Bioethics: Watching For The Dark SideBioethics: Watching For The Dark Side

Personalized medicine stands to offer many benefits, but there always will be those patients who won't want health-care providers and insurance companies to know about their health risks, especially genomic information that might show a higher chance for developing a disease that can't yet be prevented.

"The dark side of technology is that by building up health-care records, you can predict what risks a patient has for certain diseases," says Dr. Manuel Lowenhaupt, a primary-care physician and VP and national practice leader for health-care transformation at IT-services firm Capgemini. This could translate into different premiums or coverage eligibility for higher-risk patients, he says.

As more data about patients and their health risks becomes available, there will be a need for tighter controls around that data and what can be done with it, says Ed McCallister, CIO of UPMC Health Plan, the division of UPMC Health System that provides health coverage to the 35,000 employees who work at the University of Pittsburgh Medical Center, as well as to more than 300,000 other members in western Pennsylvania. "We need to make sure that health insurers don't discriminate against patients with certain genetic traits," he says.

The need for bioethicists in the medical community will grow in the coming years, says Dr. Nina Schwenk, a Mayo Clinic physician and chair of the Mayo Foundation IT committee. Mayo already is tackling some of these delicate issues: Patients are given the option of allowing their data to be used for analysis by Mayo and IBM in a data-mining project aptly called DataTrust. So far, 95% of Mayo patients have agreed to let Mayo use their data. Says Schwenk, "Patient confidentiality, security, and privacy are important parts of this work and our relationship with IBM."

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