Whose records are they

ChatGPT Health opened to every US adult on July 23. Connect Apple Health, Epic or Oracle Health and the chatbot reads your labs, your medications, your visit notes, and answers questions about them in plain language. OpenAI says 300 million people a week already bring health questions to ChatGPT, up from 230 million in January.

Some large fraction of those questions are about somebody else. That is the fact the whole design walks past. Every control in the rollout rests on one assumption, that the account holder and the patient are the same person, and in this house they never have been.

The records most likely to get connected belong to someone who cannot work the app, will not read the policy, and, in the case of dementia, cannot meaningfully agree to any of it. There is no setting for that. There is no version of the consent screen that says: I am doing this for my father, he does not know what an API is, and I still need to understand his labs before Thursday.

The privacy caution has been made well elsewhere. Once records leave the hospital system HIPAA does not travel with them, and what stands behind them is a company policy the company can revise. What that misses is who is actually clicking accept. You are not weighing a risk to yourself. You are taking it on behalf of a person who did not get a vote, because the alternative is staying confused about their care, and confusion has its own cost.

Three days earlier, OATS from AARP surveyed more than 350 caregivers and found the tools meant to help had become a source of stress, portal after portal, each with its own login. The obvious fix is to merge them, and every product in this category is racing to be the place they merge. We would spend the effort elsewhere. A caregiver buried in six portals does not need a seventh tab that combines them, because a complete record still only describes what already happened, and this rollout is US-only in a world the WHO expects to hold 2.1 billion people over 60 by 2050. Nobody lies awake wondering what the labs said.