On Privacy and Big Tech in Healthcare

Dec, 2019

The Wall Street Journal recently revealed that Ascension Health, the second largest hospital system in the nation, has secretly partnered with Google in a project code-named Nightingale to share patient data for the purpose of improving clinical outcomes and for increasing administrative efficiency. Why keep it secret? Because Google was given complete medical information including the name and birthdate on millions of patients from over 2600 hospitals in 21 states. If crunching the numbers to improve diagnosis and medical management is the object then why identify patients, especially without the knowledge or consent of those patients or their doctors? Obviously, profit is the motivation for Google, and most likely for Ascension as well. All of the Big Tech firms are trying to get a piece of the huge healthcare market and this is problematic for privacy.

Facebook launched a suicide prevention algorithm in the U.S., but not in Europe because of the European Union’s tighter privacy law. In 2017 when Facebook suffered a breach of 39 million files from a hack, it refused to say whether or not its information on those at suicide risk was compromised.

The Health and Human Services Department says it is investigating whether project Nightingale violates the Health Insurance Portability and Accountability Act of 1996 (HIPAA). Ascension claims it can share data with Google under the provision of HIPAA that allows transfer to business partners “to help the covered entity carry out its healthcare functions.” There is no such exception under the European Union’s General Data Protection Regulation (GDPR) which applies across the board and not just to healthcare providers.

The sharing of patient personal identifying information without patient consent is outrageous. Will the federal government reign in Big Tech? Unlikely. Google, Facebook, Microsoft, Amazon etc. have enormous media and political power. They fund think tanks and academic institutions and non-profits to sell their message. They hire corps of lobbyists in Washington D.C. and state capitals. They fill the campaign coffers of politicians. They control not just social media but also conventional media outlets such as the Washington Post.

In 1982 the economist Mancur Olson wrote the Rise and Decline of Nations; the book explains how free market capitalism inevitably morphs into crony capitalism – “the British Disease.” The markets come to be dominated by powerful oligopolies, and these special interests use their money and influence to shut down competition. In the just published book The Great Reversal – How America gave up on free markets, economist Thomas Philippon confirms that the U.S. is now a crony capitalist sate. The Big Tech firms, along with the international merchants and bankers, dominate the political process and get away with one outrage after another, even forcing the taxpayer to bailout the companies that are “too big to fail,” while the leaders and owners of those bankrupt entities walk away with millions in their pockets. So if you are waiting for government to take on Big Tech to protect your privacy, don’t hold your breath. Healthcare privacy is now as much of an oxymoron as computer security.

– Gary Gallo, MD