
Bosses Harness Big Data to Predict Which Workers Might Get Sick - uptown
http://www.wsj.com/articles/bosses-harness-big-data-to-predict-which-workers-might-get-sick-1455664940
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uptown
"Castlight recently launched a new product that scans insurance claims to find
women who have stopped filling birth-control prescriptions, as well as women
who have made fertility-related searches on Castlight’s health app."

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kafkaesq
Profoundly creepy.

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maratd
I think that's an understatement. Unless that data is completely anonymized,
isn't it a violation of HIPAA? Isn't this illegal?

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dragonwriter
> Unless that data is completely anonymized, isn't it a violation of HIPAA?

It sounds to me from reading various articles that Castlight is used in
various ways, including to provide information and recommendations to
employees. This use is probably fine under HIPAA.

Information that gets sent back to employers that uses PHI from insurance
claims, absent specific consent for the use intended, would seem on first
glance to be a HIPAA violation on the part of the insurer.

And, actually using it in a discriminatory way (which paying to gather it
would be _prima facie_ , though not dispositive, evidence of) would violate a
whole lot of employment law on the employers part.

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riahi
Correct. PHI coming from insurance claims absent a signed HIPAA release for
uses related beyond "treatment/medical education, payment, and operations"
would be a HIPAA violation on the part of the insurance company.

Employers themselves are not HIPAA-covered entities. Insurers _are_ however.

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braythwayt
So... Can employers use this to predict which employees might become
depressed? How about which employees might get pregnant?
([https://twitter.com/mims/status/699964784783990789](https://twitter.com/mims/status/699964784783990789))?

It’s a Brave New World of work. At Walmart, of course.

~~~
HillRat
If the wellness program is offered as part of a group health plan, then the
wellness-plan provider is a business associate of a covered entity under
HIPAA, and PHI protection applies. So in these cases, the employer cannot have
access to individual employees' health information and, more to the point,
they usually don't want it -- they're trying to cut overall costs, not
individual employees.

Having said that, I do think that more robust legislative firewalls are needed
to prevent companies from trying to push the envelope in accessing individual
employees' records (HIPAA controls covered entities' actions, but not
employers').

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6stringmerc
Caveat: In my experience, I've been subjected to a phone call from a
Registered Nurse who reviewed my personal health records and called to ask me
to switch to a cheaper medication because the company was going through some
financial difficulty. I'm 100% not making this up. Your assertion that a
company doesn't want personal health information of individual employees is
one that I do not agree with.

If a company can eliminate the 5% of people driving XX% of the premium cost -
through cancer, major surgeries, etc - then it stands to reason they would
undertake that method of reducing overhead.

The employer itself may not have access, but the party they hired may have
access, and I do agree that robust legislative firewalls and significant jail-
time for violators should be a national priority.

Or, in other words, I very much disagree "Wellness Programs" are actually
concerned with wellness (no assistance with dietary materials, gym
memberships, incentives, etc) and should be portrayed as "Health Cost
Containment Programs" which is significantly more honest.

~~~
bduerst
Who was this RN working for exactly? Your PCP? Your insurance company? A
broker? A third party?

I doubt they are employed at the company you work at, meaning your employer
isn't look at your health record.

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st3v3r
Employed directly? Maybe not. Employed by a company the employer asked to look
into reducing health plan costs? Most likely. And just as creepy and scummy.

~~~
bduerst
_Or_ it could be their PCP's RN asking them to switch their ongoing Rx to a
generic, because recent updates to their health plan means a higher co-pay or
deductible.

This happens more than you realize, and doesn't mean their employer violated
their privacy, which is why I ask.

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st3v3r
Then they would have introduced themselves as such.

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bduerst
Then it's an easy question to answer, isn't it? Any more insights into their
phone conversation, st3v3r?

Edit: I knew I recognized you, s73v3r -
[https://news.ycombinator.com/threads?id=s73v3r](https://news.ycombinator.com/threads?id=s73v3r)

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danvoell
Should we swap out "Big Data" for "Personal Information" or "Spying" in the
title of this article?

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sageabilly
How is it spying if it's information that's already available to the company,
either publicly or as a result of the person being an employee? It's not like
they're sending goons to dig through trash cans.

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danvoell
Sorry, I agree, spying may be a stretch. But so too is Big Data. It doesn't
take a complex algorithm to determine IsBuyingBirthControl vs.
IsNotBuyingBirthControl. I would like to think that I have the option to keep
this information private from my employer. The employer's best interest is to
minimize costs not to improve my health, most of the time these two correspond
but not always.

~~~
bduerst
Whether or not it's called big data is non-sequitur. Employers have had access
to claims data before the tools were available to process it en mass.

