Forbes has published my latest column: “Can You Trust What’s In Your Electronic Medical Record?

I discuss how government-mandated electronic medical records are hampering doctors’ ability to practice and resulting in medical errors. I also discuss 4 concrete steps patients can take to protect themselves.

I didn’t mention this in the Forbes piece, but there was a terrific drawing in the Journal of the American Medical Association from a couple of years ago by a 7-year old girl depicting her recent doctor visit. Even young children understand the effect of electronic medical records on their care:

No one was more surprised than the physician himself. The drawing was unmistakable. It showed the artist — a 7-year-old girl — on the examining table. Her older sister was seated nearby in a chair, as was her mother, cradling her baby sister. The doctor sat staring at the computer, his back to the patient — and everyone else. All were smiling. The picture was carefully drawn with beautiful colors and details, and you couldn’t miss the message…

 

I love this brave and thoughtful Salon essay by Caitlin Seida so very much: My embarrassing picture went viral. It begins:

I logged onto my Facebook one morning to find a message from a girlfriend. “You’re internet famous!” it read. She sent a link to a very public page whose sole purpose was posting images that mock people’s appearances. There I was in full glory — a picture of me dressed as my hero Lara Croft: Tomb Raider for Halloween — but written over the image were the words “Fridge Raider.”

Initially, she wasn’t angry, but then she saw some of the comments:

“What a waste of space,” read one. Another: “Heifers like her should be put down.” Yet another said I should just kill myself “and spare everyone’s eyes.” Hundreds of hateful messages, most of them saying that I was a worthless human being and shaming me for having the audacity to go in public dressed as a sexy video game character. How dare I dress up and have a good time!

We all know the awful humiliation of a person laughing at you. But that feeling increases tenfold when it seems like everyone is laughing at you. Scrolling through the comments, the world imploded — and took my heart with it.

In addition to issuing takedown requests to various web sites — which she was able to do because the photo was hers — she also confronted people directly about their nasty comments:

…Facebook made it easy to find people who had commented on the images. By now, the picture had metastasized through reposts on Twitter, Tumblr, Reddit, 9Gag, FailBlog. But looking through the Facebook “like” function, I could track down the most offensive commenters.

Most of them were women. Shocked? I wasn’t. Anyone who’s survived high school can tell you how women slice each other up to make ourselves feel better. I sent several of those women a message.

“You’re being an asshole,” the note said. “Why don’t you just do the right thing and delete the post and stop sharing it?”

The most common response was not remorse or defensiveness but surprise. They were startled that I could hear what they’d been saying. Their Facebook pages were set to private, after all. Most didn’t realize that when you post to a public page through your Facebook account, it doesn’t matter that your own content is restricted: The whole world can read your words anyway.

And of course, they hadn’t really thought of me as a person. Why should they? These images are throwaways, little bursts of amusement to get through a long workday. You look, you chuckle, you get some ridicule off your chest and move on to the next source of distraction. No one thought about the possibility that I might read those words. Far less, that I would talk back.

Read that last paragraph again. Personally, I’m going to be more careful about the funny things I share. I don’t want to be even a small part of any social media wave that makes a decent person’s life miserable.

Of particular concern, I think, are seemingly hilarious commentaries on the supposedly bad behavior of other people, such as this one by Elan Gale: This Man Is Hilariously Live-Tweeting His Flight-and-Feud With The Woman in #7A. I thought it mildly funny until I read the other side of the story: Bullying at 35 thousand feet. Of course, I have no way to determine the veracity of either story: both might be inventions. Yet the incident is instructive, I think. As I posted to Facebook:

It seems high time for everyone (including me!) to be suspicious of reports of god-awful behavior by random strangers. Perhaps the story is fabricated or embellished — or perhaps the circumstances aren’t quite what they seem — or perhaps the person who “schooled” the jerk just enjoys feeling like a self-righteous, sanctimonious prick. Surely, any truly awful person isn’t going to reform due to being the laughingstock of the internet… and it’s too likely that a good person will be unjustly vilified instead.

I love laughter, I really do… but there’s plenty of funny in the world without being unjust or malicious.

NoodleFood Authors, Now Fixed

 Posted by on 3 December 2013 at 2:00 pm  NoodleFood, Personal, Technology
Dec 032013
 

This weekend, I fixed the only major lingering headache from the process of converting NoodleFood from Blogger to WordPress. During that conversion, the author data was lost, such that “Diana Hsieh” was listed as the author of every post, even though just over 1,000 of NoodleFood’s more than 6,000 posts were written by someone else, mostly Paul.

I’d procrastinated on the task of fixing that for over a year and half because I feared that I’d have to update every post not written by me by hand. That would have been mighty, mighty unpleasant work.

However, I’m pleased to report that my technical skills — particularly my regex geekery — came in handy, such that I was able to automate the update by spending a few hours massaging the data. I had to:

  1. Extract data about posts authored by people other than me from Blogger’s exported XML file
  2. Integrate that with htaccess redirections so as to obtain a unique WordPress post ID for each of those posts
  3. Create and issue appropriate commands to SQL to update the relevant 1000 entries in the posts table with the correct author id

Much to my delight, that worked just fine, despite a few hiccups and setbacks.

