Facebook’s mission statement used to be “to give people the power to build community and bring the world closer together.”
All that’s changed. Zuckerberg startled the world last February when he announced: “We’ve taken steps to reduce the distribution of health-related misinformation on Facebook, but we know we have more to do. We’re currently working with outside experts on additional changes that we’ll be announcing soon.” [This is usually the point where you want to reach for your wallet, just to make sure these grifters don’t try to snatch it. –Ed.]
Forget that Facebook has had a bit of a checkered history when it comes to healthcare:
- Improperly sharing membership data from private patient groups to marketers.
- Answering the call of lawmakers and organizations like the AMA to combat misinformation about vaccines.
- Demonetizing content and tweaking search algorithms to surface information deemed “accurate” while removing groups and pages that promote misinformation according to Zuckerberg.
- Allowing the company’s blood donation request feature, launched in the U.S. earlier this year, to be infiltrated by black market blood sellers.
- Pairing hospital EHR data with demographic and social data that had to be halted in the wake of the Cambridge Analytica scandal due to the personal data of approximately 87 million Facebook users falling into the hands of a political consulting firm.
- Unveiling new mapping tools to help public health organizations stay ahead of disease outbreaks and guide disaster response; something that is definitely NOT in their charter of helping people “connect with family and friends.”
Soon is now, apparently. Facebook just hired Healthtech entrepreneur and the former Google Health strategist Dr. Roni Zeiger as its newly created Head of Health Strategy to launch its ambitions in healthcare. A part-time urgent care doctor, Zeiger has spent the bulk of his time finding ways “to tap into the knowledge created by networks of engaged patients.” Concerns regarding the potential for a patient to see their healthcare as a “one-size-fits-all” proposition has been a challenge for physicians. They walk through the doors with a laundry list of expectations based on their own, often limited, understanding of their disease, putting their doctors in the unenviable position of either having to comply with their requests or explain why unlike patient X, they should not get treatment Y. This, of course, has increased healthcare costs as physicians are reluctant to deny a patient anything out of fear of malpractice. If the patient wants an MRI when an x-ray will suffice, they will give them the MRI and justify it. It’s cheaper than taking the chance that they’ll be wrong for that small percentage of patients who might actually need an MRI due to the unforeseen. In other words, it’s easier to give patients what they want.
Payers have pushed back, however, carving out certain procedures as “experimental.” Patients are now pushing back, too. They want the “right to try” and Trump agrees with them. He recently signed an executive order giving them the opportunity to do exactly that, although it’s not entirely clear who is going to pay for it. While no one would want to deny a patient the chance to live a longer, healthier life, it is a fact that many such treatments do not pan out as being good for anybody. Decades ago, some provider groups were sued for not offering bone marrow transplants to women with stage IV breast cancer. After all was said and done, patients suffered horrendous side effects with no measurable benefit in terms of outcomes. The public is not necessarily served by the proliferation of unproven treatments that are costly and possibly harmful.
Healthcare is complicated and now we’ve got Zuckerberg [again, Zuck is not a human being but a synth –Ed.] entering into the mix encouraging patients to swap personal stories so Suzie Que in MI can “try” what worked for Jimmy Swift in NY. If it were just swapping stories, maybe it would be OK, but now we’ve got anecdotal stories, coupled with specific information deemed appropriate by Zuckerberg, who has been known to accept millions from the “he don’t care” group, shaping these stories into a path that might seem really attractive to a person who is sick. Think selling snake oil from the back of a covered wagon. Too many doctors are also getting into the mix recommending new procedures for their patients. Forget that they’re prohibited from referring a patient to a facility where they have a financial interest. Why refer the patient anywhere when they can strong arm the patient into trying “something new” by threatening to cut off their supply of opiates if they don’t. These terms are often built into the “pain contracts” patients are required to sign to be under the care of a pain management specialist. Of course, if the treatment pans out, the physician will share in the profits down the road (wink, wink). Think it’s not happening? Think again.
“Yes, siree, folks. Are you feeling down? Have the doctors given up on you? Well, have I got the thing for you.” Think this doesn’t happen?
https://www.distilnfo.com/provider/2019/06/24/facebook-adds-former-googler-roni-zeiger-as-its-new-head-of-health-strategy/
P.S. This story was written before Project Veritas released two more explosive videos, exposing how platforms such as Facebook and Google are furiously trying to engineer search results (i.e. algorithms) to produce results more in keeping with their ideology. (Yours Truly said that this was happening last year. Apologies accepted.)
People are being encouraged by Zuckerberg, et al., to share their medical histories with others and compare notes on FACEBOOK. As far as I know, Zuckerberg isn’t constrained by HIPAA regulations with respect to privacy. He can do whatever he wants with that data, including sell it, as he has done in the past.
Not too long ago, a colleague told me he quit working for a major payer when he discovered they had paid a third party vendor to track the buying habits of their membership. In other words, if you had a cardiac condition and bought a pound of bacon every week with your credit card your premiums would go up. With more legislation restricting insurers from using preexisting conditions to set premiums, payers are going to start doing things like this, if they aren’t already.
