
Paging Dr. Google: How the Tech Giant Is Laying Claim to Health Data - Bostonian
https://www.wsj.com/articles/paging-dr-google-how-the-tech-giant-is-laying-claim-to-health-data-11578719700
======
sharcerer
Result of not focussing on trust enough. Google is going to have more of this
problem. Google really has a problem understanding the compound effects of
trust and perception and dealing with it. By now, they should have taken some
concrete privacy enhancing steps which might be made for short-term but good
for long term trust, as usage of GCP, G Suite, AR will depend a lot on their
trust factor. Sundar is really coming off as weak in this regard.

~~~
deadmutex
I think they have taken privacy enhancing steps, though public perception
isn't easy to change. A lot of people (including HN users) still mistakenly
think that Google sells user data, or medical history is being used for ads,
etc.

Disclosure: I work at Google, but my opinion is my own.

~~~
bitL
That might be true now, but who knows where your current employer will be in
10 years and if they by then even remotely match your current values. We are
already seeing cracks forming and it makes difficult to trust them with our
most sensitive data. It was easier 10-15 years ago, not so much these days.

~~~
joshuamorton
I honestly don't get this: the reverence with which Google treats user data
has only increased over time. What gives you the opposite impression?

~~~
sharcerer
personally, I do think that Google handles user data well. some people here
might get triggered, but I don't have problem with it. I am talking about the
perception problem for Google among big cos, which will impact GCP and Google
Health. Though, frankly I hope now these cos realize that Amazon is some
trustworthy alternative either(as some corp thought in the mentioned article),
Amazon was in a honeymoon period for the past 3-4 years, now with their face
recog, Ring etc. the attention has shifted to them.

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rvz
> Cerner ultimately accepted a less generous offer from Amazon, in part
> because the company decided Amazon was more trustworthy on security,
> according to one of these people.

Well I don't know if even going with Amazon would be any better than going
with Google since both of them will be prominent players in healthcare
technology anytime soon. But it is more than clear that as Google obtains more
health data via hospitals contracts, GCP customers, etc this helps their deep-
learning systems learn more about you and despite releasing interesting papers
about their achievements, they have closed up some of their methods which
limits reproducible science and research.

Think very carefully about the sensitivity of this health data. Do we really
want the likes of Google and Amazon analyzing this data for commercial
purposes and later getting away with it? I neither trust that Amazon or Google
will act in the best interests of whats good for healthcare, but I guess
Cerner chose the lesser of two evils and went with a weaker devil.

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jnordwick
>>> Yet he is reluctant to allow people to opt out of Google’s core health-
search tool. He likens that to a physician knowingly offering substandard
care, he says.

>>> “If you believe me that all we are doing is organizing that information to
make it easier for your doctor, I’m going to get a little paternalistic here:
I’m never going to let that get opted out,” Dr. Feinberg says. “It’s going to
screw up your treatment. We’re not going to be able to take care of you.”

Planet Money had an interview with Dr. Feinberg, the head of the Google health
initiative. He was asked about people potentially opting out. His response was
extremely paternalistic.

He said that he views everybody in the system as his patients, and he thinks
this data aggregation and analysis from Google will improve care. So as "our"
doctor he cannot morally allow any of his his patients to withdraw themselves
from the program because, to him, that would be akin to giving you inferior
care.

So this guy gets to unilaterally appoint himself as our doctor? I certainly
didn't hire him.

>>> He boasts about his $5 Wal-Mart fleece jacket, and is an astrology
enthusiast. “I’m positive,” Dr. Feinberg says to a reporter good naturedly, if
inaccurately, “you’re Sagittarius.”

He's also heavily into astrology and was asking the interviewer his sign and
trying to guess it. I certainly would never hire a doctor that was into
astrology. How can I fire this guy?

How TF do you become a doctor that believes in astrology?

~~~
carapace
> Planet Money had an interview with Dr. Feinberg

Got a link?

~~~
jnordwick
I can't find it, sorry.

~~~
carapace
I tried to search on their site but it didn't work out (I block JS, couldn't
figure out which set of whitelist selection would make search work w/o
enabling tracking. Derp NPR, derp.)

~~~
jnordwick
I tried too. I was just listening to in Friday on the Planet Money podcast on
Spotify. It was definitely their voices too, not All Things Considered or
anything, and it had Dr. Feinberg's voice too.

(lol, that comment is back down to -1 again. Apparently you cannot say
anything bad about astrology on HN either.)

------
Despegar
>As Google has moved to expand its data collection, some potential partners
have been put off by what they viewed as the company’s aggressive maneuvers to
acquire data without providing enough information on how it would be used.

