A bit ironic given this is disseminated over the Internet...
The Internet would be far better if giant corporations didn't control platforms & endlessly surveille & profile & do so very unequally--to me that largely is a capitalism, governance & regulatory failure--power & control of infrastructure.
Understanding current environmental issues requires having a critical eye to all information related to the release and distribution of chemicals into the environment.
The Golem at Large: What You Should Know About Technology
In a series of case studies they demonstrate that the imperfections in technology are related to the uncertainties in science described in the first volume, What You Should Know About Science.
I'm in the #Humanities Commons instance, and we have free profiles like https://hcommons.org/members/stevemccartyinjapan that include a link to the old blue bird of Twitter, and members are increasingly leaving, so our admins at @hello might want to reconsider having that item in the next version of profiles.
TITLE: Polite Example Letter to a Health-Related Website Endangering Your Privacy
THIS is the letter I wish more people would send to health-related websites and merchants when they observe a privacy problem!
fullscript.com is a service that dispenses non-pharma products to patients (like medical grade supplements) based upon doctor's orders. You have to be referred by a physician to get a patient account. They even have a way of integrating with EHR systems.
They need to get security right.
To: Fullscript Support <support@fullscript.com>
Dear Fullscript Team:
I have always appreciated being able to order from your excellent website.
Your service strives to supply patients with supplements and medicines ordered by doctors. As such, what is ordered can give insight into medical conditions that patients may have.
You may or may not be covered by HIPAA regulations, but I'm sure you will agree that ethically and as a matter of good business practice, Fullscript would want to maintain medical privacy of patients given that medical practices trust you.
This is why I'm concerned with the HIGH level of 3rd party tracking going on throughout your product catalogue. On your login page, the Firefox web browser displays a "gate" icon to let me know that information (I believe my email address) is being shared with Facebook. This is also the case with your order checkout page (see attached screenshot showing Facebook "gate" icon, as well as Privacy Badger and Ghostery plug-in icons in upper right-hand corner blocking multiple outbound data connections).
Privacy Badger is a web browser plugin that detects and warns of or stops (depending upon severity) outbound information from my web browser to 3rd party URLs. Directly below is Privacy Badger's report from your checkout page:
~~~~
Privacy Badger (privacybadger.org) is a browser extension that automatically learns to block invisible trackers. Privacy Badger is made by the Electronic Frontier Foundation, a nonprofit that fights for your rights online.
Privacy Badger blocked 23 potential trackers on us.fullscript.com:
insight.adsrvr.org
js.adsrvr.org
bat.bing.com
static.cloudflareinsights.com
script.crazyegg.com
12179857.fls.doubleclick.net
12322157.fls.doubleclick.net
googleads.g.doubleclick.net
connect.facebook.net
www.google-analytics.com
analytics.google.com
www.google.com
www.googletagmanager.com
fonts.gstatic.com
ad.ipredictive.com
trc.lhmos.com
snap.licdn.com
o927579.ingest.sentry.io
js.stripe.com
m.stripe.network
m.stripe.com
q.stripe.com
r.stripe.com
~~~
Please note that I was able to successfully checkout WITH Privacy Badger blocking protections on, so most of this outbound information was NOT necessary to the operation of your website.
There are several advertising networks and 3rd party data brokers receiving some kind of information.
I am aware that a limited amount of data sharing can be necessary to the operation of a website (sometimes). I am also aware that this all is not malicious -- web development and marketing does not usually talk to the legal department before deploying tools useful to gathering site usage statistics (Crazy Egg and Google Analytics). However, these conversations need to happen.
As for "de-identified" or "anonymized" data -- data brokers collect information across several websites, and so are able to reconstruct patient identities even if you don't transmit what would obviously be PHI (protected health information). As an example, if Google sees the same cookie or pixel tracking across multiple websites and just one of them sends a name, then Google knows my name. If Facebook is sent my email address (as looks to be the case), and I happen to have a Facebook account under that same email address, then Facebook knows who I am -- and can potentially link my purchases with my profile.
The sorts of computing device data that you are collecting and forwarding here may well qualify as PHI. Please see:
Use of Online Tracking Technologies by HIPAA Covered Entities and Business Associates
<https://www.hhs.gov/hipaa/for-professionals/privacy/guidance/hipaa-online-tracking/index.html>
This HHS and OCR guidance includes many 3rd party tracking technologies.
