Sunday, February 22, 2009

I'm putting my data in Google and HealthVault

I've decided to go ahead and put my data in Google Health and MicroSoft HealthVault.
(Note: MicroSoft HealthVault is a different kind of thing from Google Health. About the only thing they have in common is that I can put my health data in them. For this post I'll only discuss Google, but the concerns people have about the two are similar, and so are my thoughts.)

This is something of an earthquake on The Dave Planet. When Google Health was first announced in January 2008, I was completely distrustful and wrote What's next, Google Health??, concluding with this:

GOOG's stock is doing great and I love their free tools, but there's no way in hell I'm giving them sensitive personal data, regardless of what their policy says. New motto for 2008: Don't Be Stupid.
It was a direct slam against Google's long-professed unofficial motto "Don't Be Evil." I expressed my concern that Google might succumb to government pressure and dish out personal medical information that someone had entrusted to Google Health. I cited how Google had caved in to China's government, and how Google CEO Eric Schmidt had severely punished for googling his personal information and publishing it. I saw hypocrisy.

Others agreed. One online forum discussed the potential for abuse, given that Google collects enormous information about each of us as we browse the web and use Google's search features – they know what you've searched for and (through ordinary marketing software that most web sites install) they know what sites you've visited.

They say they won't use that info; but... what if? What if an evil politician (take your pick: Dick Cheney, Hillary Clinton, Putin) puts the squeeze on Google to disclose such information so they can use it against you? That's less improbable than what actually did happen to Valerie Plame. In cases like that, laws will not protect you.

In online discussion groups, experts in "search engine marketing" joked about it: If Google knows you have a kidney problem, then the Google Maps "Street View" feature might point out potential donors, and the ads on the side of your screen might start promoting bathtubs and ice. (Yes, people did joke about that.)

That's a bit over the top, but you get the point.

Similar concerns continue today – this delightful image appeared on a ZDNet post this month, titled Is Google health corrupt?

So why have I gone over?

  • First, in the past year an increasingly wide range of people I trust have said "The data you're concerned about is already not as secure as you think." That doesn't leave me any more comfortable but I've come to accept that my choice of action won't make much difference.

  • Second, and more importantly, I'm concluding that we can do more good by aggregating our data into large, anonymized databanks that smart software can analyze to look for patterns. Early detection means early intervention means fewer crises.
            Diabetics are already starting to do things like this. And the Cambridge MA-based PatientsLikeMe is a full-blown example of a community (ALS / Lou Gehrig's disease) where patients are tired of waiting for the medical industry to produce results. They're uploading their data (anonymized), sharing it, looking for patterns, even creating their own clinical trials.

  • The third aspect, ultimately the deciding one, is something I see all the time in my day job, where we study new software tools: the power of "mash-ups." That's the ability to slap together two pieces of software (or data) that were created without knowing that the other one exists, and making something new out of them without anyone planning it in advance. Things can just grow in any direction people want.
            Mash-ups are a big part of what makes the Web what it is today: Anyone can put a Yahoo Map on their web site, I can take someone's YouTube video and put it on my blog, etc.

The power happens because this lets people create software gadgets without knowing how they'll be used, it lets people build tools that use data without knowing where the data will come from, and it lets people build big new systems just by assembling them out of "software Legos."

And in healthcare, that's what free public tools like Google Health and Microsoft HealthVault enable. Here's the personal example that hit me recently and tipped me:

When I was discharged from the hospital after my first week of Interleukin, I was given a complex medication schedule grid – which had to be created with pencil and ruler by a highly trained nurse.

This was not a sensible use of her time. So, being a software thinker, I spec'd out a "Med Minder" program that would take prescription instructions ("take this one 3x/day, take this one with meals," etc) and spit out a nicely printed daily schedule. I had additional ideas: "mash it up" with a database of pill images so you can see what pills to take; "mash it up" with a database of different Walgreen's pillboxes so you can see what to put in each cell of your particular pillbox.

I talked to a few people about it and hadn't found anyone interested in the idea.

But at the Google Health booth at a recent trade show, look what I saw: It takes your prescription info from Google Health and tells you how to fill your pillbox.

It was an epiphany: put my data in there, and I get access to mash-ups. All kinds of potential tools that I know could be useful become possible. The healthcare establishment isn't getting around to doing them, but ordinary data geeks are.
So here's how it boils down:

My goal is to help create a new world where healthcare is enormously more efficient than it is today, and where important new developments happen enormously faster than they do today.

And with that in mind, the advantages of uploading our data far outweigh the risks.

So I'm in.


  1. Way to lead the charge....I applaud the move. Perhaps you can help others by explaining how you minimize the effort to achieve this. That's my biggest problem with this activity. I have most records in a digital form but it is still a major slog to enter data. And then when it is entered I am still not finding it useful to save me the whole form filling nightmare for every physician visit....sigh

  2. Well, how I minimize the effort is, my hospital's completely committed to open (or "liquid") data, so in my medical record there are buttons to move it to Google Health and/or HealthVault.

    I haven't done it yet (that's coming up this weekend) but it's supposedly that simple.

    I have no idea what other people do. There should be a discussion forum somewhere on that, no?? Let's find out.


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