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Chronicles

The story behind the story

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A look at Google's healthcare efforts, like Project Nightingale and “Guardian” search tool, which are drawing scrutiny over mass collection of medical records

The company has struck deals that grant it access to millions of patient records  —  PALO ALTO, Calif. … Tweets: @zagrrl , @frankpasquale , @wsj , @bob_wachter , @erictopol , @danamattioli , @dangillmor , @elementolab , and @blmohr Tweets: Dr Gail Barnes / @zagrrl : A partnership w/ Mayo Clinic allows Google access to personally identifiable information when needed. When the arrangement was announced in September, the hospital system said publicly that data wouldn't include names or other identifiable details. https://www.wsj.com/... Frank Pasquale / @frankpasquale : “The deals allow Google to access personally identifiable health information without the knowledge of patients or doctors. The company can review complete health records, including names, dates of birth, medications and other ailments” https://www.wsj.com/... @wsj : Google has achieved the ability to view or analyze tens of millions of patient health records in at least three-quarters of U.S. states. Here's what that means for health care and privacy. https://www.wsj.com/... Bob Wachter / @bob_wachter : @WSJ w/ another big piece on @Google's efforts to acquire health data: not just @Ascensionorg but also @Intermountain. & @MayoClinic deal more complex than previously reported https://www.wsj.com/... Related podcast: https://podcasts.apple.com/... Interesting quotes from David Feinberg Eric Topol / @erictopol : On the @GoogleHealth deals with health systems for data access https://www.wsj.com/... by @realrobcopeland @DanaMattioli @_melaevans Much of the concerns would be preempted if patients owned their data and agreed to share https://twitter.com/... Dana Mattioli / @danamattioli : Google wants patient health records so badly that it dangled $250 million in credits & the potential to buy services from Cerner to try and woo the healthcare company onto its cloud w/ @realrobcopeland @_melaevans https://www.wsj.com/... Dan Gillmor / @dangillmor : WSJ: As Google gets more and more of our health data (often without our knowledge or permission), its test is “convincing the public that it can be trusted with our most personal information.” Narrator: It can't. https://www.wsj.com/... Olivier Elemento / @elementolab : Important @wsj article. Most appalling IMO is the willingness of some medical systems to share medical record data with Google without patient consent, without asking what they will do with it and frankly with little if anything in return for patients https://twitter.com/... @blmohr : “In just a few years, Google has achieved the abil­ity to view or an­a­lyze tens of mil­lions of pa­tient health records in at least three-quar­ters of U.S. states...” https://www.wsj.com/...

Wall Street Journal

Context & Ripple Effects

This piece widens the aperture on a story that broke in November, when the WSJ revealed Google's Project Nightingale partnership with Ascension, the second-largest US health system, giving the company access to millions of patient records. The new reporting shows that arrangement was not an outlier: Google holds comparable data-access deals with Mayo Clinic — where personally identifiable information can be accessed despite the system's earlier public claim that names would be excluded — and Intermountain Healthcare.

The scrutiny lands at a moment when Google is actively buying its way into hospital IT, having offered Cerner $250 million in cloud credits and potential service purchases to move to Google Cloud. The follow-on coverage frames the core problem: as the FT put it, Google cannot reach its health goals unless systems like Ascension hand over patient data — and patient concerns are the obstacle.

First-order effects

  • Patients whose records flow to Google under the Ascension, Mayo Clinic, and Intermountain agreements have little visibility into the scope of access, and Mayo Clinic's gap between its public no-names claim and the contract terms puts those health systems' credibility on the line right now.

Second-order effects

  • Other hospital systems face a squeeze: signing data-access deals with Google offers algorithmic and cloud capabilities, but each new disclosure raises the reputational cost for the next system considering one — while rivals courting the same vendors, as Google did with Cerner, must now price in the privacy backlash.

Third-order effects

  • If the pattern holds, US hospitals consolidate into data suppliers for a handful of tech platforms — a trajectory already visible in Google's later HCA Healthcare algorithm partnership — which pushes regulators toward defining how much identifiable patient data commercial analysis partnerships may consume under existing health-privacy law.

The trend: Big tech's entry into healthcare is running through hospital data-access agreements rather than products, making patient trust and privacy scrutiny the binding constraint on how fast these deals multiply.

Discussion

  • @zagrrl Dr Gail Barnes on x
    A partnership w/ Mayo Clinic allows Google access to personally identifiable information when needed. When the arrangement was announced in September, the hospital system said publicly that data wouldn't include names or other identifiable details. https://www.wsj.com/...
  • @frankpasquale Frank Pasquale on x
    “The deals allow Google to access personally identifiable health information without the knowledge of patients or doctors. The company can review complete health records, including names, dates of birth, medications and other ailments” https://www.wsj.com/...
  • @wsj @wsj on x
    Google has achieved the ability to view or analyze tens of millions of patient health records in at least three-quarters of U.S. states. Here's what that means for health care and privacy. https://www.wsj.com/...
  • @bob_wachter Bob Wachter on x
    @WSJ w/ another big piece on @Google's efforts to acquire health data: not just @Ascensionorg but also @Intermountain. & @MayoClinic deal more complex than previously reported https://www.wsj.com/... Related podcast: https://podcasts.apple.com/... Interesting quotes from David Fe…
  • @erictopol Eric Topol on x
    On the @GoogleHealth deals with health systems for data access https://www.wsj.com/... by @realrobcopeland @DanaMattioli @_melaevans Much of the concerns would be preempted if patients owned their data and agreed to share https://twitter.com/...
  • @danamattioli Dana Mattioli on x
    Google wants patient health records so badly that it dangled $250 million in credits & the potential to buy services from Cerner to try and woo the healthcare company onto its cloud w/ @realrobcopeland @_melaevans https://www.wsj.com/...
  • @dangillmor Dan Gillmor on x
    WSJ: As Google gets more and more of our health data (often without our knowledge or permission), its test is “convincing the public that it can be trusted with our most personal information.” Narrator: It can't. https://www.wsj.com/...
  • @elementolab Olivier Elemento on x
    Important @wsj article. Most appalling IMO is the willingness of some medical systems to share medical record data with Google without patient consent, without asking what they will do with it and frankly with little if anything in return for patients https://twitter.com/...
  • @blmohr @blmohr on x
    “In just a few years, Google has achieved the abil­ity to view or an­a­lyze tens of mil­lions of pa­tient health records in at least three-quar­ters of U.S. states...” https://www.wsj.com/...