An advertising opportunity

Do you fill out those product registration cards? You know, the ones that ask all about your lifestyle, hobbies, the car you drive, products you shop for, favorite brands, age, marital status, salary, if you own or rent, etc. Many of us think we have to fill them out to validate a warranty and receive important product updates. Or, perhaps, we’re lured by the promise of special promotions, free products and discount coupons.

The same precautions about sharing our personal information on product registration and warranty cards apply to our health information.

The collecting of personal information for product registration is deceptive, said Chris Hoofnagle, deputy counsel with the Electronic Privacy Information Center in Washington, D.C. to Bankrate. “Product warranty cards are information collected under the pretense of a benefit where the information goes straight to marketers. The purpose of a product warranty card is not to protect you, it’s to collect marketing information.”

While they may appear harmless, the information is put into a database of consumer portfolios and sold to marketers, giving a vast array of people access to your personal information and putting your privacy and safety in jeopardy. “The people who don't send them back are in the know. The ones who do send them back are the biggest and best targets for marketing,” said Bob Blumash, creator of Illinois-based Private Citizen.

As careful as consumers may be about revealing personal information to product companies, few take the same care when it comes to volunteering private health information to third parties who aren’t their doctors or healthcare providers. Yet, online health risk assessments, offered by growing numbers of employers and insurance companies, ask for even more personal information about lifestyle habits, medical histories, and health. The information is compiled into electronic medical databases and used to identify people to be targeted for health tests, monitoring, education and health care management.

Many are promoted as online medical records to make it easier for consumers to put all of their records and health information in one place for ready access wherever they are. In return, besides free tote bags or discounts on their insurance, participants are given targeted health information to guide them to healthful behaviors. Growing concerns are being raised about these electronic databases, including how personal information is being shared, sold and used, especially as the marketing interests behind them are becoming better recognized.

Recently, Google has entered into the arena of online health care, raising a new set of concerns. It began with a new health information project to control information to what “trusted health community contributors” believe is relevant for you. As Adam Bosworth, Vice President of Google, explained last fall:

We have already launched some improvements to web search that help patients more easily find the health information they are looking for... If you click on “treatment," your search results are refined and reordered so that sites that have been labeled as being about treatment by trusted health community contributors are boosted in the rankings. Note that how trusted a contributor is — and thus how much they affect your search results — is dependent both on Google's algorithms and on who the user decides they trust...

Recently, we learned who makes up the “Google Health Advisory Council” and you’ve no doubt already noticed its influence when you’ve tried to research controversial health topics and news. Few medical professionals would deny the importance of patients learning about their disease and medications — from objective sources. That’s not this.

Mr. Bosworth went on to say:

This is just the beginning of what our industry can do... Health information should be easier to access and organize, especially in ways that make it as simple as possible to find the information that is most relevant to a specific patient's needs.

With Microsoft, they’re developing their own online health records “to enable people to make smarter choices about their health habits and medical care,” as the New York Times reported. Concerning Microsoft’s role in this new project, the newspaper added:

This year, Microsoft bought a start-up, Medstory, whose search software is tailored for health information, and last year bought a company that makes software for retrieving and displaying patient information in hospitals. Microsoft software is already used in hospitals, clinical laboratories and doctors’ offices, and as [Steve Shihadeh, general manager of Microsoft’s health solutions group] noted, the three most popular health record systems in doctors’ offices are built with Microsoft software and programming tools.

Microsoft will not disclose its product plans, but according to people working with the company the consumer effort will include online offerings as well as software to find, retrieve and store personal health information... Mr. Shihadeh declined to discuss specifics, but said, “We’re building a broad consumer health platform, and we view this challenge as far bigger than a personal health record, which is just scratching the surface.”

You’ve probably caught the recent blog buzz about Google Health’s online health record initiative, called Google Weaver. It is not an online medical record, it’s another health risk assessment with even broader marketing potential. It asks consumers to voluntarily share the very same personal information about their health and lifestyle habits as those online health risk assessments being offered by insurance companies and employers. There are pages asking family history, health history, lab test results, etc.

Take a look at this sample page entitled “Age, sex, height...” It asks for personal details, such as your birthday, gender, ethnicity, weight, smoking habits and if you drink alcohol:

Why does Google need this information and what can they do with it? Google already can track you via your IP address and direct you to sites and offers you personalized advertising for products and services based on your established preferences. But a database with detailed information about your health and lifestyle behaviors would be even more valuable for commercial interests.

Once people fill in the online health assessment, Google Weaver will offer custom “Health Guides.” Quoting from the Google Weaver prototype, Blogoscoped said:

Get the most out of Google Health — If your medical providers or pharmacy offer secure downloading of medical records, you can find and add your records to a profile. You can also browse for websites that connect securely to Google Health and provide services for managing your health care... When you add some information to your profile, Google Health will search trusted medical sources and create a health guide targeted for you. ... Google Health will check for relevant updates to your guide whenever you add new information to the profile.

You can use the health guide, Google writes, to learn about drug interactions, treatments, tests and preventive measures.

The health information you access from Google could be selected for you, even down to your internet searches — information you use in making healthcare decisions. Commercial interests who’ve purchased access to your online health data could guide you, through ads and content, to their products and services, and help you make the “right” healthcare decisions.

There is a very significant way online health records, like Google, differ from the medical records kept by healthcare providers and hospitals: They are not bound by any medical privacy laws.

“Even though the federal HIPAA law does not protect privacy ... it's important to understand that Google wouldn't have to comply with it,” said Twila Brase, RN, president of Citizens' Council on Health Care. Google is not a covered entity, she explained. “In fact, Google could share the data broadly. They could sell it to anyone, including insurers and government. They could use it anyway they wished. They could even create medical profiles on users.”

“The real danger here is not the loss of privacy, although that certainly is a problem,” she said. “The real danger is potential loss of personal control over medical decisions.”

“Personal control and patient privacy are not found in online electronic medical records... Health plans, hospitals, government, employers and the data industry will have ready computer access to comprehensive medical records on anyone,” Ms Brase said. The potential for abuse, such as using the information to deny medical treatment, insurance coverage or benefits, employment, or to financially penalyze those not complying with government or insurer treatment protocols, is very real.