Clearview Counterpoint: Career Experts Divided On Medical Privacy Issue

Clearview Counterpoint: Career Experts Divided On Medical Privacy Issue

2009-11-19 07:08:37

How much personal health information should employers have about employees or job candidates?

Moderator: John Sumser

This month’s debate question is “How much personal health data should an employer be able to use to make job-related decisions?” Companies are getting more and more access to increasingly cheap ways to measure the physical status of their employees. Where should the limits be?

John Sumser: My desk is littered with the gadgets of personal health monitoring. Blood pressure cuffs, a blood glucose monitor, biofeedback gear, a breathing trainer and a meditation device. Nearby is a scale with a USB port. I’m looking at all of these devices to try to understand the future of personal health data.

My iPhone tracks all sorts of things. It manages health information, food consumption, the number of steps I take, exercise logs and medication schedules. It tracks where I am, what I’m doing, my finances and my physical status.

For me, it’s an amazing mirror showing me aspects of my personality that I never considered. A three-mile walk on the beach clobbers my blood pressure and sugar. The right blend of nutrients drives my mood over the following 24 hours. The more I quantify my behavior, the more I am able to manage it.

I’ve just ordered the new sleep-monitoring tool. It helps optimize the rest you get and gently wakes you at the right point sometime close to your desired wake-up.

All of a sudden, I’m swimming in personal data. Every item on my desk is rapidly getting wired into the cloud. I have little doubt that I am just an early adopter in the movement to self-quantification .

I understand that I am on the geeky edge of things. But, you can be certain that the ability to measure lots of physical aspects of human performance is right around the corner. Airports have begun measuring body temperature remotely to manage the spread of the flu.

The combination of at home DNA testing (a Google affiliate has introduced sub-$1,000 screens), health records and routinely collected bio-data offer unimaginable possibility and risks.

On the one hand, you will be able to spot and correct your own long and short-term performance problems. From weight management to diet and fitness, every aspect of your physical life will come under control. The ability to understand and improve one’s physical potential is an amazing leap forward in evolution.

On the other hand, you should expect that employers are going to be increasingly interested in the physical dimensions of performance optimization. It’s easy to imagine compensation tied to biological peaks.

For example, a study released Tuesday discusses some of the chronic health issues associated with obesity, which is expected to plague 43% of Americans by 2018. Why wouldn’t you ask less healthy employees to pay more for health insurance? Imagine scheduling the workforce based on the basis of predicted productivity. Expecting employees to submit evidence of adequate restful sleep or specific dietary intake to maintain a healthy weight doesn’t seem that far afield.

My view is that as the employment social contract changes, both employers and employees will be increasingly interested in understanding the physical aspects of job performance. My bet is that we’ll have less privacy and improved job performance.

I’m for that.

Hank Stringer: No, we should not start using all the data available to measure how well an individual does their work. We should measure how well an individual does their work but the moment we start concerning ourselves with all the data available simply because we can, we are halfway down the slippery slope.

When I first saw your point I had dreams of Fritz Lang’s “Metropolis” and Orson Welles’s “1984” all rolled up into one scene of the future American work place and it sucked. The next thing we know we will be testing 14-year-olds to see if they have any future physical obstacles that could get in the way of their contributions to work and society; sorry FDR and Stephen Hawking. I know I am carrying this two steps too far but at some point we have to check ourselves and understand we don’t have to do everything just because we can.

Jeff Hunter: Two words come to mind when I think of companies evaluating talent through health and other personal data: Apollo Thirteen. The first reason this comes to mind is because when I read statements like “you should expect that employers are going to be increasingly interested in the physical dimensions of performance optimization,” I feel like saying, “Houston we have a problem.”

But Apollo 13 is important for more than just that one phrase. The story of Apollo 13 is a great example of why employers using health data to create performance optimization is such an astoundingly bad idea. For those of you who haven’t seen the movie, Ken Mattingly was originally slated to be the command module pilot for the mission.

Three days before launch he was replaced with Jack Swigert. The reason? Health data. Specifically, Ken had been exposed to the German measles, a disease for which he had not been inoculated. Swigert was a superior health risk, and therefore more likely to perform better during the mission. The rest of the story is history. An oxygen tanks explodes three days into the flight, Mattingly (having never gotten the measles) helps save the three astronauts by figuring out how to conserve power and everyone returns safe and sound.

In short, Mattingly (the health risk) saves Swigert’s life. An astronaut’s health is measured seven ways to Sunday. They are quarantined and monitored. Even in the wildest dreams of a corporate actuarial no company would ever undertake to measure and control this much of a person’s health (or any other data, for that matter). But it turns out that you can poke, prod, measure and manipulate as much as you want: the real threat is the one you aren’t watching.

