Monday, April 22, 2019

The Stork Goes Digital

Pregnancy and childbirth, as well as the activities leading up to these, are among the most private matters women are concerned with.  They can also be some of the most expensive medical conditions that otherwise healthy young women encounter.  It comes as no surprise, then, that a company called Ovia has developed a system that lets women employees track their fertility and resulting pregnancies digitally. 

Originally, Ovia planned to promote their product directly to the consumers—young women—but as described in a recent Washington Post article, the company began to get inquiries from employers wanting to know how they could encourage their women workers to sign up.  Why?  The hope that Ovia would reduce medical-insurance costs for expensive infertility treatments and problem pregnancies.  Ovia showed employers that women who use the app can indeed benefit from the improved monitoring and awareness of warning signs that it provides.  Presently, Ovia's website clearly prioritizes this mode of delivery, and the typical user can even receive small payments from her employer to encourage her to keep checking in and providing data.  But what happens to that data?

Ovia stresses that all identifying information is stripped from the data before it is passed to the employer, who can then use it to anticipate health-care costs and glean a detailed picture of the most intimate aspects of their women employees' lives.  The contract Ovia signs with employers includes a promise that the employer will not "de-anonymize" the data to figure out exactly who is pregnant, for example, but there have been bad actors in the business world before, and it's not hard to imagine someone doing this for illegitimate reasons. 

Ovia is one of the more prominent apps of a variety that track various aspects of user health—Fitbit being the most well known.  Using such an app simply for one's own benefit is one thing.  But signing up to share intimate details with an employer-sponsored app is a different matter.  According to statistics provided by Ovia, the benefits are real—they say that users have a 30 percent reduction in premature births, and  a 30 percent increase in natural conception, as opposed to costly and absence-inducing infertility treatments. 

In a country where the burden of health insurance typically lies with the employer, one can't fault employers for doing whatever they can to minimize this cost, and gynecological-related procedures are among the most expensive ones that young women predictably encounter.  So the synergistic cooperation among Ovia, employers, and their women employees looks mostly like a win-win situation.

All the same, the article interviewed experts who expressed privacy concerns.  As long as there are no data breaches, these concerns may be largely imaginary.  But one aspect of engineering ethics is trying to imagine what could go wrong before it happens, and here's one way an app like this could be misused.

In a free country where agreements are freely arrived at between employees and employers, voluntarily sharing information is one thing.  But in countries with less freedom, such as the Peoples' Republic of China, governments are systematically worming their way into increasingly private aspects of their employees' lives.  I'm sure Ovia would like to have a market of the 1.3 billion or so people in that country.  But what if women there, instead of being offered the option to use the app, were forced to use it as a requirement of employment?  And what if turning up pregnant without first informing Ovia could be a cause for fines or imprisonment? 

It sounds awful, but such regimentation is becoming just another part of life in China, where all kinds of digital information on citizens is being used to come up with a "social credit" score.  It's sort of like a financial credit rating, but measures your reliability as far as the government is concerned.  In the dystopian novel 1984, the omnipresent Big Brother monitored everyone's actions through telescreens, which were sometimes laughed off by readers at the time because it would have taken half the population to sit behind the monitors to watch the other half.  But now in the age of AI pattern recognition, the watchers are 99% digital, and what was formerly thought impossible because of the absurd manpower demands has become quite feasible for a government that sets no bounds for snooping on its own citizens.

So far, Ovia seems to be simply another employee benefit that really does make things better for both users and the companies they work for.  Working women who get pregnant always encounter more or less conflicted situations, and anything that reduces the conflict, making employers less bothered about their women employees who have children, seems to be a good thing.  Still, it's another step into the digital future, which young persons especially seem to be embracing with little or no regret.  Things that once people blushed to tell even their doctors are now fodder for online posting, and as long as the privacy Ovia and similar apps promise is not breached, I suppose this is a good thing if it leads to healthier mothers and babies. 

Still, one wonders where the sharing of formerly private and personal data will stop, if ever.  Freedom, as an abstraction, can get overlooked in the rush to convenience that so many digital advances offer.  And so far, it looks like Ovia really has kept their promises that users' privacy will not be compromised.  But in the hands of a malevolent employer, or worse, a malevolent government, these kinds of personal-health apps could lead to serious incidents of abuse.  Let's hope that we can keep the benefits of Ovia and related apps while fending off any attempts to use it for nefarious purposes.

Sources:  The Washington Post article "Is Your Pregnancy App Sharing Your Intimate Data With Your Boss?" appeared on Apr. 10, 2019 at  I also referred to Ovia's website at 

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