The Patient Will See You Now by Eric Topol

Author:Eric Topol
Language: eng
Format: mobi, epub
Published: 2014-11-19T21:09:22+00:00

Chapter 12

Secure vs. Cure

“I do not want to live in a world where everything I do and say is

recorded.”

—Edward Snowden1

“Today’s Web-enabled gadgets should come with a digital Miranda

warning: Anything you say or do online, from a status update to a sel-

fi e, can and will be used as evidence against you on the Internet.”

—Nick Bilton, New York Times 2

In a world of Julian Assange’s Wikileaks and Edward Snowden’s exposé

of the National Security Agency, we are progressing toward zero tolerance

of governmental non-transparency.1,3 At the same time, massive Internet

security breaches are occurring or being discovered, from retailers like Target to the Heartbleed bug. Just as everything is getting digitized, making

it eminently portable and accessible, we’re betwixt and between. We want

openness but we also want to preserve our privacy. We want a government that is transparent but that will not compromise safety and enable

predators.4,5 We want full access but we also demand complete security of

our personal information. We live in a world of sophisticated hackers and

“quantrepreneurs”6 who want to sell our data to make money. To say “it’s

complicated” is a gross understatement.

Despite the complication, it is enormously important that we fi gure

these issues out. We’ve explored the many ways that data are already being

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the patient will see you now

shared. A basic premise in health care these days is that big data will ultimately lead to big cures,7,8 or at least better health. But so far there’s

been a lot of curating without a lot of cures. Much of that hinges upon

predictive analytics, which is the topic of the next chapter. We’ll explore

in the next chapter the extent to which that is true, but we can’t weigh the

potential benefi ts—whether they are as incremental as a month’s worth of

good health or as momentous as the end of cancer—unless we have clear

accounting of the downside of having individuals digitized and everybody

on the net. So the weighty issues of privacy and security for digital health

and medical data are where we turn next.

Our Digital Bread Crumbs and Data Brokers

We’ve been leaving digital bread crumbs everywhere for a few decades now,

beginning with charging things on our credit cards. Things really ramped

up in the past fi fteen years with Google and Internet searches, Amazon

and online retail purchases, Facebook likes and social network site visits,

not to mention our wireless mobile devices, which provide our precise location and much more about us in real time. And then there’s the National

Security Agency, keeping our e-mails and cellphone calls in vast databases

for warrantless searches.9,10 The bread crumbs have become bread loaves.

Avoiding this surveillance is at best highly inconvenient. In Dragnet

Nation: A Quest for Privacy, Security, and Freedom in a World of Relentless

Surveillance, 11 Julia Angwin, a ProPublica investigative journalist, explains why she quit using Google search: “My searches are among the most sensitive information about me.”12 She was annoyed about Google’s decision to

combine information from its various services, such as search and Gmail,

giving advertisers more opportunities to promote things personalized to

you. So Angwin moved to DuckDuckGo, a search engine that doesn’t store

the user’s IP address or other digital footprints.

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