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by buro9 3700 days ago
The big problem is the precedent it sets for data access.

What are the criteria for who gets access? What are the constraints of that access?

This story covers the latter being blown apart, the constraints were poorly defined and implemented and thus even if the criteria is well defined access to far more data was made possible.

I'm sure that few patients desire an end to research, or would argue that such access isn't a good thing... but what of the insurance industry? Should they have access? Would the NHS be able to define and enforce those constraints?

Perhaps that's an obvious no.

What then of an insurer partnering with a medical research company, from the viewpoint of "This costs insurance a lot of money, we'd like to fund a way to reduce that financial exposure".

The grey areas emerge immediately.

If we cannot control access to patient data, data that would be trivial to either strip anonymity or just to have in aggregate enough to still produce net-negatives (i.e. correlated by post code would reveal enough with little extra work)... and if we cannot define and enforce the constraints of access... then we really shouldn't be sharing what is highly sensitive and personal information that was originally only disclosed between a patient and a Doctor under the premise that what is shared is covered by the explicit and implicit confidentiality of that conversation.

It's always worth remembering:

Data was acquired under doctor patient confidentiality.

If we considered that data to have a licence, it is the most restrictive licence possible. One could consider what has happened here as a re-licensing without permission. Such an act could have a chilling effect on the relationship between the doctor and patient.

2 comments

You are making some implicit assumptions that they data access isn't highly controlled.

I have seen a few of these sorts of deals killed because of data access concerns, and/or computation requirements ("you can have access to anonymized data, but you have to run your code in a sandbox on our health servers").

And, this is why we have legislation.

Less implicit, from the originally linked article:

> The scale of the sharing program was apparently misrepresented to the public, originally announced as an app to help hospitals monitor patients with kidney disease with real-time alerts and analytics. But since those patients don't have their own separate dataset, Google has argued it needs access to all patient data from the participating hospitals.

No assumption there, they didn't have a separate dataset and so granted access to all patient data.

"so granted access to all patient data"

Yes, but under what conditions? Many privacy laws apply here, and treating Google as some monolithic entity where everyone working there can now read anyone's personal health history is inaccurate.

Its psuedononymous data the NHS has previously admitted can be deanonymized given sufficient effort but such deanonymization carries criminal and civil penalties.
Nope. To set a precedent it would have to precede. Giving de-identified medical records to researchers is a long-standing, well-established and regulated process. The only interesting thing here is that it's Google and not some PhD's university lab.

Here's HHS on what HIPAA has to say about this: [0]

[0] http://www.hhs.gov/hipaa/for-professionals/privacy/special-t...