Remember when people dreamed of a desktop computer in every pot?

I had an external hard drive for a number of years, that I used for storing pictures and videos that were not essential to my work, and not emotionally significant. Nevertheless, when I got the phone call that this drive, which had recently stopped working, was truly beyond repair, I thought of all the time I had put into assembling those photos and videos, and how much time it would take for me to rebuild the collection.

As I go through the list of items on this former drive, I realize that I have copies of most of the material on my local machine, on Google Drive and Photos, and even some on my cell phone. I suddenly realized that making the effort to maintain this external drive  was probably a real waste of time. As the cost of disk space continues to fall, and as Internet access speeds continue to rise (making it practical to upload anything of value to a cloud-based repository), the idea of local storage really does seem silly. Because I so often flip between my desktop computer and my phone, and at times my various tablets, it really is impractical to have anything stored in a local desktop silo, which is not universally accessible. Ultimately, the lesson seems pretty clear – keep everything in the cloud, if it means anything to you.

There is endless talk about the risks of keeping personal information and private material in the cloud. The questions are repeatedly asked as to the risk of having these materials being hacked into, illegally accessed for profiling, being accidentally deleted and the like. But, it is clearly now my personal experience that maintaining a local copy is just as problematic. Someone could hack my home computer, and it would be far easier to do so than hacking my Google Drive account. As such, nothing on my main disk or external drives is safe.

As far as backups go, I realized a while ago that I needed a copy of all of my important materials somewhere outside of my home. For years, I have been using a service that protects me against a major calamity in my home office. I pay a significant amount of money every month so that in the event that my home server totally implodes, I can retrieve all my materials and be back up and running within a day or two, with no loss of critical data. This is not a luxury, since my consulting business depends on this data. This solution works just fine for those projects that I develop and then save locally on my home system. However, when I think about it, there is no longer a need to even bother making local copies of my work.

I used to handle my personal and professional email via Microsoft Outlook (which saved my emails locally on my home machine). Now, I use Gmail, so that I can readily access my email from any Internet connected computer or device. There have been multiple occasions when this universal connectivity was extremely helpful, if not essential, to getting a project done. And after a computer crash many years ago that wiped out my local Outlook installation,  I now would never depend on local storage for my emails and calendaring and contact lists.

These days, I actually spend most of my time in online environments. There is no inherent reason why I could not draft all new documents in Google Docs and the Google equivalent of Excel and PowerPoint. Of course, there are other online options that provide the same or more functionality than Google applications. My point is that I truly seem to be using my home computer’s fast CPU and extra RAM, less than ever before. While the transition of my day to day work to the online world has been relatively slow, I am finally at a stage where I could even abandon most of my home based hardware.

I have detailed my whole experience with online versus local stores of data, because most people today are experiencing this same transition. Most people would agree that the idea of losing one’s entire collection of personal photos, music, documents and emails, all because a hard drive died, seems like a throwback to the previous century. The upshot of this, is that people are developing a greater level of comfort with a totally online existence. The fears of losing data or having it inappropriately accessed are melting away. The implications of this are tremendous, especially in terms of healthcare.

One of the grand promises of digital health care was the unification of all electronic silos of medical information. The idea was that the electronic medical record [EMR] of hospitals would readily share information with the EMR of insurance companies and health funds, and ultimately with the personal health record of the patient. From the patient’s point of view, all barriers between separate databases of health related data would fall away. Whether for general interest while exercising, or for critical data while in the emergency room for chest pain, the point was to have all pertinent medical information available quickly and at one point of access. This would be the only way, in practical terms, to make sure that critical allergies were not overlooked, and medications were not forgotten to be given or to be considered when prescribing new medications with possible negative interactions.

I personally welcome all of these cloud based healthcare tools. Admittedly, I am someone who lives within a digital environment most of my day. So for me to make the statement that I am totally comfortable with an online centralized copy of all of my medical data, is far from an Oprah moment. But the general public has also welcomed online medical data, which at present is a complete record of vital signs and activity, captured by a wide range of smartwatches. What is fascinating is that many people are demanding such cloud based repositories for their personal health data, so that they can compare it to friends, and show it to doctors. For some people, it is as if the issue of safety of cloud based medical records never existed.

Security still does concern many people. A feature that is becoming much more popular in cell phones is the “home” button which also functions as a fingerprint reader. With this capability built into the phone, a user can pick an option from the main screen of their phone, and have their fingerprint identification done seamlessly, i.e. without any need for entering a password. This is the ultimate in convenience for ensuring secure access to one’s phone.

So imagine an elderly individual walking on the street who then suddenly feels severe tightness in his or her chest, to such a point that even calling for assistance is too difficult. If the lock screen of their cell phone included a “911” button, the user could make one click, be identified via their fingerprint and simultaneously allow full access for their online medical record to the friend/family who is automatically notified. This scenario shows how sensitive data can be in the cloud but still remain protected until a user explicitly allows access. I would consider this a minimal compromise that would ensure emergent access to medical information but still maintain a solid degree of protection from random prying eyes.

There will always be people who consider any risk of misuse of personal information, as an absolute red line that makes anything and everything I described above, unacceptable. My hope is that the number of such people will diminish dramatically over time. I would expect that my (eventual) grandchildren will take it for granted that they will have full, real-time AND secured access to their personal materials, whenever and wherever they need them.

I once heard a brilliant expression that went as follows: “Every new technology is a luxury until it becomes a convenience, until it becomes a necessity”. Medical information in the cloud is already a necessity. I pray that all of the present-day stumbling blocks that are still holding developers back from fully implementing cloud based medical records, will be quickly brushed aside. But this will only happen when the general public finally realizes that everyone needs their healthcare data anytime and anywhere.

Thanks for listening.
My website is at

PS. I just saw this article online and I feel that it is very pertinent: “NHS disregards patient requests to opt out of sharing medical records”


About the Author
Dr. Nahum Kovalski received his bachelor's of science in computer science and his medical degree in Canada. He came to Israel in 1991 and married his wife of 22 years in 1992. He has 3 amazing children and has lived in Jerusalem since making Aliyah. Dr. Kovalski was with TEREM Emergency Medical Services for 21 years until June of 2014, and is now a private consultant on medicine and technology.
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