Earlier this month, the Wall Street Journal released a story detailing Google's under-the-radar foray into healthcare data—the tech giant having secured partnerships with hospital systems providing them access to tens of millions of patient health records. The WSJ story has since raised questions about big data in healthcare and whether or not we trust companies like Google with patient records.
Can we trust Google with big data in healthcare?
At the core of the issue is not only individuals' privacy, but also the profound impact Google's access to big data and patient records could have—whether positive, negative, or some mixture of both—and the inability of even Google to divine what that impact may be. Backlash over Google's deal with Ascension was set off in part due to the lack of transparency, and a lack of detail in how Google might use Ascension's data.
Taking Google Health chief Dr. David Feinberg at his word, Google's lack of detail was in part due to the experimental nature of its efforts. "At the outset, it wasn't clear how the project would advance beyond initial, experimental steps," reads the WSJ story. "We didn't know what we were doing," said Dr. Feinberg to the WSJ.
The potential, positive impact of Google's experimentation with big data in healthcare has led providers like Mayo Clinic to partner with Google to "solve complex healthcare problems." Mayo's Chief Information Officer Cris Ross told the WSJ, "We have a moral obligation to pursue discovery and advance cures for people."
But the experimental nature of Google Health's work has led other providers to cut ties with Google before projects really got started, or to avoid dealing with Google at all. "Some hospital and technology executives say they declined deals with Google lest it become a future competitor," reads the WSJ.
Ultimately, behind the question of trust and transparency is the question of how Google intends to make money from its foray into big data in healthcare—how it intends to continue to support its reported 1,000 employees in its Google Health division. And again, a lack of transparency here may be to keeps its competitive secrets, or it's possible that Google is still experimenting on that front as well. "Dr. Feinberg says he operates on a personal directive from [Eric] Schmidt: 'Don't worry about making money,'" reads the WSJ.
"It is not surprising that Google has not figured out how to make money in healthcare," Andrew Matzkin of Health Advances, a consulting firm focused on health tech, told the Financial Times. "Because there is no 'simple cookie cutter answer.'"
Google's not the only tech giant with access.
Of course, while scrutiny over Google's deals has made headlines recently, they're not the only tech giant honing in on the potential of big data in healthcare. Another Wall Street Journal story last week detailed similar data pacts sealed between hospitals and Microsoft, IBM and Amazon.
Our blogs have previously taken a deeper look at Microsoft's potential impact on healthcare in addition to both Microsoft and Amazon leveraging healthcare data to create artificial intelligence applications for providers. Both companies have a major edge over Google in the trust department.
Trust may be a reason why Microsoft and Amazon, not Google, seem to be vying for the lead in healthcare data. Google missed out on a partnership with Cerner to host their data, which opted to store its data with Amazon because they were "more trustworthy on security," a source said to the WSJ.
Major electronic health record provider Epic Systems recently notified customers that it no longer planned to pursue integrations with Google Cloud, focusing instead on platforms offered by Amazon Web Services and Microsoft's Azure service. "The report notes that 'insufficient interest' from Epic customers in Google is behind the decision to focus efforts instead with those cloud competitors," reads the Healthcare IT News story.
But ultimately, the scrutiny over Google is fueled by a distrust in tech companies handling personal data, in general. A recent Rock Health survey suggested that only 11 percent of consumers were willing to share their personal health data with tech companies, and that willingness to share health data—at all—was declining.
Where does HIPAA come in?
Also at the center of the controversy is the Health Insurance Portability and Accountability Act, or HIPAA, the legacy of which has largely been related to its rules and regulations on the sharing of health care data. Its rules may be misinterpreted by patients to think that their personal data is safeguarded, but its wide definitions have allowed this data sharing activity to go on.
"Data that can identify patients—including name and Social Security number—can’t be shared unless such records are needed for treatment, payment or hospital operations. Deals with tech companies to develop apps and algorithms can fall under these broad umbrellas," reads the Wall Street Journal story. "Hospitals aren’t required to notify patients of specific deals."
"Under HIPAA, hospitals must divulge as little as possible about patients under agreements," the WSJ story continues. "But in some cases, the minimum amount needed by tech companies can be everything in patients' records," like for Google's application under development that will allow providers to accurately search and retrieve all information for a patient.
Big data remains a big question mark in healthcare.
The Google backlash is currently center stage of a major trend in the healthcare industry, a trend that will likely have a profound impact on care and professions. For now, it leaves us with a number of questions:
- How can/should we regulate big tech's access to health data?
- Do consumers want their data shared? ...to improve healthcare?
- What should the role of HIPAA be?
- What impact will these applications have on professional competencies?
These are questions that will certainly play a role in our discussions of data and its impact on health professions at the Health Professions Network Spring Conference April 14-16 in Columbus, OH. Our excellent lineup of speakers will provide us with expert insight into how data is being used to change care, and how professionals will interact with patient data in the near future.
While our conference's focus is on practical insight for the health professionals, associations, educators and credentialing bodies that make up our membership, we also can't ignore the larger implications of the discussion surrounding patient records, regulations and big data in healthcare.