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Government finally publishes NHS contracts with Palantir, Faculty and big tech

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Re: Government finally publishes NHS contracts with Palantir, Faculty and big tech

#31

Post by Taek »

throwawaypal wrote: post #18
anonymousDan wrote: post #3

As a UK taxpayer this makes me so angry. The fact this incredibly valuable (not to mention privacy sensitive) data is given away through backroom deals for a pittance without any transparency is just infuriating.

If things like this upset you, you are seriously naive about the operations of your government. As a former Palantir employee, I can say with some confidence that the govt and private company's make efforts to ensure these things remain secret..

Echoing another commenter, it's absolutely okay to be upset about things that run-of-the mill.

If we didn't get upset about everyday human rights violations, we'd still have slaves.

Re: Government finally publishes NHS contracts with Palantir, Faculty and big tech

#32

Post by ganstyles »

thelean12 wrote: post #30
pessimizer wrote: post #15

Earlier quoted context omitted.

I'm willing the accept the 5% extra chance of death entailed by some emergency doctor not knowing my medical history. If I have something crucial, like an allergy to medication, I guess I'd just get that tattooed somewhere obvious. In the vast majority of emergency cases for the vast majority of patients, I don't think one's medical history is going to be a significant factor in getting them out of the woods far enou…

Why do you think you're informed enough to know what doctors need to know about your medical history to best treat you?

It seems pretty common sense that the main things people want to convey in medical emergencies where they're unconscious or their identity is unknown are allergies and reactions, hence why we have medical allergy bracelets and similar things.

If it's life and death and I'm unconscious, it's unlikely they would be able to access my medical records regardless, given the state of healthcare data interoperability (I have a lot of experience in this area). If I am conscious, I can tell them where to get my records, whether they're in Random Hospital X's database, or my personal DB.

I tend to agree that in the average case there's no real downside to doctors not having my medical history.

Re: Government finally publishes NHS contracts with Palantir, Faculty and big tech

#33

Post by ganstyles »

vertex-four wrote: post #19
catalogia wrote: post #12

Earlier quoted context omitted.

That might be good advice in general, but I don't think that works with medical data. If I get hurt and end up in a hospital, how would the surgeons decrypt my hard drive to find my medical history if I'm unconscious? Obviously I need to entrust this data to somebody. Edit: Not being a doctor, it's difficult for me to anticipate what sort of information doctors would consider relevant. Certainly there are some easy c…

Generally speaking, the surgeon isn't going to have your medical history until well into your treatment... probably by the time you or someone who knows you are able to tell them anything they want to know. There's not a properly linked database of healthcare records for that purpose - the hospital doesn't even know what GP you're with, never mind have instant access to your records, and it mostly works out.

To put a finer point on it: it may be easier for doctors to find your hard drive and decrypt it in some cases that than to go through and extract them from another medical provider's EHR system. I say this only partly tongue-in-cheek.

Re: Government finally publishes NHS contracts with Palantir, Faculty and big tech

#34

Post by hackissimo123 »

Taek wrote: post #31
throwawaypal wrote: post #18

Earlier quoted context omitted.

If things like this upset you, you are seriously naive about the operations of your government. As a former Palantir employee, I can say with some confidence that the govt and private company's make efforts to ensure these things remain secret..

Echoing another commenter, it's absolutely okay to be upset about things that run-of-the mill. If we didn't get upset about everyday human rights violations, we'd still have slaves.

And if we didn't get upset about everyday human rights violations, China wouldn't currently be herding people into concentration camps. Wait...

Re: Government finally publishes NHS contracts with Palantir, Faculty and big tech

#35

Post by WrtCdEvrydy »

loeg wrote: post #29
dekhn wrote: post #9

Earlier quoted context omitted.

I live in the US and used to build products to deal with sensitive healthcare data. I recall talking to an Important Person from the NHS, years ago, who proudly told me that the NHS could do things with its healthcare data that US companies could not- without having to deal with things like HIPAA, etc. I told them that while they might be able to do that, it would probably make a bunch of people mad if they weren't t…

HIPAA protects us less than most people think. As they say, the "P" in HIPAA is not for Privacy.

Funny thing, ask enough people and you'll realize most don't realize it stands for Portability.

Re: Government finally publishes NHS contracts with Palantir, Faculty and big tech

#36

Post by kjakm »

ganstyles wrote: post #33
vertex-four wrote: post #19

Earlier quoted context omitted.

Generally speaking, the surgeon isn't going to have your medical history until well into your treatment... probably by the time you or someone who knows you are able to tell them anything they want to know. There's not a properly linked database of healthcare records for that purpose - the hospital doesn't even know what GP you're with, never mind have instant access to your records, and it mostly works out.

To put a finer point on it: it may be easier for doctors to find your hard drive and decrypt it in some cases that than to go through and extract them from another medical provider's EHR system. I say this only partly tongue-in-cheek.

The article is about the NHS though so hospitals and doctors all access the same system/are all the same “medical provider”.

