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Your Health Data, Plugged In to the Web
Microsoft Promises Privacy on New Portal

By Catherine Rampell
Washington Post Staff Writer
Friday, October 5, 2007

Microsoft launched a free, ad-supported online health portal called HealthVault yesterday that allows people to upload their medical records to the Web and share the information with doctors.

Microsoft beat not only the federal government to the punch but also a number of other companies, such as Google and Steve Case's Revolution Health, that reportedly have been working on similar portals. Some privacy advocates are concerned that such sites could expose sensitive medical data to hackers and outsiders, but Microsoft said it has spent the past several years consulting with experts to ensure that HealthVault will keep personal information private.

Several other countries have already implemented nationwide medical-record networks that they say are secure. In Germany, for example, patients can carry all their medical records on a single computer chip.

The U.S. government's attempts to automate doctors' offices have been less successful.

Studies have estimated that creating a nationwide electronic medical-record network would save more than $500 billion in medical costs over 15 years, but doctors are slow to adopt technology that has been commonplace in banking and retail for more than a decade. About 90 percent of physicians and more than 80 percent of hospitals still use paper records, according to Nancy Szemraj, a spokeswoman for the Department of Health and Human Services.

Storing and trading medical records online would be "great for patients, but there's absolutely no business case for doing it in primary care," said Richard J. Baron, an internist in Philadelphia whose practice uses an electronic record system similar to HealthVault. He said the cost of software -- and the risk of using unfamiliar technology in an office without an information technology whiz on staff -- have deterred many of his colleagues. Baron said he doubts that many will be persuaded to switch from paper because of Microsoft's initiative.

Other businesses, notably WebMD and Revolution Health, have offered consumers online storage for health data. For the most part, the services rely on user-generated data rather than data from doctors' or pharmacies' records, and they generally do not allow users to share the data with others. Google has been reported to be creating a platform similar to Microsoft's, but the company declined to comment yesterday.

Other companies are expanding their health-record services. Revolution Health, started by AOL co-founder Case, plans to allow users to download prescription records into their accounts through a partnership with Medco.

"I think what Microsoft's doing is great," Case said yesterday. "I've been saying for several years that the health-care industry needs to change and that the key drivers will be technology and consumerism."

HealthVault works as a sort of depository for medical data.

Consumers can download records such as lab reports or X-rays from their health-care providers' Web sites, or data from digital devices such as glucometers, and enter it into their HealthVault account.

All data are encrypted, and consumers can choose to send any of the information to other health-care providers, family members or even physical trainers. They can also send the medical information to partnered applications on other Web sites; the American Heart Association, for example, has a program that analyzes blood-pressure records.

HealthVault is supported by ads based on search terms. For example, a search for "diabetes" yields information on the disease and links to books on the topic for sale at Amazon.com.

Getting doctors to participate in such services, experts said, would probably require more government regulation.

"Because of the way our health-care system is financed, it's made it hard to raise the capital necessary to make these conversions," said David W. Bates, a Harvard Medical School professor and chief of general medicine at Brigham and Women's Hospital in Boston. "Other countries have single-payer health systems, which makes it easier to pay for the conversion."

The biggest barrier to digitizing, physicians say, is the lack of federal standards for how the software should work. Those health-care providers who have digitized use different software products that can't communicate with one another.

For the past several years, Health and Human Services officials have worked on standards under which software vendors would store data the same way. They are still determining how to get data to transfer seamlessly from one program to another. In the meantime, HealthVault has worked with vendors to translate records from different programs into a universal format, according to Sean Nolan, who helped design HealthVault.

Some insurance companies have offered free online health record-services, sparking criticism from privacy advocates.

"You have to have lost your mind to give them any more info about you than they have," said Deborah Peel, founder of Patient Privacy Rights Foundation, which helped Microsoft craft HealthVault's privacy practices. "The revolutionary thing about HealthVault is that it gives consumers complete control over their records and guarantees no one can access that information without their consent."

Other consumer advocates have suggested that the online aggregation of data, whether through HealthVault or its competitors, could be good for patients more indirectly.

"It would be nice to have a pool database across millions of patients," said Robert Krughoff, president of Consumers' Checkbook. "You could see, of all the patients who've had a prostectomy [removal of the prostate gland], what percent had what complications. It would be one way to evaluate different procedures and treatments, since we don't have a way of evaluating their effectiveness in the long run now."

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