What I would really like to see happen is:
a) A thorough look at what information your website is sending out to what 3rd parties, along with an understanding of how data brokers can combine information tidbits from multiple websites to build profiles.
b) Use of alternative marketing analysis tools that help your business. For example, there are alternatives to Google Analytics that do not share all that data with Google and still give your marketing team the data they need.
c) An examination if you are sharing information about what products patients are clicking on and/or purchasing with 3rd parties. This would be especially problematic. (Crazy Egg tracks client progress through a website, but I'm unclear if they keep the information or just leave it with you.)
d) Use of alternative code libraries that are in-house. For example, web developers frequently utilize fonts.gstatic.com, but you could likely get fonts and other code sets elsewhere or store them in-house.
I appreciate you taking time to read this and working on the privacy concerns of your patients and affiliated medical practices.
Thanks.
~~~~~~
#AI #CollaborativeHumanAISystems #HumanAwareAI #artificialintelligence #psychology #counseling #socialwork #psychotherapy #EHR #medicalnotes #progressnotes @psychotherapist@a.gup.pe @psychotherapists@a.gup.pe @psychology@a.gup.pe @socialpsych@a.gup.pe @socialwork @psychiatry@a.gup.pe #mentalhealth #technology #psychiatry #healthcare #patientportal #HIPAA #dataprotection #infosec @infosec@a.gup.pe #doctors #hospitals #BAA #businessassociateagreement #coveredentities #privacy #HHS #OCR #fullscript
TITLE: Further Adventures in the HIPAA Silliness Zone
This short essay was inspired by a video I watched going over Microsoft legal agreements, the upshot of which is that they can harvest and use ALL of your data and creations (See *1 below in References). This inspires interesting HIPAA questions to say the least:
IF you have a HIPAA agreement with Microsoft, do they actually NOT harvest or use your data? How do they track that across all their applications and operating systems to tell?
Do their HIPAA and regular legal departments even talk to each other?
If you have a HIPAA agreement for your work computers, but then access your data through home computers, are all bets off? (And what sole proprietors don't mix use of computers for both?)
Now I don't really believe that Microsoft is doing all of this. What I THINK is that their lawyers just wrote overly broad legalese to protect them from all situations. Still -- legally it leaves us hanging. I certainly don't know that they are NOT doing it.
Then, I start thinking on some of the other crazy security situations I've encountered the past few years:
-- The multi-billion dollar medical data sales vendor that bought a calendar scheduling system, then wrote a HIPAA BAA agreement in which the PROVIDER has to pay any financial damages and penalties if THEY slip-up and lose data. (*2). Gee, what could go wrong?
-- The new AI progress notes generator service that sends data to 3rd parties including Google Tag Manager, LinkedIn Analytics, Facebook Connect, and Gravatar (*3)
-- The countless data breaches currently hitting hospitals across the USA. (*4)
It's all really quite mind numbing if you are a small healthcare provider or sole practitioner. I suspect 99% of us have just tuned this all out as noise at this point. After all, do we have the time or money to take on the legal departments of multi-billion dollar corporations?
The net results of this will be helpless nonchalance, boredom, and a gradual shifting of liability to US when upon occasion data is actually leaked by our vendors. And, of course, ever more fear and uncertainty in professions already full of it. Oh, and client data flowing through data brokers everywhere.
So what can we do? At first glance, not much. We need to be pressuring our professional associations to take on (or further take on) data security concerns including liability of giant "subcontractors" and insurance companies versus small healthcare providers. We also need to be supporting HHS and Federal government efforts to stop 3rd party trackers, including cookies, web beacons, pixel tracking, etc. from being allowable on systems related to healthcare. (*5) Bonus points if the penalties can apply mainly to larger corporations rather than hitting small provider offices hard.
Thanks,
Michael Reeder LCPC
Baltimore, MD
REFERENCES:
(*1)
The following video walks through the Microsoft Services Agreement and Microsoft Privacy Agreement to explain how Microsoft reserves the rights to use all data that you transmit through their services, or create or store in their apps (including data stored on OneDrive). It also collects information from all the programs used on your Windows machine. (This would seem to mean they can harvest data from your local hard drive, but I'm not sure.)
