Sometimes you just gotta geek out over what’s happening in health care even if its implications are years away.

In 2014, Google CEO, Sergey Brin, complained about “heavily regulated” health care that discouraged health care tech entrepreneurship. Last week Google emerged from secret talks with Ascension health system with a deal (Project Nightingale) to analyze and store health care and administrative data. Meanwhile, Amazon, who never shared Google’s timidity on health care, announced its third major health care venture in the last two years—the Amazon Care app. The rollout of the Amazon Care app for its Seattle-based employees comes after Amazon purchased online pharmacy PillPack in 2018 and teamed with Berkshire Hathaway and JPMorgan Chase to create the healthcare company, Haven. It seems like tech companies have found a remedy for health care’s regulatory headaches, or maybe it’s the chance for health care tech glory that they can’t walk away from.

There’s A Lot of Potential In Health Care Data Tech

It’s not surprising that Google changed its mind and inked a health care data deal. Google so wants to join the list of artificial intelligence (AI) pioneers, and having access to mounds of health care data is the first step to AI glory. Seriously, most health care systems around the world currently have AI projects to analyze health care data and monitor patients. And robotic surgery and robotic-assisted surgery has been a thing for well over a decade. Future AI health care projects may include machines that perform tasks currently done by health care professionals. When you think about it, the idea that if you compile enough data from multiple sources (doctors’ notes, physical exams, diagnostic images, etc.), you can teach a computer to diagnose and treat diseases is pretty cool.

Ascension also has a lot to gain if Google can manipulate the millions of patient data records into an AI system that can diagnose and treat diseases. Imagine the savings hospitals would realize if computers could replace some of the doctors and other health care specialists they would otherwise hire to perform these tasks. And it’s not just the potential savings of using artificial intelligence in health care, AI could reduce health care errors and allow hospitals to serve more patients.

Okay, I’m obviously fascinated by the possibilities of AI in health care. And if big tech can meet the privacy and security standards set by federal laws such as HIPAA, I say bring it on. We’ve already given up a lot of our privacy when it comes to health care. We’re willing to wear activity tracking devices, fill out online health risk assessments, and use telemedicine services all in the hope of improving our health or paying less for health care.

While Individual Privacy Concerns Decreases, Regulators Remain Alert

Ten years ago when I was working in private sector Human Resources benefits departments, health care data privacy was a big deal. Many workers balked at completing health risk assessments (HRA) because they thought their employers would use any “negative” health data from the assessment to fire them. They didn’t like the idea of their employer having such personal data. The Equal Employment Opportunity Commission weighed in on workplace wellness programs that charged higher health insurance plan premiums to workers that refused to complete a health risk assessment. Today, you rarely hear about health risk assessment privacy issues. But that’s not to say that privacy and security are not important in health care. The Health Insurance Portability and Accountability Act of 2003 (aka HIPAA) is a reminder to anyone who has or wants to access health care data of how seriously federal regulators take health care data privacy and security.

Between April 2003 and October 2019, the Department of Health and Human Services (HHS) received nearly 221,000 health privacy complaints. Continue Reading...

Tags: health care , health care privacy, HIPAA, Google, Ascension, HHS

There are a lot of new and exciting health care information technology (IT) companies sprouting up. Most are taking advantage of the many opportunities made possible by the Affordable Care Act, aka Obamacare. These startups are using large amounts of anonymous data from Medicare, Medicaid and private insurance databases and their own sophisticated algorithms to make health insurance and health care easier to purchase and use.

This is all great stuff but health care has an even bigger problem that these data mining and analyzing geniuses can and should address. The problem is health care fraud—a multi-billion dollar a year problem. Technology firms should create algorithms to scan health care claims and financial data to identify and prevent fraud. This type of sophisticated response is needed because health care fraud perpetrators are usually insiders that are very good at crafting and hiding their schemes.

Unfortunately, creating health care fraud detection algorithms may be the easy part for the tech industry. The challenge for these firms is working with the health care industry usual suspects including medical providers, insurers, associations and government regulators.

The health care industry is a special kind of place with several factions fighting hard to protect their members’ interests. There is also the issue of navigating a highly regulated industry and interacting with multiple government agencies. It’s kind of like old school meets new school with old school having more money, a huge head start in regards to understanding the industry and its regulations and established relationships with government policymakers. But if the nation is serious about reducing health care fraud, it is going to need the help of big data analyzing IT firms.

Health Care Fraud Is A Huge Problem Continue Reading...

Tags: obamacare, HIPAA