Should We Trust Big Tech with our Health?

Amazon, Google, Facebook, and Apple all want to be your doctor.

Big Tech has new ideas about managing your health, but considering their track records on privacy, can these companies be trusted with something as precious as your healthcare?

Last year a friend and I were brainstorming ways to fix the broken and cumbersome outdated US Healthcare System.

“Probably the easiest solution would be for Amazon to just take over everything,” suggested my friend. “But would we want that?”

In 2019, health projects are underway not just at Amazon but also at Apple, Google, and Microsoft. These companies have proven their ability to disrupt outdated industries, so why not healthcare as well?

These companies can and will make an impact on our system, but will the changes be in the best interest of patients, or corporations? Which companies can you trust most or least? What projects do they have in play?

Google’s focus is on data, all the data, and how they can recognize and predict patterns. In a clever example, Google had been using search data to predict flu trends. Their solution (now offline) was clever and cool, and potentially useful.

While Google bills itself as a search company, their core business is really advertising. Historically, it has not always been good at privacy and that, combined with their advertising motive, can lead to awkward problems.

An example: Using my personal computer, I googled at-home STD testing kits in order to compare prices with what my hospital offers. The next day Google was serving me ads about STD testing. And when my wife logged in to nytimes.com to read a dinner recipe…there were ads for STD testing. If they are this indiscreet about search and advertising, should they be trusted with your sensitive healthcare data?

Actually, they might already have your health data. Last week Google was in the healthcare news when 50 million patient records were copied from Ascension Health to Google’s cloud servers. Did these patients give permission to share their records? No. Did they have the opportunity to opt-out? No. Does this information include names, birthdays, home addresses, healthcare problems, prescription lists, and other sensitive info? Yes. Is this data being held in a secure fashion? Maybe, but according to one whistleblower, no.

Amazon is everywhere. They own my grocery store. Alexa devices are in homes and offices. They are my family’s most frequently used retailer. And now they want to deliver healthcare as well. Does being the biggest and most valuable company in the world make them a good or bad choice to manage health? Should we worry that the world’s biggest company is so deeply woven into our lives?

Amazon’s new Care product is a full-stack of health options for their insured employees that includes virtual visits, home visits, office visits, and prescription delivery. I like this model, as outlined on amazon.care. But I worry about quality: do most shoppers on Amazon buy the best item or the cheapest? Should consumers choose medical care based on price or quality? How will Amazon’s relentless downward pressure on prices impact the quality of care?

Bob, MD from Amazon.care
Bob, MD from Amazon.care

We don’t know, and I don’t know if their doctors and NPs are any good. I do know that they have a doctor named Bob. Will you trust your health to a physician who identifies himself by just 3 letters? I tried to look him up with the Washington Medical Board, but they don’t know of any Bob, MD.

If you’re a regular user of Facebook, you realize that they know a lot about you and your friends. An optimistic take on this is that it could lead to some powerful public health insights, especially when you know who has traveled to which foreign countries, who is dating whom, and who has had contact with someone who now has the flu.

Unfortunately, Facebook is terrible with privacy. Last week they were in the news when it was found that their app turns on your selfie camera as you scroll through your feed. I am skeptical about trusting a company led by a CEO who doesn’t let his kids use his product, who tapes over the camera on his own devices, and can’t give a straight answer about privacy.

Fortunately, their entry into the healthcare field so far has been relatively unremarkable and inoffensive. This service tracks your health and aging and recommends appropriate screening tests. Their goal of course: advertising. Facebook will recommend tests and screening, and then serve you ads to providers offering those services. This offering is as innocuous as it is unexciting, so I predict tepid utilization.

The company that I’m likely to most trust is Apple. In an era when Facebook is stumbling with privacy concerns and Google has given up on not being evil, Apple has seen the opportunity to position itself to be a trustworthy brand.

Apple is slowly wading into the healthcare business with some simple health steps including fitness, menstrual and ovulation tracking, and some Cardiology functions. I have now met one patient who’s Apple Watch correctly diagnosed atrial fibrillation which led him to timely treatment.

Apple A-fib alert

A lot of the technology in the “wearables” field is still very young Apple has an opportunity to make a serious impact. Just today they released information about 3 research studies they are doing with their watches.

While I do not (yet) trust these big companies with my health, I remain bullish on modern technology’s potential to impact healthcare overall.

AI is getting better at interpreting CatScans. There are scrappy startups trying to reinvent prescription delivery. And virtual visits are finally becoming more mainstream.

Perhaps these new companies will be the catalysts for meaningful change. As I watch the growth of these new companies I feel that the future of technology in healthcare is increasingly bright.

Doctor, Reader, Thinker

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