Why I Hate Secure Email Portals
Many health care enterprises are using secure email ‘portals’ to send, or should I say ‘tell the recipient to come get,’ information and attachments in a way they were told would be ‘HIPAA Compliant’. What I mean by ‘portal’ is a third party to which plain text and any attachment is sent over a secure connection (‘plain text’ is unencrypted information; it can be formatted text that is just not encrypted). The ultimate recipient receives an email inviting them to visit the portal to see the content over a connection that is also encrypted.
For example, if the hospital pharmacy director wants to send a ...
Source: Waking Up Costs - May 11, 2015 Category: Anesthesiology Authors: J. Clark Venable, M.D. Tags: Privacy Rant Security Software Source Type: blogs
Epic Quote
“To us, the only reason to have an NDA are if they’re going to tell you something that otherwise they wouldn’t want people to know (for example the possibility that they might sell data downstream) or they want to make sure that their intellectual property doesn’t conflict with ours, and that kind of lack of transparency did not sit right with us.”
Peter DeVault , Director of Interoperability, Epic Systems Corporation, Madison, WI
Tuesday, March 17 2015
Full Committee Hearing – America’s Health IT Transformation: Translating the Promise of Electronic Health Records Into Better Care
1:1...
Source: Waking Up Costs - March 22, 2015 Category: Anesthesiology Authors: J. Clark Venable, M.D. Tags: Medicine Uncategorized Source Type: blogs
Security for me but not for thee?
Bruce Schneier has penned another excellent piece on encryption called The Democratization of Cyberattack. He makes the point that technology can be developed by governments for what we consider ‘good’ uses, but that others will be able to do the same things. And he give excellent examples, too. If you’re at all interested in the topic, please go read the article. Here’s just one quote:
We can’t choose a world where the US gets to spy but China doesn’t, or even a world where governments get to spy and criminals don’t. We need to choose, as a matter of policy, communications sy...
Source: Waking Up Costs - March 2, 2015 Category: Anesthesiology Authors: J. Clark Venable, M.D. Tags: Privacy Security Source Type: blogs
Should Britain limit encryption?
In the wake of the Islamic Radical terrorist attack in France, many are calling for governments to do more to protect their citizens…including perhaps limiting the use of encryption by citizens or demanding a back door. I just read a terrific blog post from an expert, John Ackerly (formerly with the NSA and now CEO of Virtru). He says the following:
Yet degrading encryption and requiring a carte-blanche backdoor to every messaging medium is not the answer for free societies. Smarter regulations make sense, updated requirements for warrants make sense, but throwing out individual freedom in the name of greater “sec...
Source: Waking Up Costs - January 17, 2015 Category: Anesthesiology Authors: J. Clark Venable, M.D. Tags: Privacy Security Source Type: blogs
Attention Matters in Anesthesiology
Different fields in medicine rely on different cognitive abilities. One might posit that a successful internist would be good at integrating information; a surgeon, three-dimensional representations of anatomy; an anesthesiologist, being vigilant to events that will harm the patient.
The American Society of Anesthesiologists defines our mindset as ‘Vigilance’ and maintaining it is the Holy Grail of our profession. Google give the definition of vigilance as:
The action or state of keeping careful watch for possible danger or difficulties.
to which I would add ‘over an extended period of time.’...
Source: Waking Up Costs - November 8, 2014 Category: Anesthesiology Authors: J. Clark Venable, M.D. Tags: Anesthesia Medical Software Source Type: blogs
Glenn Greenwald: Why Privacy Matters
Glenn Greenwald just did an excellent TED Talk:
Glenn Greenwald was one of the first reporters to see the Edward Snowden files. In this searing talk fresh from the TEDGlobal stage, Greenwald makes the case for why you need to care about privacy, even if you’re “not doing anything you need to hide.”
The post Glenn Greenwald: Why Privacy Matters appeared first on Waking Up Costs. (Source: Waking Up Costs)
Source: Waking Up Costs - October 11, 2014 Category: Anesthesiology Authors: Clark Tags: Privacy Source Type: blogs
Hospital Mergers: Caveat Emptor
This study is an excellent review of the subject of hospital mergers and forecasts higher prices if mergers proceed.
