OK, executives at EMC, HP, IBM and Microsoft, do you really want to make a difference for your company, your fellow citizens and your country? Here’s your chance. It won’t be easy or quick, but if you are as good as you want us to believe, here’s your chance to prove it.

American health care needs you
Non-Americans may not believe this, and it is a fact Americans prefer to ignore, but America’s largest industry, health care ($2 trillion a year), is, objectively, a fiasco. Americans spend close to double what other industrialized countries do, and we rank in the bottom quartile for life expectancy and infant mortality. More money, worse results.

Naturally, big commercial interests are sluicing hundreds of billions into their pockets every year under this system. In return they pour huge amounts of “campaign contributions” – bribes – into our Ebay on the Potomac, the United States Congress – America’s only native criminal class, in the immortal words of Mark Twain.

So exactly how does storage fit into this mess?
I’m getting to that. A little more background first. In America, by historical accident, health care is attached to one’s job. No job, or a bad job, no health insurance. Health care is a major expense for American employers. For example, US automobile companies ascribe their financial woes to the cost of health insurance. Costs are high so there is always pressure to shift them somewhere else. People with health problems or sick children get fired. Insurance companies refuse to pay or underpay for care. Providers choose cheap short term palliatives over more expensive long-term solutions. And medical bills are the single largest cause of personal bankruptcy. The financial pressures are immense.

Americans know that their medical records can and will be used against them. In response, Ebay Congress passed a law, HIPAA, that promised federal protection for medical records. This law hasn’t been enforced, so public confidence is electronic medical records is in danger of collapsing.

The paradox is that, as the National Academy of Sciences has noted

Both private- and public-sector groups have identified the need to move forward expeditiously with the automation of clinical information.


Public opinion polls conducted during the last decade document high and increasing levels of concern about privacy, raising questions about whether people’s fear of violations of their privacy may lead some to forego seeking necessary health services or to withhold personal information from clinicians.

These aren’t illusory issues as the VA hospitals have demonstrated. In a New England Journal of Medicine peer-reviewed paper documenting today’s high quality of VA care, the authors noted that critical process improvements

. . . such as an integrated, comprehensive electronic medical-record system, were instituted at all VA medical centers.

OK, storage geeks, your time is now
There is bipartisan agreement that electronic medical-record systems are a major element in improving American medical care. And that means storage, lots of storage. So why aren’t more storage vendors involved?

To be fair, IBM is involved as a systems integrator and as leader of one of four consortia developing prototypes for a national health information network. Sun and Microsoft are participants in one of the other consortia, yet storage doesn’t appear to be their focus.

The StorageMojo take
Medical records are one of the biggest storage opportunities of the next decade – if Americans can be persuaded they are secure. Right now they aren’t, and with the continuing stories about lost laptops and illegal data access, there is no reason for people to get comfortable. Without public support electronic medical record systems are dead and millions of Americans will suffer from medical delay and even death.

EMC, with their recent acquisition of RSA, would seem best positioned to take on the challenge of creating, in conjunction with system integrators, truly secure medical record storage systems. HP, who is as big as IBM, is much less visible in this space even though their big storage business stands to gain the most.

Medical data security can never be solely a storage problem. Yet storage vendors have a huge vested interest is seeing that this problem gets solved. Time to get off the sidelines, big guys. Do yourselves and your country proud.

Comments welcome as always.

Update: another facet of this issue is covered in Medical Privacy Is A Sick Joke.