What big tech wants with your medical data

Big Tech wants to play doctor, and federal rules set to drop soon will pave the way for it to do just that. 

A high-tech healthcare system sounds like a great idea. Imagine going to a new doctor’s office, and being able to transfer your medical records to them directly from an app on your phone — no calling and faxing required.

The flipside? Big Tech gets access to reports from your doctor. That should be scary to anyone who has followed data breach after data breach after data breach. But, of course, tech companies promise they’ll take good care of your health data. 

Google, Amazon, and Apple, and to a lesser extent Microsoft, and Facebook, are doubling down on healthcare. Some are strengthening business ties with the healthcare industry, either getting cash to store our records in the cloud, or using patient records to create new tools. Others are catering directly to patients.

Meanwhile, thanks in part to lobbying by Silicon Valley, the Department of Health and Human Services (HHS) is on the precipice of finalizing a rule that’s supposed to improve patient access to electronic health records (EHRs). That would standardize their formatting, and make them easier to share and transfer from one place to another. 

There was rare continuity between the Obama and Trump administrations and bipartisan support in Congress to modernize the healthcare industry. But the complexity of the undertaking, privacy fears, and entrenched interests have stalled the new regulations. The final version, according to the HHS is supposed to drop”soon.”

As efforts to finalize the rule have shown, it’s tricky to balance healthcare, technology, and patient privacy. Why would tech companies want to wade into such a risky field when they already have plenty of cash? 

Two main reasons: there is a lot of money to be made, and it’s a good way to build user trust.

“Healthcare is really costly, and we’re not getting the kind of care we want and think we ought to get for the amount we’re spending as a society,” Bill Evans, the managing director of digital health venture fund Rock Health, told Mashable. “These businesses see that as an opportunity.”

The healthcare industry is set to reach $11.9 trillion by 2022, and EHR management represents a growing slice of that pie. Financially, the digital side of healthcare is attractive because it is expanding, there will be new federal rules mandating that deep-pocketed hospitals make changes, and also because healthcare is ripe for disruption. Tech companies are poised to bring their expertise in data management, storage, and analysis from other industries to healthcare.

“We have been plagued by problems that other industries have solved.”

“We have been plagued by problems that other industries have solved,” Arielle Trzcinski, a senior analayst at Forrester, told Mashable. “Tech giants want to enter healthcare because there is an opportunity to bring what they have done in other industries to healthcare.”

Healthcare also presents a long game opportunity. It could strengthen bonds with consumers, making whichever big tech company dominates in health an even more intractable part of our lives.

“Businesses that deliver healthcare deliver necessarily tight relationships with the folks they’re delivering care to,” Evans said. “I suspect that some of these large businesses who have developed a very close, high trust relationship in other areas, believe this is a moment where they can translate on that trust, deepen those relationships, and deliver new services in alignment with their existing businesses.”

The key to tapping into all of these financial opportunities is taking patient data out of labyrinthine, old-school hospital records systems, and into a modern, shareable healthcare ecosystem. The HHS rules should help achieve that reality (a concept called “interoperability”), which could displace some major healthcare players, such as Epic, and make big tech an even bigger part of our lives. 

Whether you believe this shift will make healthcare better or worse, it’s already happening. Here’s what big tech wants with your health data.

Image: ROBYN BECK/AFP via Getty Images

Google

An official organization within Google, Google Health has two main efforts. The first is a health research arm. It uses anonymized medical databases to create advanced diagnosis tools.

It also has a more enterprise-focused arm that recently got it into hot water. In what’s known as “Project Nightingale,” Google has a business deal with a major medical institution, Ascension. In that arrangement, Ascension provides Google with patient records, so Google can create tools that would enable better management and analysis of medical records for doctors and hospitals. The part of the deal that earned Google some bad publicity? It is getting access to some non-anonymized patient data without patients’ knowledge. A Google spokesperson said some of the data needs to be non-anonymized so that developers can make sure their products are working. 

Google has a few other health ventures outside of Google Health. Notably, it recently acquired FitBit, which creates mountains of health data on users. Alphabet also owns two startups, Verily and Calico, that focus on medical research and aging, respectively. It also provides cloud storage for health organizations, but Google says the fact that it stores data for clients doesn’t mean Google has access to that data. 

