Hospitals Begin Data-Mining Patients

schwit1 (797399) sends word of a new and exciting use for all of the data various entities are collecting about you. From the article: You may soon get a call from your doctor if you've let your gym membership lapse, made a habit of ordering out for pizza or begin shopping at plus-sized stores. That's because some hospitals are starting to use detailed consumer data to create profiles on current and potential patients to identify those most likely to get sick, so the hospitals can intervene before they do. Acxiom Corp. (ACXM) and LexisNexis are two of the largest data brokers who collect such information on individuals. They say their data are supposed to be used only for marketing, not for medical purposes or to be included in medical records. While both sell to health insurers, they said it's to help those companies offer better services to members.

Comments

Doesn't give warm fuzzies

[robstout]

I'm alright with my doctor having this information, in theory, but I really don't trust the insurance companies with this. "So, I see that you like taco bell. We're raising your rates."

Re:Doesn't give warm fuzzies

[timrod]

What frightens me is the idea that they could get the wrong information and give that to my doctor or insurance company. For instance, a couple of weeks ago, my car broke down. While it was in the shop, I was getting a ride to work with a co-worker. They stopped at Dunkin' Donuts every morning and got a coffee and a donut, and I would usually pay for it (along with their gas) in exchange for giving me a ride. This means my purchase history would show me buying a coffee and a donut every morning for around five days, even though I didn't actually consume either of them.

With a system like this in place, I'm sure my insurance company would see that and go "He's buying donuts, raise the premiums!" even though the donut I'm not consuming doesn't really effect me in any way.

Re:Doesn't give warm fuzzies

[plopez]

Couple that with "eventually consistent" databases and you have a recipe for disaster.

Re:Doesn't give warm fuzzies

[pepty]

If the data brokers/hospitals want to prove my consumer information is actually health information and thus HIPAA rules should bar the data brokers from selling it to most of their other clients ... sign me up.

http://www.hhs.gov/ocr/privacy/hipaa/understanding/consumers/index.html

Who must follow these [HIPAA] laws:

Health Care Clearinghouses—entities that process nonstandard health information they receive from another entity into a standard (i.e., standard electronic format or data content), or vice versa.

In addition, Business Associates of Covered Entities must follow parts of the HIPAA regulations.

Re:Doesn't give warm fuzzies

[L4t3r4lu5]

One step further; You're with a friend and stop at a convenience store, he asks you to get a pack of smokes. Your insurance states you're a non-smoker. They use this data to refuse a claim in the future.

Re:Doesn't give warm fuzzies

[digitalchinky]

I write medical imaging software, surounded by dozens of doctors every day that are not just out of earshot of the patients but sometimes not even in the same country. My sample size is obviously not representative of much at all, though at least in my tiny corner of the world the situation is the total opposite of what you describe. These people sigh and get upset when they see terminal disease, they cry when children are dying, they don't enjoy seeing people hurt and don't waste a second if it means life or death. They are often detached but they still care.

Don't mistake the human factor for doctors that are worried about getting sued because someone broke their pinky finger and had to wait for the guy having a heart attack to be treated first.

Re:Doesn't give warm fuzzies

[CreatureComfort]

Nurse Joke: "You know what you call the guy who graduated last in his class at medical school? Doctor."

Angie's List was created because separating the lousy doctors from the very few good ones is almost impossible. The AMA has lobbied successfully to make it illegal for a patient to find out the malpractice history of physicians.

If you're looking for a new doctor, the best thing you can do is talk to some local nurses. They know which ones are on the ball, and which ones are flat out dangerous.

Re:Doesn't give warm fuzzies

[interkin3tic]

I don't know, but I do know every human source has a bias, and every non-human source for reviews can be gamed. You're never going to get an absolute truth about how good or bad a doctor, or even a burrito restaurant, is. Which isn't so terrible since even the best doctor in the world could make a mistake that kills you, and even the dumbest doctors can save your life.

