In recent times there has been a steady drum beat from Health Insurer NIB asking for access to #myHR data, which, as we all know, is specifically illegal.
Here is a very recent example:
Insurer NIB wants access to members’ genetic information
Health insurer NIB wants to use genetic information and My Health Record data to calculate the risk profiles of its members, in a major push towards personalised preventive medicine.
The listed insurer has created a data science and health services company in partnership with US provider Cigna Corporation, with plans to use de-identified big data to calculate individual health risks. NIB chief executive Mark Fitzgibbon raised the ire of doctors by foreshadowing an application by the new company to access government-held electronic health records.
“Potentially this body as a registered healthcare provider, with our members’ permission, could access My Health Record,” he said. “It will be a healthcare provider and it will be eligible to apply to access that data.”
But the body in charge of My Health Record, the Australian Digital Health Agency, reiterated that My Health Record data “cannot be privatised or used for commercial purposes”. Insurers are barred from applying to access My Health Record data under legislation.
Mr Fitzgibbon said NIB had long wanted to move from being a “sick care company” into preventive medicine. The sophisticated data analytics performed by the new joint venture would be key to achieving that aim, he said.
“I think it’s a giant step forward in our ambitions and it’s going to lead to a quantum shift in the way that we think about our healthcare system,” he said.
NIB proposes to feed the health data of its members to the new joint venture company on an anonymous basis. The joint venture would then calculate the health risks faced by an individual member, and send that information back to NIB, which would then approach the member with suggested interventions. The joint venture would also undertake frontline service delivery, initially in mental health coaching and hospital discharge management. Mr Fitzgibbon flagged a push towards collecting the genetic information of members to aid the process.
Data privacy experts question whether the joint venture company could guarantee members’ information would remain anonymous. Bruce Baer Arnold, an assistant professor at Canberra Law School, said there were “real concerns” members’ health data could be compromised. “Many of the claims about anonymity just don’t stand up in practice,” he said. “And in the future, they will stand up even less.”
Reaction from the AMA and RACGP is found in the rest of the article here:
There is commentary here:
NIB's start-up a step towards better prevention
NIB's new health services start-up aims to keep consumers out of hospital. But it will attract critics.
Dec 6, 2019 — 3.06pm
NIB Group’s new health services start-up is an example of how the private health insurance industry isn’t waiting for governments to help reduce the number of consumers needing expensive hospital treatment.
Chief executive Mark Fitzgibbon will pump $10 million into the new business, which will be matched by NIB’s joint venture partner, the US health services group Cigna.
NIB will then become a customer of the new start-up, which aims to analyse and interpret data to identify patients with certain risks and then suggest and deliver early-intervention programs of care. Over time, it believes other smaller insurers and government agencies might become customers too.
Fitzgibbon gives the example of a patient who’s been to have some sun spots burnt off, and is then identified as being at high risk of skin cancer.
After data analysis by the start-up, NIB might be given a range of treatments to suggest to the consumer – drugs that boost their resistance to the sun, access to a skin check app, free dermatology appointments and even free sunblock.
Hopefully, that fund member avoids skin cancer, which keeps claim costs down and premiums under control. Clearly NIB wins from this, but so does the broader system.
Fitzgibbon is bracing for what he describes as a “cabal of criticism” around the initiative. For example, he expects doctors to worry that this represents a health insurer trying to control treatments.
More here:
What is sad about all this is that neither NIB of Cigna have any idea just how useless the data in the #myHR is – even if there is any data. (Cigna would be envisaging it contained comprehensive insurance data as they see in the US.)
You can be sure the data NIB has on its customers is much more accurate, complete and exploitable than anything held in the #myHR.
The other issue that needs discussion is around the possibility of individuals – with full informed consent – allowing access to their #myHR. Frankly as long as there is genuine consent – with the implications and risks explained – then why not? I would go further and say those who consent should be offered a small discount on their policy. If NIB is going to save money – surely the saving can be shared.
My view is that it is your health information and it is up to you to decide who to share it with and how much you trust people to protect your information. Once it is leaked it can’t be recalled and people need to consider that before agreeing to anything?
Regarding genetic information I think the bar to sharing should be higher given the life long implications and the impact on progeny and so on!
What do others think?
David.
1 comment:
Needs to be at arms-length!
There should be a separation of activities where the genetic data is held in a different data warehouse by a separate team. The advice & clinical services should be separate from the insurance teams (quotes, actuaries, financial management, sales, claims processing). You could create or contract a separate company to run the advice & clinical services.
No one in the insurance business should have your genetic information or detailed clinical records that can be used against you.
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