Wednesday, December 17, 2008

Tuesday, December 16, 2008

Personal Health Information - Privacy and Security principles

Outgoing HHS Secretary Mike Leavitt articulated his own "doctrine" on privacy and security of patient medical data. He is attempting to tackle two conflicting forces - accessibility vs. protection against unintended use. I like the strong emphasis on personal control - patient is in charge of who can access their data and how. I would like to see made explicit the notion that clinical content should really be authored by medical professionals and this authorship be clearly separated from content provided by the patient or other stakeholders. While privacy and security are clearly distinct from the realm of interoperability, I am concerned that principles below seem to regard patient data as being meant solely for human consumption - it's worthwhile keeping in mind that making this data machine-processable and truly interoperable holds enormous promise of higher quality, more cost efficient and - most importantly - correct, timely and safer care. Here are Mike Leavitt's eight principles:

Individual Access – Consumers should be provided with a simple and timely means to access and obtain their personal health information in a readable form and format.

Correction – Consumers should be provided with a timely means to dispute the accuracy or integrity of their personal identifiable health information, and to have erroneous information corrected or to have a dispute documented if their requests are denied. Consumers also should be able to add to and amend personal health information in products controlled by them such as personal health records (PHRs).

Openness and Transparency -- Consumers should have information about the policies and practices related to the collection, use and disclosure of their personal information. This can be accomplished through an easy-to-read, standard notice about how their personal health information is protected. This notice should indicate with whom their information can or cannot be shared, under what conditions and how they can exercise choice over such collections, uses and disclosures. In addition, consumers should have reasonable opportunities to review who has accessed their personal identifiable health information and to whom it has been disclosed.

Individual Choice -- Consumers should be empowered to make decisions about with whom, when, and how their personal health information is shared (or not shared).

Collection, Use, and Disclosure Limitation – It is important to limit the collection, use and disclosure of personal health information to the extent necessary to accomplish a specified purpose. The ability to collect and analyze health care data as part of a public good serves the American people and it should be encouraged. But every precaution must be taken to ensure that this personal health information is secured, deidentified when appropriate, limited in scope and protected wherever possible.

Data Integrity – Those who hold records must take reasonable steps to ensure that information is accurate and up-to-date and has not been altered or destroyed in an unauthorized manner. This principle is tightly linked to the correction principle. A process must exist in which, if consumers perceive a part of their record is inaccurate, they can notify their provider. Of course the Health Insurance Portability and Accountability Act (HIPAA) Privacy Rule provides consumers that right, but this principle should be applied even where the information is not covered by the Rule.

Safeguards – Personal identifiable health information should be protected with reasonable administrative, technical, and physical safeguards to ensure its confidentiality, integrity, and availability and to prevent unauthorized or inappropriate access, use, or disclosure.

Accountability – Compliance with these principles is strongly encouraged so that Americans can realize the benefit of electronic health information exchange. Those who break rules and put consumers’ personal health information at risk must not be tolerated. Consumers need to be confident that violators will be held accountable.

Wednesday, December 10, 2008

tap tap tap ~ 10 useful iPhone tips & tricks

tap tap tap ~ 10 useful iPhone tips & tricks - useful and beautifully illustrated iPhone tips

Google Native Client - a step to browser as operating system

Google announced Native Client - a browser plugin technology that allows applications written in native code (as opposed to code requiring a virtual machine like Java or scripting languages that are interpreted at runtime like JavaScript) to run on your computer. This means much more powerful applications taking full advantage of the processing power modern computers provide. Security is a huge concern here but Google skirts the issue by claiming that potential benefits will outweigh the risks.

Seeing Google talk about browser plugins brings to mind its own Chrome browser. Chrome plus Native Client sounds to me like a giant step toward the idea of Web browser essentially replacing the local operating system. So we have Google already basically controlling the Web and now gaining a foothold on local devices! Cloud computing, here we come.

Blue Screen of Death

Found at an airport - departures and arrivals brought to you by Microsoft...

Get notified when a web page changes

I am a big fan of RSS - the idea of a standard feed that can be consumed in various ways is incredibly useful. But not all websites that I would like to monitor have an RSS feed. TrackEngine to the rescue - one of several similar services available, it allows you to set a bookmark and when the web page changes, you get notified. It's very simple and effective. I bookmarked firmware download pages for various gadgets I have so that I can compulsively apply every new update as soon as it is humanly possible.

Tuesday, December 9, 2008

Shortcuts and Unintended Consequences

Two tenuously related tidbits. First, there's a great hint on creating a new keyboard shortcut for enabling Private Browsing mode in Safari with the goal of bypassing the annoying and quite unnecessary "are you sure?"-type dialog box. Once it's done, it's a breeze to toggle the Private Browsing mode on and off, provided you remember the shortcut. 

Beware of unintended consequences though - Facebook will take you into an endless loop of login screens if Safari is in Private Browsing mode. Use your newfangled keyboard shortcut and you'll be good to go.

Go for a drive with Google Earth browser plugin for Mac


Ray Ozzie, the new Chief Software Architect at Microsoft, in a recent interview for Wired verbalized rather well the compelling force of software: "I love software, because of you can imagine something, you can build it." These days, the trend is cloud computing - PCs are loosing relevance, applications are becoming Web services and local data storage is no longer cool in the face of the promises (unfulfilled yet) of ever-better sync. But look at this trend from a point of view of someone who is not into software 24/7 - what do you see? Aha - the sync part! These days it's about building ties from software to the real world. We've amassed plenty of bits and now it's time to try to rip the benefits of our accomplishments in the space of atoms. Kind of a "translational science" endeavor... Apple's iPhone is the prime example with it's focus on location-aware features. Of course, Google Maps is the integral part of what makes this magic actually work - it is the bits-to-atoms glue in this particular case.

Google Earth is now available as a browser plugin for Macs and for a fantastic demo, try driving a virtual milk truck around the virtual globe! Granted, this is pure software (strictly, the front end of it is; I am not considering the satellites, planes, cars outfitted with cameras, people scanning local newspapers for information that ends up in maps), but it's a crucial enabler in bits-to-atoms "sync" when it has anything to do with physical location. Imagine taking a virtual drive around the streets of Boston in preparation for being truly stuck in very real traffic!