Analysis: Much ado about the Ascension/Google Project Nightingale

• Google is engaged with one of the U.S.’s largest health-care systems on a project to collect and crunch the detailed personal-health information of millions of people across 21 states, according to The Wall Street Journal.
• Google began Project Nightingale in secret last year with St. Louis-based Ascension, a Catholic chain of 2,600 hospitals, doctors’ offices and other facilities, with the data sharing accelerating since summer, The Wall Street Journal reported.

The Wall Street Journal is reporting that, “Google is engaged with one of the U.S.’s largest health-care systems on a project to collect and crunch the detailed personal-health information of millions of people across 21 states. The initiative code-named ‘Project Nightingale,’ appears to be the biggest effort yet by a Silicon Valley giant to gain a toehold in the health-care industry through the handling of patients’ medical data. Amazon.com Inc., AMZN -0.80% Apple Inc. AAPL 0.79% and Microsoft Corp. are also aggressively pushing into health care, though they haven’t yet struck deals of this scope. Google began Project Nightingale in secret last year with St. Louis-based Ascension, a Catholic chain of 2,600 hospitals, doctors’ offices and other facilities, with the data sharing accelerating since summer, according to internal documents.”

The Wall Street Journal is also reporting that in addition to aggregating Ascension’s data from multiple disparate data centers into a Google cloud, Google has also created AI that does the following:

• Develops treatment plans and identifies deviations in care
• Determines replacements or additions of providers to the care team
• Enforces narcotics policies
• Detects missed revenue opportunities

The WSJ article, and subsequent stories, set off an avalanche of media attention given the players and number of Americans’ health records implicated, which has triggered an inquiry from the U.S. Department of Health and Human Services Office for Civil Rights. Almost as predictably, lawmakers from both sides of the aisle (some of whom are running for president) have expressed concern over the relationship.

Takeaway

First, this is why we, as taxpayers of the United States, subsidized (and mandated) the implementation of electronic health records (EHRs) to the tune of $19 billion. Allowing for data to be aggregated and analyzed at scale to improve care delivery (both what’s ordered and how its delivered) and streamlining administrative operations is the future of healthcare, and probably our best hope for reducing expenditures in a way that doesn’t result in blunt rationing.

Without knowing exactly what’s occurring, it’s difficult to definitively say that this arrangement and use of data is permissible by HIPAA. But if what’s being done sticks to the four buckets above, this should fall squarely into “treatment, payment and operations” and be legal.

If this were Ascension and a “traditional” healthcare analytics company, this news would be considered a below-the- fold news item. And it’s only a news item because of Ascension’s size and the company that inked the deal wants to crow about it. But given Google’s recent history of collecting data without consent and then using that data to develop targeted advertising, it raised eyebrows and hackles.

Second, given the heightened concern about how personal data is used (and reused), and the privacy and security of patient data, Ascension and Google should have developed a comprehensive media strategy and publicly announced this. While they would have probably had to answer the same questions, the optics of it would have been far better, and they could have controlled the message to a far greater extent. They had to know at some point this was more than likely going to hit the press (and subsequently the fan).