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Should Google Organize Your Medical Records?

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What concepts in the chapter are illustrated in this case? Who are the stakeholders?

I think this case illustrates very well the ethical and social issues surrounding the information systems. It is about the accountability, liability and control of the moral dimensions of the information system. Just like a two-sided sword, IS could improve the quality of life while at the same time threaten the well-being of the very same society who enjoy its benefits.

The stakeholders in this case can be divided into three groups. The first is everyone in the society who directly uses or impacted by the system like the doctors, hospital administrations and other actors in medical sectors. Also it touches the patients and even their family who might share the discomfort from the irresponsible use of the dossiers. The second is the people whom the society entrusted the legal system on their responsible hands. And the third are those surrounding Google’s venture in the creation of medical recordkeeping system. This includes Google’s shareholders who risk the loss or profit from the system as well as Google’s employees who might have the same fate with Revolution Health Group LLC. In brief, the stakeholders are everyone.

What are the problems with America’s current medical recordkeeping system? How would electronic medical records alleviate these problems?

America is the world’s third most populated country. With more than 300 million populations (www.cia.gouv), the paper-based medical dossiers become a major bottleneck that could downgrade the efficacy of the country’s overall medical system.

In the form of bits, the data would flow faster and require less space to store than the paper-based dossiers. Additionally data can have the indexes and be extracted to match only the corresponding inquiry thus allows accurate profiling. So information overload can be avoided and the wasted time required to synthesize fractions of data manually will become history.

What management, organization and technology factors are most critical to the creation and development of electronic medical records?

All factors involved in the creation and development of electronic medical records are equally important. The management side includes factors such as the regulatory and legal systems, the men behind the guns along with its human resources problematic, security and logistics concerns of the system’s servers, implementation strategy, etc. The organization factors include the planning and execution of the overall system maintenance program, the system’s administrators and users’ hierarchical access, etc. And from the technology point of view there are infrastructures, software and user interfaces, future upgrades, security from virtual attacks or any other basic input- processing-output factors.

What pros and cons of electronic patient records? Do you think the concerns over digitizing our medical records are valid? Why or why not?

The electronic records would allow patient profiling to match available and suitable medical treatment and facilities. The ‘pros’, among others: access to dossier can be theoretically done in one click from any point where internet is available, less paperwork, unlimited life time, less storage, easy update, etc. The ‘cons’, among others: currently uncertain or unavailability of firm laws and regulations, increasing concerns on the safety of the data storage from hackers, the reliability of the system against human and technical errors that could harm the quality of data which in return endanger the patients, disclosure of information to third parties and the consequences of its irresponsible uses, etc.

Yes the concerns over digitizing our medical records are valid since the infrastructures surrounding the system are arguably not yet ready (legal system, information confidentiality, data security, etc.).

Should people entrust Google with their electronic medical records? Why or why not?

My personal opinion on this is ‘NO’. The main reason behind my stand is that above all Google is a profit oriented company, financed by shareholders who are expecting return on their investment. Without protection from clear law and regulation as well as firm control and monitoring, who could guarantee the responsible use of the collected data? Or whether Google will not collect information about the patient more than it should. Remember about Google Wi-Spy and Buzz scandals?

In May 2010 Google admitted that its Street View mapping program collected web surfing activities from public SSID. But later on in December 2010 after the investigations by several governmental watchdogs, it was found that Google was collecting emails and passwords!

One year later, the European Union’s Justice Commissioner, Viviane Reding has complained that “Google fails to inform its users that the new privacy regime is based on its own business imperatives: to address competition from Facebook’ to grow its capacity to finely profile and target through audience buying; to collect, integrate, and utilize a user’s information in order to expand its social media, social search, and mobile marketing activities… and generally to expand its DoubleClick (advertising) operations”, (http://news.cnet.com/8301-13506_3-57388415-17/googles-new-privacy-policy-begins-does-it-break-the-law).

Probably the final blow in the story is the stepping-down of Google’s privacy director Alma Whitten, as first revealed by Forbes magazine in April 2013. (www.forbes.com/sites/kashmirhill/2013/04/01/googles-privacy-director-is-stepping-down).

If you were in charge of designing an electronic medical recordkeeping system, what are some features you would include? What are features you would avoid?

I would include features like:

– Notification via sms or email to the owner of the medical dossier whenever the dossier is being consulted containing information such as by who or the IP address from where the dossier was consulted, the exact time-date-and-duration of the consultation.

– The history page to record the dossier’s consultations, data modifications and omissions.

– Option for the owner to request cancelation or removals of the electronic dossier and to return back to the paper-based system.

I would avoid features like:

– Option to allow patient to edit and delete one or some information except minor information such as allergies.

– Information regarding the employment status or the name of the company or institutions where the patient is actually working if he is not unemployed.

– Information about the patient’s financial or bank information.

Other readings:

Businessweek. 13 March 2013. Doctors like electronic medical records as long as patients can’t touch them (electronic version)

Businessweek. 06 May 2013. Google now, is it magic or just plain creepy (electronic version)

Science.slashdot.org. 19 January 2013. Patient access to electronic medical records strengthened by new HHS rules (electronic version)

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