Re:Doesn't give warm fuzzies

[L4t3r4lu5]

Hmmmm... I'm not so sure it's so unbelieveable. If you can be labelled an enemy combatant for wearing a Casio wristwatch I'm pretty sure you can be labeled a smoker for buying some cigarettes.

You're still thinking rationaly. You can't do that around these people.

Re:Doesn't give warm fuzzies

[Anonymous Coward]

I work IT at a large practice for a specific uncommon specialty. It employs 30+ doctors. There's quite a range of different types... I don't know if it's representative of doctors as a whole but it is humanizing indeed.

There's the ancient high-brow jerk who disdains to speak with a "computer nerd with no degree" but the guy knows his medicine, despite the attitude. There's the cute lady who muddles through just barely, but has great "people skills". There's the hot-shot european-educated surgeon with a list of demands three pages long before he even does an evaluation. There's a totally chill unassuming doctor with funny posters that the other doctors make jokes about, but whom I know reads through medical journals like some of them read tumblr. And so on.

Computer skills and inclinations vary wildly too, despite my expectations there would be a higher overall competency.

Re:Doesn't give warm fuzzies

[ichthus]

You're so full of shit it's coming out of your mouth...

No, you're full of shit. And, to prove it, I'll now provide exactly twice as much evidence as you did to the contrary:


...

Re:Doesn't give warm fuzzies

[I'm New Around Here]

My doctor says it is more about the ratio between the two. You want to have a 6:1 ratio of HDL to LDL. Total amount of each isn't so important.

But that was a VA doctor, so maybe I'm just lucky to be alive. ;^)

Re:Doesn't give warm fuzzies

[Attila Dimedici]

I do not trust my doctor because they are a doctor. I trust my doctor for the same reason I trust my mechanic, because they have proven themselves to be trustworthy. The primary reason I do not trust my insurance company is because I do not actually know any of the individuals who work there, let alone the ones who might be making decisions about what to do with my personal infor.

Re:Doesn't give warm fuzzies

[Altus]

The HIPPA rules are quite importnat, they do a lot to protect privacy in that data is not simply allowed to be shared without consent (unless you are incapacitated in which case a doctor in an emergency can get just about anything he wants. There are rules for tracking access to sensitive information along with auditing of the stated reason. Its pretty good stuff.

That said, it only requires people to provide a certain level of data security.... since, say OpenSSH is an industry standard used for protecting information, it is sufficient for HIPPA requirements. Obviously a company would need to upgrade their systems in the face of a heartbleed style attack but would only be liable if they dragged their feet on it and not liable for the data lost before the bug was public. Its maybe not as secure as people would like it to be in that respect. Still, better than what we had before.

Re:Doesn't give warm fuzzies

[Anonymous Coward]

"Lots of math. It involves looking at historical data, attempting to identify patterns and critical factors, then using that model for predictive purposes."

This will fail (to help people). It may be useful as exploratory analysis, but without theory backing it up it is nothing but curve fitting. It will be even worse than current epidemiology (which has a horrible track record, possibly even worse than psychology) that is at least somewhat informed by theory and expert opinion. This new way of incorporating consumer habits is just adding in additional assumptions to mislead the interpreters. Plus, we need to get rid of strawman NHST before anything like this can be implemented intelligently.

Now, this may be able to make some people some money, but help patients...no. Unless you have access to a more detailed account of what is planned beyond mathigic and it differs greatly from what I suspect, it will not help patients.

Re:Doesn't give warm fuzzies

[jythie]

Actually it has done pretty well. Experts are involved at all stages, it is not just blind pattern recognition, and the predictive power has been significantly better then random chance.

So far the largest factor for readmission has been if their house as more then one floor and if they live alone.

Re:Doesn't give warm fuzzies

[fahrbot-bot]

What frightens me is the idea that they could get the wrong information and give that to my doctor or insurance company.

To make matters worse, it seems impossible to get erroneous information removed. For example: My wife was misdiagnosed with asthma by an allergist. From then on, until she died 10 years later, every doctor asked her about her asthma, and she would tell them about the error. Even now, 8 years *after* she died, I still get flyers in the mail from BC/BS about asthma addressed to her.