In the case of Apollo 13 it was bad quality control on the wire that connected to the lead that stirred the oxygen tank. The teflon coating on the wire was compromised, causing the explosion. Putting Mattingly on the flight with measles was never as remotely dangerous as a system failure that was created years before poor old Ken ever had the bad luck to be exposed to the disease. And this is the broader lesson, and the reason attempting to increase performance through measuring and managing health is such a bad idea.

Corporations are poor at evaluating risk. They much prefer to examine the data in front of them than to evaluate system weaknesses and hypothesis about unpredictable but catastrophic events. At the same time, all companies are being inundated with urgent but strategically irrelevant data. Into the midst of this risk paralysis and information overload steps the overworked hiring manager, who is already doing the work of three people.

Adding to that hiring manager’s info-glut won’t just fail to have the desired effect of predicting or optimizing employee performance. It will add to the distractions they already face, taking what precious little time and attention they have left to think about unpredictable change that will ruin their business and focusing it instead on whether the chunky engineer is as good as the distance runner. And all the time they will be missing the point: the reason their business objectives are at risk is general systems failures built into their team long before their dream candidate caught a cold. Houston, let’s not start this problem.

Rusty Rueff: There’s no doubt that this type of information will eventually become part of the menu of performance management, the question is who will have the guts to do it first?

As people first, employees second, we already are all over this. Just look around the office and the cubicles and see the assortment of vitamins, energy drinks, herbs and tonics, that we all use to make our overall human condition better and we are already smart enough to know when we have to perform and peak, that we get a better night sleep the night before and we caffeinate (okay not all that healthy) and we ready ourselves for the big moments.

So, why not add this into better performance management? Imagine that Lance Armstrong would proceed into any race without all the data in front of him? I doubt he would.

Kevin Kelly and Gary Wolf have been on this for a while with their Quantified Self tools ( and continue to push the boundaries on what can be measured. We already try as employers to assess some of this already in the interview process.

Haven’t we all sat in debrief meetings where someone says, ”it seems like they just ran out energy at the end of the day?” I see it this way: we are each a human operating system. We boot up each day and all day long we run routines until we run out of battery. We refresh and then we do it all over again.

The problem is that we are variable in our operating procedures and if any other operating system was this variable we would throw it out the window faster than we hated Vista. So, why wouldn’t we want to take the variability out of the human operating system to improve and predict more consistent performance?

Again, who will have the guts to try first? There will be lots and lots of ’big brother’ and privacy conversations but with a little bit of good design thinking and the right incentives, we could be there sooner than we think.

I’d love to be in the test group.

Liz Ryan: Employers are limited in what they can legally learn about an employee’s health situation before making an offer. They can require a physical after an offer is extended. I would hate to see an employer’s right to collect more health data increase. Employees — people in general, in fact — have little enough privacy as it is!

I was thrilled to see public pressure convince Clarion Health Systems, a midwestern hospital organization, to back off on its plans to weigh employees at work and fine them for exceeding a certain body-mass index, a few years ago. I remember stories from Ceaucescu’s Romania, where that sort of intrusion (and much worse) was a matter of course for working people. What was especially galling about the Clarion plan was the idea that employees exceeding a certain BMI should be fined, because their health claims would cost the company money….notwithstanding the fact that hospitals are among the most unhealthy and stressful places to work!

My hope is that if employers attempt to push the health-information envelope when it comes to extending offers, talented candidates will Just Say No to those employers and leave them to their talent-deprived fate. For the record, I believe that pre-employment drug screening should be used sparingly and that in general, the pendulum is already too far over to one side with respect to pre-employment poking and prodding. I can’t wait for the economy to improve so that affluent older Boomers can begin to retire in droves and force employers to pick up their recruiting game in order to get and keep talent.


Sumser: Health and fitness are the first areas that will come under management (as they say). In the short time involved in having this conversation with the Clearview team, several new interestedin products have come to market that track and monitor our health:

  • The Zeo which tracks and analyzes your sleep patterns and acts as an alarm clock
  • The MioWatch which gives quick access to on the fly heart performance.
  • Directlife from Phillips which includes corporate fitness programs in its agenda.
  • In addition, the MIT Technology Review is reporting the development of a A Battery-Free Implantable Neural Sensor – with one of these, you can have your measuring chip implanted without ever having to replace the battery. It’s activated by a radio.

We’re entering an era of evidence-based decision making. The degree to which the aggregate data about the employee group is a valuable corporate asset is just beginning to be understood. Every increment of measurable behavior is going to be utilized to help improve personal and collective performance. There are ways to embrace it and there are ways to recoil from it.

As we enter the data onslaught, issues like the  one we have discussed here will give us polar conversations at the dinner table and in the media. Remember that you heard about the personal performance data issue first here on Glassdoor.