It’s not called A Brave New World for nothing, isn’t it?
I have a colleague who won’t use her buyer’s card when purchasing items at the chain pharmacy where she works, even though she’ll get “extrabucks” every so often. I asked her why and she told me just what you wrote above.
Scary.
So zuckerberg is now at the level of the ignorant fool at the bus stop saying ‘ ‘ have one of these dearie , they did my lumbago a power of good,’! to the cardiac patient who helping themselves to her NAISDS such as. ibroprofen,can lead to stroke and cardiac arrest, and certainly higher BP. Just to illustrate.
Failing to understand contra indication in medicine is a great killer.
Yes sharing experience is good but the benefit as in meta – data comes from seeking out of statistics the over all trend over time. Often because B follows A, does not mean one is causal to the other. I despair.
Zuckerberg the infallible modern fool, arrogant stupidity. Truly we enter a new dark age of ignorant stupidity.
Ah, yes, HIPPA. It is a joke. It does not seriously protect any one’s privacy or rights. The electronic records requirement under HIPPA merely exposes those records to anyone who has the skill and the desire to know them; raises both medical costs and insurance costs because of the money providers and insures have to spend on compliance. But wait, there is more…..
Just one small example: In the underwriting of life insurance, medical records are frequently required to complete the underwriting. Before HIPPA, as a underwriting manager in a local agency, I was able to order such records myself and arrange for quick and fair compensation for the health providers time. Sometimes I could pick them up the same day. Usually it took a maximum of three weeks if the office manger was uncooperative (most were not).
Now, the insurance company, after receiving the application and setting it up in their system has an underwriter reviews the application and determines if records should be ordered (delaying their request by several days). Then the underwriter puts in a request to the insurance company’s certified HIPPA records provider and pays a fee. The insurance company’s certified HIPPA records provider sends the request, not to the actual health provider, but to the certified HIPPA records provider for the doctor, clinic or hospital that has the records, for a fee. The provider’s certified HIPPA records provider then obtains those records from the actual health provider, sends them back to the insurance company’s certified HIPPA records provider who, if they don’t forget, sends them to the requesting insurance company. Average time is three weeks.
This way does nothing to insure privacy, in fact it opens the health records to many, many more people and creates massive possibility of leaks and theft of that information since most of the transfer of information is done electronically.
Despite the supposedly quicker electronic communication, the amount of time required for the company to receive such information has grown, the chances of it going somewhere it shouldn’t grown, the chance of it never getting to the intended destination has grown. Plus it can just sit in a queue someplace without any one noticing.
I have been told by company’s who literally have nothing else to do but obtain medical records and send them to the correct place that they have a three to four week backlog.
HIPPA is a joke, it was the first foray of the federal government into control of our medical records and sold on lies just like Obamacareless. HIPPA is used to coerce provides into certain types of care as well and discourages other types of care.
There is a section of HIPPA that allows insurance companies and drug companies to get access to pretty much any medical records they want concerning prescription drug usage and all they need is someone’s name. No release is required. How’s that for privacy. It is even easier for we seniors who have Prescription drug coverage through Medicare Part D.
The people who think up these “privacy” laws make Franz Kafka look like a perfectly rational reporter. Of course “buyer cards” are a way of obtaining your purchasing data and the discounts you get are cheap compared to the money that those who obtain your data can sell it for.
The moniker Big Data, is used to describe the consortium of businesses that obtain and control and sell data on all of us each and very day (including our posts here BTW). It is one of the reasons that I decided early on not to use a screen name or cloak who I am. It doesn’t matter.
Forget the idea of privacy especially if it is “protected” by the Federal Government. Privacy is used to manipulate us into agreeing to all sorts of foolish, immoral and even evil things (like abortion for instance).
If I am embarrassed or ashamed by my behavior, then I probably have some confession to do.
I guess a lot has changed in the few years that I have been away from all this, but back in 2015, I had to jump through all kinds of hoops to satisfy our compliance officer that I wasn’t violating HIPAA rules right down to the requirement that you can’t disclose the birthdate of a Jane Doe in a small town if there are fewer than X number of people living in that town over that age because the patient could be identified by their birth year alone. In other words, if Aunt Bee is the only one in Mayberry over the age of 70, you wouldn’t need to know her name to identify her. You could identify her by her birthdate. We weren’t even allowed to use an identifier, like a medical record number, that could be traced back to the patient within our system. This was for a Fortune 500 company with over 5M members in the Medicare/Medicaid market so I’m guessing the rules we had to follow were pretty routine. – Perhaps now all that is left is the illusion of privacy.
Yes HIPAA is a joke. Idiot doctors refuse to use email on the ground sit is a HIPAA violation. But I met the authors of HIPAA and they disagree. Today’s doctors are such leeches, they don’t deserve respect.
That’s not fair. Doctors and other health care professionals today live and work in a climate of abject fear.
George, correct and HIPPA is an instrument of that fear. Government intervention in other areas regarding patient care is also quite constricting.
I had a highly qualified, competent caring nurse tell me that had the environment been the same when she entered the profession, she would not have chosen it as a career.