Both publications suggest we should take promises of lower costs and increased quality with a grain of salt. The wrangling over whether these mergers are in the public interest will take place largely in non-public documents and board rooms. I encourage readers to learn from the past and apply it to the present.
The post Hospital Mergers: Caveat Emptor appeared first on Waking Up Costs. (Source: Waking Up Costs)
Source: Waking Up Costs - September 18, 2014 Category: Anesthesiology Authors: Clark Tags: Health Care Reform Medicine Source Type: blogs
On Hospital Facility Fees
I’ve been following the Angry Orthopod on Twitter for quite some time. He (or she) recently had two posts that were real eye openers:
1. Employed Physicians and Facility Fees, Part 1 and
2. Employed Physicians and Facility Fees, Part 2
One excerpt:
With the rapid migration of doctors from private practice to hospital employment, the percentage of outpatient visits eligible for facility fees is soaring. More employed docs, more facility fees, more money.
The post On Hospital Facility Fees appeared first on Waking Up Costs. (Source: Waking Up Costs)
Source: Waking Up Costs - September 6, 2014 Category: Anesthesiology Authors: Clark Tags: Health Care Reform Source Type: blogs
Is your password still considered strong?
I admit it. I have been using the same password for some web sites for over a decade. But software and hardware capabilities have grown exponentially over that same time. This fact was made plain to me recently when I used a online password analyzer which estimates how long it would take a modern computer with current cracking software to break my oldest password. Zero point four six seconds. Apparently, a six character mix of letters and numbers is not adequate any longer.
If you’d like to check your own password, point your browser at https://howsecureismypassword.net/
But wait! Is this safe? Yes, for two reasons:
...
Source: Waking Up Costs - August 27, 2014 Category: Anesthesiology Authors: Clark Tags: Security Source Type: blogs
Peri-op Cardiac Evaluation Guidelines Updated
The ACC/AHA have just released updated guidelines on perioperative cardiac evaluation and management for non-cardiac surgery patients.
…recommendations in the updated guideline address elective non-cardiac surgery, which should be delayed 14 days after balloon angioplasty, 30 days after bare-metal stent implantation, and optimally 365 days after drug-eluting stent implantation
The post Peri-op Cardiac Evaluation Guidelines Updated appeared first on Waking Up Costs. (Source: Waking Up Costs)
Source: Waking Up Costs - August 20, 2014 Category: Anesthesiology Authors: Clark Tags: Anesthesia Medicine Source Type: blogs
Knee Replacement Surgery: A Race to the Bottom?
A total knee replacement is a very common operation and more than 700,000 of them are performed each year in the United States. With a mean cost of about $16,000 each, in 2011 we spent over eleven billion dollars paying for knee replacements. Projections are that, by 2030, we’ll be doing 3.5 million per year. The operation has great results and patients generally do well during and after their surgery.
Anesthetic care has improved dramatically over time. Whereas initially patients who had a knee replaced would be given large doses of narcotic pain medicines (morphine) to deal with their pain, over time anesthesiolog...
Source: Waking Up Costs - June 9, 2014 Category: Anesthesiology Authors: Clark Tags: Health Care Reform Source Type: blogs
Knee Replacement Surgery: A Race to the Bottom?
A total knee replacement is a very common operation and more than 700,000 of them are performed each year in the United States. With a mean cost of about $16,000 each, in 2011 we spent over eleven billion dollars paying for knee replacements. Projections are that, by 2030, we’ll be doing 3.5 million per year. The operation has great results and patients generally do well during and after their surgery.
Anesthetic care has improved dramatically over time. Whereas initially patients who had a knee replaced would be given large doses of narcotic pain medicines (morphine) to deal with their pain, over time anesthesiolog...
Source: Waking Up Costs - June 9, 2014 Category: Anesthesiology Authors: Clark Tags: Health Care Reform Source Type: blogs
