Hospitals across the nation have granted major technology companies including Microsoft Corp., International Business Machines and Amazon.com Inc. with the ability to access patients’ health records. The hospitals’ influence in the data economy plays off of a deal that was established between the medical system and large tech. companies in years prior.
The digitalization of patients’ health records allows for easy sharing and accessibility for those in the hospital system. With the access tech. companies now have, they can store and calculate data from the recorded medical histories, lab results and diagnoses.
While the deals between hospitals and tech. companies originally did not address the extent of which the healthcare community would share, these systems have partnered to file data and improve visits to the hospital for both doctors and patients.
In 2017, Amazon Transcribe, an automatic speech recognition service that recognizes sentence structures, automatically inserting commas and periods into written language, was launched. In 2019, Amazon Transcribe Medical was introduced. This technology can recognize medical language and store the audio of clinical data in Amazon Simple Storage Service.
“[An] issue I can see being tied to this [access to data] is insurance companies,” said English professor Dr. Jordan Canzonetta, who teaches about rhetoric and technology. “So if, let’s say, Amazon were to sell that information to an insurance company, they can start making decisions about who they’re going to insure based on the data they have acquired without patients’ consent or knowledge.”
Further advancing technology’s role in the medical world, Google partnered with healthcare systems to advance “Project Nightingale,” an initiative to accelerate the healthcare community in 2018. The project began with Google and Ascension, a Catholic hospital chain. Within the Project Nightingale system, patient data entered into the hospital’s computers flowed into the Google-run system, which then suggested a variety of outcomes, such as a replacement of doctors, additional enforcement of medication or treatment plans.
“When we generate these programs, algorithms are ultimately written by humans, so some of our biases are going to be encoded into that software or into the algorithm itself,” said Canzonetta. “The way that I’ve seen that taking shape in the medical field is that typically people of color who are patients end up not getting quality care because of some of the results that the algorithms have produced and that typically affects minorities much more frequently than people outside of that specific group.”
The data sharing from Project Nightingale took place without the patients’ or doctors’ knowledge. However, hospitals are allowed to share data as long as they are in compliance with federal privacy laws.
Microsoft and Providence hospital systems are currently utilizing doctors’ notes in patient medical records to develop an algorithm for cancer. While data absent of information identifying patients was originally intended to be transferred from the medical records, not all identifying information, such as patients’ names, could be excluded.
The Health Insurance Portability and Accountability Act (HIPAA) allows hospitals to send medical data to business partners in confidentiality, though they are required to notify patients about health-data uses. These hospitals do not need patients’ permission to share their medical data, so it is out of the patients’ control.
“Especially with your personal history that’s tied to your medical history, I don’t know if people would be okay with that information passing through different channels without their knowledge or consent,” said Canzonetta. “Typically, the arguments that are made in favor of sharing this data without peoples’ consent is that it’s meant to help better their experience to contribute to a larger body of data that will then help other patients, so the more you understand about one person’s medical history, the more you can understand about other peoples’ medical history.”
HIPAA also outlines that hospitals are prohibited from sharing patients’ names and social security numbers unless they are needed for treatment, payment or hospital operations. However, tech. companies partnered with hospitals can say that they need this information to develop apps or algorithms.
If the current trends continue, the medical field’s role in the data economy is certain to expand in the near future.