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You know, I never did quite understand when I was a youngster growing up, why Jack Benny never got older than 39...well, of course, NOW I KNOW!! Really not the kind of enlightenment I would like, but none the less...there it is. I am happy to say, that I TOO am 39, and holding .

So, in my "39" years of enlightenment, I have seen the birth of technology that was science fiction, with the likes of Buster Crab, Flash Gordon and Dick Tracy, come to life! My shoes now can tell me if I am running too slow, or not far enough...kinda' puts a different spin on Nancy Sinatra's "These Boots Were Made for Walkin'". George Orwell's 1984 has become all too real, with video cameras watching our every move, and "Big Brother" now taking on a whole new meaning, with reality-TV-legitimized voyerism. "A Clockwork Orange" is also appearing to become a reality, with mobs of youth fighting and looting across the globe. I truly hope that Charlton Heston doesn't suddenly make an appearance...."Soylent Green is PEOPLE!!!"...or even apes being in control of the planet...although some would argue the point that it is currently a fact .

Whew....alright, I feel better now.

I have been fortunate to have seen and experienced black & white, color, and hi-res digital TV; rotary vs push-button vs cordless phones; answering machines, beepers to cell phones and SKYPE; beta and VHS (BETA was better!), 8-track vs tape, vinyl vs CD/DVD; and PC's, Apple/MACs, laptops, smartphones, Sony Walkman, iPods, iPads, iPhones, and Droids; Kindles and Nooks and Sony readers; and DOS, UNIX, GUI, Windows, and Lions and Tigers...(and bears, oh my!!), Android, and Linux; CompuServe?, AOL, Yahoo, and Google; IBM, Microsoft and Apple; and the World Wide Web and Cloud computing.

WOW...and that is just what I can rattle off the top of my head! I am certain I have forgotten much more than what is on this list. But, think about it, that is a lot of technological advancement in 30 years...ok, well, maybe 35..cough...remember, I am just 39

This rapid technological advancement has dramatically affected our profession, both positively and negatively, with rapid adaptation of these new technologies into Pathology and Cytopathology, with the development of automated screening devices, digital imaging, liquid-based pap tests, and an absolute explosion in information technology and the ability to process tremendous amounts of data with computers to produce....yup...MORE DATA!

And now, there is a supercomputer, Watson, who (oh my gosh, did I just "humanize" Watson?) just might be getting ready to change Healthcare...of course, having defeated the world's best Jeopardy players. So, perhaps I have come full circle to my original opening about science fiction now becoming reality. Is Watson, perhaps our 21st century Hal?...or a prelude to world domination by machines?...

"I'll be back"....

ShareThis

November 2010

The 2010 Interim Meeting of the AMA House of Delegates recently published guidelines for physicians on the use of Social Media. The items listed below were discussed in the guidelines.

• Physicians should recognize and maintain standards of patient privacy and confidentiality in all environments, including online, and must refrain from posting identifiable patient information online.
• Physicians should routinely monitor their own Internet presence to ensure that the personal and professional information on their own sites and, to the extent possible, content posted about them by others, is accurate and appropriate. 
• When interacting with patients on the Internet, physicians must maintain appropriate boundaries of the patient-physician relationship in accordance with professional ethical guidelines just, as they would in any other context.
• Physicians should consider separating personal and professional content online in order to maintain appropriate professional boundaries.
• Physicians have a responsibility to bring content posted by colleagues that appears unprofessional to the attention of the individual, so that he or she can remove it and/or take other appropriate actions. The physician should report the matter to appropriate authorities if the behavior appears significantly above the norm, or if they fail to take action to resolve the situation. 

• Physicians must recognize that:

  • their actions online and content they post may have a negative affect on their reputations among patients and colleagues
  • their online actions may have consequences for their medical careers (particularly for physicians-in-training and medical students)
  • their actions online can undermine public trust in the medical profession

Additional Commentary

The above guidelines are worthy of careful consideration of any medical professional online. A good rule of thumb is to consider applying safe privacy settings on certain social media tools, an example of which is Facebook. You can set your privacy settings on Facebook to restrict who sees your personal information, and views your pages. If you have any question about posting something, then it is probably best to follow your instinct and NOT do so. And, consider that once you post something, consider it permanent. That will help you decide what to post, and what not to post.  

