Questions for Google

This week Google released the much-touted Google Health, an online resource for organizing personal healthcare information. As a healthcare journalist, I've eagerly awaited the unveiling, but as a patient and healthcare consumer, I'm skeptical.

In theory, online health records like this are supposed to help my doctors coordinate care, improve communication between caregivers, eliminate risk of medical errors, and ultimately reduce the cost of care, but I'm just not sold.

How can I really be sure my information is safe? I know this is the most basic of questions, and Google has attempted to answer it in a privacy policy. But if history is any indication, online information isn't safe.

• In March, a Maryland dental group accidentally posted the names, addresses, and Social Security numbers of 75,000 members on its Web site.
• In April, WellPoint announced that protected health information for about 130,000 members had somehow become publicly available on the Internet.
• And, earlier this year here in Massachusetts, 4.2 million credit and debit card numbers were stolen from Hannaford Brothers, our local grocery chain. Now everybody knows about my box-a-week Grape-Nuts habit.

I'm sure all these companies had privacy policies, too. So, if the Social Security Administration and the Internal Revenue Service can't protect me, sorry, Google, I don't have much faith in you.

Who will enter all that data and update it going forward? Entering 30+ years of medical history into a format that I'm not sure my doctor will use seems an arduous task. Google hopes to ease that burden by partnering with labs and physicians, who, I guess, will enter my information for me (at least going forward).

I can't get a complete copy of my paper records from my doctor's office without a lot of phone calls and a $15 fee for photocopying. So I'm not confident that they'll be diligent about updating my record. That said, I married almost two years ago and half of my credit cards are still in my maiden name. I'm not sure I'll be very good at updating my records either.

Who will ensure the integrity of my health record? Forget entering the data; who will double-check that it's right? What if I mistakenly say I take a medication only once a day when I actually take it twice? Will anyone correct that? And does it even matter?

How do I know I'm not just playing into Google's corporate hands? I know, I know, Google would never sell my private information to a third-party vendor. But, how do I know three years from now they won't sell my e-mail address? And Google's privacy policy does leave room for interpretation if, for example, Google Health is sold in five years (in which case, they will "provide notice before personal information is transferred and becomes subject to a different privacy policy").

Will this really help the people who need it? While I'm not eager to enter three decades of health history into a Web site, I'm confident that I can tell you every detail, year by year. The people who can't do that—my parents and grandparents, for example—may not be willing or able to update it on a Web site. Just today I called my father to ask if he'd ever had an endoscopy (long story). He couldn't remember. But he also can't get his new laptop to print and he doesn't know how to reply to e-mails. Something tells me he won't be on Google Health this week, entering his health data.

Before you e-mail me, explaining why all of these concerns are baseless and naïve, let me clearly say that I am not a techie. But neither is most of America.

Online health records, for all their potential, can create a lot of problems for healthcare leaders. Although they're supposed to save money for hospitals, insurers, and employers, they also create new challenges and a lot of questions. So, before you blindly embrace Google Health (and other online resources), make sure you're prepared to answer all the questions—from patients, physicians, the board, and your staff.