December 1, 2017
By James Swann
Major technology players like Amazon and Google are looking to capitalize on the surge in available electronic health data to make an entry into the health-care market.
The volume and variety of health data being collected through technology in clinical and other settings is transforming health care, Marcy Wilder, a health-care privacy and cybersecurity attorney with Hogan Lovells in Washington, told Bloomberg Law in a video interview. Health information is collected not only in clinical settings, but now also from wearable health devices and medical devices connected to hospital systems, Wilder said.
The enormous amount of new data gives companies a unique opportunity to both use it to improve the patient experience as well as make money from it, but privacy risks are an increasing concern.
Amazon, Google, Facebook, and Microsoft all have the ability to work with large data sets, and have shown interest in the health-care space, Wilder said.
Amazon, for example, has been approved as a wholesale pharmacy in Alabama, Arizona, Connecticut, Idaho, Louisiana, Michigan, New Jersey, New Hampshire, North Dakota, Tennessee, Nevada, and Oregon, while Facebook held its first-ever health-care summit in June, focused on health-care in the mobile era.
Google has also been active, inking a late-November deal with Change Healthcare to provide artificial intelligence and analytics through the Google Cloud platform to help interpret radiology data. Change Healthcare, based in Nashville, Tenn., offers software and analytics for health-care companies.
Google also is focusing on genetics, courtesy of Google Genomics, which is designed to organize and share large amounts of genomic data.
In previous years, the company launched Google Health personal health record services, which was offered from 2008 through 2012, Eric Fader, a health-care attorney with Day Pitney LLP in New York, told Bloomberg Law.
Other large technology companies have also been active in the health-care space, Fader said. Microsoft’s HealthVault, for example, is a platform where businesses and consumers can store their personal health information, and Apple is still offering its HealthKit, though without much apparent success, Fader said.
The HealthKit helps wearable manufacturers access and share individuals’ health data.
However, the presence of so many companies manufacturing low-priced wearables makes it unlikely that any of the aforementioned technology companies will be able to build better devices or sell enough of them to help their bottom lines, Fader said.
“I’m also skeptical that any tech company will be able to establish itself as the one accepted platform on which to store the information uploaded from all of these competing devices,” Fader said.
Amazon is currently exploring several health-related initiatives through its 1492 project team, Fader said, but the fact that nothing has been rolled out indicates the difficulty in achieving success.
The 1492 team is working on a platform for electronic health record data, as well as projects focused on health-care analytics and telemedicine.
A spokeswoman for Amazon, when asked about the 1492 project, said the company doesn’t comment on “rumors and speculation.” Google didn’t respond to a request for comment on its ongoing health-care initiatives.
With health-care data proliferating, questions of regulation and privacy will come to the fore, Fader said. “What is most interesting to me is how these mass-market devices are regulated when they collect medical information,” Fader said.
Under the Health Insurance Portability and Accountability Act, protected health information includes any information about an individual’s health status, Fader said. The number of steps a person takes in a day, for example, isn’t considered PHI, but a person’s heart and pulse rate would be, Fader said.
“Although the stakes are higher for any particular individual if it’s a cardiac device or an insulin pump that’s hacked, the increased adoption and interoperability of mass-market consumer devices will significantly increase the risk of data breaches,” Fader said.
The Food and Drug Administration, which oversees medical devices, has issued several cybersecurity guidance documents, dating back to 2014, but it and other agencies will be busy trying to ensure that device manufacturers take data privacy and security seriously, Fader said.
Health-care industry leaders are working to extract value from the data, Wilder said, but are also fearful of data breaches.
With vast volumes of health-care data washing through the sector, it’s critical for companies to have effective compliance plans in place and be prepared to handle a breach, Wilder said.
Patients also stand to benefit from better access to the surging amounts of health-care data, Vanessa Burrows, a health-care attorney with McDermott Will & Emery in Washington, told Bloomberg Law.
For example, the boom in medical records data can help prevent medical errors, increase care coordination, boost patient satisfaction, and uncover new research opportunities, Burrows said.
The growth in wearable health-care devices is especially promising, Burrows said. “Wearables directly engage patients and have the potential to change patient behavior,” Burrows said.
For example, patients can track and share their data with physicians in real time, and may be able to manage their health better when they are contributing their own data, Burrows said.
Physicians may also be able to make adjustments to patient medication based on data they receive from a wearable, Burrows said.
However, if medical records aren’t properly secured, patient privacy will be at risk, Burrows said. At the same time, health data collected by third-party entities—that is, not by payers or providers—might not have the same protection as other health or wellness data, Burrows said.
Health-care data and technology may be proliferating, but the industry for a long time has been waiting for a disruption that never seems to come, Colin Zick, a health-care attorney with Foley Hoag LLP in Boston, told Bloomberg Law.
“There are many reasons for this, but perhaps the most significant is that every new system has to be backward-compatible to paper records and PDFs,” Zick said.
Nothing will change until the legacy systems have been left behind, Zick said. “I don’t think we’ve even scratched the surface of the potential of electronic health records, wearables, and telemetry,” Zick said. Used appropriately, these technologies can address patients who aren’t following through with their medical care in innovative ways that are easy to adopt, Zick said.
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