I’m so grateful for my prior existence as a web programmer and sysadmin. I’ve been able to do so much with Philosophy in Action as a result of those skills. Even now, I surprise myself with what I can do! Heck, now that I’ve mucked around in SQL again for the first time in a few years, I might make use of that for some future projects and upgrades. That would make much of Philosophy in Action’s backend so much cleaner and easier to manage, I think.

Dec 032013
 

This article — What International Air Travel Was Like in the 1930s — fascinates me. If you just look at the pictures, like this one…

… it’s easy to think, “Oh, people had it so much better in the past! Now we’re all cramped in planes like sardines!” But once you read the text, you’ll surely change your tune.

Consider this, for example:

Imperial Airways appealed to the consumer who desired the most luxurious way to travel. But it wasn’t always very pleasant, despite the most advanced technology of the time. People would often get sick, and bowls were discreetly placed under the seats to ensure that passengers had a place to throw up. The widespread pressurization of cabins wouldn’t occur until the 1950s, so altitude sickness often meant that people needed to receive oxygen.

The temperature inside the cabin was also a major consideration, since horror stories of incredibly cold flights were common in the late 1920s.

And:

Nearly 50,000 people would fly Imperial Airways from 1930 until 1939. But these passengers paid incredibly high prices to hop around the world. The longest flights could span over 12,000 miles and cost as much as $20,000 when adjusted for inflation.

A flight from London to Brisbane, Australia, for instance, (the longest route available in 1938) took 11 days and included over two dozen scheduled stops. Today, people can make that journey in just 22 hours, with a single layover in Hong Kong, and pay less than $2,000 for a round trip ticket.

See what I mean?

 

PJ Media has just published my latest column, “Will Tomorrow’s Medical Innovations Be There When You Need Them?

My basic theme is that we must protect the freedoms necessary for the advancement of medical technology.

I start with a pair of vignettes:

How much has American medicine changed in the past 30 years?

Let’s turn the clock back to 1983. A middle-aged man, Dan, is crossing the street on a busy midday Monday. An inattentive driver runs a red light and plows into Dan at 45 mph, sending him flying across the pavement. Bystanders immediately call for help. An ambulance rushes Dan to the nearest hospital. In the ER, the doctors can’t stabilize his falling blood pressure. They prep him for emergency surgery. The trauma surgeon tries desperately to stop the internal bleeding from his badly fractured pelvis but is unsuccessful. Dan dies on the operating table.

The surgeon gives Dan’s wife the sad news: “I’m sorry, but your husband’s injuries were too severe. We did everything we could. But we weren’t able to save him.”

Fast forward to 2013. Dan’s now-grown son Don suffers the same accident. But within minutes of his arrival in the ER, he’s sent for a rapid trauma body CT scan that shows the extent of the pelvic fractures — and more importantly, shows two badly torn blood vessels that can’t be easily reached with surgery.

An interventional radiologist inserts a catheter into the femoral artery in Don’s right leg. Watching live on the fluoroscopy screen, the radiologist skillfully guides the catheter through the various twists and turns of the arterial system and positions it at the first of the two “bleeders.” From within the blood vessel, he injects specially designed “microcoils” into the torn artery and stops the bleeding. He then guides the catheter to the second bleeder and repeats the procedure. Don’s blood pressure recovers. The surgeons now have time to repair Don’s pelvic fractures and other internal injuries.

The surgeons give Don’s wife the good news: “Your husband’s injuries were pretty bad. But we were able to fix everything. He’ll still have to go through recovery and physical therapy. But he should be back to normal in six months”…

For more, read the full text of “Will Tomorrow’s Medical Innovations Be There When You Need Them?

(The material for the opening vignettes was drawn from two excellent presented last month at the 2013 annual meeting of the American Society of Emergency Radiology. )

Update #1: A great example of medical innovation coming from unexpected places was this 11/14/2013 New York Times article describing how an Argentinian car mechanic saw a Youtube video on how to extract a stuck cork from a wine bottle and realized it could also be used to help extract babies stuck in the birth canal.

His idea will be manufactured by Becton, Dickinson and Company and has already undergone initial successful safety testing in humans. It could save the lives of many babies in Third World countries and also reduce the need for Caesarean section in industralized countries.  (Via Gus Van Horn.)

Update #2: For those interested in the real-life technology used in the fictional scenario I discussed, here’s a nice medical slideshow from UCLA interventional radiologist Dr. Justin McWilliams, “Life-saving Embolizations: Trauma and GI bleeding“.

 

PJ Media has published Part 3 of my 4-part series on the changing face of American medicine under ObamaCare, “The Eyes of Big Medicine: Electronic Medical Records“.

I discuss the ObamaCare mandate for physicians to implement electronic medical records (EMRs), how this can harm patient care, and the government’s agenda in using EMRs to control doctors.

Earlier articles in the series:

Part 1: “Your Future Under Obamacare: Big Medicine Getting Bigger“.

Part 2: “How Big Medicine Will Affect Patient Care“.

