Google Health Opens To the Public

Several readers noted that the limited pilot test of Google Health has ended, and Google is now offering the service to the public at large. Google Health allows patients to enter health information, such as conditions and prescriptions, find related medical information, and share information with their health care providers (at the patient's request). Information may be entered manually or imported from partnered health care providers. The service is offered free of charge, and Google won't be including advertising. The WSJ and the NYTimes provide details about Google's numerous health partners.

Privacy

I for one won't be using it while their terms of service explicitly states that HIPAA doesn't apply to Google.

Re:Privacy

I for one won't be using it while their terms of service explicitly states that HIPAA doesn't apply to Google.

I don't trust Google. I'm of the opinion that companies have to obey the rules/laws of government. I'd rather "trust" the government if they said that HIPAA doesn't apply to Google rather than Google saying that HIPAA doesn't apply to them. There is a part of me that actually hopes that Google gets slapped by the government for violating HIPAA.

Re:Privacy

Okay, here is the government telling you that HIPAA doesn't apply to Google [hhs.gov]. Google isn't a health care provider, nor is it a health care insurance plan, nor is it a health care clearinghouse, by the legal definitions of those terms (check the law if you like), so, no, HIPAA most certainly does not apply to Google or any other company or entity providing a similar service.

Why not?

Why isn't Google a health care clearinghouse?

Health care clearinghouses include billing services, repricing companies, community health management information systems, and value-added networks and switches if these entities perform clearinghouse functions.

I'm certainly no expert but I do speak english. Is Google not a "community health management information system"?

Re:Why not?

Google is NOT a healthcare clearinghouse (you might reasonably think it meets the definition - I used to think it would as well, but covered clearinghouses are directly linked to care providers, the definition does not cover third party service providers (of medical devices, Customized off the shelf software etc.).

Regarding HIPAA applicability to google: any HIPAA CE (Covered Entity, which includes most of your health care providers who also use or maintain electronic patient data) MUST include terms in a contractual relationship with a BA (Business Associate - anyone the CE does business with involving patient data) which mirror HIPAA requirements (this is the "Business Associate Rule").

YOU can release your records to Google, this would involve NO HIPAA issues.

If your Primary Care Provider is a CE (likely) and they contract with Google (as a health partner etc.) then the terms of that contract MUST include HIPAA protections (i.e. the CE must require, contractually, that the BA meet the same HIPAA requirements which the CE is subject to).

Re:Privacy

In times like these, I would trust Google over the government ANY DAY! I'd rather have a creative, for-profit company actually try to make a difference than have the government dick around with tax dollars that companies like Google will end up generating anyway.

Re:Privacy

For those who don't want to go digging for the crunchy bits:

If you create, transmit, or display health or other information while using Google Health, you may provide only information that you own or have the right to use. When you provide your information through Google Health, you give Google a license to use and distribute it in connection with Google Health and other Google services. However, Google may only use health information you provide as permitted by the Google Health Privacy Policy, your Sharing Authorization, and applicable law. Google is not a "covered entity" under the Health Insurance Portability and Accountability Act of 1996 and the regulations promulgated thereunder ("HIPAA"). As a result, HIPAA does not apply to the transmission of health information by Google to any third party.

Exactly

You don't opt out. You have to sign up and opt in for them to get your records.

I agree 100% with GP. I even wrote Google to that effect. Not that I expect them to do anything with my feedback other than send it to the bitbucket.

This is a horrible, horrible precedent to set, allowing a 3rd party to have access to people's medical records without any protection under the law.

HIPPA *does* need to be updated, immediately, to cover online databases.

You misunderstand HIPPA

Your medical provider is covered by HIPPA and CANNOT release your records to a third party without your consent. When you go to a new doctor they generally make you sign something saying they can share it with your insurance company, who also cannot share it with Google without your consent.

The way Google Health works is you give them your data and they store it.

Uh oh...

I can see "Need Liver or Kidneys?" coming about in the recommended searches.

Re:Uh oh...

I'm concerned about what happens when they combine information about who has healthy kidneys with streetview. And put google ads offering discounts on bathtubs and ice.

This is actually Google's spam fighting measure

All people needing viagra will be notified of cheap imported viagra by Google, and the spammers will lose all their market!

Just wait till you hear about the plan they have to go after the Nigerian 409 scammers.

google information horde

so, google will have your surfing profile, your financial information, tons of images of you, your house, your friends, your networks, and how will add to it your health information. You know, Big Brother can be a government, but it can also be a corporation. Even one that claims not to do any evil.

Yes, it has advertising, through "affiliates".

Yes, Google Health supports advertising. Spamming, even. Read the developer guidelines. [google.com] Google just doesn't run the ads themselves. That's outsourced to "affiliates".

There are some rules for affiliates, like "one spam per week per user" and "no popups or popunders". Other than that, consumers are fair game. In particular, affiliates are not prohibited from using Google health data to target ads, as long as they "disclose" that somewhere in their "privacy policy". The policy says "Only use Google Health user data for the purposes disclosed in your privacy policy, and obtain users' opt-in consent if personally identifiable health data will be used for ad targeting." So a bit of fine print, and the affiliate 0wns your health history.

It's a typical slimeball tactic - pretend to be the good guy, encourage "affiliates" to do the bad stuff.

