Health Innovation: Data is Transforming Care, but at What Cost?
Innovation can have a different meaning across various industries. It begins with an idea to start something new that fosters positive change (1). In health, innovation means identifying areas of improvement and finding effective solutions to advance care. This includes the introduction of new ideas, methods or technologies that promote faster, more efficient treatments and improved patient outcomes (2). Health systems are evolving at a rapid rate as innovative technologies are being introduced into the existing infrastructure (3). In-home patient monitoring as well as electronic medical records (EMR) are available to improve hospital wait times, diagnostic speed and access to care (4). Other solutions such as telemedicine, electronic appointment booking, electronic prescription renewals, and wearable devices are reshaping the current care system, placing a greater emphasis on the patient at the center of care. The main driver of change is the need for continual quality improvement in our current system. Using technology to create proactive and reactive care solutions that better the health of Canadians has many benefits. The accessibility of data and the means to store it can create better home care solutions, cultivate personalized care opportunities, as well as reduce medical costs and errors (5). While a number of benefits exist, these all come at the cost of our privacy.
Technology offers a more efficient means for inter-professional collaboration, diagnostics and organization. The use of the internet and its ability to host personal data can be seen as a good thing. Applications such as MyChart used by Sunnybrook Health Sciences Centre, allow patients to create, manage and access personal health information at any time. This information is also accessible through the portal to family members (7). Having such technologies allows easy transfer of medical information to various facilities so the quality of care received by individuals using this platform in not compromised. However, what if this portal is left logged into, or if the capacity to share information with other family members is compromised? What measures, other than bank-like encryption, are in place to protect personal information from being demanded from other sources, such as insurance companies, when using services from personal genomics and biotech companies such as 23 and me (8)?
In Canada, set of laws outlined by the Personal Information Protection and Electronic Documents Act (PIPEDA) protect citizen privacy invasion, specifically on the issues of consent, transparency and data retention (9). However, there are no specific guidelines in PIPEDA protecting personal data posted on social networks, wearable device data storage, smartphone applications and other online activities outside of Facebook and Google from being shared and certain outlines vary province to province (6). This can lead to problems involving data access rights, how and when data is stored, security of data transfer, data analysis rights and governing policies (10). Many individuals are unaware that by accepting certain terms and agreements they are handing over their health data to the owners of that application. Although innovative health technologies will provide many benefits for health care delivery, there are a number of security and privacy implications that must be explored in order to promote and maintain fundamental medical ethical principles and social expectations (10).
Benefits regarding the use of Artificial Intelligence (AI) Technology in the future will use patient streamed data from smartphones and wearable technology to improve health outcomes (11). AI is already being used by Alphabet, Google’s parent company, to identify cancerous tissues and retinal damage. Prospective AI could provide an automated medical diagnosis from a description of symptoms, spot behavioural traits linked to mental illness or even warn an individual if they are at risk for cardiac disease. The accumulation of large volumes of data will make it easier for patients to reach out to others experiencing similar health outcomes and have support networks all over the globe (11). Overall, the industry is gravitating towards an adoption of such technologies in order to enhance health care. But is it safe to agree to share our data in order to obtain health gains, even though we are putting ourselves at risk?
The more information that is shared on the cloud or between various companies creates an intensified risk for hacking or data exploitation. Moving forward in the evolution of health innovation, policy makers need to be more mindful in the creation of new privacy guidelines that leave no room for questions or potential leakage of information. Although this is something that has yet to be established with the aforementioned acts in place within Canada currently, we must work towards this in order to keep our system safe and equitable.
1 Cashman, K. (2013). 7 Ways Leaders Can Foster Innovation. Retrieved from, https://www.forbes.com/sites/kevincashman/2013/08/21/7-ways-leaders-can-foster-innovation/#6b62d5be29a9
2 Ortiz, E., & Clancy, C. M. (2003). Use of information technology to improve the quality of health care in the United States. Health Services Research, 38(2).
3 Lippeveld, T., Sauerborn, R., Bodart, C., & World Health Organization. (2000). Design and implementation of health information systems.
4 Zahabi, M., Kaber, D. B., & Swangnetr, M. (2015). Usability and safety in electronic medical records interface design: a review of recent literature and guideline formulation. Human factors, 57(5), 805-834.
5 Islam, S. R., Kwak, D., Kabir, M. H., Hossain, M., & Kwak, K. S. (2015). The internet of things for health care: a comprehensive survey. IEEE Access, 3, 678-708.
6 Ahmad, T., (2012). Online Privacy Law: Canada. Library of Congress. Retrieved from https://www.loc.gov/law/help/online-privacy-law/canada.php
7 Sunnybrook Health Sciences Centre. (May,2016) MyChart. Hospital Resources. Retrieved from, https://sunnybrook.ca/content/?page=mychartlogin-learnmore
8 Griffith-Greene, M., (2015). Home DNA tests may affect insurance, employment Marketplace investigation finds no protection for Canadians against discrimination based on DNA test. CBC.ca. Retrieved from, http://www.cbc.ca/news/health/home-dna-tests-may-affect-insurance-employment-1.3018086
9 Office of the Privacy Commissioner of Canada. (2014). Form of Consent. Retrieved from, https://www.priv.gc.ca/en/privacy-topics/privacy-laws-in-canada/the-personal-information-protection-and-electronic-documents-act-pipeda/pipeda-compliance-help/pipeda-interpretation-bulletins/interpretations_07_consent/
10 Meingast, M., Roosta, T., & Sastry, S. (2006). Security and privacy issues with health care information technology. In Engineering in Medicine and Biology Society, 2006. EMBS'06. 28th Annual International Conference of the IEEE (pp. 5453-5458). IEEE.
11 D'Urbino, L. (2018) A revolution in health care is coming. Retrieved from, https://www.economist.com/news/leaders/21736138-welcome-doctor-you-revolution-health-care-coming