Which means that when the commitments that Microsoft has made regarding HealthVault become inconvenient, they will simply change them.
Will the data that you enter into HealthVault be secure? Would my HealthVault data be studied by my insurance company? Would access be limited to those who I choose to have access? Thank goodness Microsoft’s answer to this question was not simply “Trust Me”! Instead it is “Trust my auditor”. This is, apparently enough to satisfy the Patient Privacy Rights Foundation, and the Coalition for Patient Privacy. From a recent Patient Privacy Rights press release Dr Deborah Peel is quoted:
“Corporate claims to offer privacy mean nothing unless they are willing to take the same steps Microsoft has taken in building HealthVault,” says Peel. Microsoft has committed to independent third party audits to verify their pledge to protect privacy. “Audits are essential,” says Peel. “Technology companies have got to do better than telling consumers to just ‘trust us.’ Consumers shouldn’t trust anyone but themselves to decide who can see and use their sensitive health information.”
Apparently, this means “trust the auditors”. Of course we all know how well audits serve to protect the public from unethical corporate behavior. The alternative, which is obviously not being discussed, is the ability to inspect the code for yourself. A top GPL licensed PHR is IndivoHealth. Lets do a quick comparison.
Question: PHR Covered by HIPAA?
IndivoHealth: When it is used by a covered entity, yes.
HealthVault: No. Microsoft is not a covered entity.
Question: How is this verifiable? How can you trust that the user really has control? How can you trust that there is no proprietary back door built in to the software?
IndivoHealth: Read the IndivoHealth source code yourself. Hire an auditor of your choice to review the sourcecode. Verify that the auditor you hired is telling you the truth by hiring another auditor, again of your choice. Verify that both auditors you chose and hired are not full of… smoke… by reading the source code yourself.
HealthVault: Trust Microsoft. Trust the auditor that Microsoft pays millions of dollars a year to whistle blow on Microsoft.
I think you get the idea. Nonetheless, Deborah Peel is pretty impressed with HealthVault, from a HealthcareITNews article:
“Their model is that consumers truly should control the information and that’s the direction they want to take as a company,” said Peel. “We really think that because they are the industry leader that the rest of industry will have to follow or be left behind.”
“Microsoft has agreed to adhere to all of the privacy principles that the coalition developed in 2007, ” Peel said. “Not only adhere to them in terms of contracts but to be audited on these principles. We think they’re setting a new amazingly high bar and frankly, we think what they’re doing is really the best practice that the entire industry needs to follow.”
Well, this is good! Microsoft has agreed to follow the privacy principles! Principles are good. What are the principles? We find the principles at Patient Privacy Rights website lets go through them one at a time..
- Recognize that patients have the right to medical privacy* (later defined as: Health information privacy is an individual’s right to control the acquisition, uses, or disclosures of his or her identifiable health data.
- Recognize that user interfaces must be accessible so that health consumers with disabilities can individually manage their health records to ensure their medical privacy
Actually, Microsoft deserves credit for generally working hard in this area. Give credit where it is do. However, no commitment is made in the privacy document regarding accessibility.
- The right to medical privacy applies to all health information regardless of the source, the form it is in, or who handles it
- Give patients the right to opt-in and opt-out of electronic system
Microsoft’s policy indicates that users can quit the system and Microsoft will then delete the data after 90 days. So much for seven generations of custodianship but I guess deleting meets the “opt-out” requirement.
- Give patients the right to segment sensitive information
No commitment of segmenting information in the privacy statement.
- Give patients control over who can access their electronic health records
- Health information disclosed for one purpose may not be used for another purpose before informed consent has been obtained
- Require audit trails of every disclosure of patient information
- Require that patients be notified promptly of suspected or actual privacy breaches
- Ensure that consumers can not be compelled to share health information to obtain employment, insurance, credit, or admission to schools, unless required by statute
- Deny employers access to employees’ medical records before informed consent has been obtained
- Preserve stronger privacy protections in state laws
- No secret health databases. Consumers need a clean slate. Require all existing holders of health information to disclose if they hold a patient’s health information
- Provide meaningful penalties and enforcement mechanisms for privacy violations detected by patients, advocates, and government regulators
In short, Microsoft’s commitment to follow the policy is a commitment that they have NOT made in their policy. Microsoft is basically saying “Trust us, this is secure and private”. Everything about Microsoft’s history indicates that commitments to privacy and security are bogus. What exactly made the Dr. Peel conclude they are the market leader in Health Record security and privacy? What made her conclude that Microsoft has “committed” to third party audits?
Perhaps Dr. Peel is discussing a subject as though she were an expert, when in fact she has had little relevant training on the subject.