Re:Yes, it has advertising, through "affiliates".

Oy vey, you folks need to take a step back. The above guidelines refer to other service providers that users can opt in to and share their history with. Google is simply limiting their ability to annoy you, should you choose to opt in.

And, Google isn't protecting your information via HIPAA because it can't - it's not a "covered entity" under the definition [hhs.gov] outlined in the law. (That is, they aren't a health provider, billing clearinghouse, or health plan.) Instead, they provide the Google Health Privacy Policy [google.com], which seems pretty reasonable. Like HIPAA, it allows them to disclose information when it seems like the government (US, in this case, as that's where the service is limited to) compels it. Before you get hot and bothered, HIPAA allows this too - it's how we tell get to CPS about abused children, for example.

I'm not new here, but I'm used to Slashdot readers being somewhat more informed before having a fit. As a covered entity myself (I'm a physician), I look forward to the day when the patients who come in saying they doubled the pink pills but lost the yellow ones they took for that surgery to remove that thigamajig have a hope of a secure information repository to clarify their history, and potentially save their bacon.

missing drug side effects

I am dealing with a rare side effect from a fluoroquinolone, (think cipro, levaquin) called peripheral neuropathy. I plugged the antibiotic into google health and the side effect was not listed on the package insert. While its good to have drug interactions listed, lots of people have side effects from drugs and they need to be explicitly spelled out, not hiding in a sub menu.

I know for a fact that there is explicit warnings on the packages about this particular reaction and I'm livid it isn't warning about it on the package insert in google. Especially since it can be permanent.

I've racked up a couple thousand dollars in medical bills already from this side effect, and it was a pain to get doctors to admit it happened until I went to a major university hospital. At that hospital they diagnosed me right away and basically said I'd have to wait it out.

If you are curious, basically I couldn't walk for over a week, terrible joint pain for months along with numbness in my hands, face, and body. Its a known side effect with this class. Rare, but known.

"How does Google make money off Google Health?"

6. If it's free, how does Google make money off Google Health?
Much like other Google products we offer, Google Health is free to anyone who uses it. There are no ads in Google Health. Our primary focus is providing a good user experience and meeting our users' needs.

I've heard enough. I don't know what their long-term plan for monetizing Google Health is, and I don't really care now. I don't trust Google enough to consider even for a second entrusting my health care information to them (and I say this as someone who has thought very highly of the company since the beginning). And their weasly answer to the obvious question above, I think, justifies my mistrust.

Every for-profit company's primary focus is - making a profit. There's nothing whatsoever wrong with this, and the ideal situation arises when "providing a good user experience and meeting [...] users' needs" is aligned with the profit motive.

So why they can't be honest about their motivations in undertaking an expensive, large-scale project like this -- whatever those motivations are -- instead of trying to make us believe that they're doing it "out of the goodness of their hearts?" All their mealy-mouthedness accomplishes is to raise the suspicion that they've got something nasty up their sleeves. And that ensures that many users, including me, will never entrust their most private of private data to Google.

Re:"How does Google make money off Google Health?"

And you trust your health insurance companies? Their sole purpose is to make profit. We'd be much much better off without them, paying doctors and hospitals directly.

Re:Wow

And I don't want them caving into "big infomercial" sleazeballs that tell use phrases like "Big Pharma" to try and persuade potential customers to buy their scientifically unproven snake oil instead.

Re:Wow

This is especially true if Google doesn't just cave in to "Big Pharma" and allows you to see "alternative" or "herbal" remedies for prescriptions or OTC drugs you have entered.

Ugh, I hope Google Health doesn't become such a nexus of snake oil salesmen. Hopefully they will have minimum requirements for the scientific accuracy of medical claims to weed out this nonsense. If you want to be peddled placebos, just stick to Kevin Trudeau and his ilk's infomercials. We don't need Google Health to be infected with such a taint.

Re:Wow

I had a cold, had some herbal medicine, a few days later my cold was gone. Explain that!

Re:Wow

I had a cold, had some herbal medicine, a few days later my cold was gone.

I had a cold, didn't take a placebo, a few days later my cold was also gone.

Explain that!

Your immune system did it's job. That's what it's there for.

Re:Wow

Your sense of humor called, it's enjoying palm beach with the kids.

Re:Wow

I can see it now, 'want to get health insurance again? Pay us x dollars or we expose condition y to your health insurance provider.'

Many States have laws that prevent an insurer from charging sick people a higher premium.
In other words, if you are in their State, you have to follow their rules, and their rules say your price isn't affected by "condition y".

On a related note, I read an article [slate.com] stating that part of a McCain proposal would allow insurance companies to change their legal residency for the purpose of using another State's insurance rules. In other words, a New York insurance company can pay taxes in Arizona and use their insurance rules.

Re:Disclaimer Needed

In my Canadian province we have a government funded public health nurse phone line line. It exists for people to phone in and speak to a nurse about whatever health problem they're having, and the nurse can give advice on over the counter medication or home treatments, but will always differ to "go see a doctor" as needed. They keep a record of your calls so you can follow up on advice given and changes in your condition. It's really a very good service.

It exists to alleviate line ups in walk-in clinics and emergency rooms by keeping some of the people with less serious problems from having to go down and see a doctor. This service looks like it will serve a similar purpose.