Health care in Transition data security

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Slideshow: Health it stimulates the Patient Care, SafetyAs hospitals move their security efforts, health, security of the data is in transition. External hackers are less a concern these days that insiders snooping on medical and financial records electronic. Hospitals is to share more data with practices of small doctor who may not have sufficient safeguards in place, while mobile devices are extend well beyond institutional walls, networks. In addition, the Federal personal information protection and security standards get more strong, as are penalties for violation of these rules.

"Your greatest [threats] are internal," Terrell Herzig, security officer information of the University of Alabama at Birmingham health system (UAB), said Tuesday at a health it Conference in Atlanta. "." Employees are known for take peaks unauthorized in the files of figures such as local celebrities or prominent citizens, and with more than 50 million uninsured Americans, there is a black market thriving for identification numbers stolen and fraudulent health plan.

"We are emphasizing awareness and education" for employees and medical staff, said Mark Moroses, officer of information Chief of Continuum health partners, a system of five-hospital in New York. "We are trying to do step to have a strong hand in less flagrant violation." The loop of education is what we focus on. ?

Still, after a local newspaper exposed security vulnerabilities in a viagra cialis online pharmacy pharmacy in Continuum by obtaining an insider to emphasize how access to patient records, economy turns south, helped authorities stop and continue the employee, who was she had stolen patient identities to another hospital, but was not taken. "We did a better job of gathering of evidence," said economy turns south.

"You cannot lock the whole," said Cigdem main Delano, information officer at Morehouse School of Medicine (MSM) in Atlanta, said. "Regardless of what you do, always there is a human factor.

During this time, security and compliance officers are trying to find a delicate balance between the protection of their data and make it systems so difficult to navigate than users - especially these whimsical creatures known as physicians - rebel.

"You can also too have security," said Delano. At least someone in the MSM intended legal Department Ministry of Defense-level security in the clinical computer server room, said. But the school of medicine is not to do something with implications of national security bioterrorism research.

However, UAB has some contracts with the National Institutes of Health that involve potentially sensitive data, but did not want to prevent end users by forcing them to enter a complex password whenever they turned the computer for a few seconds. Herzig and his team chose thin client with the two factors as smart card authentication. If users remove their cards without closing a session, their sessions to remain frozen. They can reinsert cards to other workstations and simply return a personal identification number to return to work.

Continuum has essentially become its computers on wheels dumb terminal, economy turns south, said and next year will have only thin clients available for most end users. This is what Mike Wall, CEO of grid DICOM, a provider of storage Phoenix cloud and the archiving of digital medical images, called a "zero footprint" from the security perspective: no data stored on local computers.

"The whole zero-footprint thing is great, said Herzig, particularly in the era of mobility." "We made the decision that we were going to manage data, step of devices," he said.

Sometimes, however, it is impossible to keep all internal data, such as application to a growing number of patients for electronic copies of medical records and images. This is where the encryption comes in. Herzig talks to find a CD has clearly marked with the name of the patient lying in the hospital parking lot. The image on the disk was not guaranteed.

Apparently, this is a common phenomenon. "All the facilities to go to, there is a problem of CD," said wall, whose company, of course, has an interest in moving images in the cloud.

According to economy turns south, in the two years or more have security providers important information Summers to provide end-end encryption products and services end-to-health organizations. Prior to this, it was rather piecemeal.

"We went through what I affectionately call encryption conniptions", adds Herzig. "She be continuous through the space."

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WMDs -- World Medical Doctors – now being produced in Venezuela (WMDs Part 2)

WMDs -- World Medical Doctors – now being produced in Venezuela (WMDs Part 2)

Jonas, left, with his brother and his father

Jonas lives on a tiny dairy farm on the hill above Monte Carmelo. His father is intensely proud that his son is studying to be a medical online pharmacy viagra. “He’s only in his second year,” he said, “and already he sees patients.”

“Remember, Papá,” cautioned Jonas, “we do see the patients and talk to them, but we don’t treat them yet. We’re just there to observe and assist our teachers and ask questions.”

“I know that,” his father responded. “What I mean is that it’s important that all of you are learning to talk to the patients, treating them like friends and fellow human beings.”

Jonas is not the first person in his extended family to attend medical school, according to his father. He tells the story of his niece, who many years ago dreamed of being a doctor. Her mother, who was very poor, worked constantly to save every penny and told her daughter to study hard. The extended family pitched in to help the mother.

“She really did go to medical school,” explained Jonas’ father, “at one of the big city universities. Then she her got her training in a specialty, and now sees lives and sees her patients in a rich neighborhood of Caracas. Of course, now, as far as she’s concerned, I don’t exist. In fact, my niece doesn’t want to associate with anyone in the family and doesn’t talk to any of us.”

This is why the government has introduced a totally new system of teaching doctors. The old system, centered around elite universities where only a tiny minority of poor and working class students are enrolled, has continued to turn out professionals who want to work in the urban centers and enjoy a fairly rich, upper-middle class lifestyle. These kinds of universities, home to many of the students who are currently protesting against the constitutional reforms, are not unique to Venezuela, for their counterparts exist all over the world.

The Venezuelan government has avoided the temptation to abruptly seize control of these older universities and force them to operate in a manner that serves the poor majority. Instead, it has simply bypassed them and constructed a new kind of university.

