Smokes and candy bars: One more patient data set that hospitals will hold hostage

Now that they’ve got the snazzy websites with chirpy videos and lots of Facebook friends and Twitter followers, hospitals are catching on to the dark side of consumer marketing: profiling. Bloomberg reports that hospitals are starting to analyze patients based on their purchasing habits. The idea is to predict the likely sickies and intervene before […]

Now that they’ve got the snazzy websites with chirpy videos and lots of Facebook friends and Twitter followers, hospitals are catching on to the dark side of consumer marketing: profiling. Bloomberg reports that hospitals are starting to analyze patients based on their purchasing habits. The idea is to predict the likely sickies and intervene before full-blown COPD or diabetes sets in.

Information compiled by data brokers from public records and credit card transactions can reveal where a person shops, the food they buy, and whether they smoke. The largest hospital chain in the Carolinas is plugging data for 2 million people into algorithms designed to identify high-risk patients, while Pennsylvania’s biggest system uses household and demographic data. Patients and their advocates, meanwhile, say they’re concerned that big data’s expansion into medical care will hurt the doctor-patient relationship and threaten privacy.

I am not against this practice. Hospitals are going to get dinged for patients behaving badly. You can’t blame them for figuring out who is going to hurt the bottom line.

The problem is how they are using this data. Instead of laying it out to the patient and using the profile as a teaching moment, it’s just more of the same paternalistic approach. “Poor dear, you don’t know how to take care of yourself. (Insert a pat on the head here.) Let me tell you how.” The “or else” part of that sentence is silent – for now.

Hospitals, doctors, nurses, bureaucrats – everyone who touches healthcare – needs to embrace these two conflicting truths:

  1. People don’t like to be told what to do.
  2. People don’t always understand how daily choices affect their health.

Use these two facts to turn this profiling data into a teaching moment. Don’t start creepy robo-calls about diabetes or buy more pamphlets about how to stop smoking – this will just piss people off and make them even LESS likely to listen to healthcare messages.

I am extra grumpy today because I am playing phone tag with a nurse about test results. This new set of consumer purchasing data is exactly like the hunt for personal health records: one more informational weapon that hospitals and providers use against patients. We know what you’re doing and we’re going to punish you for what you’re doing, but we’re not going to give you the same information so you can make your own decisions.

And don’t even start with, “But some people won’t know what to do with the information. We don’t want to scare them.” Hospitals and doctors should be more worried about pissing off the engaged patients than worrying about the people who probably wouldn’t read the info anyway.

Please, please, please don’t gear this profiling to the lowest common denominator of patients. Create a solution for the patients who do care, who will take the time to read and learn, and who want to make informed decisions with doctors. Try to believe that if you lay it all out to a person, she will draw her own conclusions and make changes.

Patients are more likely to listen to other patients anyway, so if you respect the engaged patients, they will bring everyone else along.

And anyone who doesn’t listen or care or engage after the educational push? Then penalize those people — and ONLY those people — with the condescending approach and the insulting robocalls.

[Father Knows Best picture from flickr user Bees Knees Daily]

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