Emmott On Technology: Who Owns the Data?

Emmott On Technology: Who Owns the Data?
Thursday, November 29, 2012

As a dentist you create data as a byproduct of doing dentistry. You can’t help it. The data oozes out of the practice. The question is who owns the data?

If you ask patients the immediate and unequivocal answer is that they, the patients, own the data. That seems right; each patient should have control of his or her medical information. However, that is not how the system actually works.

If you ask a dental practice management software company (PMS) who owns the data, the immediate an unequivocal answer is that you, the doctor, own the data. Yet again this is not how the system works.

If you have a bunch of patient data stored on your office computer or somewhere in a shared database in the cloud; do you own it? The data is there because you created it. As the creator do you own it, or does each patient own his or her own and are you just the custodian? Are patient records and the valuable data they contain intellectual property? They will certainly be a significant part of the value of your dental practice if you wish to sell.

If you can sell it that must mean you own it, right? Well in reality, you can only sell the data in a very proscribed fashion. You can sell to another dentist buying the practice but you cannot sell to an insurance company looking for customers.

You also could choose to give it away, but only in certain circumstances. For example if a patient moved to another town you could give the data to the new dentist. But you cannot give it away to a stranger in the street.

Even if you sell the data in an acceptable fashion, the buyer usually is restricted in how he or she can access and use the data. Generally the user can only fully access the data using specific practice management software, and even then there are lots of limitations.

For example if a dentist in Cleveland using imaginary PMS Softrix wishes to give away some data by sending a complete chart including all the notes, x-rays and medical history digitally to a dentist in Spokane using imaginary PMS Eagleworks, it can’t be done. PMS systems can and do embed code that will only allow you to share data with selected others. For example you can only use selected e-claims companies, or you can only share a radiograph with a proprietary viewer. It isn’t even possible for a Softrix user to simply send a digital dental chart across town to another Softrix user.

As an aside, you never actually own the PMS software, even if you bought and paid for it, you just own a license to use it.

If the dentist owns the data then the dentist should be able to use that data to enhance the practice. For example a dentist could engage an e-service to search the database and find important relationships. Maybe this is something a management consultant asked for like the amount of treatment a new patient accepts related to the hygienist they saw and the insurance they have. Or it might be a hidden relationship that no one ever thought to examine, but the software discovers. This is called data mining.

Currently PMS software does not allow the dentist to use the data in this fashion. The PMS controls access and limits it to selected data and or selected vendors.

If you have the data but can’t access parts of it or more commonly can’t transfer parts of it do you really own it?

As a dentist you are expected and actually obligated—ethically and legally—to create data. Then you are required to act on that data, maintain and store it, protect it and keep it confidential. That is all pretty clear what is not at all clear is who actually owns the data?

This is just part of the issue of who owns the data. It is an issue with more questions than answers which we will need to address more effectively in the future; future is coming and it will be amazing!

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