There is more time spent on input than actual patient care. But no matter how much info goes in, it never seems to come out in a way that helps patients.
How many different price points do you have on a typical medication? My semi-educated guess is, at times, dozens.
Abject fear? Anyone who has been properly instructed in medical documentation – particularly in matters related to mental health, addiction, and any matter with the potential to be “stigmatizing” (e.g. HIV/AIDS, HCV, STD’s, etc.) – knows how to comply with the law, the requirements necessary for reimbursement, and to convey to others responsible for providing care a “summary” of the situation to date, without revealing the “intimate details” of the patient. It is perfectly acceptable to keep separate, private notes for yourself that are inaccessible to the Electronic Health Record (EHR). Private notes are not safe from subpoena, but it takes considerably more effort to secure them, and the courts are increasingly more reluctant to force their release.
I suspect they have lived in “abject fear” since the proliferation of EHR systems that flooded the behavioral health market as a result of the HITECH Act. The federal government set aside $27 billion in grants to encourage their adoption. I was in charge of approving these grants for the Department of Mental Health in Los Angles, the largest county-operated mental health department in the United States. Financial incentives were also put in place, as well as the mandate that all public and private healthcare providers be required to adopt and demonstrate “meaningful use” of EMR (electronic medical records) by January 1, 2014, as a part of the American Recovery and Reinvestment Act.I don’t know how you were “instructed” in medical documentation, Michael, but you can’t hide the patient’s medical record anymore. These systems collect everything and do so by design. The data breaches since 2008 are staggering. https://www.commonwealthfund.org/publications/newsletter-article/federal-government-has-put-billions-promoting-electronic-health
Data breaches: https://www.hipaajournal.com/healthcare-data-breach-statistics/
That’s part of it. The HIPAA regs are only part of the things that are choking the practice of medicine and pharmacy. These insane opioid regs are causing genuine hurt as well. I could go on.
As anyone with the requirement to enter notes manually or into an EHR is aware, there are significant ethical obligations one has to the patient before the medical record. According to the DHHS instructions, the HIPPA law itself allows care providers the right to their “expertise and professional judgment.” The operating concept is that the paramount clinical obligation is to protect the life and welfare of the patient, which at times 1) may result in a decision to “violate” HIPPA in order to inform an otherwise unauthorized third party, an adult child, for example, when an aged parent increasingly cannot manage the tasks of daily living on their own; or a parent when their child is a danger to themselves or others. Secondly, the converse is also true. While an EHR requires a specific diagnosis – for example, with an STD, lab results included in the record are hardly deniable – it would be inappropriate to identify how or from whom the STD was contracted is a clinical note (e.g. “expertise and professional judgment” should prevent entering such information when there is a threat of violence). Per the DHHS Office for Civil Rights, “HIPAA Helps Caregiving Connections.”
I did not suggest, by any stretch of the imagination. that anyone should attempt “hide” medical records. I am insisting, again, however, that it is perfectly acceptable to keep separate, private treatment or therapy notes for yourself, that are inaccessible to the Electronic Health Record (EHR), and the HIPPA Law refers to this distinction.
Further, the DHHS makes a special exception of mental health notes: “Psychotherapy notes are treated differently from other mental health information both because they contain particularly sensitive information and because they are the personal notes of the therapist that typically are not required or useful for treatment, payment or health care operations purposes other than by the mental health professional who created the notes.”
In every case, the intention of HIPPA is to protect patients, while still continuing to provide reimbursement claims to providers. But as the distinction made by DHHS above clearly indicates, no third party has a right to information not required or useful for treatment, payment or health care operations purposes. Many clinicians are never taught that their rights and responsibilities as providers, while continuing to function within the law.
Actually, every doctor I know has portal for communicating. My only issue with my primary’s portal is the portal provider which has a record of being hacked and forces use of an insecure Gmail account as the login.
Anything put on line is hackable.
Gail is correct–there is only an illusion of privacy.
The HIPPA provisions are enforced at the level closest to the subject. I have to shred anything that has a potential client’s name on it if it is not going into a file. I follow the rules. We have an IT guy that keeps us in compliance on the electronic side.
Nevertheless the data flows freely at the mass level. Same with financial data.
It looks good but it does not really protect anyone. If someone wants your info, they can and will get it.
Still even shredding can expose someone’s data unless every business has their own on-site shredder and disposal.
Smaller businesses hire shredding services.
Bingo!
Greek doctors are the worst.
They think they know everything and never listen.
Take two ouzo and call me in the morning.
Not fair. While I am an unstinting critic of the modern Greek polity, I have heard very good things about doctors in Greece today. Like doctors in the UK, you don’t go into medicine to get rich but because you have a yen for diagnosing illness. Believe me, I was shocked to hear this assessment of Greek physicians but it’s come from too many disparate sources to hear otherwise. Mind you, I’m not talking about hospitalization per se but the capabilities of Greek doctors to diagnose and practice individualized medical care.
Social networks operate on methods of mass social acculturation, trying to enforce their ideas using the methods of slavery, where brutal, random, whimsical, shameless reward and punishment broke the will into absolute submission into cowering fatalistic supplicancy.