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Lance R. Vick

@BenAveling @Jennifer There are no medical devices involved.

They said they only willing to communicate, schedule, and exchange medical information with patients with their apple/google mobile app moving forward, even if it means terminating relationships with existing patients.

I even offered to show up in person for every communication, and they refused.

37 comments
ahimsa

@lrvick This is infuriating! I'm so sorry you are dealing with this shit. šŸ˜”

Neil Kandalgaonkar

@lrvick @BenAveling @Jennifer 1 in 3 seniors does not even own a smartphone.

I don't understand how this could be even economically feasible, let alone legal.

What's the company?

pewresearch.org/short-reads/20

Penguin

@neilk @lrvick @BenAveling @Jennifer Iā€™m old but was a software engineer for Apple products so live on my iPhone (like now). But parents & in-laws could never use any mobile phone, either to keep it charged or dial with the tiny keypad, much less use a smartphone. Medical providers have to accommodate such people, or tell the world theyā€™re not going to care for elderly people šŸ™

toadjaune

@PenguinToot @neilk @lrvick @BenAveling @Jennifer
wondering if that's part of the point.

I'm assuming elderly people are more expensive customers, as a health provider. From a stricly financial point of view, a measure that allows you to discriminate them while calling it a technical limitation sounds quite tempting.

(no idea whether it's legal or not anywhere, tho, but it's certainly very questionable ethically)

RealGene ā˜£ļø

@PenguinToot @neilk @lrvick @BenAveling @Jennifer
And so you've accidentally stumbled upon the actual reason.

No medicine-for-profit company wants old people with their measly Medicare reimbursements and lots of chronic illnesses. Better to get the cases of tennis elbow paid for by employer plans.

If they can be made to exit the rolls simply by requiring use of a mobile phone, that's cost savings that goes right to the CEO's Ivory Backscratcher fund.

Bob K Mertz

@RealGene
I really had the feeling this was a result of the medical company just wanting to be able to make advertising money off of their patients in addition to their fees and insurance billing but this actually seems very plausible. Perhaps it's both.

Both probably are factors in this move. The only thing for certain is that medical care is not at all about care anymore.
@PenguinToot @neilk @lrvick @BenAveling @Jennifer

Penguin

@RealGene @neilk @lrvick @BenAveling @Jennifer Daughter works for her state health insurers, visits lonely elderly to be sure theyā€™re getting medical care, phones physicians as necessary to arrange visits, etc. But sheā€™s one of few people who do this, clearly more will be needed as the population ages. At least Medicare is functioning for her clients.

DELETED

@RealGene
If this were so, all they would have to do is stop providing Medicare coverage which would pose no legal roadblocks but I guarandamntee you that health plans make plenty of $$ from Medicare. Also, no indication that the original poster is a senior.
Would insurance providers prefer to ONLY insure well people and be allowed to drop them if they got sick... Yep. That's a HUGE reason we need the ACA.
Ins providers don't care about you.
@PenguinToot @neilk @lrvick @BenAveling @Jennifer

This Old Hiker

@neilk @PenguinToot @BenAveling @lrvick @Jennifer Iā€™m sure that they consider dumping elderly and indigent patients a feature, and not a bug.

burne

@PenguinToot @neilk @lrvick @BenAveling @Jennifer The thing is.. your medical insurers are in it for the profit and nothing else. Over here there is a legal requirement to provide insurance to everybody, and thus to accomodate people who can't or won't use smart phones. They cannot refuse people or pre-existing conditions or for (for instance) a condition that makes using a smartphone impossible, like old age or beginning dementia.

equi

@neilk @lrvick @BenAveling @Jennifer older people are less healthy = more costly for healthcare providers, if this "excuse" goes through they'll start doing it on purpose.

Ed Davies

@neilk Hmmm, not possible those 1 in 3 seniors without smartphones are people they'd be happy to get rid of, then?

@lrvick @BenAveling @Jennifer

Rora Borealis

@neilk @lrvick @BenAveling @Jennifer It might be intentional, to whittle down their patient base to people who are younger and less likely to be on medicare/medicaid.

Maggie Maybe

@neilk @lrvick @BenAveling @Jennifer yep my neighbors boyfriend has one so he helps her but I also help her out.

She had to take an ambulance a couple months ago and the only way to pay the bill is either by mail or online. The post office is still broken, it will never be fixed again, so she didnā€™t want to mail it. That and she needs to have her receipt for her Deduction of medical expenses from her rent and she wasnā€™t sure she would get a receipt back that way.

Philip Mallegol-Hansen

@lrvick @BenAveling @Jennifer There isnā€™t even a suitable web experience? (Putting aside that even that isnā€™t good enough of course), itā€™s installed app or bust? Thatā€™s crazy.

Lance R. Vick

@philip @BenAveling @Jennifer We asked this, and they said webapp was not an option. Android/Apple device/app or GTFO.

Rora Borealis

@lrvick @philip @BenAveling @Jennifer That's disgusting. I'm so sorry. My providers have web portals but don't require you to use any of it. They're trying to root out the patients they won't get as much from. This sucks, because others will start if they see it working.