Microsoft Now Controls All Your Data
[https://m.youtube.com/watch?v=1bxz2KpbNn4&pp=ygUkTWljcm9zb2Z0IG5vdyBjb250cm9scyBhbGwgeW91ciBkYXRh](https://m.youtube.com/watch?v=1bxz2KpbNn4&pp=ygUkTWljcm9zb2Z0IG5vdyBjb250cm9scyBhbGwgeW91ciBkYXRh)
"("Data"), how we use your information, and the legal basis we use to process your Personal Information. The Privacy Statement also describes how Microsoft uses your content, i.e. Your communications with other people; the submissions you send to Microsoft through the Services; and the files, photographs, documents, audio, digital works, live streams, and videos that you upload, store, transmit, create, generate, or share through the Services, or any input you submit to generate content ("Your Content")."
(*2)
Full Slate: Last I checked their HIPAA, privacy, and BAA agreements. Although they reserve the right to change these agreements without notification and just post them to their website, so who knows at this point. <https://www.fullslate.com>
(*3)
Autonotes.ai: In fairness, they claim that no HIPAA data should be input into their system, even though you are writing progress notes. As of 7/30/23 they sent some sort of data to Google Tag Manager, LinkedIn Analytics, Facebook Connect, Gravatar which was severe enough that the Ghostery browser plug-in felt compelled to block or flag the transmissions. I hope they have changed this.
It should be pointed out that services similar to Full Slate and Autonotes claim that data sent to 3rd parties is not PHI and/or necessary to the operation of the service. This all could be true. I find that when Privacy Badger, or Ghostery, or my Pihole DNS server block these 3rd party transmissions that the vast majority of the time services work just fine.
Please also see Use of Online Tracking Technologies by HIPAA Covered Entities and Business Associates
<https://www.hhs.gov/hipaa/for-professionals/privacy/guidance/hipaa-online-tracking/index.html>
This HHS and OCR guidance includes the sorts of 3rd party tracking technologies often referred to as non-PHI, or de-identified. My non-lawyer mind is suspicious that violations could be found at several services.
(*4)
Just take a look at any of the daily headlines on Becker's Hospital Review:
<https://www.beckershospitalreview.com/cybersecurity.html>
(*5)
Hospital associations sue HHS over pixel tracking ban
<https://www.beckershospitalreview.com/healthcare-information-technology/hospital-associations-sue-hhs-over-pixel-tracking-ban.html>
--
#AI #CollaborativeHumanAISystems #HumanAwareAI #artificialintelligence #psychology #counseling #socialwork #psychotherapy #EHR #medicalnotes #progressnotes @psychotherapist@a.gup.pe @psychotherapists@a.gup.pe @psychology@a.gup.pe @socialpsych@a.gup.pe @socialwork@a.gup.pe @psychiatry@a.gup.pe #mentalhealth #technology #psychiatry #healthcare #patientportal #HIPAA #dataprotection #infosec @infosec@a.gup.pe #doctors #hospitals #BAA #businessassociateagreement #Microsoft #coveredentities #privacy #HHS #OCR
Mark Katz surveys the age-old interrelationship between music and technology, from prehistoric musical instruments to today's digital playback devices. This Very Short Introduction takes an expansive and inclusive approach meant to broaden and challenge traditional views of music and technology.
Portable Folding Electric Car Market Report 2023: Understanding Market Behavior, Evaluating Competitive Landscape, and Crafting Effective Business Strategies
Portable Folding Electric Car Market is poised for significant revenue growth and exponential expansion, with a projected remarkable Compound Annual Growth Rate (CAGR) throughout the forecast period spanning from 2022 to 2032.
The portable folding electric car market has been gaining traction in recent years, reflecting the growing demand for compact and convenient transportation solutions. These vehicles typically feature foldable designs, allowing users to easily collapse and carry them in compact form when not in use. This makes them suitable for urban commuting, short trips, and addressing the challenges of limited parking space in crowded cities.
The market for portable folding electric cars is driven by factors such as increasing awareness of environmental issues, the push towards sustainable transportation, and advancements in electric vehicle technology. Consumers are drawn to the convenience of folding electric cars, which can be easily stored in small spaces, like apartments or offices.
