When Big Data Meets Big Healthcare
“Hello, Mr. Jones, this is Mary from Dr. Smith’s office. We notice that you’ve been buying a lot of Twinkies lately and we think you should come in for a blood sugar checkup.” How would you feel if you received such a phone call from your doctor’s office – alarmed, outraged, betrayed? Well, brace yourself because this is The Next Big Thing in health care... |
Big Data, Big Brother, and Big Healthcare
As computing power increases, and the cost of data storage decreases, software has emerged to analyze the enormous volumes of consumer information that are accessible to data brokers. As a result, it becomes possible for doctors, hospitals, and insurance companies to intrude on your privacy in new and disturbing ways. And it's already happening in several States.
Carolinas HealthCare System operates over 900 medical facilities, from hospitals to private physicians’ practices, in North and South Carolina. CHCS is buying data on consumer expenditures from a data broker who prefers to remain anonymous. The data comes from many sources including credit card records, supermarket loyalty card programs, health club membership rosters, and so on.
The health behemoth is plugging everything that Big Data knows about you into its computer model and trying to predict exactly who in its service area is at high risk of serious health problems. Then people start getting phone calls, mailings, and unsolicited emails.
“The idea is to use big data and predictive models … to find someone running into trouble that we can reach out to and try to help out,” according to Dr. Michael Dulin, chief clinical officer for analytics and outcomes at CHCS.
I am reminded of Thoreau’s Law, purportedly a quotation from the author of On Walden Pond: “If you should see a man approaching you with the obvious intention of doing you good, you should run for your life.”
Dulin is quoted in a recent Bloomberg article on Big Data and Big Health Care. He is as scary as only a True Believer can be. He seems utterly convinced that preserving your physical health is the only thing that matters, and he’s perfectly willing to stomp all over your privacy to do it.
In Dulin’s grand vision, a hospital will be able to tell if an asthmatic patient has been refilling his prescriptions regularly, or has been buying cigarettes, and do something about it. His “predictive model” will also estimate your odds of having a heart attack by looking at the foods you buy at the supermarket, and whether or not you belong to a health club.
You Got a Problem With That?
Dulin acknowledges that some people may have a problem with this; he is “considering” whether to let them opt out of the predictive modeling and “pro-active intervention” program. Wow.
The University of Pittsburgh Medical Center, which has a virtual monopoly on health care in that metropolitan area, is using demographic data instead of individual purchases data. Based on your Zip code, whether you own a car, the number of persons in your household, your income, and similar demographics, UPMC tries to predict whether you’re going to the emergency room soon. Then they start the “outreach” contacts which are intended to keep you out of the ER.
No car? UPMC will tell you about alternative transportation options. No kids and make less than $50,000? That means you’re more likely to visit an ER instead of a primary care physician, so UPMC will try to hook you up with a PCP or nurse practitioner to call first when you’ve got the sniffles.
The reason for this heightened interest in “pro-active” health care is money, of course. First, the Affordable Healthcare Act (aka Obamacare) provides financial incentives for hospitals to improve the long-term health outcomes of patients. Second, a growing number of hospitals are also insuring their patients, so they have an insurance company’s pecuniary interest in minimizing ER use and encouraging – some might say “enforcing” – patient compliance with doctors’ orders.
Traditional insurers are using Big Data to “intervene” in their customers’ lives, too. The Bloomberg article cites Jorjanne Murry, a diabetes patient in Charlotte, NC, who says she’s getting calls from her health insurer – not her doctor, her insurance provider – wanting to discuss her daily habits. She says she usually ignores such calls.
Here's an even less pleasant thought... If data brokers have access to this information about healthcare and consumer activities, then I fully expect that the government will as well. Recent news stories have proven that information is shared rather easily amongst federal agencies, politicians and political operatives - in spite of the existing laws and safeguards supposedly in place to protect your privacy.
I expect to see privacy advocates conduct an intervention of their own into this invasive trend. I know that if I get an unsolicited call from my doctor’s office about my eating habits, somebody is going to need an audiologist.
Your thoughts on this topic are welcome. Post your comment or question below...
This article was posted by Bob Rankin on 8 Jul 2014
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Most recent comments on "When Big Data Meets Big Healthcare"
(See all 23 comments for this article.)Posted by:
Ken
08 Jul 2014
I know it will not prevent a scenario like this from happening with Mr. Jones and his Twinkies, but whenever I get that discount key fob at the grocery store, I do not use my real credentials. I'm not sure it's anybody's business how much junk food or beer I buy. Someone is going to have to do a little more digging to find out that I am not really Harlan Sanders buying all those steaks.
