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Life critical healthcare sector needs digital ethics as an underlying strategy

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Dr Vikram Venkateshwaran, Director, Deloitte India, explains how legal, organisational and societal impact on the ethical treatment of digital programmes leave a major impact, and why digital ethics is an immediate priority for India Inc.

As a CTO, Mohan Kumar was excited about the new digital platform being applied at the hospital. Having designed and worked tirelessly with various stakeholders to ensure that a comprehensive platform was built that consisted of medical records collected over the years, painstakingly parsed and classified.

In parallel, approvals from the various head of departments were taken.

The system was first built for oncology or cancer treatments that would supplement the specialists in making decisions on the line of attack for treatment.

Three days from the launch, Kumar was slightly puzzled by a new email from a new associate who had joined the security team asking for a meeting. The context it seems was consent, but the hospital had a consent policy which was used while admitting patients to use their data for making decisions to decide the line of treatment for the patient.

Leaving no stone unturned in addressing concerns, Kumar immediately discovered that while he had the consent for using patient data for individual use, he did not have it for using the data even anonymised for general use to build a system.

The new associate also told him that they required consent from each patient who was critical, otherwise they would be in breach of privacy requirements considering quite a few of their patients were European subjects.

Data privacy law in India was coming into effect soon, and, eventually, that activity would have to be conducted for the entire data set.

Kumar’s incident isn’t the only instance in isolation. There are multiple instances where technologists have gone ahead and used data, without thinking of the ethical implications of the usage. While health is an individual phenomenon, and the usage of data of an individual’s health’s parameter is important, the data then being used at a system level is still open to interpretation.

What would happen if the hospital ignored digital ethics?

Well, firstly, there are legal and regulatory considerations. There are provisions in the draft Data Privacy Bill as well as the IT Act that ask for careful handling of sensitive data. These might impact any future development that the hospital had planned based on using patient data.

Secondly, several biases enter the data that cause misleading insights. These include biases like sample bias, selecting the wrong sample or exclusion bias, removing cases where the prognosis was not so good. While these biases happen at the individual level, if they find their way into a system that is being designed for decision making, then the output is catastrophic.

Finally, at some stage, this data would be shared with the industry experts, and for research, which may be misleading for the speciality as a whole, and may not be the desired outcome in the national health’s interest.

While these examples are specific to healthcare, one can see how they can be applied across other industries.

In our latest Deloitte Digital Ethics report, we delve into this subject with used cases and scenarios, apart from recommending a five-step framework of application of the strategy:

Create a committee for digital ethics: The committee should be a cross-functional team with business, technology and community experts. Like the committee at the hospital, the objective is to ensure all ethical concerns are addressed. This committee should roll into the organisation’s ethics committee, which would form the overall framework for ethics in the organisation.

Draft the policy on digital ethics: While drafting the policy on digital ethics, it is important to cover all digital programmes. Like the digital risk framework, the digital ethics policy should draw heavily from the organisation’s vision and mission and from the risk policies. The policy should cover the impact at an individual level, society and market level and a national level.

Ensure adherence: All digital projects need to be covered and assessed from the digital ethics’ perspective.

Digital governance: Make ethics an important part of the digital governance of all projects.

Education: Ensure that teams are constantly educated on the need for the right ethics and constant reinforcement and assessment of the individuals themselves.

Fast-paced businesses with business operations layered on digital touchpoints must relook with the lens of ethics, given biases might arise in the due course, in the haste to bring a faster response time to an issue.

Digital ethics is a critical aspect for the future of healthcare and organisations that would imbibe this as part of their strategy and would not only be able to scale their programmes, but would do the ‘right business thing,’ while those that ignore, will find it tough to scale up.

Legal, organisational and societal impact on the ethical treatment of digital programmes leave a major impact, and hence, it is important that India Inc. consider digital ethics as an immediate priority.

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