Manufacturers in this market are focusing on improving battery technology, reducing the overall weight of the vehicles, and enhancing their range. The goal is to provide users with a reliable and efficient means of transportation that aligns with the principles of eco-friendliness and practicality.
Urban Mobility Solutions: Portable folding electric cars are tailored to meet the demands of urban environments where traffic congestion and limited parking space are common challenges. Their compact size allows for easy maneuvering through crowded streets and efficient parking.
Foldable Design: The standout feature of these cars is their ability to fold into a more compact form, making them easy to store in tight spaces such as small apartments or offices. This feature enhances the overall convenience and versatility of these vehicles.
Range and Battery Technology: As with any electric vehicle, the range is a crucial factor. Manufacturers are continually working on improving battery technology to extend the distance these portable cars can cover on a single charge. Advances in battery efficiency and energy density contribute to the overall appeal of these vehicles.
Charging Infrastructure: The growth of the portable folding electric car market is closely tied to the expansion of charging infrastructure. As more charging stations become available in urban areas, the practicality and feasibility of using these vehicles increase, making them a more attractive option for potential buyers.
Environmental Concerns: The increasing awareness of environmental issues and the push towards sustainable transportation solutions contribute to the popularity of electric vehicles, including portable folding cars. Consumers are seeking eco-friendly alternatives to traditional gas-powered vehicles.
Government Incentives: Many governments around the world are offering incentives and subsidies to promote the adoption of electric vehicles. This support can significantly impact the affordability of portable folding electric cars, making them more accessible to a broader range of consumers.
From the CBI Archives.
UCLA CS Prof Leonard Kleinrock, successfully transmitted the first message over ARPANET from UCLA to Stanford. The group intended to transmit the word “LOGIN,” but the system crashed just after they had sent the first two letters.
Today's image of the day shows Joe Sullivan (seated) and Tom Burke (standing) using PLATO terminals to record Hennepin County election returns at the Minneapolis Business & Technical Center, as local CBS TV affiliate WCCO films the action, 1982.
How the World Really Works: The Science Behind How We Got Here and Where We're Going
An essential analysis of the modern science and technology that makes our twenty-first century lives possible—a scientist's investigation into what science really does, and does not, accomplish.
Each year the CHARLES BABBAGE INSTITUTE for COMPUTING, INFORMATION & CULTURE awards the Tomash Fellowship to an outstanding ABD researching/writing a history of computing/software dissertation.
Many leading scholars of the history and sociology of tech are past Tomash recipients!
Join us at @CCC 's #37C3 conference track "Sustainability & #Climate#Justice"! We're thrilled to focus on the pressing issues of ecological injustice and ecosystem collapse. If you're passionate about creating a sustainable, just, and #democratic#digital future, we invite you to submit your presentations by November 11, 2023. We're particularly keen to hear from underrepresented groups and those from the global south.
I'm always a bit skeptical of presentations from tech company CEOs on
how their product areas are necessary in the mental health field.
That said, this article has a few good points:
/"Umar Nizamani, CEO, International, at NiceDay, emphasised that AI will
inevitably become an essential tool in mental health care: 'I am very
confident AI will not replace therapists – but therapists using AI will
replace therapists not using AI.'"//
/
I am beginning to think this also -- for better or worse. I took a VERY
fast 60 second look at NiceDay and it appears to be another
all-encompassing EHR, but with a strong emphasis on data. Lots of tools
and questionnaires and attractive graphs for therapists to monitor
symptoms. (I need to take a longer look later.) So data-driven could
be very good, if it does not crowd out the human touch.
/"Nizamani said there had been suicides caused by AI, citing the case of
a person in Belgium who died by suicide after downloading an anxiety
app. The individual was anxious about climate change. The app suggested
'if you did not exist' it would help the planet, said Nizamani."//
/
YIKES... So, yes, his point that care in implementation is needed is
critical. I worry at the speed of the gold-rush.
/"He [//Nizamni] //called on the industry to come together to ensure
that mental health systems using AI and data are 'explainable’,
'transparent', and 'accountable'." //
/
This has been my biggest focus so far, coming from an Internet security
background when I was younger.
