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Femtech apps ‘misuse’ highly sensitive data, study finds

Apps which handle fertility data are “coercing” users into entering sensitive information that could put them at risk, experts have warned

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Femtech apps are exposing users to “unnecessary” privacy and safety risks through their poor data handling practices, new research has found.

In the most extensive evaluation of the privacy practices of female health apps to date, researchers from King’s College London and University College London (UCL) found apps which handle medical and fertility data are “coercing” users into entering sensitive information that could put them at risk.

Following an analysis of the privacy policies and data safety labels of 20 of the most popular female health apps available in the UK and US Google Play Stores, the study revealed that in many instances, user data could be subject to access from law enforcement or security authorities.

Only one app that the researchers reviewed addressed the sensitivity of menstrual data with regard to law enforcement in their privacy policies and made efforts to safeguard users against legal threats.

By contrast, many of the pregnancy-tracking apps had a requirement for users to indicate whether they have previously miscarried or had an abortion, and some apps lacked data deletion functions, or made it difficult to remove data once entered.

Experts warned this combination of poor data management practices could pose serious physical safety risks for users in countries where abortion is a criminal offence.

Lead investigator Dr Ruba Abu-Salma, King’s College London, said: “Female health apps collect sensitive data about users’ menstrual cycle, sex lives and pregnancy status, as well as personally identifiable information such as names and email addresses.

“Requiring users to disclose sensitive or potentially criminalising information as a pre-condition to deleting data is an extremely poor privacy practice with dire safety implications. It removes any form of meaningful consent offered to users.

“The consequences of leaking sensitive data like this could result in workplace monitoring and discrimination, health insurance discrimination, intimate partner violence, and criminal blackmail; all of which are risks which intersect with gendered forms of oppression, particularly in countries like the US where abortion is illegal in 14 states.”

The study revealed stark contradictions between privacy policy wording and in-app features, as well as flawed user consent mechanisms, and covert gathering of sensitive data with “rife” third-party sharing.

It found 35 per cent of the apps claimed not to share personal data with third parties in their data safety sections but contradicted this statement in their privacy policies by describing some level of third-party sharing.

Fifty per cent of the apps, the findings showed, provided explicit assurance that users’ health data would not be shared with advertisers but were ambiguous about whether this also included data collected through using the app.

Additionally, 45 per cent of privacy policies outlined a lack of responsibility for the practices of any third parties, despite also claiming to vet them.

Many of the apps in the study were also found to link users’ sexual and reproductive data to their Google searches or website visits, posing, as researchers warn, a risk of de-anonymisation for the user and could also lead to assumptions about their fertility status.

Lisa Malki, first author on the paper and former research assistant at King’s College London, said: “There is a tendency by app developers to treat period and fertility data as ‘another piece of data’ as opposed to uniquely sensitive data which has the potential to stigmatise or criminalise users.

“Increasingly risky political climates warrant a greater degree of stewardship over the safety of users, and innovation around how we might overcome the dominant model of ‘notice and consent’ which currently places a disproportionate privacy burden on users.

“It is vital that developers start to acknowledge unique privacy and safety risks to users and adopt practices which promote a humanistic and safety-conscious approach to developing health technologies.”

Co-author Dr Mark Warner, lecturer in information security at UCL, added: “It’s important to remember how important these apps are in helping women manage different aspects of their health, and so asking them to delete these apps is not a responsible solution.

“The responsibility is on app developers to ensure they are designing these apps in a way that considers and respects the unique sensitivities of both the data being directly collected from users, and the data being generated through inferences made from the data.”

To help developers improve privacy policies and practices of femtech apps, the researchers developed a resource that can be adapted and used to manually and automatically evaluate privacy policies.

They also called for more critical discussions on how these types of apps, including other wider categories of health apps such as fitness and mental health apps, look after sensitive data.

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‘Groundbreaking’ endometriosis study identifies patient priorities

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A “groundbreaking” study into endometriosis has identified three areas for future research that can help improve the outcomes for women with the condition.

The study, commissioned by Endometriosis New Zealand, attracted 1,262 participants, including 1,024 people with confirmed endometriosis, making it the largest ever study involving endometriosis patients and supporters in New Zealand.

Study participants identified the management and treatment of endometriosis, the need for a better understanding of its cause and improvements to diagnostic capability as the three main priorities for further research.

While these findings provide a clear pathway for future work, Endometriosis New Zealand chief executive, Tanya Cooke, said endometriosis research had historically been underfunded.

“With an estimated 120,000 New Zealanders living with endometriosis, much more needs to be invested into finding solutions,” Cooke explained.

