The Tricky Ethics of Google's Project Nightingale Effort

Cason Schmit
nextgov.com
Originally posted 3 Dec 19

The nation’s second-largest health system, Ascension, has agreed to allow the software behemoth Google access to tens of millions of patient records. The partnership, called Project Nightingale, aims to improve how information is used for patient care. Specifically, Ascension and Google are trying to build tools, including artificial intelligence and machine learning, “to make health records more useful, more accessible and more searchable” for doctors.

Ascension did not announce the partnership: The Wall Street Journal first reported it.

Patients and doctors have raised privacy concerns about the plan. Lack of notice to doctors and consent from patients are the primary concerns.

As a public health lawyer, I study the legal and ethical basis for using data to promote public health. Information can be used to identify health threats, understand how diseases spread and decide how to spend resources. But it’s more complicated than that.

The law deals with what can be done with data; this piece focuses on ethics, which asks what should be done.

Beyond Hippocrates

Big-data projects like this one should always be ethically scrutinized. However, data ethics debates are often narrowly focused on consent issues.

In fact, ethical determinations require balancing different, and sometimes competing, ethical principles. Sometimes it might be ethical to collect and use highly sensitive information without getting an individual’s consent.

The info is here.

Former Patient Coordinator Pleads Guilty to Wrongfully Disclosing Health Information to Cause Harm

Department of Justice
U.S. Attorney’s Office
Western District of Pennsylvania
Originally posted March 6, 2019

A resident of Butler, Pennsylvania, pleaded guilty in federal court to a charge of wrongfully disclosing the health information of another individual, United States Attorney Scott W. Brady announced today.

Linda Sue Kalina, 61, pleaded guilty to one count before United States District Judge Arthur J. Schwab.

In connection with the guilty plea, the court was advised that Linda Sue Kalina worked, from March 7, 2016 through June 23, 2017, as a Patient Information Coordinator with UPMC and its affiliate, Tri Rivers Musculoskeletal Centers (TRMC) in Mars, Pennsylvania, and that during her employment, contrary to the requirements of the Health Insurance Portability and Accountability Act (HIPAA) improperly accessed the individual health information of 111 UPMC patients who had never been provided services at TRMC. Specifically, on August 11, 2017, Kalina unlawfully disclosed personal gynecological health information related to two such patients, with the intent to cause those individuals embarrassment and mental distress.

Judge Schwab scheduled sentencing for June 25, 2019, at 10 a.m. The law provides for a total sentence of 10 years in prison, a fine of $250,000, or both. Under the Federal Sentencing Guidelines, the actual sentence imposed is based upon the seriousness of the offense and the prior criminal history, if any, of the defendant. Kalina remains on bonding pending the sentencing hearing.

Assistant United States Attorney Carolyn J. Bloch is prosecuting this case on behalf of the government.

The Federal Bureau of Investigation conducted the investigation that led to the prosecution of Kalina.

Trusting big health data

Angela Villanueva
Baylor College of Medicine Blogs
Originally posted November 10, 2017

Here is an excerpt:

Potentially exacerbating this mistrust is a sense of loss of privacy and absence of control over information describing us and our habits. Given the extent of current “everyday” data collection and sharing for marketing and other purposes, this lack of trust is not unreasonable.

Health information sharing makes many people uneasy, particularly because of the potential harms such as insurance discrimination or stigmatization. Data breaches like the recent Equifax hack may add to these concerns and affect people’s willingness to share their health data.

But it is critical to encourage members of all groups to participate in big data initiatives focused on health in order for all to benefit from the resulting discoveries. My colleagues and I recently published an article detailing eight guiding principles for successful data sharing; building trust is one of them.

Here is the article.

Psychology Can Make the Country Healthier

Insights can improve public health campaigns — and keep them from backfiring

By Crystal Hoyt and Jeni Burnette
Scientific American
Originally published June 10, 2014

Public health communications are designed to tackle significant medical issues such as obesity, AIDS, and cancer. For example, what message can best combat the growing obesity epidemic? Are educational messages effective at increasing condom use? Should cancer prevention messages stress the health risks of too much sun exposure? These are not just medical problems. These are fundamentally questions about perception, beliefs, and behavior. Psychologists bring a unique expertise to these questions and are finding consequential, and often non-intuitive, answers.

The entire article is here.