For this critique, I chose The Week in Health Law, a podcast exploring regulations and policy over data-driven healthcare delivery and discrimination. The podcast is available on The Week in Health Laws website and many popular audio mediums, such as PodBean and Spotify. Among the presenters were: Abbe Gluck, Professor of Law and the Faculty Director of the Solomon Center for Health Law and Policy at Yale Law School; Nathan Cortez, Professor of Law and Associate Dean for Research at the SMU Dedman School of Law; Sharona Hoffman, Edgar A. Hahn Professor of Law, Professor of Bioethics and Co-Director of the Law-Medicine Center at Case Western Reserve University School of Law.
The series covers a multitude of policies, but this conversation focuses primarily on the progenitors and realities of future medicine, including health data aggregation by private firms. Dr. Hoffman highlights genetic counseling and the importance of data collection. She herself is prolifically published in the importance of genetic privacy and its impact on future healthcare law. The potential to lose healthcare benefits over such data, especially those given to people who may otherwise may not have adequate care access, remains a hot issue.
I believe that the presentation is impartial and balanced. The guests are published bioethics lawyers with no vested commercial interest in the products or services discussed in the presentation (Cortez, Gluck, Hoffman, & Terry, 2018). They convey the nonpartisan voices of concerned Americans regarding their protections and privacies. Speaking to the credibility of the series, founder Nicholas Terry is himself an accomplished health law professor. One potential limitation of the discussion is that the presenters are all law professors, but not healthcare providers. While their viewpoints are certainly valid, they cannot speak with authority as a provider who utilizes data to deliver patient care. They can interpret its implications to form litigation or a defense, but they are not personally present in the care environment.
The central theme of the podcast relates directly to how I will deliver anesthesia care in the near future. Utilizing the electronic health record, data-driven healthcare already affects how anesthesia providers conduct preoperative screenings, consider treatment modalities, and save on costs. Small and large companies alike are actively collecting massive amounts of patient data, selling it to interested parties, and steering the future of care delivery (Cortez et al., 2018). As a DNP leader, however, I am concerned with the issues surrounding data mining and its effect on patient privacy. As noted in the discussion, the Health Insurance Portability and Accountability Act of 1996 (HIPAA) doesnt comprehensively define guidelines for healthcare data aggregation. The Food and Drug Administration (FDA) has relied heavily on non-binding guidance to regulate this new arena. Several congressional hearings in recent years have articulated that FDA regulations would potentially strangle a burgeoning industry, a field that has brought significant profit and jobs to our national economy (Cortez et al., 2018). A singular governmental pull for strict regulation could force data collectors to revise their methods, but at a potentially great cost. Still, the ethical question remains if a privatized company should have rights to maintain an indefinite amount of personal data for an indefinite period.
Until current healthcare law can catch up to the times, private companies and data brokers will become further entrenched in the healthcare business and gain lobbying power on Capitol Hill. As leader in the DNP community, I am closely following how developments in this area will influence how I manage care for my patients. Since I plan to operate my own practice one day, I need to understand where the lines are drawn. For example, I believe that an information system using artificial intelligence (AI) to highlight a visible tumor on a CT scan is valuable data. The idea that the same image is immediately uploaded to an insurer or gene therapist, with or without consent, is questionable. The future of healthcare no longer depends on if we decide to utilize data-driven methods of care delivery; rather, it depends on its judicious and ethical use. As we embrace this new era of medicine, only time will tell.