The frightening thing is that if someone has collected all the private data, then someone else can hack into the system and get it. "Big Brother" doesn't need to watch so closely.
Posted by:
Susan
08 Jul 2014
I heard about this. I'm not happy. Sounds like it's time to concentrate on cash for everyday transactions.
So, this is supposed to save healthcare money. But I'm sure these big data compilers are not giving the info away for free. How much are they charging hospitals and insurance companies for it? And won't that cost be reflected in our healthcare premiums and deductibles and copays?
And as for hectoring phone calls from my doctor/insurance company, I'm with you. They better be wearing earplugs if they call me. Go away, Big Brother!
Posted by:
Susan
08 Jul 2014
It seems like we are going full circle and it's a good time to start making all possible transactions in cash.
Posted by:
Jeremy
08 Jul 2014
"1984" anyone?
Posted by:
Jon
08 Jul 2014
I'm Welsh and Herself is Californian.
We often compare 'healthcare' on both sides of the Atlantic, and are very glad we live here.
Yes, both systems have big problems but doctors here are a little more able to act independently.
Any application of statistics to individual health shows an infantile lack of understanding of statistics.
For example, the 'doctor' in the USA who refuses adequite pain relief to our Great Aunt Patsy as she could be in danger of developing 'long term addiction' and 'reduction of efficacy'...... the old dear was 90 last birthday!
The same goes for obesity. I am overweight by about 14 pounds assessed by a National Sports Centre checking muscle bulk, bone density fat etc. According to 'statistics' I am obese needing to lose at least 56 pounds to be anywhere near a 'healthy' weight.
If all this data is made available to those with vested interests you can be sure that it will only increase costs for those who do not fit the average and not reduce costs for those who do.
Jon
P.S. Unfortunately Aunty is far to old to get a nice card from a doctor and enjoy her pain relief.
Posted by:
John Anderson
08 Jul 2014
Interesting that the data broker prefers to remain anonymous but has no qualms about trampling the anonymity of those referenced by the data.
Has someone sent Dr Dulin a copy of '1984' by Orwell?
Posted by:
Dan Crawford
08 Jul 2014
Long ago I abandoned the delusion that medicine as practiced in the US was a 'human service' - it is our biggest business and we are all its minions.
Posted by:
Jim Kniskern
08 Jul 2014
I have been involved with Quality Control since the days of W. Edwards Deming, who converted Japan from trinkets to modern autos and technology. And the company I worked for (Westvaco) became a world-wide supplier to all six continents via QC.
Medicine is still mostly old school where people doesn't see a doctor until they become sick. Now doctors want to join this century-long successful approach and anticipate medical problems at the early stages. In concert with Technology, Big Data will prove it both cost-efficient and health-effective, benefiting all citizens.
Posted by:
ed
08 Jul 2014
Re:Big data meets healthcare.
I am glad I'm pushing 60.George Orwell was right.There will be no personal freedom.
Posted by:
Mac 'n' Cheese
08 Jul 2014
Thank you, Bob.
The ACLU put together a 2-1/2 minute video seven or eight years ago that shows exactly how big data can get involved when some poor guy tries to order a pizza. It all seemed so futuristic back in 2007. Not so much now.
The video is both amusing and disturbing (NOTE: There is no audio for the first 10 seconds.)
View it at https://www.youtube.com/watch?v=-zh9fibMaEk
If you can't see that web address, go to YouTube and in the search box enter "the big brother pizza shop"
Lee
Posted by:
RandiO
09 Jul 2014
Borg was right!
Even just using cash is no salvation, since the cameras already know who you are and that you are purchasing a pack of smokes, despite the fact that you lied and said you don't smoke in your ACA application.
Posted by:
Lloyd Collins
09 Jul 2014
I have been receiving Post Cards from my Insurance Company for a couple of years now, telling me to contact their Nurse on the Phone for minor issues. So, it really has already started.
Posted by:
SamiamHis
09 Jul 2014
This article is so timely and scary. I have stopped using plastic for just these reasons. I budget better with cash and my transactions are private except to the local clerk I am doing business with. I know a brilliant local doctor who wants to buck this system and connect with retired rich doctors (who would come back into medicine if it were really about healing patients) and start a whole new hospital organization in direct opposition to the Affordable Care Act which has taken over our entire medical system and more. The goal is for patient care being the prime objective, not the bottom line. He is sick of being told how to treat patients, filling out forms to cover the government regulations and following the rules of the insurance companies at the behest of the government. All this comes at the cost of true patient care and he is fed up. When will people wake up to what is taking place???? Thanks for posting this Bob!
