Google and Microsoft are demanding Web access to electronic medical records and took their complaints right to the top this week.
Google chairman Eric Schmidt and Microsoft chief strategy officer Craig Mundie both hammered NCHIT David Blumenthal on the issue during an advisory committee meeting Thursday.
What's most interesting is that both Blumenthal and U.S. Chief Technology Officer Aneesh Chopra pushed back.
The HITECH stimulus money goes to hospitals that automate records and deliver the functional requirements of a recently-passed plan on meaningful use.
The resulting Electronic Health Records (EHRs) are covered by the HIPAA law, in terms of how they can be shared. What Schmidt and Mundie want is that EHRs respond to Web standards so the records can be turned into Personal Health Records (PHRs) controlled by patients.
Here's the difference. If the wrong person looks at your EHR, they could be fined heavily by the government. If you give your PHR to someone who then distributes it to the world, neither government nor your doctor has any liability -- that was your decision.
Schmidt and Mundie based their arguments on the efficiency of Web standards and the need for patient control over their health records.
Blumenthal pointed out that the HITECH stimulus is about EHRs, not PHRs. But what was most interesting was the active pushback by Chopra, who suggested patients could be given "summaries" of their records.
At this point, Nextgov reports, Schmidt came close to losing his temper. "Giving me a summary...is not the same as giving me the record," he said.
He's right. But the Google-Microsoft challenge is one the Administration needs to address far more directly than it has:
- On the one hand, forcing vendors to cooperate with Google and Microsoft has all sorts of nasty privacy implications, since Google Health and Microsoft HealthVault are not subject to HIPAA.
- On the other hand, denying Google and Microsoft access to the full records leaves the data under the proprietary control of doctors and hospitals, and keeps people from gaining the full value of PHRs and personalized health.
Given the outright lies being told right now concerning the main health care plan -- Obama does not want to kill your grandma -- it's hard to see how subtle differences between EHRs and PHRs can be explained so that 300 million people can access their data and be counted on to keep it secure.
So it seems to me that Google and Microsoft are barking up the wrong tree. Rather than addressing their questions to Blumenthal and Chopra, they should be creating a public education campaign on PHRs that will create demand for access to records from the bottom up.
As a first step, perhaps Microsoft could explain on its main HealthVault page what a PHR is, and the difference between that and an EHR.
As a second step, perhaps Microsoft and Google could both get on board the health reform train. That would add weight to their words in any future meetings with Administration officials.