>Google pushed one medical-data manager not to share data with other
companies, according to a person familiar with the pitch.

>As part of its huge offer for Cerner, whose software is embedded in doctors’
offices in 30 countries, Google used its size to its advantage. Google Cloud
executives offered that other arms of the conglomerate would buy unspecified
other services from Cerner, people familiar with the matter say.

>Cerner ultimately accepted a less generous offer from Amazon, in part because
the company decided Amazon was more trustworthy on security, according to one
of these people.

>Existing players in the health-care data market also fear that the tech giant
will gain too much power in their industry. Some hospital and technology
executives say they declined deals with Google lest it become a future
competitor.

>“We could never pin down Google on what their true business model was,” says
a Cerner executive involved in the discussions.

It seems like Google is using GCP as a venus fly trap and Cerner was right to
avoid them. The lure is cheap bog standard cloud services, but only if you
have a more all-encompassing partnership where your data helps them develop
other Google products.

>Reiterating what Google has told lawmakers and industry executives in private
meetings over the past two months, Dr. Feinberg says he operates on a personal
directive from Mr. Schmidt: “Don’t worry about making money.”

This quote is extremely telling in my opinion, and it's just classic Google.
The most generous interpretation of this is that Google has altruistic
motivations to make advances in health and they shouldn't worry about how to
monetize whatever they build. That of course is completely absurd and
extremely dangerous because that is exactly how Google slides into evil (evil
is banal). The less generous interpretation is that Dr. Feinberg is only there
to provide a sheen of health industry credibility (key opinion leader) and he
has no actual ownership of Google's health business at all.

And judging by this paragraph, I'm leaning to the latter:

>Outcry over the Ascension deal, including a federal inquiry and objections
from patients, shocked executives inside Google, and opened fissures in its
top ranks over how to proceed, according to people with knowledge of the
discussions. The head of Google Health, Dr. Feinberg, pushed to tell the
public more about his division’s operations, but met resistance from longtime
staffers who cite the company’s tradition of keeping potential new products
under wraps.

~~~
carapace
In re: “Don’t worry about making money.”:

They're sitting in a firehose of cashflow. They waste more in a day than most
people earn in a lifetime. I was working as a contractor there and the Occam's
Razor hypothesis I formed to account for the massive waste I saw was that they
have so much money that they can afford to _sequester_ talent. (Meaning, they
can hire a bunch of people just to keep them from working for competitors.)

I know that's not true, but it's less upsetting than admitting they're just
that wasteful.

~~~
Infinitesimus
> Meaning, they can hire a bunch of people just to keep them from working for
> competitors.

I think that's pretty true and partly explains why they respond so well to
competing offers from other tech companies when you're negotiating salary

------
shrike
Assuming Google has access to patient PII would this data be covered by the
CCPA
([https://en.wikipedia.org/wiki/California_Consumer_Privacy_Ac...](https://en.wikipedia.org/wiki/California_Consumer_Privacy_Act))?
I couldn't find a Health Data option at
[https://takeout.google.com](https://takeout.google.com).

~~~
JMTQp8lwXL
De-anonymzed (health) data likely isn't covered by HIPAA, and with a few still
generic data points likely associated with the health data, such as health,
gender, age, and location -- you could work backwards to reach an identity.
There's likely a loophole for whole security of health data thing.

~~~
pgodzin
Did you mean de-identified instead of de-anonymzed?

~~~
JMTQp8lwXL
I meant anonymized can easily become de-anonymized.

------
rb808
I can't read it but sounds like a good thing. Its always a waste to see our
smartest developers working on social media or advertising. Hopefully the
teams at Google can improve our healthcare which would be one of the most
rewarding things they could work on.

~~~
saagarjha
It would be a shame if that data ended up being used for advertising, though.

~~~
deadmutex
From the article:

"The company says its intentions in health are unconnected with its
advertising business".

I posted this exact comment elsewhere in the thread. You can search for a
discussion on this page around it.

~~~
coding123
Don't have to believe it.

~~~
shadowgovt
But we'll believe the rest of the article? By what criteria do we pick and
choose?

~~~
wongarsu
Incentives.

Does it make sense for a tech giant employing lots of data scientists and
existing health products (Google Fit) to expand further into Health? Yes.

