Are they *completely* insane?

1 February 2007

I went to a conference about ‘getting online’ in San Francisco back in 1994 or so. I was working at a glossy magazine, and we were investigating the online world. As an editor, I was using AOL for Windows (which had just come out) for research — it was quicker an easier than calling the library’s reference desk forty times a day.

The big question at the time, though, was, “AOL, or HTML?” Do you create a relationship with AOL, and put your content there, or do you strike out on your own and create a ‘web site on the internet?’ I remember sitting next to a woman from HBO, and they were grappling with the same decision our magazine was.

Steve Case wasn’t able to convince me. On the flight back, I sat (in business class, when business class used to MATTER) next to a guy with a book about HTML, and between SFO and ORD, he really sealed the decision for me. I bought my own HTML book shortly afterwards, and to the web we went.

It would have been a bad idea to give up control of our company’s information and image to AOL. The web allowed us to control and change our message whenever we wanted, and I knew that was going to be worth the investment of time that we’d make striking out on our own, doing it for ourselves.

Well, now Steve Case is involved with another venture that wants to help you out. RevolutionHealth.com (no, no link) sounds like an interesting idea, helping folks with their medical issues, records, and billing. What? Wait a minute. They want you to PUT YOUR MEDICAL RECORDS ON THE INTERNET? Are they INSANE?

Screen shot from Revolution Health -- we store your faxed medical records on our secure servers

I just don’t know what would compel someone to create a business model based on something like this. We’ve learned time and time again that our financial information isn’t safe online. How many times have you had to change credit cards? Most people I know have had to. Online banking is ‘secure’…but not THAT secure. Difference is, your money is insured, and if someone steals it, you can get it back.

You can’t unpublish data, though. Nosy folks can’t unlearn the fact that you’ve got surgery coming up, or you take medications for anxiety, or you had an abortion, or that you have a genetic predisposition for breast cancer, or whatever else your medical records might reflect.

At World Wide Web 2004 in Manhattan, Tim Berners-Lee talked about the semantic web, and how you’ll be able to link dates with events, and then those events with people, and then those people with information — and while it all sounded really cool, all I could think of is the fact that everyone I went to a cocktail party with could suddenly have access to x-rays of my broken ankle. This new service makes that frightening possibility that much more real.

So, thanks for AOL, Steve Case, but I’m going to sit this one out.



  1. Overheard in a field overlooking the Wright brothers barn, late 1800s… “Those boys want to build something so people can FLY!??? Are they INSANE!?”…

    OR… in the late 1900s: “What!? People are really gonna actually write PUBLIC diary entries online for all the world to read? Are they INSANE!?” — “Online banking? Who is going to pay bills and want their bank accounts accessible ONLINE!!? Are they INSANE!?”

    Get real.

  2. Hi Corey. Interesting analogies. Also, I think it’s important to disclose that you work for Revolution Health.

    Physicists, as a general rule, didn’t think that the idea of flight was insane. Birds did it, you see. So it’s not as though it was impossible in their world at that time…it just hadn’t been cracked yet.

    I never heard anyone claim that blogs were an insane idea, although there are surely plenty of insane bloggers.

    I mentioned online banking — remember, there’s insurance to cover online banking ‘mistakes’ and ‘problems’.

    But as someone who a) is root and has the scars to prove it, and 2) has been the victim of data security ‘inconsistencies’ in the past, I know all to well how easy it is in Q1 2007 to lose control of data. Period. Medical information is, as far as I’m concerned, the most important personal data there is, and compiling it online is, in my opinion, rather insane.

    I didn’t even mention the notion that Revolution Health could easily write its terms of service to USE that information for, say, marketing purposes (a la AOL), could make it very difficult to close an account (a la AOL)…The way the privacy policy works now, not only will RH use members’ information to ‘make the experience better’ at the web site, but will also research information about members’ NEIGHBORS? *sigh*

  3. Corey,

    Although you, as an employee of Revolution Health, may be upset that someone is questioning the big-picture wisdom of the venture that you and your colleagues are undertaking, I think that you are missing the point just as effectively as Kerri is making it.

