Sunday, August 18, 2013

Journal Entry 4

                                                                                                        Rita Truex Module 4


The article referenced is of interest because originally I considered data mining in the basic sense of an organization using data to supply information to it to predict outcomes and to improve care.  The article brings to light one of the many uses of data mining by pharmaceutical manufacturers for the purpose of advertising new medications to the public and to physicians. At issue is the use of prescribing data by physicians that pharmaceutical companies may buy from data mining companies, which buy the data from pharmacies after the patient information has been de-identified. The state of Vermont had restricted the information available to drug companies for advertising, but the pharmaceutical and data mining companies appealed to the Supreme Court which found that advertising based on the data was covered under the 1st amendment right to free speech (as long as the drug companies’ advertising is truthful.)

The article authors found both positive and negative aspects of the ruling. Opportunities to use the data for drug safety testing after the release of a medication, to use the information for comparative effectiveness review and for research and public health exists that may in the future help improve the health of the population. On the other hand, the use for advertising new, as yet not tested in the general population medications requires ethical consideration, particularly when physicians targeted for the marketing come under undue influence by the pharmaceutical industry to prescribe those medications. The authors point to the escalation of healthcare costs when newer, more expensive drugs are used and to patient safety when those medications are prescribed in large numbers  before the effects on the larger population can be known (for example COX-2 inhibitors.) The authors end the article by calling for informaticists to keep patient safety in mind when considering how data mining is employed for research and advertising.

This article illustrated the ethical concerns regarding data mining for commercial purposes. Protection of patients from possible coercive advertising is a paramount concern to all healthcare providers as there have been many consumer protections put in place over the years (such as limits on advertising cigarettes) that have helped to sway public opinion towards better health practices. The implications for nursing practice and informatics practice are to always keep patient safety as the foremost concern when new drugs are being advertised to the consumer and to protect patient information. Nursing informaticist should be mindful of comparative effectiveness reviews to help drive down health care costs and should educate patients to ask their physicians about lower cost, equally effective medications. Finally, data mining is necessary to research and public safety, the limits place on it by law should not hinder these priorities. 

2 comments:

  1. I also feel that data mining is very important with the advent of new drugs it is imperative to keep tract of side effects and interactions. As long as privacy is maintained DM is useful and should not be hindered by the HIPAA laws

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  2. Rita, this is a very interesting article about an alternate utilization of data mining. Pharmaceutical companies often find a way around the loopholes. Physicians do not need to be harassed with advertisements when they are trying to provide patient care. They receive emails regarding prescription refills and health information reminders. I am glad that the courts protected patient's privacy and maintained security. I do agree with you that gathering data for drug safety testing after the release of a medication can be useful for research and public health but I fear the advertisements will overshadow the benefits of this process.

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