INSUBCONTINENT EXCLUSIVE:
Spending for consumer digital healthcare companies is set to explode in the next few years; the Office of the National Coordinator for
Health Information Technology is currently reviewing the requirements for data sharing with the Department of Health and Human Services, and
their initiatives will unlock a wave of data access never before seen in the U.S
healthcare system.
Already, startups and large technology companies are jockeying for position over how to leverage this access and take
advantage of new sensor technologies that provide unprecedented windows into patient health.
Venture capital investors are expected to
invest roughly $50 billion in approximately 4,500 startups in the healthcare industry, according to data from CB Insights
In all, there have been 3,409 investments made in the healthcare market through the third quarter of 2019, with 31% of those deals done in
what CB Insights identifies as digital health companies.
The explosion of data is unprecedented and already companies like Apple and Google
are jockeying for control over how that data will be served up to healthcare practitioners and patients.
Chart courtesy of CB
Insights
Apple and Google are setting out two divergent paths for handling patient data
For patient advocates, there a clear winner, and as startups look to play in these emerging ecosystems, it what the patient wants that may
matter most.
&The second that this data hits those shiny Silicon Valley apps, instead of being under HIPAA that covered, you become a user
and you have no rights,& says one patient advocate.
Last week, after reports in The Wall Street Journal and The New York Times, Google
confirmed the details of a partnership with religiously-affiliated hospital and assisted living network, Ascension, a deal that involved the
movement of millions of patient records into Google infrastructure.
The Alphabet subsidiary had first announced the agreement in its July
earnings call, but the precise details of its work with the hospital records of Ascension patients were undisclosed until a more detailed
description of the project was leaked by a whistleblower.
Google was not only moving patient records onto its cloud infrastructure, but was
also developing tools to &help Ascension doctors and nurses more quickly and easily access relevant patient information, in a consolidated
view,& the company confirmed in a blog post.
For the source of the Journal reporting, there were too many pieces of information about the
project that both the Google engineers who were working on &Nightingale& and the doctors and patients in the Ascension healthcare system
were kept in the dark about.
As the whistleblower wrote in a Guardian editorial late last week:
With a deal as sensitive as the transfer of
the personal data of more than 50 million Americans to Google the oversight should be extensive
Every aspect needed to be pored over to ensure that it complied with federal rules controlling the confidential handling of protected health
information under the 1996 HIPAA legislation.
Working with a team of 150 Google employees and 100 or so Ascension staff was eye-opening
But I kept being struck by how little context and information we were operating within.
What AI algorithms were at work in real time as the
data was being transferred across from hospital groups to the search giant? What was Google planning to do with the data they were being
given access to? No-one seemed to know.
Above all: why was the information being handed over in a form that had not been &de-identified& &
the term the industry uses for removing all personal details so that a patient medical record could not be directly linked back to them? And
why had no patients and doctors been told what was happening?
I was worried too about the security aspect of placing vast amounts of medical
data in the digital cloud
Think about the recent hacks on banks or the 2013 data breach suffered by theretail giant Target& now imagine a similar event was inflicted
on the healthcare data of millions.
Google insists that no patient data is being used to sell ads, or being coupled with either its own
consumer data or data from other customers it may be working with in healthcare (a list that includes the Cleveland Clinic, Hunterdon
Healthcare, and McKesson).
However, Google handling of patient data — through its own work with other partners and through DeepMind Health
(a division of a Google spinout which the search giant recently acquired) — has been controversial.
In 2018, the search giant work with
National Health Service was criticized for not adhering to data governance standards and potentially breaking the law
And, earlier this year, Google was sued for allegedly mishandling patient data by including too much potentially identifiable patient
information used in a study conducted by the University of Chicago Medical Center, Google, and the University of Chicago.
UK report warns
DeepMind Health could gain ‘excessive monopoly power&
In each instance, Google insisted that it followed all appropriate regulations, but
the problem that the company faces is growing concern from a new crop of lawmakers and concerned consumers that the regulations which exist
on the books are no longer appropriate.
Technology is coming for healthcare data
The news of Google work with Ascension and the concerns it
has raised among consumers is just one example of the company broader efforts to capture more of the multi-trillion dollar healthcare
market.
Google kicked off November with a $2.1 billion bid for Fitbit — a deal that would potentially put an incredible amount of
currently unregulated consumer health data squarely under the magnifying glass of Google mammoth data analysis tools.
