They're watching....

I have one of these in my wallet.  Often, I'm glad I do because I can buy one package of Thomas' English Muffins and get a second package free.  Or the four for a dollar cans of Polar Seltzer becomes five for a dollar with the simple swipe of the card across an infrared beam reader.  It's quite nice of Stop & Shop to do this for me.

But alas, I clearly understand that the company is watching my every move and that niceness has nothing to do with it.  They are analyzing my buying patterns not only for valuable market research purposes, but also so that they know precisely how to target me.  It's no accident that when my receipt is spit out of the automated register, it's accompanied by coupons for english muffins and seltzer water.

There's nothing new here.  Marketers have been assessing our shopping habbits and buying patterns for decades, but newer technologies have brought the practice to even higher levels of sophistication.  Google's entire business model is predicated on intricate and automated means of understanding what we do when we're on-line, what we search for and what we type when we're in places like their gmail program.  I once typed to a friend in a gmail message that I had passed through a town named Spoon River and the very next day I received an "exclusive" email offer on a new set of silverware.  Coincidence?  Maybe.

Over the weekend, The Wall Street Journal addressed the reach of similar technologies into the delivery of health care.  Selected excerpts from the article, by Anne Kadet:

Whether a patient comes in for a gall-bladder operation or to have a baby, the routine remains the same for staff at Sharp HealthCare hospitals in San Diego. The front desk checks insurance records to make sure the bills get paid on time. Nurses take vitals and tag their charges with a bar-coded wristband. And behind the scenes, fund-raisers scan the assets of each patient -- to find out whether they're "megarich," "wealthy" or merely "comfortable."

While the folks checking in don't know it, the nonprofit hospital chain is hunting for prospective donors. Armed with powerful data-mining software, staffers screen admissions records to find wealthy patients who've shown prior interest in the hospital. Those who make the cut may enjoy a bedside visit from a "patient-relations director" who offers perks like free parking passes for visitors.

Medical institutions have been particularly aggressive about prospect research. Some use software to screen admissions lists; some even train doctors to identify new prospects. Once a patient is scouted as a VIP, the perks roll in. At the Hospital of the University of Pennsylvania, some 1,200 donors and volunteers can get priority for appointments with specialists. At San Diego's Sharp HealthCare, major donors receive a card with staffers' pager numbers.
 
Some people question whether these practices should be overlapping with medical care. Arthur Caplan, a bioethicist at the University of Pennsylvania School of Medicine, says it's hard to justify "golden runways" that whisk donors past waiting lists. During treatment and recovery, he adds, patients may feel too vulnerable to refuse a solicitation.

Hospitals say grateful patients are their only natural donor constituency. Paul Mischler, the Pennsylvania hospital's senior executive director of development, says the donor relationship "can be a natural, rewarding part of the healing process."

The key question pertains to the ethics of not-for-profit health care organizations utilizing sophisticated technologies and techniquess to "hunt for prospective donors" and "screen admissions lists".  What about providing perks (e.g., faster appointment times) for patients with means?  And training physicians to screen patients for donor prospecting purposes?

It strikes me that the mere deployment of sophisticated tools to facilitate more effective fundraising performance for often cash-strapped, mission oriented health care organizations is not a bad thing.  It can drive efficiencies and aid in supporitng needed programs and services.

But the latter scenarios, such as offering differential care for those who are better prospects but who do not pay for the higher end services and asking clinical staff to do prospecting, crosses over the line.