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Technology Blog

LURKING BENEATH THE SURFACE: HIDDEN IMPACTS OF PIXEL TRACKING

By
The FTC Office of Technology
March 16, 2023
Image

A DEEP DIVE INTO THE TECHNICAL SIDE OF FTC’S RECENT CASES ON DIGITAL HEALTH
PLATFORMS, GOODRX & BETTERHELP

The Federal Trade Commission recently took enforcement action against GoodRx[1]
and BetterHelp[2], two digital healthcare platforms, for allegedly sharing user
health data with third parties for advertising. Both cases highlighted the use
of third-party tracking pixels, which enable platforms to amass, analyze, and
infer information about user activity.[3] The remedies in GoodRx[4] and
BetterHelp[5] include strong provisions like bans that place strict,
comprehensive limits on whether and how certain user information may be
disclosed for advertising. In GoodRx and BetterHelp, this included a ban on the
sharing of health information for any advertising purposes, and the BetterHelp
order further bans the disclosure of other personal information for
re-targeting.

WHAT IS PIXEL TRACKING?

Tracking pixels have evolved from tiny, pixel-sized images on web pages for
tracking purposes to include a broad range of HTML and JavaScript embedded in
web sites (and email).[6] Tracking pixels can be hidden from sight and can track
and send all sorts of personal data such as how a user interacts with a web page
including specific items a user has purchased or information users have typed
within a form while on the site.[7] Businesses often want to use them to track
consumer behavior (pageviews, clicks, interactions with ads) and target ads to
users who may be more likely to engage or purchase something based on that prior
online behavior.[8]

HOW DOES IT WORK?

Companies who are interested in pixel tracking must first choose a pixel
tracking provider. The provider will then generate a tracking pixel, a small
piece of code that will be placed into the website or ad and define their
tracking goals such as purchases, clicks, or pageviews. The company will then
use some version of a dashboard or interface with the provider to track, test,
and refine their settings.

Pixel tracking can be monetized several ways. One way to monetize pixel tracking
is for companies to use the tracking data collected to improve the company's own
marketing campaigns. The data can be used to target more specific audiences with
ads and other marketing messages. Another is that companies can monetize the
data collected by further optimizing their own ad targeting systems and charging
other companies to use its advertising offerings.[9]

WHAT ARE THE CONCERNS?

Widespread usage of invisible pixels with no way for consumers to avoid.
Traditional controls such as blocking third party cookies may not entirely
prevent pixels from collecting and sharing information.[10] Additionally, many
consumers may not realize that tracking pixels exist because they’re invisibly
embedded within web pages that users might interact with. Pixels are widely
considered an industry standard tool, but the GoodRx and BetterHelp examples
show that they may collect sensitive data. Academic[11] and public reporting[12]
teams have found that thousands of the most visited webpages have pixels and
other methods that leak personal information to third parties.

Lack of clarity around data collection and use. With pixels, any type of
personal and identifying information can be collected and shared.[13] In fact,
information collected from a pixel can be used to identify social media profiles
through matching information such as a user's email address that automatically
connect a user to their social media account on the platform if they have one.
These third parties are often covert about how they store the data, and in some
cases do not know what kinds of information is being tracked and where it is
being stored.[14] These interactions may be further complicated by dark patterns
and related practices, which may result in consumer confusion or unwanted
sharing.[15]

Personal information may not be effectively removed. Some pixel tracking methods
ostensibly attempt to remove personal information but may in fact still leak
enough information to identify an individual. For instance, some tracking pixels
“hash” personal information to scramble personally identifiable information such
as names or email,[16] which the FTC has said may be inadequate in some cases,
because hashes can be reversed or used to link data across different
databases.[17]

RESEARCH QUESTIONS

Researchers and journalists have played a key role investigating practices and
trends in online tracking, including pixel tracking. The FTC’s actions against
GoodRx and BetterHelp raise questions for which continued research could prove
useful.

1. Industry conditions and competitive dynamics. Which pixel providers are
particularly competitively significant for various tracking use cases, and
how has competition in this industry evolved? How prevalent is pixel
tracking relative to other forms of online tracking? What broader impact
does pixel tracking have on competitive conditions in online tracking and
advertising?
2. Consumer harms. What unique consumer harms, financial or otherwise, can
result from the use of pixel tracking technologies? How might the harms of
pixel tracking technologies differ for certain communities?
3. Business rationales. Does data collection from pixel tracking offer business
advantages or disadvantages to companies, relative to alternative forms of
data collection? What financial impact does pixel tracking have on
advertising networks, data brokers, social networks, advertisers, and other
parties?
4. Data processing, use, and monetization. To what extent do first
parties—including companies with diverse businesses practices—internally
share data to use for purposes that consumers might not reasonably expect?
For parties that obtain data via pixel tracking, what processing do they
perform on this data, and how do they use and monetize this data beyond
direct ad targeting? Do other platforms that handle sensitive data (e.g.,
health, financial, location, etc.) make use of third-party tools like pixel
tracking in ways that risk exposing that data?
5. Data retention and management. What is the minimum data retention period
necessary to provide services based on pixel tracking? What are the
circumstances that inform retention periods? How do companies keep track of
the data they receive from pixels?

Our agency remains committed to protecting consumers and enforcing the law.
Companies using tracking pixels that impermissibly disclose an individual’s
personal information (which may include health information) to third parties may
be violating the FTC Act,[18] the FTC’s Health Breach Notification Rule,[19] the
HIPAA Privacy, Security, and Breach Notification Rules,[20] other state or
federal statutes involving the disclosure of personal information, and your
privacy promises to consumers.As the Office of Technology grows,[21] we will
work to ensure the agency continues to be forward thinking and equipped to
address and decipher developing technologies and harms.