Another thing to consider is how you talk to others online, and respond and comment to others. Always be courteous, watch your language (you would be surprised), and use the rule of thumb of treating others online as you would want others to treat you... The Golden Rule still applies on the web! 

Final Words

As medical professionals, we have a wonderful opportunity to utilize a huge social network of other medical professionals, healthcare workers, and students to expand our sharing of educational information, challenges, and interesting cases with little effort. Through your mobile phone/iPhone, netbook/iPad, or web browser, in just minutes, you have access to the richest source and opportunity of dynamic knowledge in existence. Take advantage of it...get online...get involved...and HAVE FUN ! 

The Latest "Buzzword"- Cloud Computing 

In a recent article, Sagoo and Weber1 begin by briefly describing that "...Cloud computing is no longer a technological dream – it's the buzz concept of 2009...." In their article, they do a nice job at "...demystifying the technology to explore the legal and commercial risks." This new technology is being fueled by cost efficiency and flexibility of use2.  

Introduction

To simplify the definition, "...cloud computing is typically understood to mean a computer network that provides on-demand scalable IT resources over the Internet. ...".1 This requires a computer, and internet access. The user does not have to have any knowledge of how this works...it is invisible to them. IT support is carried out by the cloud which supports them. An example of this is Google Apps (ie. google docs). Google provides the support for this cloud, not your local IT department. They are responsible for the network communication, ie. computer network and internet access. These cloud services are either provided at no fee (open-source), or are rented by the end-user.  The adoption of this technology is predicted to be huge, although it is limited at this time by concerns over security. The articles by Sagoo and Weber1 and Chow, et. al2 provide a detailed discussion of these security concerns. Certainly, as it relates to health care, and the government's strong momentum to the development of the electronic medical record (EMR), this is an important and essential consideration in assuring not only individual privacy but corporate privacy as well. 

Legal Concerns ²

• VM-level attacks: vulnerabilities mitigated with monitoring and firewalls
• Cloud provider vulnerabilities: platform level, ie. SQL injection attacks or cross-site scripting
• Phishing cloud provider: a new attack vector
• Expanded network attack surface: the cloud user must protect the infrastructure used to connect with the cloud.
• Authentication and Authorization: enterprise does not extend to the cloud. How does company merge this with the cloud provider?
• Forensics in the cloud: investigators allowed to seize and recover data.

• Uptime: can the cloud provider scale to meet the needs to handle certain applications, ie. a large utility company billing millions of consumers in the cloud.
• Single point of failure: not there are more single points of failure and attack
• Assurance of computational integrity: can the cloud provider assure validity of statistics or data retrieved/computed?

• Due diligence: subpoena or other legal request, can the cloud user compel the provider to respond in the time required? Issues of enterprise retention policy, assurance of destruction by cloud provider.
• Auditability: SOX and HIPAA requirements, how do you perform on-site audit? how to assure data is properly isolated and cannot be viewed by those without a need to view
• Contractual obligation: beware of "non-assertion" clauses in cloud provider, need to address via contracts areas related to patent and intellectual property
• Cloud provider espionage: worry about theft of company proprietary information by cloud provider.
• Data lock-in: in no data standardization format, a particular vendors format may pose a problem if they go out of business, leaving cloud user scrambling for a solution. 
• Transitive nature: the cloud provider may use subcontractors for services, for which they have less control. This affects trust between cloud user and provider. 

Summary Presentation

This is a nice summary slideshow to perhaps help understand the overall concept.  

References

1. www.osborneclarke.com/publications/commercial/Hot_Topic/11768.asp
2. www.parc.com/content/attachments/ControllingDataInTheCloud-CCSW-09.pdf
3. 1105govinfoevents.com/events/2009/VM09/CurtAubleyPresentation.pdf