Google looks up health data – and it looks perfectly legal


Last week, when Google debunked Fitbit in a $ 2.1 billion acquisition, the lecture was mostly about what the company would do with all the wrist jingling and power walk data. It's no secret that Google's parent Alphabet – along with other giants Apple and Facebook – is on an aggressive hunt for health data. But it turns out that there is a cheaper way to access it: Collaborate with health professionals.

On Monday, the Wall Street Journal reported details of Project Nightingale, Google's sub-radar partnership with Ascension, the nation's second-largest health system. The project, which reportedly started last year, includes sharing personal health data to tens of millions of unsuspecting patients. The bulk of the work is done under the Google Cloud division, which has developed AI-based services for medical providers.

Google states that it acts as a business association for Ascension, a scheme that can provide identifiable health information, but with legal restrictions. Under the Health Insurance Transferability Act, better known as HIPAA, patient records and other medical details can be used “just to help the covered entity perform its health care functions.” An important aspect of the work involves designing a health platform for ascent. which can suggest individualized treatment plans, tests and procedures.

The magazine says that Google is doing the work for free with the idea of ​​testing a platform that can be sold to other healthcare professionals, and apparently trained on their respective data sets. In addition to the Cloud team, Google employees with access include members of Google Brain, which focuses on AI applications.

Dianne Bourque, an attorney with the law firm of Mintz who specializes in health law, says HIPAA, although generally strict, is also written to encourage improvements in the quality of health care. "If you're shocked that your entire medical record just went to a giant company like Google, it doesn't make you feel better that it's affordable under HIPAA," she says. "But that's it."

The federal Hospital Privacy Act allows hospitals and other health care professionals to share information with their business associates without first asking patients. That is why your clinic does not get permission from you to share your information with its cloud-based electronic medical journalist.

HIPAA defines the functions of a business association quite broadly, says Mark Rothstein, a bioethicist and public health lawyer. at the University of Louisville. This allows the health care system to disclose all kinds of sensitive information to companies that patients may not expect without having to tell them. In this case, Rothstein says, Google's services can be seen as "quality improvement," one of HIPAA's allowed business-to-business applications. But he says it's unclear why the company would need to know the name and date of the patients to get it. Instead, each patient could have been assigned a unique number by Ascension to remain anonymous to Google.

"The fact that these data can be individually identified suggests that there is a definitive use where a person's identity is going to be important," Rothstein says. “If the goal was just to develop a model that would be valuable for making better informed decisions, you could do so with de-identified data. This suggests that it is not exactly what they are looking for. "

According to Bourque, Google actually had to anonymize the information before it could be used to develop machine learning models it could sell in other contexts. Given the potential breadth of the data, one of the biggest remaining questions is whether Ascension has allowed the tech giant to do so.

Tariq Shaukat, president of Google Cloud Industrial Products, wrote in a blog post that health data would not be combined with consumer data or used outside the scope of the contract with Ascension. However, the scope is somewhat unclear. Shaukat wrote that the project includes moving Ascension's data processing infrastructure to the cloud, as well as unspecified "tools" for "doctors and nurses to improve care."

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