Providers, primarily hospitals, are engaging in unprecedented patient record sharing with technology kingpins of Google, Microsoft Amazon, and IBM, exposing millions of patients’ sensitive identifiable medical records in a period of growing digital security concerns. Have providers been sufficiently upfront about all of this?
These providers, in most cases, also serve as clinical investigational sites, and with the adoption and standardization of electronic health records, the lines between patient and investigator blur—many providers now tap into and access electronic health records (patients) to find subjects for clinical trials. These systems form a critical backbone for the health and research system. There is value in the data, but it must be tapped into and harnessed.
A recent report from the Wall Street Journal demonstrates the extent to which such hospitals are sharing sensitive data from Washington and Massachusetts to Minnesota. And unfortunately, as we learned with the Google and Ascension deal, (Project Nightingale), it is not unlawful for a major health provider to open up patient record access to a tech company, such as Google, without informing the patient.
Market Demands Aggregation of Health Data Key to AI Future
From the tech giants’ point of view, they must tap into, access, and exploit this data for the purposes of machine learning and other artificial intelligence initiative. Although the tech giants like to get ahead of the curve and pilot various algorithms, ultimately the market demands ever-increasing efficiency and productivity—not to mention the ability to realize data-driven breakthroughs for their organizations.
Microsoft & Providence St. Joseph
For example, Microsoft inked a deal with Providence St. Joseph to access and harness sensitive patient records in the EHR (including physicians notes) purportedly for an AI-based cancer care algorithm. As the two outlined in a press release, ultimately Providence St. Joseph seeks to deploy next-generation solutions and emerging technologies from Microsoft and its partners at a major facility in the Seattle area.
IBM & Brigham and Women’s Hospital
IBM’s AI unit—Watson—invested $50 million in Brigham and Women’s Hospital and Vanderbilt University for health AI purposes. Arguably the most well-known AI brand ambassador, Watson, will support a 10-year research collaboration with the two separate centers, advancing the science of AI and its application with a focus on health challenges ideally suited for AI solutions. What are some primary initial target projects? Possibly the use of AI as a means of improving the utility and value of EHR and claims data to target important public health issues, such as patient safety, precision medicine, and health equity. Moreover, the collaborative seeks explore and better understand how the patient experience can benefit from deploying such advanced capabilities.
Amazon and Fred Hutch
A stealthy initiative between Amazon and Fred Hutch emerged for the public to contemplate in 2018. At the center of this collaborative emerges Amazon’s “Grand Challenge” initiative led by Babak Parviz, the Google Glass developer. The focus at a high level reported “a series of bold projects involving cancer research, medical records and last-mile delivery,” CNBC shares. Amazon has built the largest cloud platform (Microsoft is second and rapidly gaining thanks to their new CEO) in the enterprise, and its Grand Challenge seeks to not only improve healthcare but also raise the bar for delivery—something Amazon knows a thing or two about when it comes to delivery of goods to consumers—that almighty “last mile.”
No Choice but to Share
In the end, healthcare in America is delivered in a competitive landscape, representing a dynamic ecosystem of interests—providers and their research arms, regardless of whether non-profit or for-profit, compete in the marketplace for patients. Who can provide superior services? How can patient safety be improved? How can the patient experience be transformed for the better? How can costs be controlled or productivity increased so that healthcare institutions can thrive? How can superior decisions be made to benefit the patient’s (or community’s) healthcare? How can medical processes be optimized and improved by AI for the benefit of the patient?
AI, in its many different emerging forms, will be at the heart of many of these answers. Already, TrialSite News covers countless programs and projects where medical and research institutions are gaining benefit from these powerful technologies. Of course, AI is at the early stages of its life cycle, and there will be many mistakes—some severe. AI algorithms are useless, unless they have access to the appropriate data. Hence, the race is on for the technology giants to partner up with providers/researchers to experiment, learn, and hopefully innovate in the pursuit of delivering results and demonstrating value.
The Provider & Tech Obligation
Patient data represents the fundamental building blocks for AI innovation in healthcare. Without it, there can be no value. Providers should go above and beyond the standard data privacy and protection status quo (e.g. meet baseline legal and compliance requirements) and act as a fiduciary—serve the patient and protect their personally identifiable information. Negotiate and incorporate severe penalties for any breaches that compromise patient data integrity and privacy.
As a matter of good business practice (when applicable), providers should practice the concept of transparency with their patient community. In the context of personally identifiable patient data, medical professionals should announce what they are doing, why it is important, and what benefits of what they seek to achieve. Remember: although healthcare is a business, it is also a special business with a special obligation to the patient. Cases where the public finds out about a patient-record-sharing provider or tech deal via some investigative journalism-based exposé is what triggers uncertainty and mistrust.