/"Arden Tomison, CEO and founder of Thalamos"/ spoke on how his company
automates and streamlines complex bureaucracy and paperwork to both
speed patients getting help and extract the useful data from the forms
for clinicians to use. More at: https://www.thalamos.co.uk/
/"Dr Stefano Goria, co-founder and CTO at Thymia, gave an example of
'frontier AI': 'mental health biomarkers' which are 'driving towards
precision medicine' in mental health. Goria said thymia’s biomarkers
(e.g. how someone sounds, or how they appear in a video) could help
clinicians be aware of symptoms and diagnose conditions that are often
missed."//
/
Now THIS is how I'd like to receive my AI augmentation. Give me
improved diagnostic tools rather than replacing me with chatbots or
over-crowding the therapy process with too much automated tool data
collection (some is good). I just want this to remain in the hands of
the solo practitioner rather than being a performance monitor on us by
insurance companies. I want to see empowered clinicians.
Apparently some people have to be told that using AI services in the
cloud to compose medical letters is a violation of HIPAA.
Now what I would like to see with all the AI-assisted EHR systems
currently being developed (EPIC, Oracle, Amazon, etc.) is not only BAA
contracts in place with the tech companies, but also:
a) Separate AI systems that don't share data with the main AI system.
(So the Hospital AI database would be separate from the general AI
database), or
b) Much better: Separate AI software and databases that are held
internal to the Hospital's own computer servers with restricted Internet
access to the outside.
This is wholly feasible, yet somehow I have a low trust level of it
occurring.
For any private practice people out there playing with AI on a small
office scale, I'm not a lawyer, but what I would recommend are a) AI
systems that can be run on a desktop (not in the cloud), and b) cutting
them off from Internet or severe restrictions on where those desktops
can call out to since you likely don't know what's in the code of the AI
you downloaded!
*Iowa health system warns against using ChatGPT to draft patient letters*
<https://www.beckershospitalreview.com/cybersecurity/iowa-health-system-warns-against-using-chatgpt-to-draft-patient-letters.html>
/Iowa City-based University of Iowa Health Care is warning employees
against the use of ChatGPT for its potential to violate HIPAA.../
--
#AI #CollaborativeHumanAISystems #HumanAwareAI #chatbotgpt #chatgpt
#artificialintelligence #psychology #counseling #socialwork
#psychotherapy #EHR #medicalnotes #progressnotes
@psychotherapist@a.gup.pe @psychotherapists@a.gup.pe
@psychology@a.gup.pe @socialpsych@a.gup.pe @socialwork@a.gup.pe
@psychiatry@a.gup.pe #mentalhealth #technology #psychiatry #healthcare
#patientportal
#HIPAA #dataprotection #infosec @infosec@a.gup.pe #doctors #hospitals
#BAA #businessassociateagreement
.
.
NYU Information for Practice puts out 400-500 good quality health-related research posts per week but its too much for many people, so that bot is limited to just subscribers. You can read it or subscribe at @PsychResearchBot@mastodon.clinicians-exchange.org
.
Since 1991 The National Psychologist has focused on keeping practicing psychologists current with news, information and items of interest. Check them out for more free articles, resources, and subscription information: <https://www.nationalpsychologist.com>
.
EMAIL DAILY DIGEST OF RSS FEEDS -- SUBSCRIBE:
<http://subscribe-article-digests.clinicians-exchange.org>
.
READ ONLINE: <http://read-the-rss-mega-archive.clinicians-exchange.org>
It's primitive... but it works... mostly...
CBI is thrilled to have just added three addtional, stellar scholars as CBI Research Fellows, UC, Davis' Gerardo Con Diaz, Cornell's Rebecca Slayton & American Swedish Institute President/CEO (past CMU Prof. & Vice Provost) Molly Wright Steenson. Congrats & many thanks to Con, Rececca & Molly! @histodons@sociology@sigchi@ACM #technology#AI#HCI#history
Achieve educational success with just three steps. This infographic guides you through defining your learning objectives, evaluating learning platforms, and considering support and costs. Your path to choosing the perfect online learning solution starts here, paving the way for a successful and rewarding learning journey.
Please share: In DC, on Fri, Oct. 20 @9am (& later airing on CSPAN) Princeton's Matt Jones VT's Janet Abbate, Columbia's Matt Connelly, & I are doing a public/free https://mastodon.social/@AHAHistorians@historians.social AHA Congressional Briefing on how AI history informs AI risks.