Re:Doesn't give warm fuzzies

[PJ6]

The AMA has lobbied successfully to make it illegal for a patient to find out the malpractice history of physicians.

This may be true for your state, but not in MA. You can go here to review the profile of any physician that has ever been registered in the state of Massachusetts. These profiles include malpractice, disciplinary action, and criminal history. This information is primary and authoritative; the site that hospitals and other healthcare providers use to check on their doctors, and what the public sees, is one in the same. In addition, anyone is allowed to call the Board of Medicine to request specific details about any averse information shown here.

Many other states have similar websites that were made in direct response to the concerns of those like you.

Time to Legislate Data Mining

[Anonymous Coward]

If we criminalized collection of data without specific field level consent, we could end this invasion of privacy.

Re:Time to Legislate Data Mining

[Wycliffe]

We could start by requiring mandatory reporting to a central agency and then a way for that central agency to send a
unsubscribe back to the data collector.

A government website where you can log in and see any place your name, social, phone number, etc.. is being used
and a way to opt-out would be great. I'm still getting mail from people who haven't lived in my house for 5+ years.

I think the 2 big problems with this plan is:
1) Do we really want another giant government program/website.
2) Sometimes the information collected is incomplete. Sometimes they only have a phone number, sometimes only an
address, maybe just an email, sometimes less than that. So you would need a secure way to verify a phone number,
an address, and a social at a bare minimum.

It does seem crazy that stuff gets out and there is no way to recall your information. I have facebook friends
who are now dead and yet their page is still active, people can still post to them, etc...

Re:Time to Legislate Data Mining

[BitZtream]

You can't allow for consent at all, if you do, every contract will simply require your consent in order for service to be rendered.

The only way you stop data mining is to make it illegal, no exceptions. Its really no different than outlawing slavery. You can't allow someone to sign away their privacy or bodies to slavery otherwise they'll be duped, tricked or forced into a situation where they have to sign away those rights even if they don't want to.

Want a bank loan? All banks will require you to allow them to mine your data or no loan, so you don't actually have a choice if you want a loan. But it'll just be extended to everything. Cell phone companies already do it. Power companies will start, and they'll add that you have to allow ANY and ALL of their affiliates to mine you as well ... and then everyone will become an affiliate of the power company.

Nope, the only solution is to 100% outlaw data mining, which just isn't going to happen because the general public is basically too ignorant of the issue to care.

Re:Time to Legislate Data Mining

[gstoddart]

We could start by requiring mandatory reporting to a central agency

We can call it Big Brother. That's a nice name which implies someone looking out for your welfare, right?

a way for that central agency to send a
unsubscribe back to the data collector.

Sorry, citizen, all information once collected can and will be used against you.

In order to maximize corporate profits and governmental control, this information is vital to national interests.

Re:Time to Legislate Data Mining

[fropenn]

There are plenty of benefits that can be found from data mining. Lots of research, for example, uses data mining to identify trends, patterns, relationships, etc. that are then used to develop and test hypotheses.

So it's not data mining that's the problem, rather, it's the way some corporations and institutions use data mining for their best interest and not in the best interest of those whose data they have.

Re:Time to Legislate Data Mining

[bzipitidoo]

Few issues are completely one sided, but slavery is about as close as you can get. That roof over their heads is just cheap rationalising to help the masters feel good. Like patting yourself on the back for feeding someone a fish today, when you could have taught them how to fish but you won't because you want to keep control. You even go as far as stopping them from figuring out how to fish on their own, on the notion that they can't handle such dangerous knowledge. Slavery wasn't even really good for the plantation owners. Their world view was seriously warped by the prejudice they ingrained in themselves. They really believed their self justifying propaganda about blacks being inferior, latched hard onto the whole idea of the White Man's Burden. Laboring under such wrong thinking leads to systemic weakness.

