The government is encouraging people to register for its eHealth service that stores health records including medical visits, list of medications, immunisation records and imaging in an online database. You and your local doctor have access to the records for reviewing test results, checking treatment history and important details such as allergies or vaccinations.
At the same time, the big tech companies want to be the virtual safe-deposit box for personal health records, activity tracking and general wellbeing data such as cholesterol and other blood test results. Apple, Google and Microsoft all have portals that link to fitness trackers and let you record, view and analyse your personal health data. But is it okay for these tech giants to have access to personal medical information?
Government My Health Record
My Health Record is an online summary of your health information that requires you to register and log in with your myGov account. The record may include some or all of your medical history such as prescribed medications, Medicare benefits record, organ donation pledge, hospital discharge information, Medicare and PBS information, imaging ultrasound or x-ray results, immunisations, blood tests and other pathology results, allergies as well as advance care planning information. The information can be shared with medical practitioners, registered nurses and healthcare providers.
You can control what goes into it and who is allowed to access it. You can choose to share your health information with your doctors, hospitals and other. Individual clinical or Medicare documents, but unhidden documents can remain accessible for 30 years after the My Health Record owner has died, or 130 years after the document was uploaded.
Can you link your health apps?
If you're into e-health, then you may be looking for ways to bring your medical records together with your details for health apps on your smartphone or linked to a fitness tracker. There's no reason to get too excited as we're a long way from being able to integrate medical and fitness records and tracking into one central site. It's also not for everyone. Some people may understandably have privacy concerns about having all their personal records and information together in one place.
Healthi (iOS/Android) is a smartphone and tablet app that links to your government My Health Record account. You can access your own as well as children or dependants' records and anyone that has you listed as a nominee. It's not created or managed by the government; instead it's a third-party app that requires your permission to retrieve your My Health information. It can include list of medications, paid Medicare benefits details and other documents. It currently has no capacity to send information from the app to your My Health Record. In terms of security, Healthi temporarily downloads your health information directly from your My Health Record to your device and encrypts the information while in transit. Your information is not stored on Healthi servers and is removed from the device once it's been updated to your account and it does not share your data with other service providers.
MyChild's eHealth Record (iOS/Android) is a smartphone and tablet app this gives you access to the Child Development functions from your child's My Health Record. You will need to first register your child/ren for a My Health Record and sign in with your MyGov account to access to your children's My Health Record. The Child Development section is like the online version the blue 'Baby Book' given to parents for their newborn that tracks the child's early health and development through personal measurements, immunisations records and health checks and emergency contact information.
What about data hacks?
There have been a series of large scale data hacks from dating sites to gaming platforms so it's understandable it can make you nervous about uploading health data to an online site. While these hacks expose the potential for data breaches, it also reminds us to always use a strong, unique password because that's often the easiest line of attack. If in doubt, read the privacy statement before using the service and check if it has a data breach notification policy.
The Office of the Australian Information Commissioner (OAIC) is currently reviewing health privacy guidelines and publishes ehealth privacy information for consumers. These hacks underscore the need to have a mandatory data breach regime in place in Australia to protect all users of online service. The government promised such a regime would be in place by the end of the year when it introduced the mandatory data retention regime, but it's yet to come.
Your eHealth wallet
Microsoft HealthVault
This is the most comprehensive (at the moment) and aims to be a doctor-in-the-cloud, storing medical information including illnesses, health history, medications, scans, allergies and blood pressure details.
You can track exercise with connected devices and there's a weight management dashboard with progress and goals.
The Vault will store data from a range of wearable devices including the Microsoft Band and other brands such as the FitBit, blood pressure monitors, scales and blood glucose monitors.
Apple Health
Apple Health aims to be your medical ID during emergencies with important information on your medical conditions.
The app stores calories burned, steps, distance and stairs climbed. It can collect data such as heart rate from monitoring devices such as the Apple Watch and fitness apps such as iSmoothRun.
It can also record blood type, allergies, cholesterol levels, blood sugar reproductive cycles, sleep data, and vitamin and mineral intake from food and other nutrition information.
Google Fit
Google Fit doesn't store medical information, but does store activity data such as time, steps, calories and distance. It tracks weight and lets you set fitness goals such as number of steps, time spent exercising or number of calories burnt. Activity can be tracked with a wearable device or added afterwards manually.
The Google Fit mobile app runs on Android smartphones and the Google Fit database is a web platform that stores and displays information from other apps such as RunKeeper and MapMyFitness and fitness trackers such as Pebble and Polar. The Google Fit Android Wear app runs on devices such as smartwatches.
Cronometer
This aims to be a one-stop-shop for people managing their weight and monitoring their activity. It has iOS and Android mobile apps and a web database to log and analyse exercise, food and calories and biometric information such as sleep, blood pressure and heart rate.
It puts a lot of focus on diet, and includes intake targets for 48 different vitamins, minerals and nutrients.
It links to Fitbit and Withings devices and the Apple Health app.
What about privacy?
Many people will naturally be concerned about the privacy implications of putting such personal information online and trusting these companies to protect it from hackers. As a guide, you want to only share information that you feel comfortable storing in an external database and be sure to have a strong, unique password to secure your login.
- Microsoft's HealthVault requires you to grant health services, such as test labs and medical imaging centres, access to specific data (or all of your data) in a health record and set permissions for what they can do, such as view results.
- Apple says that data from its Health app that's stored in iCloud is encrypted while in transit and in storage. Third-party apps that access HealthKit, the development tool needed to work with the Health app, must have a privacy policy. You'll need to read the policies of each fitness or health app before providing them access to your personal data.
- Google just has a general privacy policy that covers how it protects data in the Google Fit database. In terms of privacy, third-party apps and devices that access health and fitness data can use the information stored in your Google Fit account.
Dr Google enters the health field
Google might be the first port of call for worries patients, but it's getting actively involved in health services in the UK. The search giant, through its artificial intelligence platform DeepMind, has teamed up with the government's National Health Service (NHS) in a five-year deal to develop its clinical app Streams.
Streams allows clinicians to view patient data, provides alerts to nurses and doctors when test results reveal a potential problem and hold patient medical history. It will include live data as well as historical health records from the NHS hospitals.
However, the deal has been criticised because it gives Google access to sensitive health information about millions of people and it's not clear what opt-out mechanisms are available to patients.
The system may be developed to make predictions about patients at risk of developing certain conditions and monitoring for outbreaks of infectious diseases.
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