“Google CEO: ‘Cloud Computing’ Is Key to Patient-Owned PHR’s”
by Don Long
Medical Device Week
March 3, 2008

This article reports on the 2008 Health Information and Management Systems Society’s (HIMSS) annual conference, at which Eric Schmidt (Google’s CEO) was a presenter.   PHR stands for “personal health record,” a term familiar to many in the health care industries, but not so familiar to those outside the industry.  A PHR is essentially a log or journal of an individuals health care treatment, evaluation and laboratory results.  Today, many individuals do not have PHRs, but rather, their doctors and other health care providers individually maintain medical records on their behalves.   PHRs in an electronic format has been referred to as EMRs (electronic medical record), and, “[t]he federal government has been the pioneer in the field of developing standards for universal, interoperable and portable EMR that are often linked to the development of universal health care coverage.” [pg. 1]  Of course the underlying assumption with regard to EMRs is, “that the government would be the one to have, and the one to control, this information.”  [pg. 2]  One of the primary themes of discussed at the conference was the importance of who controls and has access to an individual’s PHR/EMR.  The distinction drawn between the two is that ideally, a PHR would also be in electronic (digital) format, but rather than having the government have access too and control individuals medical records (as would be the case for EMR), each individual would control their health care information.  Hence, the idea is to make PHRs “patient-centric,” as opposed to having the government or health care providers in control of individuals’ medical records.  [pg. 2]
This is where cloud computing comes into the picture.  Schmidt was at the HIMSS conference to give a presentation on Google Health.  Google Health is a technology that Schmidt says is still in the development phase.  What is Google Health?  According to Schmidt, Google Health is “a system for enabling the creation of PHR, based on ‘cloud computing’ – offering healthcare data that would be completely portable and privacy-protected.” [pg. 4]  The idea is that the system will be “consumer-focused – users can access their data and control who sees it.  The data follows the consumer, wherever they go.  Interoperability is important…[the system]…would not be tethered to a particular health system.” [pg. 4]
This article raises a few important policy issues.  First, there is the issue of creating the informational system necessary to consider providing universalized health care and how individuals medical records should be controlled, stored, and collected.  Second, rather obviously stemming from the prior matter, is the issue of privacy.  Hypothetically, the idea behind using cloud computing (through Google Health) to create and manage individuals’ PHR is so that the individuals have control over their medical records and have the ability to grant a particular health care provider or the government access to their records upon their approval.  If privacy is such an important issue, we should certainly be asking whether we want Google serve as the gateway for establishing and maintaining our medical records and history.