Google Health 2018: Worst Case Scenarios
By Jack Powers
Published: June 2, 2008
ANALYSIS Google Health organizes a patient's diverse medical data into a coherent on-line personal health record (PHR). The visceral reaction of many to the privacy concerns is revealing: most people think they need to keep medical data secret because they're covering something up -- with employers, insurers, loved ones, maybe even themselves.
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Congressman Smith gets careless with his Google Health password -- or maybe a hacker gets at his record. His enemies post his data to the web where his colleagues, his girlfriend, his mom, his children and his constituents learn of his history of gonorrhea, depression, ED and shingles. Smith resigns.
As part of her company's corporate wellness initiative, Smoker Sue is pressured to link her fitness data to the company's medical network. She places at the bottom of the wellness rankings which are used -- unofficially -- in performance reviews and project assignments. To the detriment of her career, she ignores friendly robotic reminders to stop smoking, eat better and work out more.
The O'Halloran Family's genomic profile becomes the source of conflict when it turns out that several of the teenaged kids seem to come from different genetic backgrounds. Mom and dad have to explain which one is adopted, which is an IVF child from a donor egg, and which were from earlier marriages. In addition, the blood relations get told that they may be at higher than average risk for colon cancer. The family trip to Ireland is canceled.
Pharma Phil doesn't always take his hypertension medicine, and his insurance company warns him that his e-prescriptions have not been filled by his on-line drug store. Phil's wife Phyllis -- and her primary care physician -- get notices of impending polypharmacy: she's getting too many different prescriptions from different doctors as well as vitamin and supplements reported through the pharmacy link. Their insurance won't pay for non-standard care.
Lonesome Larry's on-line dating service links his Google Health record in addition to surveying 23 degrees of compatibility. The service doesn't even suggest prospective mates who take anti-depressants, who seem to be less than fit, or who have had major operations in the last two years. A herpes infection is OK, though.
Facebook Fred adds an application that displays his STD test status as a badge on his social media profile pages. At some colleges, the fad is banned because some badges are counterfeit. Third-party testing firms spring up to deliver authenticated results, often to mobile phones.
Grandma Grace's home care computer tests her from time to time for signs of depression, anxiety and problems with cognitive functions. The results accumulate in her Google Health record and become the "scientific" basis for county commitment proceedings.
Doctor Dan defensively reviews the Google Health record for every new patient: missing a detail in the record could become the basis for a malpractice action. He hires a web PR agency to monitor and correct the reviews of his work that have been posted on-line, and he worries that his patients' diet and fitness stats, aggregated by insurance companies or employer groups, are not competitive with other doctors in town.
Because she once opted in with her Google Health record to an on-line health group, Media Marie gets bombarded in the mail, on-line and on the phone with sales pitches for new cures and treatments specific to her conditions -- and to her diet and exercise history. The ads become a little insulting because they know a lot about Marie.
Anonymized Google Health data is mined by Pleasantville public health officials to chart wellness patterns and develop health policy. Government commissions use the stats as the basis for regulating smoking, trans-fats, sugar and alcohol. Households with strong wellness metrics are eligible for tax rebates.
HEALTH RECORD REPAIR
Since GenX Jerry's career, marriage prospects, insurance coverage, love life and tax bill depend on the contents of his Google Health record, he hires a health record repair company to review, correct and authenticate his health details and to estimate the damage bad data has done.
As consumers come to control their own health information, they are at risk of giving away data too freely. Most of our imagined applications are consensual commercial relationships, not regulated medical practices. Like the Google Health system itself, they don't fall under existing health information privacy regimes.
We brainstormed some Best Case Scenarios last week. (Subscribe to the IN3 Network mailing list for updates.) \\