The great part about being able to talk to other people is to improve your own knowledge and opinions. This forum and an open mind are wonderful resources.

On reflection, there's probably nothing beyond what I would print on an emergency medical card that would be needed in an urgent situation. So the use of an encrypted USB would be the right thing to do. I might go the extra step of telling the password to my emergency contacts so, if they were contacted, they could disclose the password under the right conditions.

Also, most people might not have anything to add to the USB stick that wouldn't be on their emergency card/ID. But what if you're a cancer patient or survivor? Or you have degenerative bone disease, lupus, HIV or cystic fibrosis? Wouldn't your treatment regimen and progress be useful to your treating physician after you are stabilized? Recent foreign travel to areas associated with particular diseases? Date of last tetanus booster? Past fractures, surgery or heart issues? I'm not a medical professional so I don't know what's relevant, but I know I have difficult remembering all the details of my medical history without referring to notes. And if I have to carry notes aren't they more susceptible to inappropriate disclosure than being on a USB key?

But, without getting into details, and for reasons not necessarily my own, I have a lot of interaction with hospitals, doctors, clinics and insurance companies. For longer-term care, the more medical history you can provide, the better your chances for success, both physically and financially.

In regards to confidentiality, in spite of HIPAA, there are still plenty of gaps in the system, mostly due to human error or indifference. But think of who you are trying to keep your medical history from and why?

• Certainly, you don't want your info posted on the Internet or in a newspaper, where any prospective employer or mate could access it without knowing all the details.
• Your insurance company already knows the info, and shares it with other insurance companies as part of their "coordination of benefits."
• Some conditions must be reported to local health departments and/or the CDC.
• Your prescription plan has much of your info.
• Many insurance companies off-shore or outsource processes to foreign locations where the rules and attitudes are different.
• In many case, particularly with larger employers, your employer IS the insurance company, and a firm like AETNA or United Healthcare or Medco are just "program administrators." In this case, your employer also knows your full medical history. And when mergers and divestitures occur, this information gets propagated, even if only incidentally via computer archives.
• In smaller companies its not too difficult to correlate the "aggregate, anonymized" activity data to specific employees.
• HIPAA notwithstanding, there are still plenty of confidentiality breaches due to human error, ignorance or indifference, or even intentional disregard of the law. I see it regularly, and I don't work in the health care field.

The reality is that, for most people, unless you are famous or the data was found locally in your community or at work, or the information shows you were treated for an STD from a 15 year-old prostitute in Bangkok or some other controversial condition, nobody would care and no harm would be done.

Since I'm not famous, not even within my own community, and I have no skeletons in my closet like underage hookers, (foreign or otherwise), I'm not as concerned about the confidentiality of my medical history as I am in my chances for survival.

Like you, I'm always listening with an open mind.