NYT story notes how the investment to create incentives to single practice physicians is classic textbook reactionto market failure:
… only about 17 percent of the nation’s physicians are using computerized patient records, according to a government-sponsored survey published last year in The New England Journal of Medicine.“This is really not a technology problem,” observed Erik Brynjolfsson, an economist at the Sloan School of Management at the Massachusetts Institute of Technology. “It’s a matter of incentives and market failure.”
Former Washington Gov. Gary Locke is slated to be appointed Secretary of Commerce:
Experience in technology policy will also be important for the next commerce secretary, Cantwell said, since he will have to appoint the next director of the National Institute of Standards and Technology, oversee the U.S. Patent and Trademark Office, and provide leadership on issues like cybersecurity.
The National Institute of Standards and Technology (NIST) does important stuff — like set standards and prescriptions such as the new guide on maintaining data security while teleworking. This riveting 46 page how to is written in “broad language in order to be helpful to any group that engages in telework. (see NIST release)”
In the executive summary you will find the important steps any individual should take before connecting at home or at the local cafe.
- Before implementing any of the recommendations or suggestions in the guide, users should back up all data and verify the validity of the backups. Readers with little or no experience configuring personal computers, consumer devices, or home networks should seek assistance in applying the recommendations. Every telework device’s existing configuration and environment is unique, so changing its configuration could have unforeseen consequences, including loss of data and loss of device or application functionality.
- Before teleworking, users should understand not only their organization’s policies and requirements, but also appropriate ways of protecting the organization’s information that they may access.
- Teleworkers should ensure that all the devices on their wired and wireless home networks are properly secured, as well as the home networks themselves.
- Teleworkers who use their own desktop or laptop PCs for telework should secure their operating systems and primary applications.
- Teleworkers who use their own consumer devices for telework should secure them based on the security recommendations from the devices’ manufacturers.
- Teleworkers should consider the security state of a third-party device before using it for telework.
Each of the steps are reasonable — but who will invest the resources required to make those steps effective?
Standards are being published and have been published for some time. Yet, breaches continue to occur. So, is the current status of policy and policy outcomes optimal or do we need to create another paradigm for cybersecurity?
These terms are strongly related, inter-related to be more precise, and have a significant effect upon the level of trust and confidence that any information system engenders with its users. Separately dealing with each attributed of a network, as though the relationship between each term were independent, is not good design. Yet, read the following taken from Cnet article on problems building a new healthcare system:
Lawmakers and health care representatives also asked the HISPC to clarify why privacy issues were such a critical part of maintaining electronic health records.
“It seems to me there is a big concern about the digitization of data as separate, but if we have the right security measures, that data is no different from the data physically sitting in my office,” said Herb Conway, a physician who sits on the New Jersey state legislature. “Are we going to be designing laws that interfere with our ability to have interoperability?
“While we appreciate that different states have different rules, we’re trying to find a way to streamline the process so patient treatment is not affected by delays in sharing information,” he said.
Post notes several barriers to successful implementation of an EMR system for US.
Although the federal government set a goal five years ago of creating an electronic health record for every American by 2014, the effort has lagged for several reasons. Roadblocks include concerns over lack of universal protocols for collecting data as well as rules that establish how, with whom and under what circumstances the data can be shared. Many health-care providers — physician practices, testing facilities, hospitals and clinics — fear liability if private information gets into the wrong hands. Embedded in all these issues is the cost, an estimated $150 billion, which has proven to be a significant barrier to that 2014 target.
So, who is responsible for defining the standards? Who will define liabilities? How many stakeholders are there to be included to construct a realistic evaluation model?
BBC reports one manager in Britain very upset over the cost to his organization:
Andrew Way, chief executive of London’s Royal Free Hospital, said technical problems had cost the trust £10m and meant fewer patients could be seen.
The Department of Health said lessons had been learnt from the trial.
The England scheme, part of a £12bn IT upgrade, aims to put 50 million patient records on a secure database by 2014.
Implementation costs are important to consider when designing and evaluating policies.