Where is this university? All over Venezuela, because it exists in the realm of ideas, not in a particular set of buildings. The Mission Sucre school of Integral Community Medicine trains students where they live, utilizing the local medical facilities and doctors in their towns and neighborhoods as the campus and professors. The students enter with the expectation that they are choosing a vocation that involves serving the people and their home communities after they finish their training.

This unique form of education could not exist without Cuban doctors. They arrived by the thousands to staff the Barrio Adentro neighborhood medical offices that sprouted up all over the country in 2003 and 2004 and brought free health care to poor barrios and rural areas that had neglected for many decades. The Cubans are helped by a four or five thousand Venezuelan doctors who were trained in the old system, but for reasons of social commitment and political conviction have chosen to work with the poor.

Party time for medical students
After dancing, Doctor Barbara, takes a break at the feet of her students, Magale, Antonio, and Luisa.

About a month ago Jonas invited me to walk up the mountain to his house where I joined him and his fellow students for a little rest and relaxation. It was Sunday, time for a little music and dancing, plus sitting and chatting and enjoying the view over the valley below. Barbara, the dynamic Cuban physician who holds the students to a rigorous schedule the other six days of the week, took charge of the family kitchen and prepared a big pot of tasty stew.

All of the students are residents of some part of the municipality surrounding Sanare (comparable to a county in the U.S.) and are enrolled in the second or third year of the Mission Sucre medical program (also see earlier article, Fidel’s WMDs) Their Cuban and Venezuelan teachers work in local “ambulatorios” (free public walk-in facilities in various neighborhoods and villages) or in the Barrio Adentro 2 Diagnostic Clinic in the middle of Sanare.

The medical career is demanding. After completing six months of classroom preparation to make sure everyone is starting out on an equal footing, the students commit themselves to a six-year program. The first year is devoted totally to classroom study, but by the second year, the students are spending half the day with patients in medical settings. They spend their mornings accompanying doctors as they see patients and offer treatments, looking after medical records and medications, weighing and measuring babies and children while the doctors attend to the rest of the family. Their afternoons are spent in the classrooms. Nights are for study, reviewing CDs of lectures from Cuban universities, and some sleep.

The first year serves to sort out the serious students, the ones who truly have a vocation for medicine, and the less committed drop out. Jonas thinks that the students who come from the rural villages and farms are most likely to stick with the program, perhaps because they are used to hard work. His fellow student Luisa comes from La Bucarita, an isolated coffee-growing village more than two hours out of Sanare by Jeep. She’s living with an elderly relative in Sanare and really misses the company of her large family, but she’s determined to get her medical degree.

Jonas had been out of high school for a number of years before the new integral community medical program began. During the early years of the Bolivarian Revolution, he and other recent high-school graduates were teaching as temporary rural “maestros,” even though they didn’t have college degrees. They served as literacy volunteers who went to the more isolated areas of the county to work for Mission Robinson, the basic education program that taught illiterate adults to read and now helps them and others to complete their elementary schooling. At the same time, he also continued helping his father with farm work and building a new house for the family.

Doctora Edita is a Venezuelan physician who was serving the poor before the Cubans arrived.

Some Venezuelans, like Doctor Edita Goyo, who trained as a pediatrician in the big city of Barquisimeto, were committed to providing health care to everyone before the Chavez government came to power. The Barrio Adentro program was the answer to Edita’s dreams. It has allowed her to practice medicine for the last three years with dedicated Cuban professionals in the walk-in medical office in Palo Verde, a village just outside of Sanare. Currently she’s works in the same room with the Doctor Barbara, who arrived five months ago and replaced the previous Cuban doctor. (The Cubans generally sign up for a two-year tour of duty, and many re-enlist for another round of service.) They and their six medical students make a formidable team.

Antonio and Luisa bring records and medications as Dr. Barbara consults with a family.Dr. Barbara served in four other countries, including Angola, before coming to Venezuela.

Each doctor has a desk, one on each side of the room, where they receive a steady stream of patients while the students perform various tasks. One mother arrived with four little children, two on her knee and two standing and clinging to her. The medical students moved in and entertained the children one by one, then managed to measure them and examine their eyes, ears, and throats. Meanwhile Doctor Barbara took extensive notes on the medical history of the woman, for she was the one who was ill.

The files on individuals and families are extensive and allow the doctors and students to review the various trends within the community. They use this information to create wall charts describing the predominant health care problems in Palo Verde. This provides them with a comprehensive view of the most pressing local needs that “integral community medicine” must address. One important component of the medical team’s work is educating the public about preventative measures. Many of the common maladies enumerated on the wall charts – such as diabetes, asthma, and hypertension – are combated by introducing exercise programs and changing diets.

I saw the wall charts below three years ago in a Barrio Adentro office in Caracas. Volunteers from the local Health Committee had helped the Cuban doctors gather information on every family in the neighborhood. The charts showed exactly how many local residents (and the numbers were high) suffered from preventable afflictions such as malnutrition, hypertension, and asthma.
The medical students were having good luck entertaining most of the kids, but this baby simply did not want to get weighed by Jonas. Fellow student Vanesa is amused by the proceedings.

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