Virtual care has become the new norm in healthcare and the emergence of for-profit, direct-to-consumer virtual care has raised concerns regarding patient privacy, autonomy and quality of care.
In a first of its kind study, published in BMJ Open, researchers examine how virtual care companies in Canada collect, use and value patient data.
“We found that the industry highly values patient data, not just to provide medical care, but also as a revenue stream,” says Dr. Sheryl Spithoff, physician at Women’s College Hospital (WCH) and lead study author. “Industry insiders reported that companies use patient names, emails and browsing information to conduct targeted marketing of their products and services. In some cases, companies shared the data with third parties – subsidiaries of the same parent corporation.”
The most surprising discovery was the direct influence that companies had on clinical care.
“Some companies were adjusting patient care pathways in order to increase the uptake of a drug or vaccine at the behest of the pharmaceutical company,” says Dr. Spithoff. “The analysts would adjust the frequency of reminders, timing of visits and then look at the patient data to see how many patients received the vaccine or drug. They would make adjustments to optimize uptake. As a result, patient care may be focused on the objectives of the pharmaceutical industry rather than providing the best patient care.”
Concerns regarding data privacy also pose an issue for structurally marginalized communities.
“The use of this data poses risks to patient privacy when it is shared internally or with third parties,” explains Dr. Spithoff. “This may be harmful to groups who share characteristics. Data, identified or not, are often used to make inferences about groups. If data analysts do not consider the social context, data uses may reinforce social biases and lead to discrimination against structurally marginalized groups.”
Patients may agree to these uses of their data because of high levels of trust in the Canadian health system, problematic consent processes and a lack of other options for care. With the rise of for-profit virtual care, researchers and policymakers should explore the impact of commercial interests on the development of care pathways.
To read the study, click here.