A new online service, HealthVault.com, provides a single, web-accessible repository for all your health records. There is much here to like, but — there are a lot of buts.
It has always bothered me that every new doctor or medical service asks the same questions, and each with a separate form. Dentist, specialists, emergency clinics, labs, pharmacies — same questions, again and again. What drugs are you taking? Which of these diseases have you had? Family medical history. It's inconvenient but more important, it compromises one's health care: I'll bet I have answered these 100 times and there are certainly differences, either because things have changed or I don't remember every detail.
This can be important information: A doctor's diagnosis and treatment depend on what the doctor knows about you. And in an urgent situation, or when the patient is not lucid, having accessible medical records can be life and death. I really want better online medical records.
As a technologist, it makes me especially crazy. Everyone else, from the DMV to the grocery store, has an online record system that is better than the medical community's. There are legitimate issues but nothing that can't be solved — and that have already been solved. Every medical office can readily access my credit information already. Clearly we can solve the privacy and networking and access issues.
Some worry about the security issue: Having all your medical data in some centralized database worries people. But do you really think your privacy is more guarded when there are 25 uncontrolled, unencrypted copies of your records, in 25 medical offices all over the county, immediately readable by 100 office staff?
Along comes HealthVault. It's a good start. It keeps all the information for you and your family under what looks like tight security. It holds contact and profile information, medical records, etc. You can upload image files and documents. The sharing facilities seem robust — you can invite someone to view the information and choose what they may see.
Two issues are access and trust. In terms of access, will my doctors accept a HealthVault login as a substitute for their form? Not yet, but they have a few partners who are using the date.
The bigger issue is trust. Note that I did not say "security" — that's a technical issue. It's the human issue of trust that will make or break this, and other, medical automation solutions.
HealthVault is owned by Microsoft. Do you trust Microsoft? I don't share the common distrust of of their corporate intent — I think they mean well and their corporate ethos is that technology is powerful medicine to help people. They also believe that profit and benefit go hand in hand. So I trust their intent.
I am not sure if I trust their technology. They're competent technologists. They certainly are capable of making an accessible, trustworthy, secure system. But will they?
Every Microsoft product is full of defects. Even after years of refinement, glitches remain — sometimes the same issues for year after year.
I worry about bloat. Huge applications mean more opportunity for bugs and functional flaws and Microsoft often seems to not know how to say no to a feature. Worse, they keep adding rather than fixing — a palette, an assistant, a wizard, a "ribbon" — layer upon layer of new things to repair incomprehensible interfaces only a programmer could have designed.
This all affects usability. I am always in awe of what they spend on usability testing and redesign. They seem incapable of simplicity. The continuous repair tells me they know there is a problem but don't know how they are causing it.
I tried to edit my contact information. There is no link to let me do that. I think I know why. I haven't confirmed my identity by replying to the e-mail, but guess what: It's not telling me that. There is no Edit link and they give the user no clue. It's programmer-think: If a capability is not available, don't show it. Would Apple or Amazon or Yahoo have done this?
So, will I use this? Even without my doctors' buy-in, there is enough functionality for me to get started. But that's mostly because I am a tech geek. Others would not likely try this, yet.
And then there is the trust issue.
I expect that the underlying security is fine. But it's like the president of United Airlines once said, "If the tray tables are dirty, the customer has to be wondering about the condition of the engines." As much as I may want this service, I am not going to be uploading my data, given how dirty their tray tables are.