Google's controversial deal with more than one hundred and fifty hospitals in the United States

Google, through its online data hosting platform (Google Cloud), has signed an agreement with Ascension, one of the largest health players in the United States. SEBASTIEN VUAGNAT / AFP

"Exclusive: Nightingale, Google's secret project, amasses the personal health data of millions of Americans": the title of this article published by the Wall Street Journal Tuesday, November 11th is scary. Especially since, according to the newspaper, "Patients have not been informed" of this transmission of personal information.

The digital giant, through its online data hosting platform (Google Cloud), has signed an agreement with Ascension, one of the largest players in health in the United States, which operates two thousand six hundred health care sites, including 150 hospitals and 50 senior homes. The contract – the largest negotiated by Google in the sector – provides for the transfer of complete medical records: patient identity, diagnoses, test results, antecedents.

The goal is to try to develop, through data analysis and using artificial intelligence (AI), tools to suggest to doctors complementary examinations, additional benefits or treatments, or even identify abnormalities in the course of care, explains the Wall Street Journal.

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The sensitive area of ​​health questions

How is it possible that patients have not been informed? Google and Ascension have clarified a posteriori that the agreement was legal and respected the Health Insurance Portability and Accountability Act (Hippa). This 1996 text on the US health insurance system provides that private sector actors can share data without informing patients if "The information is used to help the entity carry out its health missions". But that's the case, insists Google: "These data can not be – and will not be – combined with other data held by Google on consumers", assures the company in its release.

Ascension, private Catholic and associative structure, "remains the data manager"

Affected patients will not see their health data cross-referenced with the extensive information from their Internet searches or the YouTube video platform for advertising purposes, the company promises. Ascension, private catholic and associative structure, "Remains the data manager and we provide them with services", writes the search giant online.

However, note the Wall Street Journal the records of millions of patients are accessible to more than one hundred and fifty employees of Google, which has in the past sometimes been blamed for data protection issues. This agreement in the sensitive area of ​​health with a digital giant questions the many recent scandals related to privacy, including the Cambridge Analytica case at Facebook. The contract also highlights the limits of the data protection arsenal in the United States. Many voices call for the creation of a law on privacy and an ad hoc agency – as it has existed in France since 1978, with the law on computers and freedoms and the National Commission for Informatics and freedoms (CNIL).

The progress of GAFA in the field of health

The emotion created by the scoop of Wall Street Journal also to the surprise of the readers, because the agreement was not known. In its statement, Google implies that it was not secret because the company had mentioned in July in its conference call with financial analysts after the results of the second quarter. But the information was terse: "Finally, Google Cloud's artificial intelligence and machine learning solutions also help healthcare organizations (…) like Ascension to improve the experience and outcomes of care ", had just announced a manager. By not having communicated further upstream, Google finds itself in reaction on the defensive.

The Ascension Agreement is a Test for the Mountain View Firm

Beyond the doubts about data protection, the contract illustrates the progress of GAFA (Google, Apple, Facebook and Amazon) in general, and Google in particular, in the field of health. The agreement with Ascension is a test for the firm in Mountain View, California: it develops – for free, according to the Wall Street Journal – applications or algorithms intended to help caregivers. "We seek to provide tools that Ascension could use to make improvements in clinical quality and patient safety," wrote Tariq Shaukat, the leader of Google Cloud.

Uniting and cross-referencing large databases, then ingesting a patient's medical history into AI software would theoretically find new correlations or even improve treatments and assist physicians – or, at least minimum, reduce expenses or increase revenues. However, this research is underway and the precise benefits remain to be partially proven, as shown by the limitations encountered in the beginning by IBM's Watson project. "Some of the solutions studied for Ascension are not yet deployed and are in the preliminary test state," said Mr. Shaukat.

Google Cloud health customers and partners

Prior to the Ascension contract, Google Cloud recalls that it already has other customers, including the Cleveland Clinic (Ohio), the American Cancer Society, the pharmaceutical and computer company McKesson … but these partnerships seem less important and sometimes involve the simple transfer of data hosting, from servers in-house to Google's servers, accessible on the Web, with any computer enabled.

Google also established in 2016 a partnership with the pharmaceutical group Sanofi to study diabetes treatments; it was expanded in June to improve drug development "Custom" as well as monitoring their effects on patients. Google's parent company, Alphabet, also owns Calico, a life-extension research subsidiary, and Verily, which partnered with Novartis, Sanofi, Pfizer, and Otsuka in May to improve the cumbersome clinical trial process. to test drugs on guinea pigs.

A recent acquisition of Google has also fueled speculation about its ambitions in health: that of Fitbit. The purchase of this manufacturer of connected wristbands for sport and well-being could provide devices capable of measuring health data. It is also one of Apple's approaches, which has great ambitions in health with its Apple Watch. For its part, Amazon also intends to enter the market, including its own cloud subsidiary, the world leader in the sector.

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