I wonder why this is coming out of Google and not Verily.
Google to use patient data to develop healthcare algorithms for hospital chain
41–50 of 57 posts
Re: Google to use patient data to develop healthcare algorithms for hospital chain
#42Earlier quoted context omitted.
That's true if the data is PHI, which means that it's personally identifiable. Per TFA, Google is using anonymized data. There are a bunch of companies that do this already, for example my last startup had anonymized health records from ~240 million Americans.
My last startup does this as well, but in our experience deidentification is not nearly as robust as the companies using it claim it is.
We had biostatisticians on staff as well as third party companies review our de-idenitification regularly. From a population level we were quite solid.
That said, were I an attacker trying to re-identify a specific person's data it would be hard to do with just basic demographic information but if you combine some specific health knowledge (a couple health problems you know your coworker has) or appointment info (date, type of doctor, stuff that may also come up in common conversations) it gets a lot easier.
Re: Google to use patient data to develop healthcare algorithms for hospital chain
#43Earlier quoted context omitted.
> a large amount of what we were after as researchers was only available in free-text Is there no way to parse this? Surely the EMR systems could have a simple key-value syntax. Patient history is too complex to be expressed that way but there is a lot of other valuable data that could. Blood pressure, for example. Ideally, things like lab results would already be stored as structured data.
I mean they kinda do since lots and lots of systems support HL7 which can best be described as "JSON but so so so much worse" or "CSV with '|' kinda."
This is a bit of a simplification. HL7 is the standards body, not the standard itself - which (for everyone else who may not know) is "HL7 v2".
FHIR is an actually-JSON (+XML) health data protocol that is gaining adoption (most recently because of CMS Interoperability and Patient Access Final Rule), so it's not all bad.
Re: Google to use patient data to develop healthcare algorithms for hospital chain
#44Earlier quoted context omitted.
What about it? There was definitely not any use of healthcare data for advertising.
The concern wasn't about ads, it was about patient privacy. You guys basically put together a search engine for medical encounters, allowing physicians to access medical records they shouldn't be able to: https://www.wsj.com/articles/behind-googles-project-nighting...
Can you elaborate more? I don't believe the search engine produced did not let physicians access anything they weren't supposed to. This is well stated in their public documentation.
Re: Google to use patient data to develop healthcare algorithms for hospital chain
#45Earlier quoted context omitted.
I mean they kinda do since lots and lots of systems support HL7 which can best be described as "JSON but so so so much worse" or "CSV with '|' kinda."
This is a bit of a simplification. HL7 is the standards body, not the standard itself - which (for everyone else who may not know) is "HL7 v2". FHIR is an actually-JSON (+XML) health data protocol that is gaining adoption (most recently because of CMS Interoperability and Patient Access Final Rule), so it's not all bad.
FHIR is a breath of fresh air but it's so kinda worse because while it's great you still need the HL7 parser logic lying around in your code and now a bunch of additional code paths for FHIR
:/
Re: Google to use patient data to develop healthcare algorithms for hospital chain
#46I work as a data engineer in an academic medical research institution. Most electronic medical records (EMR) systems are really about billing. Yes, there are clinically relevant data fields available but a large amount of what we were after as researchers was only available in free-text. Data abstraction is still mostly a human-expert driven activity. It would be fun if that could be better automated but there is sig…
The US is a money and capitalism first culture. This is before things like privacy. I'm not suggesting what is right or should be but rather an observation of what is the case.
Yep. Here's my anecdotal story:
I am involved with phone call centers. I have a lot of numbers. I use phone numbers like others use throwaway catch-all email addresses.
I signed up for the covid vaccine through my family doctor who partners with a hospital. They required registration (no walk ups) and the online form was branded (domain, privacy policy, everything) to the hospital. I used a unique email address and a unique phone number. I'm a curious person.
To confirm the appointment they send you a text. Guess what number the text went to? Not the one I typed in. It was to a unique number that I only used with my Google billing account. (I was using a corporate computer in no way tied to Google.)
I looked into it and the hospital partners with a fourth-party health care scheduling servicer, who then has some sort of partnership with Google cause all I saw was that Google bought a low-percentage stake in the company.
Something tells me the integration between these types of companies and Google is much stronger than the article lets on.
Re: Google to use patient data to develop healthcare algorithms for hospital chain
#47I wonder why this is coming out of Google and not Verily.
There is a whole division within Research called Google Health led by David Feinberg (https://www.linkedin.com/in/david-feinberg-4b5b76/) which works on these sorts of problems. It's sort of situated between Cloud and Research, as many of the problems they want to solve are... well, research problems that need large real-world datasets to solve.
Verily has its own things it wants to focus on, and I don't think large EHR analytics projects are one of them. Their ambitions are probably budget limited now (IE, they have to be selective about which projects to take on) while Google Research and Cloud have a lot of funding to build products like this.
Re: Google to use patient data to develop healthcare algorithms for hospital chain
#48"Don't be evil." For-profit healthcare is evil. https://www.pbs.org/video/the-healthcare-divide-rv6npd/
This is irrelevant. Even in a fully socialized healthcare system we would still want orgs and companies and the government looking at patient data to figure out better therapies. Just because the current data comes with price tags doesn't mean we should be stopping medical research on it.
Re: Google to use patient data to develop healthcare algorithms for hospital chain
#49If I'm reading the article correctly, this is allowed by HIPAA already and is already happening (for research purposes and by third party healthcare companies?). I would much rather google handle this data rather than unknown third parties with their own agendas, at least with google, the data comes with privacy risks that are relatively well known and might actually be useful for clinicians due to google's expertise…
Google, an adtech company, should not have access to patient records – anonymized or not.
Re: Google to use patient data to develop healthcare algorithms for hospital chain
#50Earlier quoted context omitted.
so let's clarify a few things. All the things you described that suck (e.g. preauth, drug renewal, etc) are made to suck, on purpose, by ... drumroll ... you insurance company which, believe it or not is usually a for profit entity (USA USA USA) and therefore is incentivized to take your money and not pay any out in premium. Paying for your care to them is a loss, and what they do is try to minimize loss ratio. (reme…
Yes, let's clarify a few things. For starters, I'm a physician, and have formerly worked in health insurance at the management level. I assume your comment was aimed at someone at a different level of familiarity with the topic. I'd be happy to re-evaluate my understanding of your comment if you'd care to clarify with the newfound knowledge that I'll understand a more nuanced argument, if you care to provide one. Res…
From the insurance side: I found the throwaway's reference of MLR very confusing and seems to be misinformed about the ACA market and MLR caps in particular.
Exchange plans are just about the most price sensitive insurance product I can think of; in ACA markets typically the lowest premium plan will capture the overwhelming majority of the signups. Insurance co's are highly incentivized to optimize their MLR to provide the maximum amount of care up to the rebate threshold, while driving costs down as much as possible to ensure you can offer the lowest premium plan on the exchange and be the take-all winner.
Also, so much of prior auth, step therapy, etc are dictated by federal or state regulations and not necessarily what the insurer would like or prefer to do.
There are plenty of pain points in our insurance industry but to carte blanche blame "for profit" companies seems really lazy.