Mark your Google calendars because from today ‘Don’t be evil’ rides again, via the DeepMind AI division of the Alphabet ad giant, as a Hippocratic assurance to ‘Do no harm’.
It’s no small irony that DeepMind’s new mantra for its healthcare push, voiced by co-founder Mustafa Suleyman at an outreach event today for patients to hear what the Google-owned company wants to build with U.K. National Health Service data, is uncomfortably close to its old one — i.e. the one that embarrassingly fell out of favor.
Suleyman cited the Hippocratic oath when discussing his takeaways from patient feedback on the company’s plans.
“[Do no harm] has to be a mantra we repeat and becomes an inherent part of our process,” he said towards the end of the three hour discussion session which was live streamed onYouTube (with a call for comments via a #DMHpatients Twitter hashtag).
“And [do no harm] should be the first measure of success before any deployment or before we attempt to demonstrate any utility and patient benefit,” he added.
After taking questions and listening to views from the small group of patients, health professionals and members of the public selected by the company to be in the audience, Suleyman flagged other takeaways. One of which was the need to widen access to the patient engagement channel DeepMind has now opened up.
He conceded it was unfortunate the event had been held in Google’s shiny, central London offices.
“As you say this is a fancy, intimidating building and I’m sorry for that, in some ways, it’s a shame that that’s the tone. I really agree with you that we have to find other spaces, community spaces that are more accessible to a more diverse group of people,” he said.
“As we formalize the process [of listening to patients] we want to make sure that there are other people being paid around the table and patients’ contributions should also be paid, and we’ll make sure that that’s the case. Potentially we should be thinking about how to run sessions like these on the weekends or in the evenings, when different stakeholders might have more time to get involved,” he added.
Alphabet’s AI division also said today it is intending to “define” what it dubs a “patient involvement strategy” by 2017.
Although DeepMind kicked off data-sharing collaborations with the NHS last fall — inking a wide-ranging data-sharing agreement with London’s Royal Free NHS Trust in September 2015 — and only publicly revealing the DeepMind Health initiative this February, two months after beginning hospital user tests of one of the apps it’s co-developing with the Royal Free… So it’s hard not to see its attitude towards patient engagement and involvement as something of an afterthought up to now.
Controversy and scrutiny
It also looks like a response to the controversy generated earlier this year by DeepMind’s first publicly announced collaboration with an NHS Trust (the Royal Free) — given that criticism of that project (Streams, an app for identifying acute kidney injury) has focused on how much patient identifiable data the Google-owned company is being given access to power the app, without patient knowledge, let alone consultation or consent. (DeepMind and the Royal Free maintain they do not need patient consent to share the data in that instance as they say the app is for direct patient care — a point the company now reiterates on its website, in a section labeled ‘Information Governance‘.)
The UK’s data protection watchdog, the ICO, is investigating complaints about the Streams app. The National Data Guardian, which is tasked with ensuring citizens’ health data is safeguarded and used properly, is also taking a closer look at how data is being shared. Streams was also not registered as a medical device prior to being tested in hospitals — but should have been, according to the MHRA regulatory body. So DeepMind Health’s modus operandi has already rocked a fair few boats — even as Suleyman was at pains to stress it’s “very early days” for DeepMind Health in his public comments today.
Tellingly the Google-owned company also now has a section of its Health website labeled ‘For Patients‘, where it describes its intention to create “meaningful patient involvement” and claims it is “incorporating patient and public involvement (PPI) at every stage of our projects”. (Although here, again, it notes another future intention: to create a patient advisory group to “contribute more extensively to our projects” — suggesting it could have done much more to involve patients in its first wave of NHS projects and research partnerships.)
“What we’re really doing today is to try and invite people openly to come and help us design the mechanism of interaction,” said Suleyman, summing up DeepMind’s intention for the outreach event. “Many people in this room have much more expertise and experience than we do and we recognize that we have a lot to learn here, and so today I think is an opportunity for us to learn. We’re really grateful for people’s time. We recognize that it’s valuable and we really think this is potentially an opportunity to do this the right way.”
He did not directly reference the Streams app data-sharing controversy, although the entire session was structured to illustrate (as DeepMind views it) the benefits of sharing health data for patients and health outcomes — and thus create a strong narrative to implicitly defend its actions — with much talk of the economic squeeze on the publicly funded NHS and the need to move towards earlier diagnosis of conditions to save resources as well as lives. Tl;dr: DeepMind’s sales pitch to grease the NHS health data funnel is that AI could automate efficiency savings for a chronically cash-strapped NHS. Ergo: you can’t afford not to give us your data!
And while Google’s podium included speakers who do not work directly for Alphabet, all speakers at the event were selected by the company to speak, so unsurprisingly aligned with its views. For example, we heard from Graham Silk of health data sharing advocacy group, Empower: Data4Health, rather than — say — Phil Booth from health data privacy advocacy groupMedConfidential, which has been critical of DeepMind’s handling of NHS data.
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