The ultimate reason the Confederacy lost was that when they started the war, they were already way behind economically, and that was thanks to slavery. Slave powered economies simply are not competitive. Very static, resistant to change, and lacking innovation. They deluded themselves that southerners were more manly than northerners. Hoped that, a few other advantages like King Cotton, and most of all the advantage of being the defender would be enough to tip the scale against the Union's huge numeric advantages. But often their leadership would squander the defensive advantage by making reckless assaults, possibly out of that misplaced sense of greater manliness. Lots of battles in Confederate territory have more confederate than union casualties. General Hood was the ultimate in reckless aggressiveness, and President Davis put him in command because he wanted aggressive action. The result was that Hood got his army killed, first seriously reduced at Atlanta, then finsihed at Nashville.

What I don't like is the "blame the victim" angle of this data mining. Instead of this approach of mitigating things the consumer did, as if they might be bad for our health, why not grill the store? Like, instead of haranging the consumer about a pizza they ate, what about a talk with the pizza vendor for using too much salt or fat or whatever? One thing that the US does is pour way too much salt on our food. There is precedent. I think bars are legally constrained not to sell alcohol to someone who is drunk, and/or required to prevent them from driving away.

Donut want

[Anonymous Coward]

Thanks a lot autocorrect. Now my insurance premiums are going up.

I am a professional translator, me

[Anonymous Coward]

...and so I can tell that by "better services", they mean "withdraw coverage or raise the insurance premium the millisecond your risk increases".

Re:I am a professional translator, me

[plopez]

More along the lines of "increase CEO bonuses". The only goal corporations really pursue.

HIPAA?

[Primate Pete]

How is not a HIPAA violation to share my health data (which is necessary for the marketing to be profitable) with advertisers? Under most circumstances, just identifying people as patients is not allowed, let alone saying that John Doe, who has hypertension, has been ordering pizza.

Re:HIPAA?

[BitZtream]

You have it backwards.

The hospital is taking marketing data and using it for pseudo healthcare related reasons.

They aren't giving Taco Bell your health data from the hospital, they are giving the hospital your Taco Bell receipts.

The hospital then uses this to figure out new ways to rip you off for their already ridiculously over priced health services.

(My wife is a doctor, I'm more than qualified to comment on how ridiculously over priced their rip off services are)

Re:HIPAA?

[Anonymous Coward]

Yes, heath insurance /= heathcare /= health. Finally people are starting to understand this.

Re:HIPAA?

[Anonymous Coward]

The hospital is taking marketing data and using it for pseudo healthcare related reasons.

This seems as good a place as any to bring this up. Have other people been getting creepy robocalls from people claiming to be affiliated with their insurance companies?

CSB: Robocall from a 'bot that knows my name, and it claims I need to fill out a survey for my health insurer. I ignore it. Bot calls back a few months later and says it just wants to be sure I'm getting the health care I need, etc.

I do some digging and discover a company called Inovalon (formerly MedAssurant). The deal appears to be that because the insurance companies can't do medical underwriting anymore, they give their customer data to Inovalon. Inovalon then tries to harass customers into getting a "personal health visit" either at a physician's office, or at your home (small PDF of FAQs for physicians).

Of note from the PDF: "What are the qualifications of the medical professional who will be evaluating my patient if they have a Personal Health Visit with someone else? The assessment is limited to a physical exam; treatment will not be provided. The medical professional will be a licensed physician, nurse practitioner, or physician assistant hired to perform this service. It is important to note that this exam is in addition to any regular visits the member has with you and is not a substitute for the memberâ(TM)s annual physical examination" / "Will I be paid? No. We have contracted with Inovalon to perform these visits. Since there are no additional resources required from you or your staff, no compensation will be provided to you. After the examination is complete, the documentation from the exam will be sent to you so you can better coordinate your patientâ(TM)s care."

Translation: Medspeak: "Go see your doctor, a doctor, any doctor, because an annual checkup is a good idea." Marketspeak: "It'll keep you healthy!" Truth: "See a doctor that your insurance company chooses, so that it gets all the data and we know who to drop from coverage when/if PPACA is repealed. We can't do medical underwriting anymore, but we can ask nicely and maybe get the data anyways."

