Cogs in the Machine: Two Countries Attempt to Balance Individualized Concerns in the Pursuit of Public Health

Oliver Kim (University of Pittsburgh), Cogs in the Machine: Two Countries Attempt to Balance Individualized Concerns in the Pursuit of Public Health, Southern Illinois U. L. J., Vol. 44 (2019):

Just like an online video going viral, healthcare can now be crowdsourced, providing a new method for public health officials to follow and analyze trends in a community’s health. For example, data that might have been impossible to collect, sort, and analyze, may now be assembled and processed in large sets by actors such as Big Tech and Big Data. Doing so could help researchers, policymakers, and public health officials make better decisions on critical interventions to improve health across entire communities. But having vast amounts of information about individuals and their health status freely flowing may raise alarm if health information gathered by clinicians and medical researchers is used for unauthorized non-clinical purposes.

This article analyzes this tension and provides a legal and policy comparison between the United States and Australia. First, this article provides a general overview of the public policy promises made when both countries embarked on significant campaigns to digitize health information. Second, this article examines the disconnect between policymakers’ proposals seeking to free health information and the distrust both from the public generally and from certain specific segments of society. Third, this article discusses the public health challenge of opioid misuse facing both countries, and the fourth section explains how health information technology is being utilized to address this challenge and some of the concerns that have been raised about this type of surveillance. Finally, this article offers policy recommendations for Australia as it contemplates how to best utilize health information technology to address its opioid crisis based on the American experience. Hopefully, such recommendations will produce collaborations that will not only lead to political, legal, and ethical changes to improve public health surveillance but also to a better system that will save lives and improve individuals’ health and well-being as well.