Danny Boling ā˜®ļø

@lrvick

That is NUTS. There's no logical or technological reason for such a decision. jfc... šŸ˜ 

@philip @BenAveling @Jennifer

Jennifer

@lrvick @BenAveling that is so unethical! Might be a long shot, but send an email to the Verge and Ars Technica. They cover all kinds of tech news and have big audiences. @nilay_patel is on here but don't know how active he is.

JoD

@lrvick sorry youā€™re dealing w this. if this is in the US - providers can not discriminate based on sex, race, and ethnicity. Beyond that they can pick and choose patients at their discretion. Your local newspaper and news station might be interested to hear. I wonder if this could be argued that it creates a monopoly. Orgs/companies like AARP, Jitterbug, your email provider would/could help fight.

CassandraZeroCovid

@jodmentum @lrvick

Actually ACA added gender and age to non- discrimination clause for any Federal program (ACA/ Medicare/ Medicaid).

Billy Smith

@lrvick @BenAveling @Jennifer

You haven't said which country you are based in, but under USA law, UK law, and EU law, it's called "tying" and is illegal under the anti-monopoly legislation.

This is one of the things that the #FAANG 's are being sued over right now. :D

Matt Stoller would be able to point you to someone who could help.

thebignewsletter.com/

Billy Smith

@lrvick @BenAveling @Jennifer

Also, under UK law, there's disability accessibility requirements, hence the req's for a web interface for the NHS systems.

Cory Doctorow is another person who would be able to point you to someone who could help.

@pluralistic

Nonya Bidniss šŸ„„šŸŒ“

@lrvick Terrible. I'm seeing more and more health providers and other businesses trying really hard to get people to install & use apps and I just won't do it. šŸ¤¬ @BenAveling @Jennifer

Killick

@Nonya_Bidniss @lrvick @BenAveling @Jennifer

My health insurer keeps nagging me to visit their portal for reasons. No.

Maggie Maybe

@killick @Nonya_Bidniss @lrvick @BenAveling @Jennifer I swear pain management purposely ignored and messed up every voicemail I left for six months to force me to use their stupid Klarna app. The benefit is that when they mess up my messages I can show the provider screenshots of what I said to show that thereā€™s no reason an error should have been made.

But I only install it when I need to send them a message and then I uninstall it immediately after completing the communication. Because they were making so many errors I donā€™t mind having things in writing. But if I didnā€™t have a smart phone I wouldnā€™t be able to deal with them because they canā€™t handle anything over the phone. And we donā€™t have a lot of options for pain management practices around here.

@killick @Nonya_Bidniss @lrvick @BenAveling @Jennifer I swear pain management purposely ignored and messed up every voicemail I left for six months to force me to use their stupid Klarna app. The benefit is that when they mess up my messages I can show the provider screenshots of what I said to show that thereā€™s no reason an error should have been made.

Billy Smith

@Nonya_Bidniss @lrvick @BenAveling @Jennifer

It's also worth remembering that most of the mobile apps are just a html/web interface which uses a click-agreement wrap-around, so they can't be legally reverse-engineered, so security through obscurity.

The bonus for the service providers is that they can require the mandated use of arbitration rather than the courts through any changes in the ToS agreements.

Don't agree, and you don't get to use the service.

Janet Vertesi

@BillySmith @Nonya_Bidniss @lrvick @BenAveling @Jennifer

This is a big point that @pluralistic is often on about, that these ā€œappsā€ are merely HTML wrappers that allow them to evade standard security, ToS, etc. I am glad you called Bs on this!

Billy Smith

@cyberlyra @Nonya_Bidniss @lrvick @BenAveling @Jennifer @pluralistic

They're using the DMCA legislation in exactly the way that was warned about when the DMCA laws were being written.

Sapient

@lrvick

So... they're using a third party app to keep customer data safe? Or is this an in house app by the medical provider... Either way I'm sure that app provider has nothing but the most top notch security in place, and this totally wont end up biting them in the ass.

nsfw :donor:

@sapient @lrvick Probably Epic Systems; they're the 800 pound gorilla of that space. I have three different "MyChart" apps from three providers that are all just reskinned versions of the Epic app.

Maggie Maybe

@lrvick @BenAveling @Jennifer this is awful, I got really pissed off in 2021 when Rite Aid told me I couldnā€™t schedule a Covid vaccine appointment without a Google account, I told them I wasnā€™t linking my Google account to my Pharmacy account couldnā€™t they just pencil me in. They could not because they would not get paid.

So instead I just went to the National Guard site in the city next to mine and stood in line at the mall.

But has genocide Joe considered that maybe thatā€™s why thereā€™s not a huge uptake with the vaccines? If people have to connect their Google account to the pharmacy to schedule one are old people doing that? Iā€™m not doing that.

@lrvick @BenAveling @Jennifer this is awful, I got really pissed off in 2021 when Rite Aid told me I couldnā€™t schedule a Covid vaccine appointment without a Google account, I told them I wasnā€™t linking my Google account to my Pharmacy account couldnā€™t they just pencil me in. They could not because they would not get paid.

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