CSB: Zero health problems for 15+ years, annual physicals every 3-5 years, I take my own vitals because blood pressure and blood sugar levels are trivially cheap to measure at home. Zero claims to insurance. Zero contact with insurance company for that entire time until this year when I switched from employer's expensive gold-plated plan to cheaper bronze ACA plan. Since then, six robocalls. Next open enrollment period, I'm seriously considering calling them up and telling them in most cordial fashion to go fuck themselves.

Anyone up for HIPAA?

[CaptainDork]

Law firms recently received instructions regarding "secondary" violations of HIPAA. For instance, a firm might store X-ray images and depositions, expert affidavits, diagnoses, etc. that are strictly controlled at the source, but not necessarily at law firms, be the form of retention paper or digital. It would seem logical that all parties who have access to, or store, HIPAA-covered information should be regulated the same.

Re:Anyone up for HIPAA?

[sribe]

Law firms recently received instructions regarding "secondary" violations of HIPAA. For instance, a firm might store X-ray images and depositions, expert affidavits, diagnoses, etc. that are strictly controlled at the source, but not necessarily at law firms, be the form of retention paper or digital. It would seem logical that all parties who have access to, or store, HIPAA-covered information should be regulated the same.

No, it really does not make sense. Take the law firms for example, if you provide your information to a law firm with the intent of suing a hospital or doctor, you are providing it with the intent that it (might) eventually be used in PUBLIC court proceedings. Why should a morass of privacy regulations apply in that situation?

Anathetic?

[khr]

Is data mining patients done under local or general anesthetic?

Ordering Pizza in the Future

[HarryTk]

This youtube video attributed to ACLU has been around at least 8 years, and explains it all. "Ordering Pizza in the Future" -- http://www.youtube.com/watch?v...

Re:Not likely

[bmorency]

It might not happen very often but when I call my son's doctor and leave a message he will call me back at the end of the day every time. It is always him and not his secretary. That is one of the thing I really like about him.

Something I'd like to see

[dargaud]

I live in a country with full healthcare. One thing I'd like to see is a (somewhat) obligation to give results on your treatment. Each time you go to the doctor to get some treatment, some time later you'd receive a mail with a link to a webform with a few _simple_ questions such as: did the treatment help ? Did you feel any adverse effect ? For how long were you sick ? For how long did you take your treatment ? Did you take any extra drugs, etc. And if you fail to respond to too many emails, your 'free' health care starts being dinged in you pocket. Of course, with exemption for some people and/or disease.

It wouldn't cost much to implement, and would be a trove of info. Have a public structure derived from the national healthcare in charge of it which enforces strong anonymity, and provide anonymity data to big data analysts. It wouldn't take long to figure out scandals such as the Mediator. I mean, if you can't take ONE minute to answer some questions that WILL help others, why should you get free health care ?

Re:Something I'd like to see

[MitchDev]

Haha, I can't wait until the news stories about the 1/1000000 case where a botched surgery results in death and the family is sent a survey asking 'On a scale of Least Satisfied to Most Satisfied, how would you rate the care you received?'

Depends on whether your relatives like or hate you...

Cash Cash Baby

[TigerPlish]

All the more incentive to go back to paper money.

Use debit / credit cards and open yourself to fraud and tracking, use cash and open yourself to robbery.

Either way, we lost the war. The corporations won.

The Public didn't even know there was a war on.

Another benefit is using cash...

[Sir_Eptishous]

I started using cash for most of my "discretionary" purchases lately.
Things like grocery shopping, clothing, Home Depot, going to the bar, etc...

I initially started doing it because of how porous and UN-trustworthy the whole paradigm of card transactions is.

This article hits home on how using cash helps me in another way, being that my purchases can't be tracked.

You know it really is interesting seeing how (for lack of a better phrase) Orwellian the whole system is getting.
Interesting, as in Hindenburg appointing Hitler Chancellor in 1933...