The Curse of the Internet

It's hard to imagine our lives without the

Internet  - either mobile or desktop.

The Internet has become a catalyst of innovation, an essential tool in business and social life. It brought new levels of participation and access to knowledge. It enabled new forms of interaction, albeit mostly utilized for entertainment purposes (as in the famous answer of a Reddit user to a now deleted question captured in the figure on the right).

But despite all the advantages and conveniences, does the Internet really serve us or is it the other way around?

Internet companies, large and small, are quietly but forcefully collecting our life's data hoping to have us "on the leash."

If people want to use a web service, the service gets away with almost anything. Google knows about our friendships, content of gmail and google voice conversations. They see the places we go or want to go on maps and how we spend time on millions of websites. Amazon knows about our tastes and interests, phone carriers have nearly minute-by-minute accounts of months and years of our lives, credit card companies are building our psychographic profiles. Target stores can figure out their customers' health conditions before they do... and if you think other companies are better protecting sensitive information (remember the giant data breach?), think again.

Discovered this week, major security flow dubbed "Heartbleed" had existed for over two years. The defect in encryption technology used by many websites and networking equipment makers have put millions of passwords and other sensitive information at risk. Just another reminder of why you should scrutinize the security on the Internet and other web-connected gadgetry.

Vulnerabilities can be found everywhere. The network of a big oil company was hacked through the online menu of a Chinese restaurant popular with employees. Target was breached through its heating and cooling system. Printers, thermostats, videoconferencing equipment, household items, even vending machines and gas pumps can be used to gain access to your data. And so can employees of the companies collecting data. Last year there were multiple cases when stolen patient identification information was used to file unauthorized income tax returns.

Recently published SANS healthcare cyberthreat report reveals that health care networks (hospitals, insurance carriers, pharmaceutical companies, web sites, software and devices) - have been and continue to be compromised by successful cybercriminal attacks. Health networks seem to have the weakest Internet security among sites dealing with sensitive information, often not addressing very basic issues, vulnerable to off-line password guessing and user impersonation attack.

Trust is especially important in health care. As the days of blind trust that 'doctor knows best' are becoming a distant memory, new cases of security breaches can lower the trust further discouraging use of digital health services and disclosure of important medically relevant information.

At present, most digital health products and corporate wellness programs fail both companies and patients. There are many fundamental flaws responsible for that. And the lack of trust is not going to make it any more successful.

Paraphrasing Derek Thompson's passage about Facebook and Amazon, for the Internet of Things for Health and Wellness to succeed, we have to embrace a new version of intimacy that felt natural when the good old-fashioned country doctor made house calls. The machines have to know us. Will we let them?

REFERENCES

Pogue D (2014). The curse of the cloud. Scientific American, 310 (2) PMID: 24640327

Wu F, & Xu L (2013). Security analysis and Improvement of a Privacy Authentication Scheme for Telecare Medical Information Systems. Journal of medical systems, 37 (4) PMID: 23818249

The SANS-Norse Healthcare Cyberthreat Report: http://norse-corp.com/HealthcareReport2014.html

Changing Culture of Medicine

by Aurametrix

Healthcare is the largest service industry in the world. Its old ways don't work anymore.
One of the reasons is that medical profession is seen increasingly in financial terms. Can you separate the businessman from the doctor? Not in American Medicine, says Kevin Pho, MD, author of the web's leading physician blog.

We need to change the way health care is envisioned, organized and delivered. We need creative approaches to building novel business models, and "disruptive technologies" to shake up the current system.

The current model motivates doctors to think about diagnostic tests based on available technologies and profit, not the need. They will, indeed, order a heart-stress test when the nuclear camera is in the next room, diagnose and treat harmless cancers, and be under financial pressure to see as many patients as possible.

The reform should create a different culture among health care professionals. Solutions include retail clinics that let people pay cash for low-end services and care, new primary care models such as Qliance, MDVIP, QuickHealth, and 1Life, clinics staffed largely by non-physicians, divorcing of physician payments from volume of services, more electronic encounters between doctors and patients and more automation.

Aurametrix works on automatic solutions beyond electronic medical records, for a healthier world.