A spokesperson said that Google has long considered itself involved in our healthcare because we turn to Google search all the time for information about our health.

These medical searches do get absorbed into the information Google has on us for advertising purposes. However, it has also put advertising restrictions in place that prevent companies from targeting ads on the basis of healthcare characteristics, such as conditions we have or medications we take. 

Google is putting in legwork now to make tools that could eventually become lucrative industry standards. Add FitBit and moonshot projects involving anti-aging and curing diseases, and Google could become your doctor’s (very rich) best friend.

Amazon

Amazon has one of the most potentially far reaching, but also least immediately clear, efforts in healthcare.

First, AWS is a dominant player in cloud storage. It stores patient data for healthcare customers, and offers downloadable databases of medical data for clients. Amazon did not respond to a request for comment for this article. But in a prior conversation, an AWS spokesperson said that it’s the responsibility of customers that sell medical datasets through AWS to ensure that healthcare data complies with patient privacy regulations and policy.

Next, Amazon made two big moves beyond data storage. The first was its 2018 acquisition of online prescription delivery service PillPack. 

“Amazon acquiring PillPack is a significant signal about the ways they see their expertise in supply chain management and delivery pairing well with an important market that’s still too expensive for consumers,” Evans said. 

Basically, Amazon upended the way we buy almost everything. It wants to do the same for medicine. Your co-pays and insurance payouts (along with your data) would go to Amazon, not your local pharmacy.

Then there is Haven, a joint “health-care venture” with JP Morgan Chase and Berkshire Hathaway. It’s still not clear what it’s going to look like. A medical provider, an insurer, an employer-based medical service — it’s all in the cards. We do know it wants to try out its venture on Amazon and the banks’ 1.2 million employees before offering anything to the public. And if the bosses at Amazon like their system for employee healthcare, who’s to say your boss won’t like it — and buy it — too.

Apple

In 2019, Tim Cook made the eyebrow raising observation that Apple’s “greatest contribution to mankind” will be in health. That came on the tails of Apple’s announcement that its latest Apple Watch could take ECGs, detect falls, and call 911. 

With the Apple Watch and its Health app, Apple is hardcore in the health game on a personal services level. It is also making plays in research and innovation, conducting large clinical studies with medical institutions, and letting Apple users enroll in studies directly from their phones through a new Research app, which will remotely monitor some of their health data, for science! 

Imagine a world where your doctor prescribes an Apple Watch and your insurance pays for it. Apple certainly is.

Imagine a world where your doctor prescribes an Apple Watch and your insurance pays for it.

But Apple is going even further. 

In 2018, a Health app update let medical institutions give Apple access to health record through an API. That would allow patients to see their medical records right on their iPhones and easily share them. Apple’s plan is all about giving patients access to their medical plans, not using them to create products.

That’s something Apple confirmed to Mashable. The files live on an individual’s phone, and when they are in transit or in storage in the cloud they are encrypted. The files do not go into Apple’s own network, nor are they sent elsewhere on behalf of a medical institution.

The dream of Apple Health as a seamless middleman is still in progress, according to Evans. The HHS’ new bill that standardizes EHR formatting could pave a smoother road for Apple Health, making the company an even more intimate (and dominant) force in our lives.

Microsoft

Microsoft’s cloud division, Azure, is competing with AWS and Google in the medical records cloud storage business, hard. It has developed its own API to simplify and standardize records storage. Microsoft declined to comment when asked how patient data is a part of its business plans, and how it protects patient privacy. 

Medical cloud storage was estimated as a $10.1 billion dollar industry in 2018, growing over 11 percent per year. If Microsoft can strengthen its foothold, that’s a nice pot to pull from for a payday.

Facebook

Facebook launched a tool called Facebook Preventive Health in November 2019. If you opt in, Facebook uses basic demographic information about you (your age and gender, for example) to surface recommended tests and treatments, like mammograms and flu shots. It says it doesn’t use information about health and whether you use the tool in advertising. 

Anyone who’s dealt with the hassle of getting records to prove you’d been vaccinated as a child, or dared to switch doctors, or had to fill out the same medical history information again and again, knows there’s room for improvement when it comes to tech and healthcare. With the new HHS rules, that change is coming. But, ideally, modernized healthcare would come with modernized privacy laws.