PUBLISHED
WED, DEC 18 2019 UPDATED WED, DEC 18 2019 Christina Farr@CHRISSYFARR
KEY
POINTS
·
Hospitals have access
to a trove of patient health information.
·
Tech companies are
pitching them relationships and deals that involve gaining access to that
data.
·
Some health system
execs say they’re overwhelmed by the deluge of requests.
Hospitals, many of which are increasingly
in dire financial straits,
are weighing a lucrative new opportunity: selling patient health information to
tech companies.
Aaron Miri is chief information officer at Dell
Medical School and University of Texas Health in Austin, so he gets plenty of
tech start-ups approaching him to pitch deals and partnerships. Five years ago,
he’d get about one pitch per quarter. But these days, with huge data-driven
players like Amazon and Google making
incursions into the health space, and venture money flooding into Silicon
Valley start-ups aiming to bring machine learning to
health care, the cadence is far more frequent.
“It’s all the time,” he said via phone. “Often,
once a day or more.”
Hospitals have access to vast amounts of
people’s health information, including lab and imaging results and medication
lists. This data can help software programmers train their systems to recognize
patterns that in turn can lead to better care. For example, it can help
recognize signs of disease to make a diagnosis. But health systems
administrators say it could also be used in unintended or harmful ways, like
being cross-referenced with other data to identify individuals at higher risk
of diseases and then raise their health premiums, or to target advertising to
individuals.
‘Inundated with requests’
“We are getting inundated with requests from
companies who tell us they want to make our medical record more searchable,”
said Stephen Klasko, CEO of Jefferson Health. “I’ll hear about something like
this at least once a week.”
Klasko and his colleague Karen Knudsen, who’s
the chair of Jefferson’s cancer center, say some start-ups won’t let a “no”
from hospital officials stop them, and will then search for and pitch individual
physicians or scientists.
“We often find, once we look deeper into the
pitch, that it starts as a joint development project and ends up somehow with
us being both the product and the customer that pays for the product,” adds
Knudsen.
Some requests are for research partnerships with
a goal to publish in academic publications, such as Google Brain’s work to detect a
condition known as diabetic retinopathy.
But more often than not, Miri said, there’s a
commercial component that involves developing some kind of product.
For instance, Flatiron Health, a Google-backed
health-tech company, is just one of the businesses that partners with health
systems to gather up patient data, which it analyzes for insights about how
different drugs are performing in the real world and sells to pharma. The
company says on its website that it has 2.2 million active patient records
available for research. When it sold for $1.9 billion to Roche last year, some health-tech experts noted
that the sale amounted to roughly $1,000 per record.
Google, which boasts a variety of health system
partners, is looking to build software tools to predict a patient’s potential
risk of sepsis, a potentially life-threatening condition. It’s also working
with health systems’ data, including Ascension’s, to build a search
tool for the electronic medical record.
Miri said his team is extremely cautious about
these requests, and there’s an extensive process in place to determine what the
company intends to do with the data.
But he’s concerned that other hospital networks
— especially if they’re under financial pressure — won’t be so careful.
Anonymous data may not stay that way
Typically, data from health systems is stripped
of characteristics that could be used to identify individual patients, like
Social Security numbers and dates of service, before it gets shared. (Sometimes
the data is not anonymized, but in those cases parties are typically bound by
strict agreements forbidding them from using the data for commercial purposes
or anything beyond patient care.)
This de-identified patient data has become its
own small economy: There’s a whole market of brokers who compile
the data from providers and other health-care organizations and sell it to
buyers. Just one company alone, IQVIA, said on its website that
it has access to more than 600 million patient records globally that are
nonidentified, much of which it accesses through provider organizations. The
buyers, which include pharma marketers, will often use it for things like
clinical trial recruiting.
But hospital execs worry that this data may be
used in unintended ways, and not always in the patient’s best interest.
For starters, researchers have shown that de-identified
data does not always stay that way, as it’s possible to cross-reference
information from multiple datasets to associate a person with particular
information.
For instance, a study by Carnegie Mellon University from
2000 showed how anonymized U.S. census data could identify some individuals
simply by combining a few rare characteristics such as city of birth and
current ZIP code. Earlier this year, researchers in Europe published a method they
claim was able to correctly identify 99.98% of Americans in de-identified
datasets using 15 demographic attributes.
Beyond that, health-care companies -- including
health insurers -- are tapping third parties to purchase data from brokers
about people’s habits that could be used to identify them, like what they post
on social media or what they order online, according to a recent series of
reports from NPR and ProPublica. Health insurers might be able
to use this data to figure out what a potential customer might cost them, the
reports suggest, justifying higher premiums.
Tech companies are also under particular
scrutiny because they already have access to a massive trove of information
about people, which they use to serve their own needs. For instance, the health
data Google collects could eventually help it micro-target advertisements to
people with particular health conditions. Policymakers are proactively
calling for a revision and potential upgrade of the health
privacy rules known as HIPAA, out of concern for what might happen as tech
companies continue to march into the medical sector.
This uncertainty is why some hospital
administrators take a skeptical eye to all the requests they get.
“All of this outreach is putting tremendous
pressure on us provider organizations as we generally want to do the right
thing,” said Miri.
“I don’t believe that most people are in it for
the wrong reason, but it’s often not easy to make heads or tails of what’s
legitimate and what isn’t, and the real intention behind it.”
No comments:
Post a Comment