The United States Federal government is pushing for most Americans to have their medical records stored in electronic form by 2014. Electronic health record (EHR) systems store patient records in a central database that can be accessed by many physicians at more than one location. Such a system eliminates problems caused by duplicate records at different physician offices, avoids having to fill out a new patient history with each new physician visited by the patient, and reduces errors made by incorrectly deciphering handwritten notes and prescriptions. Electronic records can make for a better and healthier world. However, the cost of moving to electronic systems is prohibitive, especially for small medical practices. At this point, only ten percent of small medical offices and five percent of solo practitioners have moved to EHR systems.

Although the government is introducing financial incentives to encourage physicians to use HER systems, some big companies that aren’t typically associated with health care are becoming involved—p articularly Microsoft and Google. Approximately 52 percent of adults look to the Web when seeking health advice. Google and Microsoft believe that they can better assist health consumers by providing them with a robust tool for managing their health records. Microsoft’s tool is named HealthVault, while Google’s is named Google Health. The companies see their EHR systems as a solution to the government’s problem for finding a low-cost records system designed for both physicians and patients.

John D. Halamka, a doctor and CIO of the Harvard Medical School, thinks systems in which the patient manages the information, such as those proposed by Microsoft and Google, are the inevitable future. “Patients will ultimately be the stewards of their own information,” Halamka stated. “In the future, health care will be a much more collaborative process between patients and doctors.”

Google agrees that patients should be in charge. A statement at Google Health’s welcome page reads, “At Google, we feel patients should be in charge of their health information, and they should be able to grant their health care providers, family members, or whomever they choose, access to this information. Google Health was developed to meet this need.”

But just how private and secure will our medical records be when stored in Web-accessible databases, protected only by one password? Privacy and security concerns are raised both by corporate access to private records by Microsoft and Google and outsider access by hackers. It is likely that both companies will use automated systems to target advertising at individuals based on medical records, just as Google’s email places ads next to e-mail messages based on the message contents. Unauthorized users might also be able to access records stored on a network that billions of users around the world use.

Another problem that complicates Google and Microsoft’s involvement is that third-party medical record services are not covered by the Health Insurance Portability and Accountability Act (HIPAA). HIPAA provides strict standards for keeping medical records private. If a patient chooses to use Microsoft or Google to store medical records, those records would no longer be protected by the standards imposed by HIPAA in its current form.

As in similar cases, patients should weigh the costs in terms of privacy and security against the benefits of convenience and data reliability. Meanwhile, the software vendors need to work to build higher levels of security, privacy assurances, and customer trust.

1. Why does the U.S. Federal government want to move health records to electronic systems?

2. What benefits and risks are offered by Web-based health records management systems like Google Health?

3. How might Google and Microsoft reassure users about the privacy and security issues posed in this article?

4. Would you consider registering for Google Health? Why or why not?