Posted by:
MmeMoxie
09 Jul 2014
First of all ... You can lead a horse to water ... But, you can NOT make him drink!!!
I see several legal violations, with this new approach, for medicine. Secondly, I do NOT need my doctor or nurse or office personnel ... Telling me, what to do with my medications or how, I should take them. This is always discussed, when I go see my doctor, on a regular basis ... NOT just when I am sick!!!
The first thing that, comes to mind ... Just HOW is the doctor or nurse to know if, they are actually talking or texting the right patient??? Remember, doctor/patient confidentiality is paramount, in the medical field. When a patient comes in person, to see their doctor, then this is not an issue ... But, it is a MAJOR issue, when it is done over the phone or by texting.
Yes, I am completely aware, that patients call their doctors all the time, to hear about test results, medication refills or changes in medication, so on and so on, and that isn't an issue, but, in reality ... It really can be a major issue, since, the doctor or nurse can NOT see the person, on the other end of the phone.
The law is called the Health Insurance Portability and Accountability Act or routinely called HIPAA. This was law was signed by Pres. Clinton in 1996. It is the Title II portion, that is really "touching", as far as interpretation is concerned. Read the following, to see for yourself.
"Title II of HIPAA defines policies, procedures and guidelines for maintaining the privacy and security of individually identifiable health information as well as outlining numerous offenses relating to health care and sets civil and criminal penalties for violations. It also creates several programs to control fraud and abuse within the health care system.[10][11][12] However, the most significant provisions of Title II are its Administrative Simplification rules. Title II requires the Department of Health and Human Services (HHS) to draft rules aimed at increasing the efficiency of the health care system by creating standards for the use and dissemination of health care information."
Many may wonder why, I am so informed, as well as very, very concerned, about all of this ... I worked in the Medical/Surgical Field, for over 25 years and do know about patient confidentiality ... It applies to all who take care of a patient and should it be found out, that someone broke confidentiality ... They are FIRED, on the spot. I have seen it happen.
Posted by:
TonyS
09 Jul 2014
An interesting development, but nothing new as life insurance firms and medical insurance require your doctor to fill in the forms with all your ailments and the medical insurance wants all the details of your illnesses if you want them to pay the bill.
If you look on the positive side, preventive medicine is cheaper and more effective. On the negative side, discrimination may take place if you don't follow the requirements for that preventive medicine regime. If you don't follow "advice" you might find yourself having to pay the bill for your own "excesses" as determined by some computer.
As most Americans seem completely paranoid about their non-existent privacy, I can see this "pro-active" system being a load of codswallop within a short time as people become more careful about where and how they purchase goods and services.
Posted by:
JP
09 Jul 2014
I sent a link to this article to 2 Charlotte TV news departments. I received a callback from one of them about an hour later. The reporter wanted to know what I knew about all this which was nothing more that what Bob wrote and what was in the Bloomberg article. After I told her that, she admitted that she'd just called Dr. Dulin who told her they only paid for things like age and gender. I questioned why they'd pay for something that was already in their system. Her reply: "hmmm." Maybe she'll do some more investigating, do a report and get others involved in putting an end to this. Probably no end in sight, though. :(
Posted by:
jspence
10 Jul 2014
How about the "sun police" ... too many basal cell carcinomas? So you're out in the sun too much?
No problem, we'll just confine you to a nice dark room.
Posted by:
MmeMoxie
10 Jul 2014
@JP --- Good move, JP ... Good move!!! You want some action, on this issue and you did the right thing, calling your local TV Station. The reporter just might do an investigating report, but only, if, the Head Honcho approves it. Sorry but, that's how TV News and Newspapers work, approval by the Big Guy or Gal.
Those of us, who are very concerned, should probably start writing letters to the Editors, to get the "ball" rolling. I go to a clinic and I really don't think, they would do what the Carolinas HealthCare System is wanting or planning to do. My clinic, happens to be run by doctors, a true rarity indeed, these days. Yes, there is a Business department, run by a solid competent Head Manager. But ... That does NOT mean, I am not concerned.
Posted by:
KatieA.
10 Jul 2014
Thank you to Mac 'N Cheese for posting the You Tube link to the Big Bro Pizza video. I didn't know whether to "laugh or cry" while listening to it. It was really funny, but at the same time, it made me feel sad because this is already happening,in a way.
Someone here already mentioned that they received a phone call(s) from a health insurance case manager who wanted to talk to them.
Posted by:
hedy 84
16 Jul 2014
Yes 1984 came into my thoughts at once.
If you have not read it do so.
I am 84 next month and hope it takes some time to implement and reach Australia.
Thank you Bob