Health gets personal in the cloud

Google Health Beta and Microsoft's My Health Info

by Brian Ahier | @ahier | comments: 13

Healthcare is one of the biggest industries in the world. The United States spends over 17% of its GDP on healthcare and the issue of the industry's future is being hotly debated in Congress. Whatever happens to other elements of health reform, health information technology will play a key role in moving us towards the goal of bending the cost curve and improving quality and clinical outcomes. A Personal Health Record (PHR) is one way that patients can have some control of their own health data, while providing an interoperable platform for sharing relevant clinical data between providers. Healthcare is changing rapidly and there are some important trends worth watching.

Healthcare in the near future will be quite different than it is today. Web enabled technology is already changing the way medicine is practiced. As the digital nation comes of age we will see new opportunities, and new challenges, bringing healthcare in America into the 21st century. Health consumers will come to expect they will have control over their own health data. Having secure, interoperable access to clinical data will allow patients to partner with their care providers in new ways incorporating Web 2.0 principles.

For example, Google announced at the Health 2.0 conference that they have entered into a partnership to provide telehealth services through their Google Health platform using MDLiveCare. With the integration of MDLiveCare technology, Google can provide a service that offers patients access to doctors from remote locations, via webcam or telephone, into its personal health record offering. This will be particularly valuable for those who are caring for their loved ones from far away. My family is scattered around the country and caring for our mother with advanced stage Alzheimer's was quite a challenge that would have benefited from this type of service. Here is a screenshot of Google Health:

"Patients remember less than 25% of what they're told when they consult with a doctor,” said Bob Smoley, CEO, MDLiveCare, in the statement. "By directly synchronizing the information that's shared…we're able to provide patients with a convenient solution to review their physician or therapist encounters."

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Converting to Electronic Health Records: fits and starts

by Andy Oram | @praxagora | comments: 26

The people of the United States are finally pulling together around the goals of reducing health care costs (by far the highest per capita in the world) and improving outcomes (we have the worst health of any developed country). Everyone seems to recognize the critical importance of data and communications in these efforts. So several of us at O'Reilly Media, having been involved with information technologies for some time, are tracking the issues that come up in deploying computer technology in health care--not just to streamline payments, not just to facilitate access by doctors to records, but actually to create new ways to deliver and track health care.

I recently attended a forum on how my state, Massachusetts, is facilitating the move to Electronic Health Records, a prerequisite for many things doctors, patients, and insurance companies can do to improve health. It's notable that the chief sponsor of the event, the Massachusetts Health Data Consortium, derives a lot of its support from insurance companies. Lots of invective has be\ en thrown at these companies recently, but the questions of technology can pull together the insurers, providers, and patients in a common quest. [AO: My original blog said that insurance companies set up MHDC, but this was incorrect.]

My own understanding of the progress and frustrations in deploying heath care technology was enhanced by the conversations I had that day and the statistics bandied about.

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MySpace's Data Availability is not Data Portability

by David Recordon | @daveman692 | comments: 10

Yesterday MySpace, Yahoo!, eBay, Photobucket (also owned by News Corp), and Twitter announced the Data Availability Initiative. While I could write at length about how this shows the big companies have already realized how to diminish the DataPortability group's brand by linking anything they do "data portability," that isn't the point of this post. The crux of the announcement yesterday was that shortly MySpace would begin allowing third-parties to embed MySpace profile information within their own services in the name of "data portability". Unfortunately, the details around this remain buzzword-laden at best.

Their press release yesterday stated:

Additionally, rather than updating information across the Web (e.g. default photo, favorite movies or music) for each site where a user spends time, now a user can update their profile in one place and dynamically share that information with the other sites they care about. MySpace will be rolling out a centralized location within the site that allows users to manage how their content and data is made available to third party sites they have chosen to engage with.

At first glance this seems like a great thing. MySpace is partnering with Yahoo!, eBay, Photobucket, and Twitter to solve a pain point on the web; the inability to keep parts of your profile in sync around the web where you'd like them to be. The announcement didn't however offer any insight into how this would work beyond that, "the MySpace Data Availability initiative uses OAUTH [sic] and Restful APIs as its core technology underpinnings." After this announcement I had the pleasure of speaking with a reporter who was on the briefing call. He explained that MySpace said that due to their terms of service the participating sites (e.g. Twitter) would not be allowed to cache or store any of the profile information. In my mind this led to the Data Availability API being structured in one of two ways: 1) on each page load Twitter makes a request to MySpace fetching the protected profile information via OAuth to then display on their site or 2) Twitter includes JavaScript which the browser then uses to fill in the corresponding profile information when it renders the page. Either case is not an example of data portability no matter how you define the term!

To make this worse one of the pieces of profile information made available is a list of a MySpace user's friends. Once again there are two reasonable ways to do this: 1) MySpace provides a user's friends as a list of hashed email addresses to Twitter or 2) MySpace provides a user's friends as a list of MySpace usernames. While the hashed email route would certainly be simpler and easier for sites like Twitter to match against their own user database, I highly doubt this will be the implementation due to concerns around undesired account linking. Rather I think MySpace will choose to provide a list of other MySpace usernames. What this means is that in order for Twitter to make use of the information they must encourage all of their users to fill in their MySpace account on Twitter so that they can map a MySpace username to a Twitter username. Obviously in the best interests of MySpace to have more of their profiles linked to from around the web thus increasing page rank, visitors, and thus ad revenue.

At the end of the day it seems that MySpace is trying to become a large centralized profile repository on the internet. One where information might be available but certainly not allowed to be actually moved outside the network's walls. A good try, but just as no one would like Microsoft own identity for the entire web with Passport I fail to see how others will let MySpace own all of the profiles.

Update: Just got off a plane from London and realized that I missed a link to Chris Saad, DataPortability's co-founder, explaining yesterday that they "hope to see the MySpace “Data Availability” initiative evolve toward becoming a compliant implementation of the DataPortability Best Practices." While MySpace did not say in their release that Data Availability is a form of data portability, it certainly seemed to be interpreted that way.