Microsoft Corp.
launched a Web site Thursday for managing personal health
and medical information, but privacy advocates worry that
neither the technology nor U.S. law will protect
patients' most confidential details.
From the
consumer's point of view, Microsoft's HealthVault site is
part filing cabinet, part library, and part fax
machine for an individual's or a family's medical
records and notes.
The free site can
store medical histories, immunization data, and other
records from doctors' offices and hospital visits, including
data from devices like heart monitors. It is also tied
to a health information search engine the software
maker launched last month. Users can dole out access
to different slices of their health data via e-mailed
invitations to doctors, family members, and other
people as the need arises.
Microsoft has
been kicking around the idea of a health site since at
least 2000, when Chief Executive Steve Ballmer described a
''health vault'' in a speech to financial
professionals in New York.
The software
maker isn't the first to jump into the ring. Across the
country, groups of providers are starting ''regional health
information organizations'' to share data
electronically. Insurance providers and private
companies market their own flavors of patient-controlled
storehouses of records, and employers including Wal-Mart
Stores Inc. offer such tools to workers.
Steve Case,
co-founder of AOL, has launched Revolution Health, an
information Web site that offers a records management tool
for paying members, and Google Inc. has indicated it
will launch its own service.
Microsoft's
Windows operating system runs more than 90% of the world's
desktop computers, including those in hospitals and doctor's
offices. The HealthVault site works with different
operating systems and browsers, but Microsoft may have
an edge with Windows desktop applications. The company
launched one such program Thursday that helps upload data
from devices like heart rate monitors.
The HealthVault
site itself doesn't do much more than provide a window
into stored information and a mechanism for sharing it.
Microsoft hopes hospitals, doctors' offices, advocacy
groups and insurance companies will build Web
applications that patients will want to use.
The American
Heart Association, American Lung Association, and other
organizations already have applications in the works,
Microsoft said. And devices including blood glucose
monitoring systems made by Johnson & Johnson will
be able to upload data into the system.
Microsoft said
CapMed, which already markets personal health record
tools, also plans to create an application for HealthVault,
as does Kryptiq Corp., whose program will help doctors
send and receive information from HealthVault with
technology they already use.
Microsoft said it
plans to support HealthVault with advertising revenue
from the search portion of the site.
In an interview,
Sean Nolan, chief architect of the company's
two-year-old Health Solutions group, characterized this
''beta'' launch of HealthVault as an early step into a
difficult industry.
For one thing,
there's no guarantee any two providers will call the same
treatment or lab work by the same name.
Then, many health
records are not yet ready to be handled this way.
Between 80% and 85% of doctors in private practice don't
keep electronic records, and hospitals aren't much
better, according to Lynne Dunbrack, program director
of market research group Health Industry Insights. Paper
records can be scanned or faxed to create an electronic
version.
When it comes to
technology, health care is ''where other industries were
in the 1980s,'' Dunbrack said.
As the industry
increases its use of data sharing, opportunities for
privacy violations will multiply, said Sue Blevins,
president of the Washington, D.C.-based think
tank Institute for Health Freedom.
The 1996 Health
Insurance Portability and Accountability Act, or HIPAA,
gives hospitals, doctors, insurance companies, and other
related entities access to patients' records without
consent for various purposes.
This alone
troubles Blevins, but ''adding electronic ease just
magnifies the problem,'' she said. Patients need to be
able to control their own data, she said.
With HealthVault,
Microsoft tried to build in protections from the start,
spelling out exactly what data is shared each time the user
connects to a new application or gives someone new
permission to see a record.
What Microsoft is
doing ''is very, very good,'' Blevins said, but she
added that she still has concerns about who really owns data
that live on Microsoft servers, or what happens to
records when someone dies.
While consumers
have been willing to send financial details over the Web
in spite of identity-theft horror stories, many still
consider private medical information too sensitive to
put online.
''Financial
information is certainly sensitive, but medical information
adds another whole degree of concern, when it's HIV test
results or information regarding mental health
treatment,'' said Reece Hirsch, a partner at the law
firm Sonnenschein Nath & Rosenthal in San
Francisco. ''There's a lot of emotional distress associated
with inappropriate disclosure of that information.''
Microsoft's
HealthVault isn't subject to many of HIPAA's rules or state
medical privacy laws because it's seen as the digital
equivalent of patients asking doctors to fax them a
copy of their records. But the software maker must
still grapple with whether sharing data exposes it to
greater financial risk in the event that hackers get their
hands on confidential medical data.
Many state-level
security-breach notification laws have been passed in
the last couple of years, giving identity theft victims the
ability to sue companies whose systems are hacked or
whose computers are stolen, Hirsch said. The health
care industry is just one U.S. sector that's treading
lightly as a result.
Some of the best
sources of comprehensive health records data, major
insurance companies, haven't agreed to build applications
that work with HealthVault. But even if Microsoft were
able to get providers and insurance companies to feed
data into HealthVault, it's not clear consumers will
use it.
Dunbrack said
most people who have access to a way of managing their
medical records online don't even know it exists.
''Historically, personal health records have had
really pretty abysmal track records,'' she said. (AP)