April 2012

A close read of CISPA's broad language reveals that Joe Internet's privacy isn't all that would be in jeopardy if the bill makes it through the Senate and past President Obama's veto pen.

CISPA poses a threat to the privacy of entire organizations, from nonprofits and small business on up to the enterprise -- and even to the very future of cloud computing. Drawing from the bill's exact language, CISPA would permit "certified entities" and "cyber security providers" to "voluntarily" share any customer data with other certified entities, so long as the data constitutes "cyber threat intelligence" for "cyber security purposes" -- as well as for the sake of "national security." In a nutshell, the federal government and "certified entities" could freely pass around customer data in the name of security, without due process and without any fear of reprisal if their purported security fears turn out to be completely unwarranted. "Certified entities" can mean federal agencies, other public agencies, utilities, and private organizations. That's a potentially long, long list of whistleblowers.

One place where handwriting persists is on medical prescriptions, and that’s unfortunate. Sloppy writing or inappropriate directions can lead to what doctors delicately refer to as preventable A.D.E.’s, or adverse drug events. These can encompass minor but still avoidable problems, like rashes or diarrhea, and much more serious events like, well, death.

Studies show that errors are much less likely if a doctor clicks to select medications from an onscreen list and sends the prescription data via computer to the pharmacy. Rainu Kaushal, a professor of medical informatics at Weill Cornell Medical College, led a study published in 2010 in which she and four colleagues followed prescriptions issued by a sample of providers in outpatient settings in New York. (Providers included physicians, physician assistants and nurse practitioners.) Some were prescribing electronically for the first time, and some continued to use paper. The researchers found an astonishing 37 errors for every 100 paper prescriptions, versus around 7 per 100 for those who used e-prescribing software. These errors didn’t even include legibility issues, when the pharmacist couldn’t read the handwriting with confidence and called the provider to clarify.

One in 10 doctors who work outside hospitals in the United States began using electronic health records in 2011, helped along by the promise of $27 billion in incentives from the federal government.

As of the end of last year, 35 percent of such doctors had a system that performed at least basic functions, including ordering of prescriptions and storing doctor notes and test results, according to one in a series of studies on the topic published in the latest issue of the journal Health Affairs. The technology is spreading, the result of years of fierce, well-funded advocacy aimed at soothing doctors’ concerns about the hassle and cost of the systems. To date, $146 million in incentive payments have been distributed to doctors and hospitals in the state to help pay for installation, training, and upkeep, according to Bridget Scrimenti, spokeswoman for the Massachusetts eHealth Institute, part of an independent state agency working on the issue. Now, some involved in health information technology say it is time to focus more attention on making sure the systems are safe.

[Commentary] The e-book “After Friday Night Lights” was pulled from Amazon after Amazon made the work available for free. It had been priced at $2.99 but the plan hit a pothole after Apple, which had been looking to get into shorter works in a digital format, decided to include e-books in a promotion that it does with Starbucks. It selected the digital sequel as a Pick of the Week, giving customers a code they could redeem online for the book. (The author said he still received a royalty of $1.50 for each copy sold.) Amazon interpreted the promotion as a price drop and lowered its price for “After Friday Night Lights” to exactly zero. Byliner, the e-book’s publisher, withdrew the book from Amazon’s shelves, saying it did so to “protect our authors’ interest.”