Re: Government finally publishes NHS contracts with Palantir, Faculty and big tech

#37

Post by DanBC »

vinay427 wrote: post #17
heavenlyblue wrote: post #14

Earlier quoted context omitted.

NHS in general is way less known than UK citizens think. Especially in Europe where the existence of a national healthcare system is not a religion but a norm.

> Especially in Europe where the existence of a national healthcare system is not a religion but a norm. An NHS-type system is not at all the norm in Europe. Comprehensive and universal health insurance or even single-payer health insurance are not the same as the single-payer (mostly) single-provider system in the UK. In most of the Germanic countries, for instance, the norm is closer to the multiple-payer multiple-…

> single-provider system in the UK

England doesn't have a single provider system.

I don't know about Wales, Scotland, or Northern Ireland (they each have health systems that are devolved and thus separate).

Re: Government finally publishes NHS contracts with Palantir, Faculty and big tech

#38

Post by vertex-four »

kjakm wrote: post #36
ganstyles wrote: post #33

Earlier quoted context omitted.

To put a finer point on it: it may be easier for doctors to find your hard drive and decrypt it in some cases that than to go through and extract them from another medical provider's EHR system. I say this only partly tongue-in-cheek.

The article is about the NHS though so hospitals and doctors all access the same system/are all the same “medical provider”.

Not really. Hospitals don't talk to each other properly, GPs don't talk to each other. I've been asked to bring blood test results in paper from my GP to a specialist clinic because they couldn't work out how to get them emailed over - and it is essentially various forms of email that much exchange does happen over.

An "integrated system" has been something the NHS has been sinking money into for decades and getting nowhere with.

Re: Government finally publishes NHS contracts with Palantir, Faculty and big tech

#39

Post by vinay427 »

DanBC wrote: post #37
vinay427 wrote: post #17

Earlier quoted context omitted.

> Especially in Europe where the existence of a national healthcare system is not a religion but a norm. An NHS-type system is not at all the norm in Europe. Comprehensive and universal health insurance or even single-payer health insurance are not the same as the single-payer (mostly) single-provider system in the UK. In most of the Germanic countries, for instance, the norm is closer to the multiple-payer multiple-…

> single-provider system in the UK England doesn't have a single provider system. I don't know about Wales, Scotland, or Northern Ireland (they each have health systems that are devolved and thus separate).

I did specify "(mostly)" which I think is rather accurate. It's rather close to a completely single-provider model (in each of the constituent devolved regions, as you note) compared to the system in Canada, for instance.

> With largely public or government owned providers, this also fits into the 'Beveridge Model' of health care systems, sometimes considered to be single-payer, with relatively little private involvement compared to other universal systems.

Source: https://en.wikipedia.org/wiki/Single-payer_healthcare#United...

Re: Government finally publishes NHS contracts with Palantir, Faculty and big tech

#40

Post by DanBC »

kjakm wrote: post #36
ganstyles wrote: post #33

Earlier quoted context omitted.

To put a finer point on it: it may be easier for doctors to find your hard drive and decrypt it in some cases that than to go through and extract them from another medical provider's EHR system. I say this only partly tongue-in-cheek.

The article is about the NHS though so hospitals and doctors all access the same system/are all the same “medical provider”.

No, that's not correct.

A while ago we had (these numbers keep changing as the organisations merge).

     207 clinical commissioning groups (CCGs)
     135 acute non-specialist trusts (including 84 foundation trusts),
      17 acute specialist trusts (including 16 foundation trusts),
      54 mental health trusts (including 42 foundation trusts),
      35 community providers (11 NHS trusts, 6 foundation trusts, 17 social enterprises and 1 limited company),
      10 ambulance trusts (including 5 foundation trusts), and
   7,454 GP practices.
The CCGs take money from NHS England and they commission services from local provider organisations. Those organisations don't have to be NHS Trusts (I think it's still law that CCGs are forbidden from having a preference for NHS Trusts).

NHS Trusts and NHS Foundation Trusts are independent organisations. They have their own board of directors and non-executive directors. Foundation Trusts do to, and they have additional responsibilities to their members.

In Gloucestershire we have one CCG, one acute hospitals trust, one trust that covers MH, LD, and community care, we have an ambo trust that covers the south west, and we have a local authority that commissions drug and alcohol services from non-profit orgs, and then a bunch of GP surgeries on top.

This means they all make their own decision on software packages to buy, and a lot of that info is locked up in their system. While there's some commonality in software packages used (eg, lots of use of SystmOne) it's not always easy to get the information from one organisation to another.

If I am diabetic and see me GP's diabetes clinic, and then I am admitted to mental health hospital, it can be hard to get my diabetes clinic notes into my MH hospital notes.

I posted a twitter thread just today about an NHS organisation who employ someone to print out one database, and then to enter that information into another database. Have a read of the twitter thread, because there are a bunch of people who agree. https://news.ycombinator.com/item?id=23426262

Inter-operability is going to be big business in the English NHS for anyone who can crack it.

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