Dumbest Thing Ever

 Posted by on 9 July 2013 at 10:00 am  Security, Technology, WTF
Jul 092013
 

Although it’s only July, I feel pretty confident claiming that this Washington Post column by Robert J. Samuelson is the most ridiculously stoopid thing I’ll read all year: Beware the Internet and the danger of cyberattacks. It begins:

If I could, I would repeal the Internet. It is the technological marvel of the age, but it is not — as most people imagine — a symbol of progress. Just the opposite. We would be better off without it. I grant its astonishing capabilities: the instant access to vast amounts of information, the pleasures of YouTube and iTunes, the convenience of GPS and much more. But the Internet’s benefits are relatively modest compared with previous transformative technologies, and it brings with it a terrifying danger: cyberwar. Amid the controversy over leaks from the National Security Agency, this looms as an even bigger downside.

No, it doesn’t get any better. No, it’s not satire. So I’ll let Captain Picard “speak” for me:

Facebook Word Cloud

 Posted by on 30 May 2013 at 2:00 pm  Personal, Technology
May 302013
 

Wolfram-Alpha made me a word cloud from my posts to Facebook… and I love it! It really does represent my life and values.

Just as a reminder, my Facebook policy is that I only friend people who I know in person or online, but anyone who hasn’t been a bastard to me can subscribe to my feed.

 

Back in January, the internet was agog over the report that a pastor objected to the 18% gratuity added to her bill for being part of a large party by writing on the receipt, “I give God 10% why do you get 18?”

The proper answer, of course, is provided by Grumpy Cat:

Your waitress offers you a genuine service, in exchange for your tip… God, not so much.

However, what I find particularly interesting about the story from an ethical perspective lie in the details of what happened at the restaurant and afterwards.

[Chelsea Welch's co-worker [at an Applebee's in the St. Louis area] had waited on a large party hosted by Pastor Alois Bell of the World Deliverance Ministries Church in Granite City, Ill. As is common at many restaurants, an 18 percent tip was automatically added to the bill.

Pastor Bell crossed out the automatic tip and wrote “0″ on the receipt, along with this message: “I give God 10% why do you get 18?”

Welch, who did not wait on Pastor Bell’s table took a photo of the bill and uploaded it to Reddit where it soon went viral. “I thought the note was insulting, but it was also comical,” Welch told TheConsumerist. “I posted it to Reddit because I thought other users would find it entertaining.”

Bell, who did not see the humor in this, complained to the restaurant’s manager. Bell told The Smoking Gun she did not expect her signature to be all over the Internet.

Applebee’s confirms that Welch was fired. In a statement, the company says:

“Our Guests’ personal information – including their meal check – is private, and neither Applebee’s nor its franchisees have a right to share this information publicly. We value our Guests’ trust above all else. Our franchisee has apologized to the Guest and has taken disciplinary action with the Team Member for violating their Guest’s right to privacy. This individual is no longer employed by the franchisee.”

Pastor Bell told The Smoking Gun she is sorry for what happened and points out that she left a $6.29 cash tip on the table.

“My heart is really broken,” she told them. “I’ve brought embarrassment to my church and my ministry.”

As this story makes clear, the waitress didn’t intend for anyone to be able to identify the pastor in question, and she took measures to prevent that identification. Alas, the power of the internet was too great. Also, the waitress reports that the pastor “contacted her Applebee’s location, demanding that everyone be fired, from the servers involved to the managers.” (That’s a quote from the article, not from the waitress.)

On the one hand, I understand why Applebee’s fired the server who posted the receipt. The restaurant wants its customers to feel secure in their privacy while on premises, particularly in their dealings with their employees, particularly in their financial transactions.

Nonetheless, in this age of social media, people’s expectations of privacy must change… or they will get burned. If you’re in public, your antics might be broadcast far and wide across the internet for other people’s amusement. Then, if you act petulant and bossy about that, as this pastor seemed to do, you’ll be lambasted even more.

Ultimately, a person needs to be responsible for his own privacy. That requires thinking in advance about what he wishes to keep private or not. That requires attention to what he says and does in view or earshot of other people. That requires being selective about what he emails or posts online. That requires providing appropriate context for public actions if he wants to avoid being misjudged.

A rational person does not broadcast his private activities to the world, then blame others for taking notice.

Computer Security Versus User Stupidity

 Posted by on 30 April 2013 at 10:00 am  Security, Technology
Apr 302013
 

Most people are reasonable sensible and decent, in my experience. Alas, that’s not true of everyone, as this story of what’s wrong with IT security in a nutshell reveals. (It was posted to an IT security list.)

Last time [we] sent out a warning email along the lines of:

We never ask for your username and password. If you get an email that looks like: “There is an issue with your account. Please reply with your username and password and we will rectify it”

You should never reply to these messages with your details.

50 people replied with their usernames and passwords.

I’m not sure whether that’s better or worse than the vast numbers of people who use “0000″ as their ATM pin code. Either way, I’m just amazed… and I’m thinking that schools and businesses need to teach the basics of computer security.

Suffusion theme by Sayontan Sinha