Data mining by hospitals may be profitable, but not risk-free

The USA Today published a story yesterday about a few hospitals using aggregated consumer data for marketing of such hospitals' most lucrative services. The article describes several instances where such direct marketing efforts yielded significant profits for the hospitals.

We see healthcare providers using aggregated and de-identified data on a regular basis, both for marketing and research purposes. We also see third party vendors (including EHR vendors) adding data mining provisions in their license agreements, which allow such vendors to use the healthcare provider's de-identified patient data for such vendor's internal and commercial purposes.

While these practices are widespread and are becoming standard, they are certainly not risk-free.  Healthcare providers should keep in mind that the updated HIPAA Privacy Rule (as modified by the HITECH Act) includes significant new restrictions on covered entities' marketing efforts. Providers should make sure that their marketing efforts, as well as the marketing activities of their subcontractors and business associates, fully comply with these recent regulations. This may require revisions in existing contracts, including Business Associate Agreements, between providers and IT vendors.

Healthcare providers should also insist on full indemnification by the IT vendors against all claims and damages arising out of such vendor's use of the provider's de-identified patient data. Studies have shown that de-identified data can be aggregated or de-identified inappropriately; and it can also be re-identified. Providers should protect themselves contractually prior to allowing the vendor to access and use the hospital's data (including patient data).

The above is certainly not an exhaustive list of all potential issues associated with data mining by healthcare providers and their business partners. But the USA Today article should serve as a good reminder that healthcare providers engaging in such data mining and marketing activities must protect their organizations from liability for damages relating to such data use.

"Hospitals mine patient records in search of customers," USA Today (February 5, 2012).

In the news: Privacy breaches and de-identification

  • According to LA Weekly, Huping Zhou, a former employee at the UCLA Healthcare System, pleaded guilty to federal charges of breaches of patient privacy.  Zhou, 48, accessed the UCLA patient records system 323 times during the three-week period, mostly looking for the files of celebrities, after being let go by the hospital. Names of targeted celebrities have not been revealed.  This case follows a similar breach at UCLA Medical Center, when Lawanda Jackson, a former nurse at the Center, plead guilty to wrongfully accessing information of Britney Spears and Farrah Fawcett.
  • Delaware Online reports about a new unfortunate trend in medical identity theft -- searching for copies of discarded prescriptions:  "In the latest crime trend to hit Delaware, police are reporting that people looking for drugs such as Oxycontin and Vicodin are stalking customers who throw away prescription bags containing paperwork with details about their pills and themselves. They use the personal information to call in prescriptions and charge them to the victims' insurance. Then they turn around and sell the drugs."  According to Bruce DiVincenzo, chief agent of Delaware's Office of Narcotics and Dangerous Drugs:

They're making their own scripts by ordering paper from the Internet," he said. "It's the patient's name that they want, because that person is actively listed as a customer of the pharmacy and will not raise suspicion."

Pharmacies like CVS and Happy Harry's (a subsidiary of Walgreens) take certain precautions to prevent such identity theft, including checking ID's before filling prescriptions and reminding customers to be careful with their receipts and copies of prescriptions.

  • According to Washington Technology, HHS is looking for a contractor to research the effectiveness of "de-identifying" PHI:

Under this new contract, HHS will research re-identifying the data and matching it to a specific individual.

'The contractor shall take one or more HIPAA Privacy Rule de-identified data sets and, using methods and technologies that exclude 'brute force' matching, demonstrate the ability or inability to re-identify the data,' the notice states.

The re-identification must be an accurate and unambiguous match to an individual.

"Former UCLA Health Worker Pleads Guilty To Accessing Celebrities' Medical Records," LA Weekly (January 8, 2010).

"Delaware crime: Trash-picking identity theft targets pharmacy customers," Delaware Online (January 6, 2009).

"HHS wants contractor to test privacy of 'anonymous' data," Washington Technology (January 5, 2010).