A multi-billion dollar industry exists from the buying and selling of your healthcare data. Certain state exceptions under federal privacy rules allow hospital data to be sold to data brokers. Private companies are seeking to gain access to your medical records to advance their mission, but sometime also to make a quick buck.
The right of businesses to profit from health information without patient permission has been previously upheld by the United States Supreme Court. For example, in the 1990s, a data broker was selling data to some big pharmaceutical companies on what individual providers were prescribing to patients. These pharmaceutical companies then used that information to provide targeted marketing to prescribers for the purposes of increasing drug sales. However, once patients started to understand and voice their complaints, a couple of states passed legislation to limit the trade of prescriber specific information. But, the data broker objected so the case went to the Supreme Court and was won by the data broker on the grounds of free speech.
While the practice of buying and selling medical data is technically acceptable under the Health Insurance and Portability and Accountability Act (HIPPA) because the data is supposed to be anonymous, one of the challenges with the increasing number of these deals is patient privacy is at risk since it is easier now to piece together deidentified records using unstructured data sources like Facebook, Twitter and other social media platforms.
However, it is also important to note that not all data brokers have misguided intent. There are many organizations in this space with honorable missions. For example, Sloan Kettering made a deal to sell pathology samples to Paige.AI to develop artificial intelligence to help in finding a cure to cancer. In the case of curing cancer, the patient’s medical data is being used to increase the quality of care. However, data brokers do not currently have any fiduciary responsibilities to patients.
There are some considerations that health systems can put in place to help reinforce ethical best practices:
1. Only enter into a data transfer deal if it benefits patients
2. Have a separate agreement form from the consent form that patients complete for their normal healthcare
3. Asking the patient for permission to sell their data should be done by the third party vendor to ensure that there is no misunderstanding or abuse of the patient/provider relationship
4. Any default consent options should be that patients do not elect to have their data sold
5. Consent language should be worded in an easy to understand fashion and potentially in video form for so that patients can clearly understand usage, risks, and their options
6. Transparency should be provided to the patients and healthcare staff on how the records are being used, who owns the data, and in what way it will be used, especially if there is a financial gain for the health system
Last year GlaxoSmithKline, a large pharmaceutical company came under global scrutiny when they tried to invest $300 million in 23andMe, due to concerns around lack of transparency of what data was being shared combined with the lack of choice for patients to participate.
Given that researchers predict that healthcare data will grow faster than in manufacturing, financial services, or media experiencing a compound annual growth rate of 36 percent through 2025, these issues are likely to continue to surface for governing bodies as well as public policy influencers.
What has been your experience with data brokers? How do you think this will play out in the future?
#AI #BigData #BioEthics #Healthcare