Thursday, May 17, 2012

Target Knows your Secrets

Target Stores and Patient Privacy

It is a core value (and the law) in medical practice to protect a patient’s privacy. This means that we never divulge any PHI (protected health information) about our patients to anyone who is not legally entitled to that information. We do not discuss a pregnant patient’s issues with her spouse. We do not discuss a teenager’s request for birth control (or prenatal care) with her parents. We adhere in the strongest possible way to the confidentiality of all medical information, and have done so long before the word HIPPA ever entered our vocabulary.

Thus, I was stunned to receive a complaint from a patient accusing my practice of selling her medical information to Target Department Store! Without revealing any confidential information, the issue is that she was early pregnant and thought that almost nobody knew about it and yet she received a pregnancy and baby merchandise coupon book from Target, telling her that “these might help!” She became angry, rightfully so, but directed her anger at us, which was quite upsetting.

Is it possible that Target has slipped a spy into my office, paying someone for this type of information so they will know who to mail those coupon booklets to? Maybe pharmacies upload PN Vitamin purchases to Target? Maybe labs that get back positive pregnancy tests are getting a kickback for sharing this information? How is a patient in this situation ever going to find out where the “leak” is? Sounds like a spy movie plot.
Farrah Fawcett

This reminds me of the UCLA Unit Secretary who leaked information about Farrah Fawcett’s rectal cancer diagnosis to the National Enquirer. I am pleased to state that a thorough investigation of our office has not identified any “leaks” or “moles” from Target in our practice. (But, can we be certain? Even the FBI took years to discover their own mole, Robert Hanssen). I wonder how much Target pays for this information? 

So, how did Target learn that this patient was pregnant? Are there “cappers” out there secretly going to Ob/Gyn offices, collecting a bounty from Target for every pregnancy identified?

It turns out that Target has been collecting massive amounts of data about its customers’ purchasing habits over time. A few years ago they hired someone with 2 Master’s degrees, one in Statistics and one in Economics and asked him how to analyze their data (called data mining) and try to determine with a high probability that a customer could be pregnant. This was surprisingly easy!

The fact is that pregnant women make unusual purchases or often change their usual ones. Did you know that the when a women switches her hand lotion to unscented, chances are she is in the second trimester of pregnancy? This makes sense. The easy stuff would be to identify who bought home pregnancy tests, and maybe even see if later they stopped buying tampons and pads? Maybe they tracked the purchase of ovulation predictor kits followed by the purchase of pregnancy tests? Or purchases of prenatal vitamins? But they go even further. Buying a large purse and also zinc and magnesium supplements tells the Target computer that the shopper is 87% likely to be pregnant!

Once the computer identified women likely to be pregnant, Target started marketing pregnancy and newborn merchandise heavily to these customers. E-mails, coupons in the mail, flyers, whatever worked. Also, the coupons and e-mails used codes to identify who got them, so using one of those coupons ringed a bell in their computer which then “targeted” (pun intended) the client for even more specific marketing!

It is getting harder and harder to keep our personal medical information personal. But we still owe it to ourselves to try. And, if you get a pregnancy coupon book in the mail from Target, please don't accuse your ob/gyn doctor's office of selling that information to them.