It was only a matter of time before Google positioned Wave for electronic healthcare record management, and now two of its engineers, Shirley Gaw and Umesh Shankar, have done just that. In a recent paper, to be presented at USENIX HealthSec '10, part of the 19th USENIX Security Symposium, which runs from August 11-13, 2010, they argue that many of the features built into Wave could support existing protocols.

The authors admit that their document is meant to be 'thought-provoking', but it does appear to answer some of the issues that currently slow down take up or deployment of digital records. Here's a quick summary of their main points about how Wave could help:

• However many times the record is updated, the most recent version is always well defined, irrespective of the number of authors and how often they communicate. This "fits well with the distributed electronic health record model."
• "The merging of health records maps to the collaborative document editing problem". So Wave's framework for aggregating and managing the actions of many writers makes "data provenance much easier to document and implement in real systems."
• The play back feature, which enables an end user to review amends and additions in the order in which they appeared, is also useful according to the authors. This means that you can always check who contributed to the record at every step - vital with so many parties contributing to the same document. 
• "Federation allows different authoritative providers, so both tech companies and HMOs can start offering this right away, while preserving integrity by deciding who else to trust."
• It is aligned with existing protocols including CCR and CCD. "Wave understands XML tags, so existing formats---at a fine enough granularity---can be largely reused. You can continue to source from any underlying data store, but Wave changes the model for the 'system view' of a record and offers the opportunity to review snapshots of the record along a timeline and monitor the evolution of the record.

The authors also admit that this approach would require patients and other stakeholders to be more relaxed about data privacy. One of the fundamental features of Wave is that all contributing providers can see the record history. Healthcare providers can also edit data sent from other providers although the authors argue that this enables a doctor offering a second opinion, for example, to update earlier diagnoses.