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    A review of Halaxy (HealthKit)

    Halaxy vs Power Diary

    There are some important things about Halaxy (formerly HealthKit) that we want to bring to the attention of health practitioners.

    Choosing the right practice management software for your clinic can be a difficult and confusing decision. To help make the decision a little easier, we periodically review competitor systems and compare different aspects of them to Power Diary. When doing this, we ask ourselves:
    What is the most important and helpful information people need to know about the differences between system X and us? Usually this comes down to different features, usability, costs, security, reliability etc.

    Not in Halaxy’s case.

    There are concerning differences in how Halaxy uses your clients’ health data.

    Halaxy’s Terms-of-Use and Privacy Policy are different. Very Different.

    Before we dive in, let’s deal with the elephant in the room. Halaxy is a competitor of Power Diary. To avoid accusations that we’re interpreting their Terms of Use (TOU) and Privacy Policy (PP) in an out-of-context manner, we’ve attached full copies of Halaxy’s Terms of Use and Privacy Policy (printed from their website on 25th March 2020) so you can review these directly, and form your own view.

    Furthermore we’re highlighting Halaxy’s TOU and PP because they contain clauses we think most practitioners and patients would not expect. In fact we haven’t found clauses like Halaxy’s in any other commonly used competitors in the marketplace including:

    • Medical Director
    • Coreplus
    • Front Desk
    • Zedmed
    • Best Practice
    • Genie
    • Janeapp
    • Cliniko
    • TM2 / TM3
    • PPMS
    • PracticePal
    • Writeupp

    So what’s actually in Halaxy’s Privacy Policy?

    Halaxy’s Privacy Policy starts out with a fairly standard introduction, and reinforces the notion that by providing Personal Information, you consent to Halaxy using it in the manner described in that policy. This is all pretty normal boring stuff.

    Data Collected

    It then goes on to list the type of personal information Halaxy may collect. Again this list is fairly standard for a Practice Management System, however it’s important to note that the personal information collected may include health information entered into Halaxy by a patient or practitioner, including:

    • “..the treatment you have received…
    • …service type, service description…
    • …which practitioner treated you…
    • …test results…
    • …current and past medical history”

    This becomes particularly relevant when we look at Halaxy’s permitted purposes of use which they detail next.

    Permitted Purposes of Use

    Halaxy’s Privacy Policy then outlines the full range of permitted purposes that it can use and / or disclose the Personal Information entered into its system. Among the standard uses that might be expected, a number of purposes are included that we think neither practitioners nor patients would reasonably expect or knowingly consent to. This includes:

    • “…conduct research and for advertising and marketing”
    • “for medical research purposes, including providing this information to third parties for this purpose”
    • “to send you marketing and promotional messages…sent by…our business partners”

    You can see a more complete range in this screenshot here:

    In other words, Halaxy’s Privacy Policy appears to give it permission to access, use and disclose individually identifiable medical information that has been entered into its system for purposes that include medical research, marketing, advertising or other commercial activities. Furthermore there does not appear to be any requirement for Halaxy to notify practitioners or patients when data is used for these purposes, who patient data has been provided to, or any mechanisms for practitioners or patients to prevent the further use of their data once it has been provided to third parties.

    What about patient consent? Who is responsible?

    To understand this we need to look at Halaxy’s overall Terms and Conditions which can be found here: https://halaxy.com/article/terms.

    The clearest answer to the consent question appears to be contained in the section Practitioner Specific Clauses, Section 5. General Obligations where it states that you (the practitioner) warrant to Halaxy:

    “That all Persons for whom or to whom services are provided are aware of and comply with and accept all terms of these Terms that apply in relation to Data, including the Privacy Policy.”

    Put simply, this appears to indicate that if you’re a practitioner using Halaxy, you agree that you have made your patients aware of how Halaxy can use patient’s health data, and you have obtained patient’s consent for this.

    This appears to be further emphasised in Halaxy’s Privacy Policy under “Collection of personal information – what, how and why; In Addition; 3.” where it states that if you are using Halaxy and providing information to it about someone else i.e. entering patient treatment information, that you have made the person aware of, and gained their consent for Halaxy to use and disclose that information for all the purposes previously mentioned.

    Whilst there are also circumstances where patients can provide consent to Halaxy’s Privacy Policy directly, i.e if they were to register directly on the system, it would appear that failing this, it is the practitioner who enters patient data into Halaxy that is attesting to the fact that they have obtained their patients’ consent for Halaxy’s subsequent use of their data.

    Is Halaxy different to other PMS providers?

    In our view, Halaxy cannot be compared to other practice management systems due to their differences in their Terms of Use, Privacy Policy and pricing structures.

    In our review of Practice Management Systems, we found that nearly all systems, including Power Diary, operate something like this:

    Base Fee:
    Practices pay a monthly, annual or once-off fee to use the PMS.

    Fees for Extras:
    Additional fees typically apply for extras such as SMS use, payment processing etc.

    Data Use:
    Patient health data entered is considered to be the exclusive property of the practice. It is only used by the PMS in a manner you’d reasonably expect as part of operating a Practice Management System. The Privacy Policies do not allow accessing or using patient data for other commercial or research purposes.

    Halaxy’s Terms and Conditions, Privacy Policy and it’s pricing model indicate a very different approach:

    Base Fee:
    Halaxy’s core features are free to use.

    Fees for Extras:
    Fees apply for extras such as SMS use, payment processing etc.

    Data Use:
    Whilst ownership of patient health data entered remains the property of the practice, it’s Privacy Policy appears to allow Halaxy to access, use or disclose this information to third parties for a range of commercial, research or promotional purposes.

    In other words, unlike other systems, Halaxy’s Terms of Use and Privacy Policy appears to leave open the option for Halaxy to monetize the data practitioners enter about their clients.

    “If you don’t pay for a product, you are the product”

    Providing services or software for free in exchange for people’s personal data is not new, and not necessarily a bad thing. It comes down to people making an informed decision. Most people use free services like Google, Facebook, Instagram, and understand their data is used for advertising and other purposes.

    Halaxy advise users they “are building the largest, most unique health longitudinal datasets in the world” and that by using Halaxy they’re “contributing” in exchange for “access” to the system.

    In our view this does not make it clear enough that Halaxy can use and disclose patient data for a much wider range of uses. Furthermore, the onus of gaining consent for that data use primarily lies with the practitioner.

    Concerned – What should you do?

    First of all read Halaxy’s full Terms of Use and Privacy Policy and decide for yourself whether they meet your expectations and the expectations of your patients. If you’re not sure about any element seek the opinion of a legal professional who specialises in health and follow their advice.

    Not happy with the Terms of Use and Privacy Policy and unsure what to do? We’ll leave the final word on that to Halaxy.

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