What areas of healthcare are seeing increasing activity on the part of the global tech companies? How can their products and services help improve medicine? And what are the challenges arising from the activities of these tech giants? Together with her team of researchers, ethics professor Christiane Woopen conducted on behalf of the Stiftung a comprehensive study of tech giants in the healthcare sector. In the following interview, Christiane Woopen discusses the impact of digital transformation on the field. Identifying the various opportunities and risks at hand, the ethicist calls for the government to issue a clear policy position and for a broad social debate on what role the tech giants should play in the healthcare system.
Together with your team, you examined the spectrum of products and services offered by the tech giants. Of all the findings, which one impressed you the most?
Woopen: “I was particularly impressed by the sheer variety of activities underway. The tech giants are developing very different health-related products and applications for healthcare professionals as well as patients and users looking to engage in healthy behavior. In addition to being quite active in healthcare systems and markets with their wide range of offerings, these companies are also very active in research and development. They are engaged in a number of collaborations in both the public and private sectors. Ultimately, in one way or another, they’re just about everywhere.”
What are, in your opinion, the biggest challenges to healthcare emerging from the tech giants’ activities?
Woopen: “In my view, the biggest challenge lies in being able to leverage the tech giants’ expertise in advancing digital healthcare while, at the same time, maintaining the ethical standards that, for example, the Data Ethics Commission and the German and European Ethics Councils have elaborated. These include, for example, ensuring human dignity, freedom and self-determination, privacy, sustainability standards, and avoiding discrimination, which are particularly relevant for applications involving so-called artificial intelligence. The tech giants enjoy considerable power by virtue of their financial might, vast technological capacities, and their access to unimaginable amounts of data. They are already having a profound impact on our way of life. I think this power should be curbed by introducing data-sharing models, for example, and we should do more to prevent widespread dependencies from emerging.”
And the greatest opportunities?
Woopen: “I see an opportunity first of all in restructuring the healthcare system in a way that places the patient truly at the center of care. When patients have easy access to health information and their own health data that is both quality-assured and understandable, they feel less helpless and subject to the mercy of others. They can then build their own healthcare network. For healthcare professionals, I see much more streamlined and efficient processes ahead, as well as evidence-based support for their activities that involves digital assistance and, ultimately, a learning healthcare system would mark a major step forward. Data from everyday medical care would be subject to scientific analysis, with findings being cycled back into care through algorithmic systems that support clinical decision-making processes, for example. This would also contribute to the advancement of individually tailored precision medicine, which some see as the greatest opportunity facing digital healthcare.”
What should health policy address specifically in the coming years with regards to the tech giants?
Woopen: “In my view, healthcare policy should take a clear political stance on the role and involvement of tech giants in the healthcare system and initiate a public debate on this issue. There are already a number of initiatives at both the German and European levels aimed at using digitalization’s potential for the benefit of healthcare and the economy as well as minimizing the associated risks. Ultimately, however, these efforts remain rather timid and often get bogged down by minute details. In order to really leverage data potential, we need to have legal safeguards in place to protect those who are the source of the data. This could involve, for example, prohibiting insurance companies and employers from exploiting this data. A vigorous innovation policy would also promote initiatives for smaller, non-monopolistic or oligopolistic companies. Last but not least, we need to promote digital health literacy across society.”
The digital transformation of healthcare also has implications for all of us as individuals. What do we need to address most urgently as a society?
Woopen: “I’ve always been concerned about the considerable power that the tech giants have. In many respects, they make our lives easier and more convenient, and they can also make valuable contributions to our health. At the same time, however, they have an enormous influence in our everyday lives and, in fact, tremendous capacity to determine what we percieve to be important, beautiful and desirable. If their products and services can help us better prevent diseases in particular, that would mark a big step forward. On the other hand, we would, in my opinion, pay too high of a price with seamless surveillance and a constant fixation on data. Health is important, but it is not the highest good. Living a fulfilled life involves much more than can be reflected in data or calculated with the help of algorithms.”
Prof. Dr. med. Christiane Woopen currently holds the Heinrich Hertz Chair of Life Ethics in the transdisciplinary research area of “Individuals, Institutions and Societies” at the University of Bonn and is Director of the university’s recently established Center for Life Ethics. She is also the former Executive Director of the Cologne Center for Ethics, Rights, Economics, and Social Sciences of Health (ceres) at the University of Cologne, where the study was developed.