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Healthcare Cybersecurity: An Internet ID For All Americans?

From CBS News:

President Obama is planning to hand the U.S. Commerce Department authority over a forthcoming cybersecurity effort to create an Internet ID for Americans, a White House official said here today.

It’s “the absolute perfect spot in the U.S. government” to centralize efforts toward creating an “identity ecosystem” for the Internet, White House Cybersecurity Coordinator Howard Schmidt said.

That news, first reported by CNET, effectively pushes the department to the forefront of the issue, beating out other potential candidates including the National Security Agency and the Department of Homeland Security. The move also is likely to please privacy and civil liberties groups that have raised concerns in the past over the dual roles of police and intelligence agencies.

No, they’re not talking about a national ID card, just an international internet ID. The announcement came at an event today at the Stanford Institute for Economic Policy Research, where U.S. Commerce Secretary Gary Locke and Schmidt spoke. The Obama administration is currently drafting what it’s calling the National Strategy for Trusted Identities in Cyberspace, which Locke said will be released by the president in the next few months. (An early version was publicly released last summer.)

“We are not talking about a national ID card,” Locke said at the Stanford event. “We are not talking about a government-controlled system. What we are talking about is enhancing online security and privacy and reducing and perhaps even eliminating the need to memorize a dozen passwords, through creation and use of more trusted digital identities.”

Imagine: Anyone registered with such a cyber-ID who conferences with their doctor via a “secure server” can also be tracked by the government with such a mechanism. And the issue of not needing more than one password? While convenient, the ramifications of multiple accounts being compromised if a data leak were to occur remains with such a mechanism. Read more »

*This blog post was originally published at Dr. Wes*

The “e-Patient” Revolution: Is It Over?

There’s a conversation brewing over use of the term “e-patient.” The online health revolution is over, it’s been suggested. Web use, after all, has become so widely adopted  that the term “e-patient” may have more historical meaning.

Dropping the “e” might indicate that we’ve arrived. I’m not so sure. Perhaps the revolution we thought was going on never entirely took off. Or maybe it’s all about how you define the revolution.

Here’s what I see: Day in and day out, over weeks and months, hundreds of patients visit my clinic. I talk to them candidly about the tools they use and how technology and community is changing how they see their problems. I do the same with friends and family members. And like it or not, they’re a lot closer to “e-Patient 1.0″ than many of us would like to think. Read more »

*This blog post was originally published at 33 Charts*

Luddism And Internet-Based Medicine

My recent post on the subject of email from patients raised more eyebrows than I expected. It also put me in a position I’m unfamiliar with: Looking like a luddite.

Perhaps I’m not forward-thinking enough in my reluctance to embrace this advance. Perhaps I’ve gotten conservative as I’ve grown grey. Electronic communication is a great idea (I’m doing it right now), so why not apply it to my medical practice? Has Ned Lud gotten into my circle of influence?

This is, of course, extremely ironic. I lived so much on the cutting edge that my butt developed calluses. The calluses, however, were not just put there by the edge, they also came from occasional kicking.

The problem is I have an addiction: I’m addicted to change. I’m constantly looking for new and perhaps better ways to do things, then impatiently going after anything new and shiny. This served us well in the sense that I got us on EMR, got it working well, and have continued to keep us away from repeating mistakes too often. If something doesn’t work, I’m quick to look for the cause, and more importantly, how to fix it. Read more »

*This blog post was originally published at Musings of a Distractible Mind*

A Story Of Online Care Without OpenNotes

Next in our series on my experience with OpenNotes, a project sponsored by the Robert Wood Johnson Foundation’s Pioneer Portfolio.

This item has nothing to do with OpenNotes itself –- it’s what I’m seeing now that I’ve started accessing my doctor’s notes. In short, I see the clinical impact of not viewing my record as a shared working document.

Here’s the story. 

In OpenNotes, patient participants can see the visit notes their primary physicians entered. Note “primary,” not specialists. I imagine they needed to keep the study design simple.

So here I am in the study, going through life. Five weeks ago I wrote my first realization: After the visit I’d forgotten something, so I logged in. Read more »

*This blog post was originally published at*

“E-Visits” With Patients: For Greedy Doctors Or Not?

Dr. Wes (a cardiology blogger whom all should read) wrote a very compelling post about technology and the bondage it can create for doctors:

The devaluation of doctors’ time continues unabated.

As we move into our new era of health care delivery with millions more needing physician time (and other health care provider’s time, for that matter) –- we’re seeing a powerful force emerge –- a subtle marketing of limitless physician availability facilitated by the advance of the electronic medical record, social media, and smartphones.

Doctors, you see, must be always present, always available, always giving.

These sound like dire words, but the degree to which it has resonated around the Web among doctors is telling. Read more »

*This blog post was originally published at Musings of a Distractible Mind*

Latest Interviews

IDEA Labs: Medical Students Take The Lead In Healthcare Innovation

It’s no secret that doctors are disappointed with the way that the U.S. healthcare system is evolving. Most feel helpless about improving their work conditions or solving technical problems in patient care. Fortunately one young medical student was undeterred by the mountain of disappointment carried by his senior clinician mentors…

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How To Be A Successful Patient: Young Doctors Offer Some Advice

I am proud to be a part of the American Resident Project an initiative that promotes the writing of medical students residents and new physicians as they explore ideas for transforming American health care delivery. I recently had the opportunity to interview three of the writing fellows about how to…

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Latest Book Reviews

Book Review: Is Empathy Learned By Faking It Till It’s Real?

I m often asked to do book reviews on my blog and I rarely agree to them. This is because it takes me a long time to read a book and then if I don t enjoy it I figure the author would rather me remain silent than publish my…

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The Spirit Of The Place: Samuel Shem’s New Book May Depress You

When I was in medical school I read Samuel Shem s House Of God as a right of passage. At the time I found it to be a cynical yet eerily accurate portrayal of the underbelly of academic medicine. I gained comfort from its gallows humor and it made me…

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Eat To Save Your Life: Another Half-True Diet Book

I am hesitant to review diet books because they are so often a tangled mess of fact and fiction. Teasing out their truth from falsehood is about as exhausting as delousing a long-haired elementary school student. However after being approached by the authors’ PR agency with the promise of a…

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