Idea of online medical records raises questions

Google, the California search-engine company, and the Cleveland Clinic — an Ohio medical institution with a reputation for quality care — recently announced they will collaborate on a pilot program to store patient records online.

The test program will allow 1,500 to 10,000 patient volunteers at the Cleveland Clinic to store certain records — information on prescriptions, allergies and laboratory test results — in a secure Google account. Patients will have passwords and only they will be able to access the medical records.

The idea is to allow patients to control their medical records. If they decide to change doctors or hospitals, they will be able to electronically transfer their Google records by themselves. Patients will be offered the service free.

Some privacy advocates wonder whether hackers will be able to access the Google medical records or whether the company will use them commercially. Google says it will not share or sell the data.

Many hospitals have been keeping — and improving — electronic patient records for a number of years. In some cases, both hospitals and patients' own physicians can access those computer records. Right now, patients can't move the records around electronically, but some doctors say that could happen in the future.

At the North Shore-Long Island Jewish Health System, Dr. Barry Goetz is director of ambulatory clinical-information systems.

Starting in June, North Shore will provide records on patients who have received care there available to hospitals across the system.

Initially, though, patients won't be able to move their information around as in the Google model.

Goetz said privacy is a concern. "There's a lot of questions with regard to shared medical information as to who should be the adjudicator of whether that information should be shared or not," he said.

Pam Dixon, executive director of the World Privacy Forum, says she's concerned the Health Insurance Portability and Accountability Act — which governs medical privacy — might not cover information stored on Google.

The World Privacy Forum is a San Diego not-for-profit public interest research group.

"The concern is we have the movement of data out of the health-care sector [the Cleveland Clinic] to a noncovered entity [Google]," Dixon said.

"We will not share nor will we sell users' information," said Google spokesman Gabriel Stricker.

It's unclear whether Google plans to make money on the medical-records program.

Stricker pointed to Google News, which attracts users but does not have ads that make money for the search engine. "When you create a good user experience, that's good for Google," Stricker said.

Strickler would not say whether Google has plans to expand the pilot program beyond the Cleveland Clinic in the future.

Arthur Caplan, a bioethicist at the University of Pennsylvania , urged caution with all electronic medical records.

"You're going to have to build a clear firewall that says this is off-limits for commercial use," Caplan said. "They have to be clear about who will use the records."