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When HIPAA Doesn’t Apply

Got a call from a long-time patient over the weekend. Hearing a not overly alarming story but one that was not terribly reassuring either, I suggested she go to the Emergency Department.

Later that morning, sitting at an internet cafe with DSS eating breakfast, each of us surfing on our respective laptops, he says conversationally, “So I see Miss LTP is in the ER.”

My heart stopped and my stomach dropped. Had he managed to access the voicemail program I use for after hours calls? My EMR? Had I left shortcuts up to any patient-related materials on that machine? When had I last used it anyway? My mind was racing. I wasn’t all that concerned specifically about him knowing that a particular person was in the ER, since he understands confidentiality. But if he was able to access confidential patient information, did that mean I had a security breach?

“How do you know that?” I asked him carefully, after a very long pause, during which all of the above ran through my head. Read more »

*This blog post was originally published at Musings of a Dinosaur*

Veterans Affairs CIO Says iPads Need To Be Secured For Medical Use

In a nod to the reality of rapid physician adoption of tablets and smartphones, the CIO of the VA system recently stated that the VA must find a way to accommodate  iPads at a  conference on federal information technology.

According to Baker, the fact is that 100,000 residents rotate through the VA each year and “they’re all carrying mobile devices”. In order for them to do their jobs, they want to be able to access resources on the internet.

In an article published at nextgov.com, CIO Roger Baker said:

I’ve told my folks I don’t want to say ‘no’ to those devices anymore…I want to know how I say yes.

The key, according to Baker, is security. While the iPad can be secured, proper protocols need to be developed. Otherwise, the device can be likened to a “huge unencrypted USB stick with no pin”. In order to facilitate development of security protocols, a pilot program has been launched giving out iPads to select employees in situations where security is looser. Read more »

*This blog post was originally published at iMedicalApps*

Healthcare Reform: Why I’m Scared

I’m scared because I’m reading articles about people threatening to kill — note that word “kill” — elected officials because of their vote on healthcare reform.

A man was arrested last week for his threats against Nancy Pelosi. Another man was arrested for threatening the two senators from Washington state, saying, “I do pack, and I will not blink when I’m confronted. It’s not a threat, it’s a guarantee.”

One congressman’s campaign received an email that read, “If our tea parties had hoods, we would burn your (expletive) on a cross on the White House front lawn,” while another had bricks thrown through the windows of his brother’s house (which was listed as his official address) and the propane line to his gas grill was cut.

The Associated Press reported that the Senate’s Sargent-At-Arms, who monitors security in both houses, reported 42 incidents in the first three months of 2010 — nearly three times the 15 cases that occurred during the same timeframe in 2009, and all related to healthcare reform. Read more »

*This blog post was originally published at A Medical Writer's Musings on Medicine, Health Care, and the Writing Life*

Wireless Hacking Of Medical Implants: A Call For Regulation

Researchers from the Medical Device Safety Institute at Beth Israel Deaconess Medical Center in Boston and the Department of Computer Science and Engineering at the University of Washington in Seattle have published an article in the latest New England Journal of Medicine suggesting technological and regulatory actions that they hope will increase the security and privacy of implantable medical devices.

As has been reported earlier, implantable pacemakers, defibrillators, and similar devices are subject to wireless hacking that may influence their functionality. Although a lip-smacking target for devious hackers, an actual incident where a person’s implant has been interfered with is yet to be reported.

NEJM: Improving the Security and Privacy of Implantable Medical Devices…

Flashback: Implant Hacking Possible, Not Probable…Yet

*This blog post was originally published at Medgadget*

Why Secure E-Mail Is Not Healthcare Communications Utopia

I am fortunate to work at an institution that has a fully deployed electronic medical record (EMR) system that incorporates outpatient physician notes and inpatient notes under one umbrella. By and large, patient care is facilitated since both outpatient and inpatient notes appear simultaneously in the patient’s chart, along side telephone messages and clinical results. While there are plenty of kinks to work out, most of us have to admit that there are huge patient care advantages to such a system.

The system also promotes a secure e-mail service for patients to e-mail their physician and a mechanism to have their results forwarded directly to them. With the ability to empower patients directly, many would consider this as the Utopian model for heath care delivery of the future.

And what could be better? Patients get virtually unlimited access to their health care provider, 24-7. Results are whisked to the patient. Speed. Efficiency. “Green.” It’s all good, right?

Maybe. Read more »

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

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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