Thank you to the contributors to this post: FTC Technologists (Joe Calandrino,
Varoon Mathur, Aaron Alva, and Stephanie T. Nguyen) and FTC staff across BCP,
BC, OPP and OGC (Michael Atleson, Lerone Banks, Manmeet Dhindsa, Peggy Bayer
Femenella, Alex Gaynor, Nick Jones, Janice Kopec, Josephine Liu, Ryan Mehm,
Kevin Moriarty, Miles Plant, Ronnie Solomon, Mark Suter, Olivier Sylvain, Ben
Wiseman, and Erika Wodinsky).

--------------------------------------------------------------------------------

[1]"FTC Enforcement Action to Bar GoodRx from Sharing Consumers’ Sensitive
Health Info for Advertising." FTC Press Releases. February 1, 2023.
https://www.ftc.gov/news-events/news/press-releases/2023/02/ftc-enforcement-action-bar-goodrx-sharing-consumers-sensitive-health-info-advertising

[2]"FTC to Ban BetterHelp from Revealing Consumers’ Data, Including Sensitive
Mental Health Information, to Facebook and Others for Targeted Advertising." FTC
Press Releases. March 2, 2023.
https://www.ftc.gov/news-events/news/press-releases/2023/03/ftc-ban-betterhelp-revealing-consumers-data-including-sensitive-mental-health-information-facebook

[3]T.Feathers, K.Palmer, S.Fondrie-Teitler. "Out of Control: Dozens of
Telehealth Startups Sent Sensitive Health Information to Big Tech Companies."
The Markup. December 13, 2022.
https://themarkup.org/pixel-hunt/2022/12/13/out-of-control-dozens-of-telehealth-startups-sent-sensitive-health-information-to-big-tech-companies (link
is external)

[4]"GoodRx Stipulated Order for Permanent Injunction, Civil Penalty Judgment,
and Other Relief." Federal Trade Commission. January 24, 2023.
https://www.ftc.gov/system/files/ftc_gov/pdf/goodrx_stipulated_order_for_permanent_injunction_civil_penalty_judgment_and_other_relief.pdf

[5]"BetterHelp Agreement Containing Consent Order" Federal Trade Commission.
January 24, 2023.
https://www.ftc.gov/system/files/ftc_gov/pdf/202_3169-betterhelp-consent.pdf

[6] S. Mattu, A. Waller, S. Fondrie-Teitler, and M. Gorelick. "How We Built a
Meta Pixel Inspector". The Markup. April 28, 2022.
https://themarkup.org/show-your-work/2022/04/28/how-we-built-a-meta-pixel-inspector(link
is external)

[7] ibid.

[8] J. Keegan. "Forget Milk and Eggs: Supermarkets Are Having a Fire Sale on
Data About You". The Markup. February 16, 2023.

[9]M. Eddy. "How Companies Turn Your Data Into Money". PC Mag. October 10, 2018.
https://www.pcmag.com/news/how-companies-turn-your-data-into-money(link is
external)

[10]Disabling cookies might limit the ability of advertisers to track user
behavior or capture user information, disabling cookies does not necessarily
mean that you have disabled pixel tracking. Pixel tracking can still occur even
if cookies are disabled, as tracking pixels do not always rely on cookies to
function.
"Most Browser Tracking Protection Doesn’t Actually Stop Tracking by Default, but
We Can Help". DuckDuckGo. March 30, 2021.
https://spreadprivacy.com/browser-privacy-protection/ (link is external)

[11]A. Senol, G. Acar, M. Humbert, F.Z.Borgesius. “Leaky Forms: A Study of Email
and Password Exfiltration Before Form Submission.“ 31st Usenix Security
Symposium. Aug 10-12,
2022. https://www.usenix.org/conference/usenixsecurity22/presentation/senol (link
is external)

[12]J. Angwin. "The Online Tracking Company That Knows Your Name". The Markup.
May 14, 2022.
https://themarkup.org/newsletter/hello-world/the-online-tracking-company-that-knows-your-name (link
is external)

[13]S. Mattu, A. Waller, S. Fondrie-Teitler, and M. Gorelick. "How We Built a
Meta Pixel Inspector". The Markup. April 28, 2022.

[14]L. Franceschi-Bicchierai. "Facebook Doesn’t Know What It Does With Your
Data, Or Where It Goes: Leaked Document". Vice. April 26, 2022.

[15]“FTC to Ramp Up Enforcement against Illegal Dark Patterns that Trick or Trap
Consumers into Subscriptions.“ Federal Trade Commission. October 28, 2021.
https://www.ftc.gov/news-events/news/press-releases/2021/10/ftc-ramp-enforcement-against-illegal-dark-patterns-trick-or-trap-consumers-subscriptions

[16]T. Feathers, S. Fondrie-Teitler, A. Waller, and S. Mattu. "Facebook Is
Receiving Sensitive Medical Information from Hospital Websites". The Markup.
June 16, 2022.
https://themarkup.org/pixel-hunt/2022/06/16/facebook-is-receiving-sensitive-medical-information-from-hospital-websites(link
is external)

[17]E.Felten. "Does Hasing Make Data ’Anonymous’?". Tech@FTC Blog. April 28,
2022.
https://www.ftc.gov/policy/advocacy-research/tech-at-ftc/2012/04/does-hashing-make-data-anonymous

[18](15 U.S.C. Sec. 45(a)(1))

[19](16 CFR Part 318)

[20](“HIPAA Rules”) (45 CFR Part 160 and 45 CFR Part 164)

[21]https://www.ftc.gov/policy/advocacy-research/tech-at-ftc/2023/02/century-technological-evolution-federal-trade-commission

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