About Google Health and Microsoft HealtVault as basid EHR system for developing countries

[Juan Bru]

What do you think about systems as Google Health and Microsoft HealthVault to be used as basic EHR system for developing countries?

Thanks for your time.

[Mark N. Erlenmeyer]

My confidence would be improved if I didn't see "Google" and "Microsoft" before the names of the systems. Does anyone have so much trust in either company to submit extremely sensitive personal information, and have them store and provide others with "controlled" access to it?

A privacy policy is just a bunch of words that can be changed at any time. Google references Safe Harbor -- is there regular auditing to ensure they continue to be in compliance?

[Juan Bru]

Dear Mark,

I'am in agree with you. But security is a problem for any infrastructure configuration.
A good option is to separate medical record id from personal id. Another option is to get Google/MS technology and run in your own infrastructure, but then you loose one of main advantages, that is, run on their systems.

[Mark N. Erlenmeyer]

Yes, security is always a concern and there are ways to effectively manage it. In the case of medical records, I think that an independent agency should be able to audit companies to ensure compliance. I don't necessarily feel this way about other sensitive information, such as credit card data for example. Why? Medical data are the most personal information that can be connected with an individual. Credit damage can be repaired, but how could damage caused by the misuse of health records be repaired?

[Priyesh]

The major issues would be cost and availability of computers, broadband connectivity and vendor interface (hospitals, labs, pharmacies) in resource poor settings. Not many hospitals use computers (which is changing gradually) and not many patients are information seekers nor do they have access to computers (except bigger cities) hence the use would be limited. There may be possibilities where a large chain of private or public hospitals takes it up as a strategic objective and empowers its patients with information.

[Roy Alger]

You have to bear in mind that Google Health and HealthVault are essentially PERSONAL health records. In the USA, they have started linking up with partners in order for health information to flow from providers to the health record of the consumer.

It will be a long time before these large companies get around to doing that in developing countries.

Of course, you could consider the route of creating your own backend EHR and including the API's that will allow your patients to use Google Health as the consumer portal into that EHR. This would allow them to supplement the EHR data with their own demographic and health information, as well as empowering them with access to their EHR information.

We in South Africa have created our own consumer portal called Medibook into a PHR/EHR, but we may still consider interfacing with Google Health.

Regards

Roy

[Juan Bru]

Thanks to everybody.

I'am in agree that misuse of PHR is terrific. But good use of these PHRs in medical day day-to-day work, research and others will save so many lives...We have to find the way to protect PHRs, and do the job.

Google is PHR, but i do for simple use as needed in many problems in resource poor environment would be quite easy to convert in an EHR for medical use.