Does it make sense for a company earning most of their money through
advertising to keep health data they are processing completely separate from
their core business? In the long run yes, but they can also make a lot of
money in the short to medium term by breaking that commitment

~~~
deadmutex
> they can also make a lot of money in the short to medium term by breaking
> that commitment

I personally don't see an incentive for Google to make a quick buck by
sacrificing the long term. I see it as quite the opposite, since Google has a
lot of cash on hand. See [1]

[1] [https://markets.businessinsider.com/news/stocks/alphabet-
goo...](https://markets.businessinsider.com/news/stocks/alphabet-google-
parent-now-has-more-cash-than-apple-2019-7-1028404234)

------
utopian3
Article is paywalled. If someone can see it: is the premise that Google is
harvesting patient data for their own AI/ML healthcare projects' benefit? Or
is this just cloud storage (Cerner putting objects in a bucket)? Or both...

~~~
jnetterf
Cerner just wanted cloud storage. Google gave them a good offer, seemingly to
harvest patient data for their own project.

You can use archive.is to read some paywalled content:
[http://archive.is/RcG5b](http://archive.is/RcG5b)

~~~
gordon_freeman
As per the article: And then Cerner got skeptical of Google's real intent with
its Cloud business model and went with AWS instead.

------
drevil-v2
I find it disingenuous that the article refers to Google as a “tech giant”.
The implications are far more sinister if instead it was referred to as
“advertising giant” as advertising is what is what is driving Google to
acquire this data.

Call it for what it is.

~~~
deadmutex
From the article:

"The company says its intentions in health are unconnected with its
advertising business".

~~~
obmelvin
Exactly. There is so much money to be made from healthcare service, it is a
market & revenue stream totally separate from advertising, and it can provide
great value to many people.

There are things one could be critical of regarding their acquisition of data,
etc. but I don't think it is in Google's best interest to use the data for
advertising.

~~~
allovernow
Why would you trust a literal corporate mouthpiece? You think Zuckerberg cares
about your privacy too?

No way in hell Google isn't going to use this for advertisement. It's exactly
the kind of huge free money that drives everyone else to collect data totally
unrelated to their core business. Even if the intentions are benign now,
there's no reason to trust they'll be so later, based on Google's track record
and the typical tech mindset.

Just imagine the kind of profiles you could build on people with medical data.
Beyond targeted drug advertisement, medical devices, and the like, you know
which people are sedentary, which play sports, who probably smokes, and I'd
bet good money there are correlations between certain conditions and shopping
habits, religious preference, and even political preferences. Just begging to
be clustered with the latest hot neural net.

~~~
joshuamorton
> No way in hell Google isn't going to use this for advertisement.

There are ample ones: It's illegal, it's highly unethical, and you wouldn't be
able to keep something like that a secret.

> Even if the intentions are benign now, there's no reason to trust they'll be
> so later, based on Google's track record and the typical tech mindset.

What track record?

~~~
rhizome
Why do you say it's illegal? Google is not a covered entity under HIPAA as far
as I can tell, is it something else?

~~~
jrs95
I was under the impression that HIPAA applies to anyone in possession of
private healthcare information (medical information tied to personally
identifiable information)

~~~
Consultant32452
[https://www.hhs.gov/hipaa/for-professionals/covered-
entities...](https://www.hhs.gov/hipaa/for-professionals/covered-
entities/index.html)

It doesn't appear to be as broad as you (and I) imagined. Google might qualify
as a "Health Care Clearinghouse" in this case, but it's far from clear.

~~~
nvrspyx
As that link states, HIPAA extends to "business associates". Google isn't a
"covered entity" as that has a specific definition, but it is a business
associate in relation to a covered entity (e.g. health care providers). The
reason for the two different terms is because covered entities deal with
patients directly, thus have certain rules that only apply to them in relation
to interacting with said patients. Since Google is a business associate that
does not directly interact with patients, only the rules specifically in
relation to PHI and other business activities apply as others (e.g. patient
interaction) are moot.

Protected Health Information is protected under HIPAA for both covered
entities and business associates alike. Otherwise, HIPAA would be pointless if
covered entities could just pass the PHI to business associates or shell
companies unfettered.

Note: I would not consider myself a "HIPAA expert", but I'm a clinical
researcher that has to ensure HIPAA compliance for my lab.

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neuro_image3
Well we've given google everything else, we may as well give them all our
healthcare information too.

So glad our corporate surveillance masters are teaming up to infiltrate every
aspect of our existence.

~~~
jocoda
Rather say that google _took_ everything else. Few realized the value of what
was up for grabs at the time but by making life easy for web developers with
g-analytics google created a firehose of user data. By using g-analytics we
gave the web away.

Where is this firehose of health data is going to lead to?

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hi5eyes
how long until google shuts down their health service apps

~~~
outside1234
probably right after GCP

