The patient makes barking noises when excited: Google's Personal Health Record

I did a sneaky test of Google's new personal health record, since I was wondering whether they would keep my personal health record confidential.

I filled out a completely truthful profile for a member of our family: a 6-year-old male weighing 35 pounds, who has a whistling heart murmur but is otherwise in excellent health, as he runs daily. The patient is excitable, and makes barking noises when excited or agitated – as dogs often do.

I haven't received any spam or junk mail in his name since entering his profile two months ago. This may mean Google is serious about keeping medical information private…at least for now.

Advice: Consider using a personal health record to track your family's treatments, immunizations, and upcoming appointments.

Read all about it: UCLA Medical Center's healthcare for Farrah, Britney Spears, Tom Cruise & Mariah Carey

California health regulators have connected 14 more people affiliated with UCLA Medical Center, including four physicians, to the improper viewing of celebrity medical records, bringing the number of current and former workers apparently implicated in the snooping scandal to 68.

The additional violations came to light in a report by the California Department of Public Health, which was sent to the hospital Friday. The findings are the latest to stem from reports in The Los Angeles Times about UCLA employees' prying into records of celebrities and co-workers. The regulators faulted UCLA for failure to maintain patient confidentiality and report the breaches to regulators.

One employee reviewed the records of actress Farrah Fawcett on 104 days between July 1, 2006, and May 21, 2007. She also looked at the records of pop star Britney Spears, whose medical files have been viewed inappropriately by dozens of other UCLA workers. The employee was indicted by a federal grand jury last month for allegedly selling information to the news media from medical records of celebrity patients. If convicted, she faces up to 10 years in prison.

Earlier news stories described the inappropriate viewing of the UCLA Medical Center's healthcare records of Tom Cruise and Mariah Carey.

State inspectors found that 13 other people affiliated with UCLA apparently snooped on Britney's records between July 2006 and May 2007. That is in addition to 53 staffers identified in three previous state reports who looked at her records on other occasions. The 13 included three physicians, a physician trainee, three registered nurses, two outside contractors, a volunteer and three support staff.

A note on this blog's policy on the "outing" of healthcare organizations where errors have occurred: Normally I do not name the organization. In this case, because of their published history of numerous repeated errors with no apparent system safeguard to prevent their recurrence, I have referred to UCLA Medical Center by name.

Advice to Hollywood celebrities: Choose other places than UCLA Medical Center to get your healthcare, unless you want riffraff like me to read about it.

Read another privacy story.

Thanks to Charles Ornstein for the source article in the May 14 issue of the Los Angeles Times.

Birthday parties have been cancelled: Secrecy through HIPAA

An Emergency Room nurse in Illinois told Gerard Nussbaum he could not stay with his father-in-law while the elderly man was being treated for a stroke. Another nurse threatened Gerard with arrest for scanning the older man’s medical chart to prove to her that she was about to administer a dangerous second round of sedatives.

Both nurses claimed—wrongly--that the Health Insurance Portability and Accountability Act (HIPAA) prohibited them from helping. But Gerard knew better, as a health care and HIPAA consultant, so he stood his ground.

Recent government studies have found some health care providers apply the HIPAA regulations overzealously, blocking family members and caretakers from learning useful information. Birthday parties in nursing homes in New York and Arizona have been cancelled for fear that revealing residents’ dates of birth would be illegal.

In reality, HIPAA says health care providers may share information with others unless the patient objects, but does not require them to do so. Their disclosure of information is voluntary; the law leaves them broad discretion.


Advice to patient advocates: Stand your ground with health care providers if you need some information to help your patient.

Read another of our privacy stories, or read Jane Gross’ source story in today’s New York Times.

I need to be the sole focus of my exam: Patient privilege

D.J. Listort’s retort:

I resent the guilt trip laced behind the Ethicist’s advice to "find another way to do your fair share for the health-care community of which you are a member and from which you benefit" (in The NY Times Magazine of April 15). Because I do not wish to have residents or interns present during my examination does not mean I haven’t done my fair share by paying my (staggering) medical-insurance premiums or by waiting for what often is an interminable amount of time for my appointment.

I need the precious one-on-one with my doctors so that they and I may have a confidential and attentive session to discuss, diagnose and treat my ills. Why didn’t the doctor provide a form (what’s one more?) at the first appointment to cover a request to have residents present so that the rules, and my preferences, are clear before the examination starts? I’m sorry, but I need to be the sole focus of my exam, and I don’t need to be chided for insisting that I am.

Advice for patients: To guarantee privacy in your exam, discuss it with the receptionist when you arrive for the appointment.

Read one of our patient/physician partnership stories.