A chain of medical clinics in NSW, Queensland and Victoria have been singled out by Australia’s leading consumer group, CHOICE, for refusing to bulk-bill patients who did not sign up to their app-based rewards program.
Patients of the Our Medical clinics – a chain of 33 medical, dental and radiology clinics operated by Cornerstone Health – were “outraged” at being forced to choose between signing up to the practice’s app or paying the full $90 fee, especially given that the company’s online privacy declaration allows for data sharing with third parties.
Specifically, the policy states that personal and health information collected on individual patients can be used “to conduct business processing functions including providing personal information to our related bodies corporate, contractors, service providers or other third parties.”
The policy also says that if the member has permitted the rewards program to access their device’s location settings, then their location will be tracked – a feature likely linked to the app’s ability to enable patients to check-in for a GP consult, as well as access eScripts, results and referrals.
A spokesperson for Cornerstone Health told Medical Forum that Our Medical “has not and will not ever use personal data for commercial purposes or share it with third parties for financial gain.”
“Our Medical also operates a rewards program for patients, which offers additional health benefits such as free flu vaccines and discounted access to dentistry and physio,” she said.
“The rewards program also acts as a verification process: it is our obligation under Medicare to verify that the person named on the Medicare card is the person that we’re delivering care to, and one of the significant challenges of healthcare is capturing accurate and up-to-date information such as correct name, mobile number, and email address.
“To enable us to do that, we’re putting it in the hands of the patient to ensure its accurate and kept up to date, and our privacy policy includes reference to direct communication with patients including for feedback purposes.
“We handle all personal information in accordance with relevant privacy and health records legislation, and no additional information is captured within this rewards program than in a usual patient registration process.”
However, Melbourne University Professor of Law and co-director of the Centre for AI and Digital Ethics, Ms Jeannie Paterson, told CHOICE that while charging patients more for refusing to sign up to an app was probably not illegal, it was “ethically outrageous.”
She also believed Our Medical’s online privacy policy was “ridiculously unclear and undefined” and that the approach “ran counter to the reasonable assumptions made by the public about how medical professionals handled personal health information.”
“It’s so difficult for consumers to manage their personal information and their sensitive information because they’re used to dealing with doctors where the parameters and the ethics are well understood and well regulated,” Professor Paterson said.
“Now we’re in that grey zone of dealing with digital platforms or digital health intermediaries where the assumptions that we had about how medical professionals handle information simply don’t apply.”
Consumers Health Forum of Australia CEO, Dr Elizabeth Deveny, was also concerned about the implications of primary care becoming increasingly corporatised in Australia.
“Where profit is put before patients, you have to question whether people are getting optimal care,” she said. “For people on low incomes or pensions, many of whom would be eligible for bulk billing at most GP clinics, this approach raises serious questions about equity and accessibility of services.”
CHOICE senior campaigns and policy adviser, Mr Rafi Alam, noted that too many businesses were finding ways to collect data in “unfair or underhanded ways.”
“Consumers shouldn’t be pressured to sign up to apps or reward programs just to access a service, especially when it’s something as essential as a GP appointment,” he said.
While the practice is legal, CHOICE has used the case to call for federal reform on commercial data collection.
“Introducing a ‘fair and reasonable use’ test in the Privacy Act would ensure businesses only collect and use data for the express purpose of providing the service and not use it in ways that unfairly exploit the customer,” Mr Alam said.
(ED: this article was first published in its original form by CHOICE’s Jarni Blakkarly on 15 August as Medical centres forcing patients to share their personal data).