Commercialising health records and scientific knowledge and skills??

2 December, 2018

According to an article in yesterday's Wall street Journal ("Big Tech Expands Footprint in Health" - behind a paywall, unfortunately - https://www.wsj.com/articles/amazon-starts-selling-software-to-mine-pati...), Amazon.com Inc. is starting to sell software that mines patient medical records for information doctors and hospitals could use to improve treatment and cut costs. The move is the latest by a big technology company into health care, an industry where it sees opportunities for growth. ---------'

It should not be purely about market, about profit and shareholders ------- where is the best interest of the ‘patient informed consent’, confidentiality and trust between ‘person-practitioner’ /’patient-practitioner’/’family-practitioner’ relationship in health care today and the future: delivering health care has always sought to optimise the pros whilst preventing /avoiding the cons

Companies are selling software that ‘mines’ patient data from medical records (that is records collected from patients / carers following informed consent and based on mutual trust) for information doctors and hospitals could use to ‘improve treatment and cut costs’. Is it really about improving ‘treatment and costs’ only, what about its use by profit making companies and industry from the insurance companies to hackers, blackmailers, personal security breaching industry, etc etc. These softwares can ‘read digitized patient records and other clinical notes, analyze them and pluck out key data points’, but mind you they are seeking (’mining’) personal patient history, clinical and test facts that doctors and other health practitioners get from confidential interaction which has anchored the trust that patients and their carers for centuries have in each other. Now we read about scientists creating 'designer babies' in China (‘gene-modified babies in China’).

This mutual Trust between patients and providers has rightly been protected by professions and society for as long. The Trust cannot be left to the whims and exploitation of individuals or groups, whereever and in every country.

If you ask me, it was for good reason that ‘Health care trailed other data-heavy industries, including retail and banking, in converting critical information to computers from paper’. Surely business considerations about buying and selling non human items and stock could not and should not just be transferred to human health care without due localisation to context of health care, global health. ‘Electronic health records are now a standard feature in most hospitals, but that wasn’t the case a decade ago. More than 80% of hospitals have electronic health records, up from about 10% in 2008 (in USA)’. Because, ‘Hospitals rushed to install digital records after Congress included incentives for the technology as part of federal spending to speed economic recovery from the last recession’. But who tells patients that Big business is 'mining' their records and what they tell their practitioners in total unbreachable confidence.

Wall Street Journal says that ‘the $3.2 trillion health-care lucrative market is a natural target for tech companies seeking new sources of growth, especially as more patient medical records get digitized and pressure rises to provide better health care at lower cost’.

In particular, the market for storing and analyzing health information is worth more than $7 billion a year, according to research firm Grand View Research: already in competition are International Business Machines Corp.’s Watson Health, UnitedHealth Group Inc.’s Optum, Apple Inc. (‘talking with the Department of Veterans Affairs about software to allow veterans to transfer their health records to iPhones’), Alphabet Inc.’s Google (‘has hired a prominent hospital-system chief).

Apparently, 'Amazon Web Services, has been using its cloud-computing division to sell text-analysis software to companies outside medicine for their use' to make profit on peoples health issues and without their informed consent. So where is the regulation of such companies by health regulators who have protected patients and public health since the beginning of mankind and need to continue doing so now and in future.

‘In addition, Amazon is eyeing greater sales of medical supplies through an app, embedded in electronic medical records, that doctors can use to send links to products that patients would buy, according to people who developed the app and doctors who have used it’.

Is the world now going to the situation where human health is equated literally to ‘travel booking’, ‘supply-chain management’, ‘commodity Profit &Loss accounting’, ‘cash and carry’, ‘pay as you go’, etc etc.? Where are the mandatory global standards for regulatory bodies and ethics bodies that protect the use of research results, innovation. knowledge and skill to protect humanity and human conscience?. That ensures that individuals or groups in society do not use knowledge and skills for commercial purpose mainly, without regard to the consequences for health, safety, consent and privacy of present and future generations of the human race. How can it all be only about balance sheet and money?.

Joseph Ana.

AFRICA CENTRE FOR CLINICAL GOVERNANCE RESEARCH & PATIENT SAFETY

@Health Resources International (HRI) WA.

National Implementing Organisation: 12-Pillar Clinical Governance

National Implementing Organisation: PACK Nigeria Programme for PHC

Publisher: Medical and Health Journals; Books and Periodicals.

Nigeria: 8 Amaku Street, State Housing & 20 Eta Agbor Road, Calabar.

Tel: +234 (0) 8063600642

Website: www.hriwestafrica.com email: jneana@yahoo.co.uk ; hriwestafrica@gmail.com

HIFA profile: Joseph Ana is the Lead Consultant and Trainer at the Africa Centre for Clinical Governance Research and Patient Safety in Calabar, Nigeria. In 2015 he won the NMA Award of Excellence for establishing 12-Pillar Clinical Governance, Quality and Safety initiative in Nigeria. He has been the pioneer Chairman of the Nigerian Medical Association (NMA) National Committee on Clinical Governance and Research since 2012. He is also Chairman of the Quality & Performance subcommittee of the Technical Working Group for the implementation of the Nigeria Health Act. He is a pioneer Trustee-Director of the NMF (Nigerian Medical Forum) which took the BMJ to West Africa in 1995. He is particularly interested in strengthening health systems for quality and safety in LMICs. He has written Five books on the 12-Pillar Clinical Governance for LMICs, including a TOOLS for Implementation. He established the Department of Clinical Governance, Servicom & e-health in the Cross River State Ministry of Health, Nigeria in 2007. Website: www.hriwestafrica.com Joseph is a member of the HIFA Steering Group: http://www.hifa.org/people/steering-group

http://www.hifa.org/support/members/joseph-0

jneana AT yahoo.co.uk