More Google in Your Life?
You may have heard about Google's Personal Health Record (PHR) initiative, which supports online storage of a user's (what else) personal health record. (Is there any sphere of life in which this company is not contemplating involvement?) The company has recently added the capability of storing images, PDF documents, audio and video files to a cumulative maximum storage capacity of 100 MB and with an individual file size limit of 4 MB. (These current limits pretty much exclude sophisticated medical imaging files.)
I think the generic electronic health record (EHR) is a fundamentally good idea. I just don't know if Google is the most appropriate repository or server of these very personal files. At the end of the day, whether Google provides the service or it's provided by some governmental agency or NGO, I have these questions and concerns:
- Security and need-to-know access are the pivotal issues. Can we devise an airtight security fence around these data? Who can and cannot gain access, and under what circumstances? I'm cautiously pessimistic.
- How do the persons - principally clinicians - who need access get to know that the data exist and exactly how to access them?
- We'll need a universal controlled medical vocabulary and imposed syntax. Perhaps the model is something like the National Library of Medicine's MeSH vocabulary. Who will define and impose these standards?
- Who will store the massive quantities of data and associated backups? Who will provide the necessary bandwidth? Who will pay for the service?
I sincerely seek sensible, quick answers to these questions because the EHR can be an invaluable clinical and economic resource in our fragile healthcare system.