The move by Kaiser Permanente to implement Microsoft's HealthVault is a big step. According to Carlton Doty, an analyst for Forrester research, "This deal is fairly significant although not at all surprising. Kaiser is only the first of many insurers to come". HealthVault is already in use in organizations such as The American Heart Association, the American Stroke Association, DPS Weight Management, and many other medical records companies. Kaiser's decision to outsource their HRS to Microsoft is just one aspect of the insurance market's move; Aetna insurance has developed their own "Care Engine", also a B.O/ database patient health tracker. In February 2008, Google implemented its own HRS, Google Health, which allows patients to search for doctors under specific parameters, track health information, and learn more about prescription drugs, breaking medical news and alternative therapy choices.

 

As the new HRS market develops, the need for complete availability of patient records becomes more than a question of customer satisfaction and competitive business, but one of compliance with existing and developing privacy laws. The Patient Safety and Quality Improvement Act of 2005 (PSQIA) established a voluntary reporting system to improve medical data availability, while maintaining the required privacy and security of said records. This act is under the jurisdiction of the Office for Civil Rights, which is responsible for "interpreting standards for enforcement and for guidance to Patient Safety Organizations (PSOs) and providers" * ; in more relative terms, the new and developing HRS systems.

Opening up the metaphorical "file cabinet" of paper based records into the larger world of database/ B.O systems will not be a simple transition. One of the most obvious pitfalls of HRS systems is that of security. Unfortunately, creating a UI understandable to the average individual opens potential breaches, leaving patient information vulnerable for marketing or criminal activities. The IT industry is responding with an approach of educated caution. According to Pam Dixon, Executive director of the World Privacy Forum, "Although it appears that the Kaiser Microsoft program may be covered, in general, PHR [public health record] services operated by technology companies do not fall under the Health Insurance Portability and Accountability Act (HIPAA)." What this means is that under current laws, information passed willingly to a third party is no longer under the strict stipulation of the ruling bodies of the medical community. "The regulations govern the dissemination of information from healthcare professionals and their staff as well as insurance companies, billing services, clearinghouses and community health information systems. Since Microsoft, Google and the like do not fall under those classifications; they are not bound by HIPAA." (Walaika Haskins, ecommerce news, 2008).

 

Ultimately, the public demand for more personal control over their health and health care systems will be met with the resistance in both the medical and IT industries, but it is a demand that will be met, redefining those industries in the process. Issues of flawed security and human error are issues which cannot be avoided in either medicine or information, and it is the function of both industries to develop failsafe after failsafe in order to protect our clients; it's why we get paid. Kaiser's choice to outsource to Microsoft's HealthVault is an important trial which should be monitored closely by all those in the Medical IT industry. Kaiser Permanente is willing to risk its reputation on the implementation of this Microsoft beta product. Such a move illustrates both the confidence Kaiser has in HealthVault, as well as the incredible demand by patients to have a health system that they can understand.