“The reality is the outcomes for many endometriosis patients are pretty poor, with diagnosis often taking many years and treatment patchy across the country.”

Estimates based on Australian data suggest that endometriosis is likely to be costing New Zealand somewhere in the range of $1.3-1.5bn annually through increased healthcare costs and lost workforce productivity.

Cooke said: “The good news is that our findings align closely with those in Australia and provide three clear priorities for future research – improved treatment options, causation and better diagnostic capability.

“What New Zealand now requires is proper funding for a future research programme that can investigate these priorities more closely and improve the outcomes for individuals living with endometriosis.”

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Virtual care platform secures US$46m to address US maternal health crisis

Pomelo Care will use the funding to scale its care model and improve maternal and infant outcomes

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Marta Bralic Kerns, founder and CEO of Pomelo Care

The US virtual maternity care platform Pomelo Care has secured US$46m in funding to address the US maternal health crisis.

One in 10 babies born in the US today start their life in a neonatal intensive care unit.

Healthcare access continues to worsen, with one in eight births occurring in US counties with limited-to-no access to maternal care. Due to significant gaps in postpartum care, about half of pregnancy-related deaths in the US occur after hospital discharge.

The evidence exists for how to identify people at highest risk for complications and which interventions are most effective, but existing data gaps and provider capacity challenges make it difficult to apply these interventions at scale.

Pomelo has developed a care model that aims to address these challenges by analysing claims and health record data to identify individual risk factors and providing virtual pregnancy, postpartum, and infant care to patients to reduce those risks.

“We’ve long known what works to reduce maternal and infant complications,” said Marta Bralic Kerns, founder and CEO of Pomelo Care.

“The questions have always been: can you identify the patients who are at highest risk, can you deeply engage them in care to drive uptake of the prevention strategies we know work, and can you do it in the highest risk populations with the most limited access to care?”

“This data demonstrates that we absolutely can. And with this additional funding, we’ll have the opportunity to scale our care model to more pregnant people across the country.”

The funding, led by existing investors First Round Capital and Andreessen Horowitz (a16z) Bio + Health, is hoped to help Pomelo accelerate its partnerships with payors across the US and increase access to “evidence-based” care.

Josh Kopelman, partner at First Round Capital and Pomelo board member, said: “It’s rare to come across an opportunity where the incentives between patient, provider and payor are all aligned.

“Marta and the Pomelo team have found an incredible opportunity to dramatically improve outcomes for the highest risk populations, while helping payors reduce their avoidable costs.”

Vineeta Agarwala, general partner at a16z Bio + Health and Pomelo board member, added: “Pomelo is one among a small set of health tech companies that have earned true scale.

“This scale is evident in our partnerships with major Medicaid and commercial plans covering over three million lives, which create the opportunity to collaborate with OB providers, labour and delivery wards, and NICUs nationwide, while serving hundreds of thousands of expecting mothers and newborns with high quality, technology-enabled care.”

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One in three UK fertility patients seek treatment abroad due to high costs

Expensive fertility treatments prompt UK patients to seek help abroad

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One in three fertility patients in the UK seek treatment abroad due to high costs, a new survey has shown.

Fertility Family has gathered insights from 429 UK participants who have experienced difficulties with infertility.

The Infertility Awareness Report found that the high cost of fertility treatment in the UK has driven over one in four people to spend over £10,000 on both treatments and investigative procedures.

The research showed around 35 per cent of people struggling with infertility have considered seeking fertility treatment abroad due to the prospect of lower costs.

Of those seeking fertility treatment in a foreign country, however, only 14 per cent believed that clinics abroad have a higher success rate.

Of those actively trying to conceive almost one in five have used their life savings in the pursuit of having a child, whilst 25 per cent have paid for their fertility treatments using a credit card.

Dr Gill Lockwood, consultant at Fertility Family, said: “While we tend to cast our gaze on women when it comes to infertility, case studies have shown that infertility can impact both women and men in similar ways. However, women have been observed to seek help more than men.

“Although the psychological struggles of infertility can be overwhelming, many patients ultimately reach some type of resolution. Some of the alternatives include becoming parents to a relative’s children, adopting children, or deciding to adopt a child-free lifestyle.

“Needless to say, this resolution is usually psychologically demanding, and patients may feel forever impacted by the experience of infertility.”

A combination of fertility struggles and accessible healthcare have impacted people across the UK significantly, with one in two admitting to feeling “ashamed” due to their difficulties trying to conceive.

A further 31 per cent reported feeling that other people think “less” of them due to their fertility struggles, showcasing the need for better mental health support.

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