticipated to change the health care system in North America,there was increased media speculation about Microsoft being left behind.But,Microsoft had their own plans with the entry of Microsoft Health Vault.There are numerous myths about the battle fought between Microsoft and Google on Health Sector.
Microsoft Health Vault is just a platform,it is a collection of different vendors selling PHR products.Microsoft offers a environment in which all these vendors of PHR products could be together.
What Google plans is going to keenly watched will it be similar to Google Social or Android-mobile phone application platform or just a stand alone Personal Health Record?
Google plans to launch an online health service that will include personal medical records, health-care-related search features, diet and exercise regimens, and a directory of physicians with links to Web sites.

Health is unique but also Universal, it is extremely complex and expensive.To create an ideal PHR business model is not going to be an easy task.People who use PHR,ie stakeholders ranging from patients to physicians to health officials in Government are all worried about one major issue and that is Privacy and security of the collected data.

Privacy Pitfalls

Anita Allen, a law professor at the University of Pennsylvania and an expert on privacy law, says no matter what entity endorses personal online medical records, privacy issues will loom large. “Anyone’s health records should be regarded as personal and sensitive,” says Allen. “People need to be mindful of discrimination from employers and insurers.”

One issue with HealthVault and similar efforts is that they aren’t covered by HIPAA (the Health Insurance Portability and Accountability Act). HIPAA, passed in 1996, created standards for electronic health care transactions and addressed security and privacy issues. Under HIPAA, a patient’s medical record and payment history can’t be linked to an individual by an unauthorized person. These rules apply to health plans, health care clearinghouses — such as billing services and information providers — and health care networks.

Although HIPAA covers the institutions installing EMR systems, Allen says that regulation wouldn’t cover entities like Microsoft, Google or any other web service that allows medical records to be stored online. “HIPAA doesn’t prevent you from uploading information and accepting terms of an agreement. Anything that happens to those records is routine and covered in courts under privacy law.”

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The other questions which are pertinent to PHR world are

Populating the data-should it be by physicians or individuals?

How will the business vendors of PHR products generate revenues if they offer it for free?If paid ,Who will pay for the system?Patients or their employers or insurance.

How long will the health data be stored?How many years?

Meanwhile Wallstreet Journal along with Harris Interactive has just released another poll about Personal health records and their impact on American people.
The survey of 2,153 U.S. adults, conducted Nov. 12-14, shows three-quarters of respondents agree that patients could receive better care if doctors and researchers were able to share information more easily via electronic systems and 63% agree sharing of such records could decrease medical errors. Fifty-five percent agree this could reduce health-care costs, compared with 15% who disagree. However, about one-quarter of adults remain unsure whether electronic medical records can provide these benefits.

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There still many more questions which need to be answered,before we can have a conclusive answer.Health care industry is a large ocean and PHR is just one subset of this ocean.

The Laws of More (Moore’s, on computing power; Nielsen’s, on bandwidth) continue to make technology smaller, more powerful, more ubiquitous, easier to use and cheaper to buy. But human beings are rapidly approaching the satiation point when it comes to how much time they can devote to using all this technology.

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