The problem with Google’s health care ambitions is that no one knows where they end

Yesterday, The Wall Street Journal accused Google of stealthily collecting sensitive patient data from millions of Americans without their consent. The New York Times soon followed with its own report, offering more detail on “Project Nightingale” and noting how it was likely to rile up privacy advocates. Forbes then published its own story, followed by another article from Business Insider, each drip-feeding more details about this initiative.

When you might ask, will it all end?

The problem is not the reporting; it’s that Google’s own ambitions in health care have no clear limits, which is something that Project Nightingale illustrates.

LIKE GOOGLE SEARCH, “PROJECT NIGHTINGALE” STARTS WITH ORGANIZING DATA
At its core, this is a data deal. Google is centralizing patient information for Ascension, a nonprofit health care provider with thousands of facilities in 23 states. With the help of its cloud tools and G Suite, Google is collating Ascension patient data, including medication history, lab tests, and biographical information. This should improve treatment. In return, Google learns how to build its own medical tools, which it hopes to sell far and wide. As a creepy little extra spin, neither Google nor Ascension informed patients that their information was being used in this way — but this is completely legal, as Wired explains.

Where things get murky is asking: what will Google do next? What does it do with this data, and what are its long-term ambitions with Ascension? According to the stories and press releases from yesterday, Google is doing the following:

“Testing a service that would use its search and artificial intelligence technology to analyze patient records” (Forbes)
Creating “an omnibus search tool to aggregate disparate patient data and host it all in one place” (The Wall Street Journal)
“Testing software that allows medical providers to search a patient’s electronic health record by specific data categories and create graphs of the information, like blood test results over time” (The New York Times)
“[Providing] tools that Ascension could use to support improvements in clinical quality and patient safety” (Google’s own blog)
“Exploring artificial intelligence/machine learning applications that will have the potential to support improvements in clinical quality and effectiveness” (Ascension’s statement)
You could summarize most of this by saying Google is building a search engine for health care providers, aka following its long-held corporate mission “to organize the world’s information and make it universally accessible and useful.” But it seems the Ascension deal also includes some far-reaching research, particularly using AI and machine learning. This is where we get to the second part of Google’s mission statement-making information useful — and it’s here that the company’s ambitions seem limitless.

So far in health care, Google has designed tools to assess heart disease risk from eye scans, detect breast cancer in biopsies, and predict a patient’s overall risk of premature death. It’s built “augmented reality” microscopes, assistant apps for nurses and doctors, and partnered with dozens of health care providers. It’s even throwing money at anti-aging research. In short, it’s doing a bit of everything, which is why when the company says it’s covertly collected data from millions of patients, it’s not surprising that people are suspicious.

It doesn’t help that the company’s past health care initiatives have had a problem with boundaries. An early deal between the UK’s National Health Service and Google’s London AI subsidiary, DeepMind, broke local data-sharing laws, and Google is currently being sued for work with the University of Chicago Medical Center allegedly involving inappropriate access to medical records. Some reports about the Ascension deal say that this, too, could be breaching federal law, though the facts on this are not at all clear.

Speaking to The Guardian, a purported whistleblower involved in Project Nightingale said: “Most Americans would feel uncomfortable if they knew their data was being haphazardly transferred to Google without proper safeguards and security in place. This is a totally new way of doing things. Do you want your most personal information transferred to Google? I think a lot of people would say no.”

Ultimately, health care is just too big for Google to ignore. The market is worth $3.5 trillion in the US alone, which is why tech companies like Microsoft, Amazon, and Apple are all piling in, hoping to become leaders in a new era of digital health care. As a company that specializes in search, Google seems particularly well-positioned to profit from this gold rush, which is going to rely primarily on organizing and analyzing information.

Google has already shown that, with a simple search box, it can move the world. That’s what it’s currently building for Ascension, but who knows what it will do next?