My hospital HAL - Google man moots syringe that says no
Late bid for crazed Google exec of the year award
Google VP Jonathan Rosenberg's windy sermon on 'Open' has been widely panned, but his interesting intervention on identity, health records and medical procedures has been little remarked, so far. Which is a pity, considering how close Google's High Command is to the High Command of the party likely to win next year's election, and what that party might well do about the health service.
So would you let this man look after your health records? This is what Rosenberg has to say on the subject:
Let's say your child has an allergy to certain medicines. Would you allow her medical data to be accessible by a smart wireless syringe which could prevent an EMT or nurse from accidentally giving her that medicine? I would, but you might decide the metal bracelet around her wrist is sufficient. And that's the point — people can and will reach different decisions, and when it comes to their personal information we need to treat all of those decisions with equal respect.
Ah, but is that really the point? Rosenberg's smart syringe may be small, but if we think it through - as, it seems, he has not - it's right up there with Eric Schmidt and Larry Page's brain implants and Sergey Brin's Mars colonisation plans. But something akin to what Rosenberg is talking about has already been attempted, at vast expense and to little effect - it's called the NHS National Programme for IT (NPfIT).
Consider what Rosenberg's smart syringe is doing, what hospital staff do already, and what the NPfIT was supposed to do. In most cases, hospitals know the identity of the patient, and look up the records of that patient before they do anything that might turn out to be life-threatening. They generally do this with computers, syringes not being fitted with screens big enough for them to read, and they generally also ask the patient about known allergies. In the most common hospital scenarios, a syringe designed to say 'I'm sorry Dave, I'm afraid I can't do that', is almost entirely redundant. But it is the kind of superficially cool crap that appeals to a certain kind of techie.
It's in the less straightforward scenarios that the syringe and the NPfIT might seem attractive to some people. At the outset of the project, someone - possibly Bill Gates - convinced Tony Blair that it would be a cool idea if everybody's medical records were instantly available throughout the National Health Service. So Tony Blair gets run over in Gateshead and carted to the local hospital, and although he's never had medical treatment in that area before, his records are immediately available. And indeed they're immediately available to hundreds of thousands of NHS staff, whether or not Tony's been carted off to hospital. But that's another story.
The smart syringe is clearly pointless here as well, because it assumes that medical records can be wirelessly accessed, so in the UK it would be presupposing that the NPfIT had actually completed its rollout (quite…) or that everybody's medical records were stored in a Google/Microsoft cloud and could be readily accessed from there.
What though, if it isn't possible to identify the patient? The number of cases where this is an issue is vanishingly small, because even where you can't safely identify the patient it's usually fairly obvious what's wrong with them, so there are things you can do to stabilise them while you try to find out more about them. If they're carrying an allergy alert card or wearing a bracelet then you'd likely take that into account, if it was relevant to the condition they came in with.
But say an emergency patient is unconscious, is not carrying ID or some form of allergy alert, and is allergic to one of the drugs usually used to treat their condition? The smart syringe and the NPfIT are both useless here too, unless you've got some kind of effective biometric ID system in place, or the patient has been chipped.
Is this what you have in mind, Jonathan? Whatever, if you do have that kind of ID system in place the syringe is still redundant because you can just look them up on a screen and not flipping-well inject them. Biometric ID, incidentally, may be good enough for the UK Border Agency, but it's far too unreliable to be used for conclusive ID in hospitals, where you might kill somebody.
But shall we try to take Jonathan's idea to its logical conclusion? Say you've got a magic system that can ID anybody, and hospitals full to the gunwales with medical kit that's able to consult medical records and take action accordingly. The human hospital staff become mere slaves to the machine, unable (indeed, forbidden) to take action if the computer says no. That fixes all of the privacy issues (except for the one beginning with G), because if they can't treat anybody there's no reason for them to have access to the records.
It's kind of like that future vision of search where you don't actually have to go looking for anything, or even think about what you might want to look for, because Google will know what you want before you do, and push it to you. So, say you were a crazed multi-billionaire in charge of the world's creepiest and most powerful IT company? But you didn't know you were crazy? And you walked into a hospital to visit a friend?
Grab arms would come out of the walls, straightjacket you, slam you down on a trolley and whiz you off in a cloud of flying syringes to the care home. And the home would never let you out. This idea begins to grow on me. ®
As an diabetic the very last thing I want is some fuckwit smart syringe refusing to inject me with insulin.
1) This is a pointless analogy. Apparently all Rosenberg wants to say is that people make different decisions regarding their personal information and that these different decisions need to be equally respected by Google, but instead of just saying that we have some incidental guff about children, health and accidental death.
2) The analogy contains one of the shittest pieces of reasoning I have seen this long, long year
"Let's say your child has an allergy to certain medicines. Would you allow her medical data to be accessible by a smart wireless syringe which could prevent an EMT or nurse from accidentally giving her that medicine?"
OK, well let's say I don't have any children and then let's say I take this argument to pieces and put it back together again in the wrong order?
a) The records are incorrect;
b) The records are correct but the computer's gone haywire?
Now let's say Mr. Rosenberg has an allergy to certain medicines: Would he allow his medical data to be accessible by a smart wireless syringe which could prevent an EMT or nurse from giving him the correct medicine and accidentally give him the medicine he's allergic to because the system's broken? I bet he fucking-well wouldn't.
Rosenberg seems to be presuming that computer systems never go wrong: They are perfect and always do their master's bidding correctly. Fortunately most people seem to live in the really real world, and right here in the real world this kind of talk is specious nonsense. Not only do computers have a long way to go before they're maintenance-free, they also rely entirely upon their less-than-perfect human masters for software code, hardware build and data-input. Which means Mr. Rosenberg is now dead because some minimum-wage typist in a data-centre somewhere was having an off-day and screwed up when inputting his allergies.
Not that this proves much. Rosenberg works in marketing and marketing consists mainly of glossing over the facts in such a way you forget that the blue sky they want you to believe in is actually a sky that's pissing down with rain and filled with dysenteric pigeons.
This will be why - having made his point about equal respect Rosenberg doesn't say anything else about how Google might respect different people's decisions about their personal information. What's the betting he hasn't really thought about that, and that anything he might say about it will be specious guff to distract you from the huge bird pellet headed your way?
They won't even take the most basic step
Problem is not what technology COULD do to help. It's the will to do it that is lacking.
About 10 years ago someone was killed with an injection into the blood that should have gone into the spine. Someone wrote in the BMJ that since lumbar needles are so different, and since medication is made up by the hospital pharmacy, it would be easy to create a separate syringe type. Lumbar drugs are then only dispensed in a lumbar syringe, which only takes a lumbar needle, and no nurse or Dr will ever stick one of these in a vein, as they are so glaringly different. Problem solved.
Except noone actually did it and we still read these stories of needless death every 2 years or so.