Regarding On IT, privacy is the priority:
I applaud the authors for raising and framing this issue so well. I fear, however, that the problems we in the U.S. face are both formidable and systemic.
It's not just the Health Insurance Portability and Accountability Act that's problematic -- it's the entire healthcare payment system that HIPAA seeks to both manage and placate.
The U.K.'s National Programme for Information Technology -- an ambitious effort to create a national health record for England -- is instructive. The architects of this project understand the issues of privacy and public trust, and have proposed an architecture that will meet the requirements. But public response and the concerns raised -- see Warning over privacy of 50m patient files
-- still put the future of the project in doubt.
As is so often the case, it all comes down to trust: Do you trust -- insert organization name here -- to keep your information private? In the U.K., the organization in question is the government itself and its agency, the National Health Service. In the U.S., it's a patchwork quilt of public/private, not-for-profit/for-profit entities, and the principal body of legislation intended to protect us is HIPAA.
This act mandates privacy protections but grants an enormous -- and much-abused -- exception for "healthcare operations" ... whatever that means. In practice, the payors have enormous clout, and "healthcare operations" is pretty much whatever they want it to be.
So, to trust that our medical records will be kept private, we must trust the U.S. insurance industry. This won't be an easy sell.
Bill ClarkCertified information systems security professionalSecurity and privacy systems architectShelburne, Vt.
It's so easily lost
I wonder who still has privacy in this age we're living? I guess someone's privacy can always be violated the minute your personal information leaves your person and is shared with someone else.
Jacky PoteauBrockton, Mass.To submit a letter to YOUR VIEWS, click here . Please include your name, title and hometown.