In the 1880s, when the world-renowned Mayo Clinic was still a young fraternal surgical practice in the newish state of Minnesota, its doctors scribbled notes about their patients into heavy, leather-bound ledgers. But, in 1907, a physician there named Henry Plummer came up with something better. He thought the episodes of a patient’s medical history should all be in one place, not scattered between many doctors’ journals. So he introduced a new system, creating for every Mayo patient a centrally housed file folder and a unique identifying number that was to be inscribed on every piece of paper that went inside it—doctor’s notes, lab results, patient correspondence, birth and death records. And recognizing the scientific value in these dossiers, he also convinced Mayo’s leadership to make them available for teaching and research to any physician at the practice.
This development marked the beginning of modern medical record-keeping in the US. And from the beginning, the endeavor has been animated by an inextricable tension between sharing and secrecy—between the potential to mine patient data for new medical insights and the rights of patients to keep that information private.
Last week, that tension came to the fore again when the Mayo Clinic announced that Google would begin securely storing the hospital’s patient data in a private corner of the company’s cloud. It’s a switch from Microsoft Azure, where Mayo has stored patient data since May of last year, when it completed a years-long project to get all of its care sites onto a single electronic health record system. (Project Plummer, it was called.)
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