Fears over NHS plan to tap into mobile phones
Doubts over trial for mental health monitoring system
THE NHS could soon be monitoring mobile phone data to assess mental health as part of a controversial new trial.
Under proposals from Birmingham and Solihull Mental Health NHS Foundation Trust, patients’ call and message records and location details would be combined with health records to predict the likelihood of a mental health crisis.
This could involve tracking features such as daily movements, frequency of calls and missed calls, and call duration.
The proposal is the second phase of a trial in which four years of patient data from four Community Mental Health Teams were handed to Spanish telecoms firm Telefonica, which trades as O2 in the UK.
The data was used to develop an algorithm that identifies patients most at risk of experiencing a mental health crisis and alerts health professionals who can then take action.
With the trial deemed a success, the trust is now seeking advice from the Information Commissioners Office (ICO) regarding the use of mobile phone data, which they hope will further improve the technology. But Dr Neil Bhatia, a GP and Information Governance Lead, has serious doubts about the proposals.
“For me it just seems a strange idea,” he said.
“It’s a bit like people monitoring social media and then automatically alerting the police if you type a post saying ‘I’m feeling a little bit down today’. It just seems really creepy to me.
“And they may say we were trying to improve quality for our patients, but personally I don’t think tracking their phone calls and locations is the right way of doing it. Surely it’s better to give patients the facilities.
“When you’re a mental health patient and you’re feeling low it’s very difficult sometimes to know where to turn in a crisis, and this is a poor substitute.”
The proposals are currently undergoing a Data Protection Impact Assessment to address data protection implications, with the results expected in the coming weeks.
Dr Bhatia has further concerns about how difficult it could be for patients to opt-out of the process.
“A lot of things are legal and lawful, arguably, but just because it’s legal and lawful doesn’t make it right,” he said.
“There are a lot of privacy issues with it. You need to let people know that their location is being sent to a third party. I don’t know how they are going to inform people or respond to objections; you should have the right to say to O2 ‘no, I don’t want my location details to be sent to anybody’.
“And then there’s the issue of opting out. How can you opt out or object to something if you don’t know it’s happening?
“Are they going to have to fill in a form, write a letter, include a picture of their passport? These are things that organisations from around the country have made as difficult as possible, because they don’t want people to opt out. There will be a small poster in a corner of a noticeboard in a waiting room in the bowels of a hospital, and they’ll say, ‘we’ve got posters up’.”
The health records for phase one of the trial were given to Telefonica without patients’ consent, something the NHS says was not necessary as the records were anonymised. However, Dr Bhatia says he has serious questions about how mobile data will be anonymised in phase two of the trial.
“The second phase can’t be anonymous, because if you’re trying to pick up certain people you can’t give out anonymised data as you won’t be able to identify the person,” he said. “As soon as data is identifiable, they’ll have to get individual consent from the patient.”
A spokesperson for the trust said that it is currently consulting with the ICO and will release more information in due course, adding: “Phase two is still in its infancy and ahead of processing any data, the trust has sought legal advice from one of the leading information lawyers in the country.
“We will continue to review and seek appropriate advice on the information and research governance requirements and engage our service users on any future phases of work under this project.”
Just because it’s legal and lawful doesn’t make it right Dr Neil Bhatia, a GP and Information Governance Lead