    Specifically, I believe that taking advantage of new technologies to facilitate what people have done, in some form or another, for dozens to hundreds of years, does not exist on the same plane as collating some the most intimate details of an individual’s life and making that information available for the asking (or buying, or stealing, as the case may be).

    It may be that you believe that you are merely doing the latter in service of the former, but to do so without regard and consideration for the big-picture consequences is, I think, irresponsible. Possibly to the point of insanity. 🙂

    Is “get real” really the most apposite response you can come up with? Does your statement represent Revolution Health’s official position? Can you actually speak to the concerns that were raised here in a reasonable and informed manner, officially or otherwise?

  4. The opinions expressed herein are my own personal opinions and do not represent my employer’s view in anyway.

    With that out of the way… 🙂

    My only point was that fear is evidently a factor for you (just kidding, I like when Joe Rogan says it). And I can relate ($3000.00 worth of rims were just recently charged to my personal credit card by some store in the Bahamas, go figure). That said, I only hope that fear doesn’t prevent progress from being made in this area.

    And I do take offense to the “are they insane” tagline..mostly because – well, we really are trying to change things for the better (as it relates to empowering the consumer).

    And like planes, blogs, and online banking, online access to one’s personal medical records is inevitable – the major monoliths like Google, et. are all getting into the PHR game. But to your point(s) – trust, safety, and security must be key.

    Hopefully, with HIPAA rules and regulations enforced, innovations in security and and privacy as time goes on, and additional guidelines and standards agreed upon by the industry as a whole – the prospect of consumers taking “ownership” of their personal medical records in a digital form can be a fear-free reality.

    Just my naive $00.02

  5. I’m not quite grok’ing the problem being solved here… the great “how this makes my life better” reward, for which I’m being asked to pay (directly or indirectly).

    and in all candor, this bit here has the resultant effect of frightening me more than before I read it:

    >>Hopefully, with HIPAA rules and regulations enforced, innovations in security and and privacy as time goes on, and additional guidelines and standards agreed upon by the industry as a whole – the prospect of consumers taking “ownership” of their personal medical records in a digital form can be a fear-free reality.

  6. The opinions on whether you are comfortable or not – great, to each their own. However, what I think is interesting is that you think the business model is actually shaped around this. I guess I don’t see that – no one has successfully monetized online health records to date, and it is one area of a fairly large, comprehensive site that I would argue wouldn’t make or break a service like this.

  7. A little late to the party, but I’ll leave some graffiti on the wall for the next visitor 🙂

    @Tim: “no one has successfully monetized online heath records to date” – sorry, but that’s a poor argument. Replace “health care” with email, photo-sharing, document creation or any other online business that now exists. Someone will find a way. Google’s partnership with the Cleveland Clinic (revenues of over $4 billion/year) might be that method. I’m sure that Google can find a way to monetize your health records without the individual paying for them – and, hopefully, without being served ads based off your diseases – most likely by charging institutions to store their records or retrieve them. Anything that can be rendered into bits can now be monetized at some point.

    @Corey – inevitability does not mean something is a good idea. Personal health data available over the internet, which can never be fully> secured, is a bad idea. I can say this with certainty without needing to be a Luddite or technophobe. Yes, at some point health records will likely be available over the internet and there will be problems – more personal data stolen, bits lost in transmission that render you as HIV-positive instead of negative, and the like. And when the data is all in one place it can be collated and sold-on, maybe even illegitimately! 🙂 I can imagine some scammer already thinking up ways to monetize THAT information: a search engine for employers to check in on potential employees, a la Gattaca, or for neighbors to search for each other’s problems. All it takes is one mistake and the data is free, never to be secured again. “You can’t unpublish data…”

    and @Naomi – right on. US citizens especially don’t need to take anymore “ownership” of their records than they already do. Look how poorly we manage our SSNs and mother’s maiden names already. Plus, there would be lawsuits to remove information, or change it, and even more instances of “ask your doctor if ____ is right for you.” Ugh, I can already imagine the TV ads encouraging people to look for symptoms in their own medical history…

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