Managed Care - July 2008 - (Page 6) LEGISLATION & REGULATION Microsoft & Google PHRs Draw Government Interest These giant Internet players can offer the fluidity of personal data and information, but they don’t have to comply with privacy standards By John Carroll s chief medical information officer at University Hospitals in northern Ohio, Holly Miller, MD, is playing a leading role in ushering in a new era of electronic health records for patients. And she is impressed by the potential that giant vendors like Google and Microsoft have in offering to draw together all of a patient’s scattered personal health records (PHRs) into one online site, regardless of who is treating them or covering their care. “It is fabulous to have this fluidity of data,” says Miller. An individual treated by one physician doesn’t have to cart around records to see another doctor. Those records would be more easily accessible and providers could do a better job of treating patients. “It’s a huge enhancement on patient safety and the care we could provide. This is a tremendous advancement.” There is just one, big problem. While her hospital not only has to comply with the Health Insurance Portability and Accountability Act (HIPAA) on maintaining the privacy and security of the data, there is also a heavy demand by accreditation groups for regular data audits to make sure that the university is complying with privacy standards. None of those standards, though, applies to Microsoft or Google. And even though patients’ medical records can routinely contain some compromising personal information, says Miller, they may not realize just how much is at stake when they routinely agree to sign off on third-party Web sites’ terms and conditions that they are unlikely to even read. Providers and insurers alike are paying considerable attention to that issue, especially after Kaiser Permanente triggered a pilot project that could eventually lead millions ofbeen a contributJohn Carroll, a freelance writer, has its members to aggregateoftheir health records years. ing editor MANAGED CARE for six in Microsoft’s A HealthVault. And the Google Health platform is promising strong competition. “We would have to choose whether we use one of the platforms,” says Dr. Miller, who is about a year away from rolling out electronic patient records. “I hope by then there is some regulation of the third-party vendors.” The House Committee on Energy and Commerce’s subcommittee on health has already taken a first step in that direction, outlining a set of new privacy rules in late May and beginning to gather feedback. Coming shortly after Congress approved new rules governing the privacy and use of genetic information, the committee’s action appears to signal intent on extending the law’s reach not only to third-party vendors like Google and Microsoft, but also to regional health information organizations that were set up to foster the adoption of electronic records. A rough outline of what the committee has in mind is raising concerns among insurers and providers that they still may face a future where different rules apply to different players taking the field of health records. Patients may not realize what is at stake when they let Google or Microsoft collect and hold their personal information, says Holly Miller, MD. An even playing field? Kaiser Permanente has long had a reputation as one of the technology innovators in the health insurance field. As an integrated network with its own enormous provider group, Kaiser has an inside track ramping up electronic health records that connect patients, doctors, and hospitals. And 25 percent of its 8.7 million members actually have their own online personal health records. This new move by the country’s largest HMO, though, allows individuals to combine the clinical data now stored in their My Health Manager programs with more health and wellness information. 6 MANAGED CARE / JULY 2008
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