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“Google CEO: ‘Cloud Computing’ Is Key to Patient-Owned PHR’s”
by Don Long
Medical Device Week
March 3, 2008

This article reports on the 2008 Health Information and Management Systems Society’s (HIMSS) annual conference, at which Eric Schmidt (Google’s CEO) was a presenter.   PHR stands for “personal health record,” a term familiar to many in the health care industries, but not so familiar to those outside the industry.  A PHR is essentially a log or journal of an individuals health care treatment, evaluation and laboratory results.  Today, many individuals do not have PHRs, but rather, their doctors and other health care providers individually maintain medical records on their behalves.   PHRs in an electronic format has been referred to as EMRs (electronic medical record), and, “[t]he federal government has been the pioneer in the field of developing standards for universal, interoperable and portable EMR that are often linked to the development of universal health care coverage.” [pg. 1]  Of course the underlying assumption with regard to EMRs is, “that the government would be the one to have, and the one to control, this information.”  [pg. 2]  One of the primary themes of discussed at the conference was the importance of who controls and has access to an individual’s PHR/EMR.  The distinction drawn between the two is that ideally, a PHR would also be in electronic (digital) format, but rather than having the government have access too and control individuals medical records (as would be the case for EMR), each individual would control their health care information.  Hence, the idea is to make PHRs “patient-centric,” as opposed to having the government or health care providers in control of individuals’ medical records.  [pg. 2]  

This is where cloud computing comes into the picture.  Schmidt was at the HIMSS conference to give a presentation on Google Health.  Google Health is a technology that Schmidt says is still in the development phase.  What is Google Health?  According to Schmidt, Google Health is “a system for enabling the creation of PHR, based on ‘cloud computing’ – offering healthcare data that would be completely portable and privacy-protected.” [pg. 4]  The idea is that the system will be “consumer-focused – users can access their data and control who sees it.  The data follows the consumer, wherever they go.  Interoperability is important…[the system]...would not be tethered to a particular health system.” [pg. 4]

This article raises a few important policy issues.  First, there is the issue of creating the informational system necessary to consider providing universalized health care and how individuals medical records should be controlled, stored, and collected.  Second, rather obviously stemming from the prior matter, is the issue of privacy.  Hypothetically, the idea behind using cloud computing (through Google Health) to create and manage individuals’ PHR is so that the individuals have control over their medical records and have the ability to grant a particular health care provider or the government access to their records upon their approval.  If privacy is such an important issue, we should certainly be asking whether we want Google serve as the gateway for establishing and maintaining our medical records and history.

Levine, Richard (1975, April 13). A real mental ward becomes a movie 'Cuckoo's Nest'. New York Times.

This newspaper article published in the New York Times in 1975, describes the experience of the reporter on the movie set while filming of One Flew Over the Cuckoo's Nest was in progress.  The movie was filmed on location in an abandoned ward of the Oregan State Hospital.  Not only was the film shot in a real ward, but many of the actors and crew members were actual patients of the hospital.  One patient, named Gordon, who had been admitted twice for rape, was a full-time employee of the filming company.  Some of the hospital staff were concerned that audiences may draw the wrong conclusions from the film due to its location.  They worried that the Oregon State Hospital would garner a bad reputation.  However, the hospital director, who also has a role in the movie, believed that it would be a benefit both as an experience and financially for the patients to be involved in the filming.  He did, however, ask that a disclaimer be placed on the film denying its factual portrayal of a real mental institution.
This article is interesting because it compares and contrasts life on a real ward with the events being portrayed in the film.  The reporter's experience is nicely weaved within his observations of the filming, and they illuminate many of the similarities, as well as differences, between real life and the fictional ward.  For example, the reporter describes an incident in which he witnesses a woman in the high-security wing being given oxygen by hospital aides.  A nurse explained that the woman was an uncooperative patient who had been given an electroconvulsive shock treatment.  This strongly mirrors the scene in Cuckoo's Nest where McMurphy and other patients, after creating havoc at a group meeting, are subjected to ECT treatments.  It reminds one that these treatments do, in fact, exist, and are given out for similar reasons as in the film.  It also shows the remnants from the older asylum system of mental health that still existed in the 70s.  Another incident that the reporter described that bore resemblance to the film was a patient basketball team.  The team had just played at a local high school, and although it had lost by 40 points, the existence of the team brings to mind the basketball match in Cuckoo's Nest between the staff and the patients.  It also is an example of the beginning of the transition from institution-based to community-based mental health care.  The basketball team was a form of community that would have fit in well with the reform efforts of the time.

A new study suggests that children who grow up within a third of a mile of a freeway may be sustaining permanent respiratory problems.

Researchers studied developing lung function in 1,445 children living in 12 Southern California communities for eight years, from age 10 to 18. They found that the closer the children lived to a freeway, the more likely they were to experience reduced growth in lung function as measured by the standard tests.

"That living near freeways is a health issue is something we've known about for a long time," said Gennet Paauwe, a spokeswoman for the California Air Resources Board, which financed part of the research. "All of this points to the fact that California's air pollution control program needs to continue with its aggressive reduction in air pollutants. But I think this would translate to any other part of the U.S. where people are living near heavily trafficked roadways."

The findings were published online Friday by the British journal Lancet.

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