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FussyZeus
No amount of Economic benefit is worth the invasiveness of these practices. My
boss doesn't need to know what medications I'm on, what kind of food I eat, or
how many videogames I'm buying. If it's not occurring on company time it's
none of his business, end of discussion.

This creepy ass practice needs to be stopped now. If my employer ever tries
anything like this, I will quit on the spot. No redemption, no change, nothing
will bring me back because once it's been done one time, it WILL be done
again.

~~~
FussyZeus
Sidebar: This is why I much prefer working at a small business where employees
are treated like people, not resources to be extracted and then cast aside
when they no longer produce enough.

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untog
This is why, after years of living in the US, it still staggers me that people
think your employer controlling your access to healthcare is normal and not
anything to be concerned about.

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kafkaesq
...whilst maintaining the conditions that actually make them sick.

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adenner
This version of the article wasn't paywalled for me:
[http://www.nasdaq.com/article/bosses-harness-big-data-to-
pre...](http://www.nasdaq.com/article/bosses-harness-big-data-to-predict-
which-workers-might-get-sick-20160216-01321)

It is great to think that my employer is paying for this but just got rid of
our gym membership reimbursement.

~~~
brazzledazzle
Either good ol' right hand/left hand lack of
coordination/direction/information sharing or it wasn't "cost effective".
Either way, you have to love corporate bullshit.

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thanatropism
Ever heard about the manager who figured that about 40% of sick leaves take
place on Mondays or Fridays?

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kelvin0
Simple, we also need a : 'Employees Harness big data to predict which
employers are most likely to do crummy predictions'

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minikites
"We're not firing you because you're pregnant, we're firing you to cut costs!"

~~~
Avshalom
They're trying to kill me," Yossarian told him calmly.

No one's trying to kill you," Clevinger cried.

Then why are they shooting at me?" Yossarian asked.

They're shooting at everyone," Clevinger answered. "They're trying to kill
everyone."

And what difference does that make?

~~~
OneOneOneOne
Catch-22

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AstralStorm
Harness big data, such as typical flu season dates? Or maybe weather forecast?

What, do you need precision down to the last day for planning purposes?

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zodPod
So all I have to do is vote in a mid-term election and I'll be healthier?!
</s>

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falcolas
I couldn't get past the paywall, but let me take a rough guess: those working
in an open office after an illness hits the schools were most susceptible.
First the parents, then a few waves of those who caught it from them.

Based on experience from the last few months, two major illnesses (one viral,
one bacterial) flowed through the schools and into the parents, who came to
work and subsequently took out 3/4 the workforce.

Nothing unexpected, sadly.

~~~
DanBC
No, your post has nothing to do with the article, which starts with people
getting back surgery (or not) depending on which doctors they see.

Walmart spotted that, and decided to see if they can predict other stuff. They
now send messages to people "at risk of diabetes"

> Employee wellness firms and insurers are working with companies to mine data
> about the prescription drugs workers use, how they shop and even whether
> they vote, to predict their individual health needs and recommend
> treatments.

> Trying to stem rising health-care costs, some companies, including retailer
> Wal-Mart Stores Inc., are paying firms like Castlight Healthcare Inc. to
> collect and crunch employee data to identify, for example, which workers are
> at risk for diabetes, and target them with personalized messages nudging
> them toward a doctor or services such as weight-loss programs.

It has some other stuff too:

> Welltok Inc., whose clients include Colorado’s state employees, has found
> that people who vote in midterm elections tend to be healthier than those
> who skip them, says Chris Coloian, the firm’s chief solutions officer.

There are plenty of risks:

> “There are enormous potential risks” in these efforts, such as the exposure
> of personal health data to employers or others,” says Frank Pasquale, a law
> professor at the University of Maryland, who studies health privacy.

I'm reminded of the supermarket loyalty card scheme that was outing pregnant
women to their family by sending them vouchers for baby products (nappies
etc). Some of these women were young adults living with their parents. (I can
only find a link to a US story about Target:
[http://www.nytimes.com/2012/02/19/magazine/shopping-
habits.h...](http://www.nytimes.com/2012/02/19/magazine/shopping-
habits.html?pagewanted=1&_r=3&ref=charlesduhigg) But I think it's happened in
the UK with Boots too.)

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johnward
We get random boxes of baby formula and wipes after having a registry at
target.

side note: It's pretty hard to have a decent discussion when pay wall links
hit the front page. Half of us can't even read them. There is probably a way
around it but not worth my time.

~~~
hyperpape
I looked up workarounds today, and it's as simple as googling the article
title, then clicking the link.

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DanBC
Or, on HN, clicking the "web" link, and then clicking one of the results.

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johnward
Did not know the web link trick.

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the_economist
Hint: those workers who regularly stay out all night drinking alcohol will
miss many more days of work.

