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The US government has now adopted a policy of fostering the adoption of electronic medical records (EMR). The policy is intended to increase the efficiency of the US healthcare system, thereby lowering costs and reducing the incidence of preventable errors. At the same time, through its The Health Insurance Portability and Accountability Act (HIPAA) privacy rules, the government has set minimum standards for the security of those records. These two goals-privacy and security of these records, along with their free interchange among medical providers-can easily wind up at odds with each other. A recent study that looked at the role of state privacy laws in EMR adoption suggests that the problem is very real, as state privacy laws seem to inhibit the use of EMR by hospitals located there. The authors, based at MIT and the University of Virginia, line up a variety of data that validate their suggestion that privacy and the use of EMR may require a careful balance. So, for example, they cite some highly publicized lapses when it comes to the maintenance of patient privacy: someone once offered the records of 200,000 patients for sale on Craigslist, while hospitals have seen their own employees attempt to get at the electronic files of famous patients. Perhaps more significantly, the authors suggest that the public, as represented by their legislators, has concerns about the privacy of EMR. They found that states that have passed their own privacy laws to supplement the HIPAA rules tend to have a higher percentage of their populace signed up for the Do Not Call Registry, indicating a corresponding individual-level interest in maintaining privacy. So, they looked at whether these laws had any impact on the adoption of EMR by hospitals located in each state.

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Companies in the technology, media and telecommunications industries (TMT) significantly reduced investment in security spending in 2008, according to a new survey from Deloitte Touche Tohmatsu. The third edition of the Deloitte TMT Global Security Survey reveals that 32 percent of respondents reduced their information security budgets, while 60 percent of respondents believe they are "falling behind" or still "catching up" to their security threats -- a significant increase from 49 percent over the previous year. "This year's results indicate companies are explicitly scaling back. With funding decreasing and the threats increasing, it is more important than ever for TMT companies to be highly cost efficient in addressing their security risks," said Irfan Saif, a principal in Deloitte & Touche LLP's Audit and Enterprise Risk Services practice. "Companies that do not have a sound understanding of their security risk profile, or who under-invest in security now, may find themselves exposed to significant and increasingly sophisticated threats that they are not equipped to mitigate." With the proliferation of digitized assets, security should claim a significant portion of a company's overall IT budget. However, only 6 percent of respondents allocate 7 percent or more of their total budget to IT security. This year represents a significant decline from the previous edition of the survey, which showed that 36 percent of the respondents allocated 7 percent or more of their budget to IT security. The survey also indicates that declining security investment is hindering adoption of new security technologies, with only 53 percent of respondents considering their organizations to be early adopters, or part of the early majority, down from 67 percent in 2007. Companies are focusing more effort on optimizing solutions that are already in place rather than investing in cutting-edge technology that can be capitalized upon during economic recovery.

Social, Social, Social! It seems everyone is talking about the need to adopt some flavor of Social to propel business forward. Unless you live under a very large rock, you are aware of the popularity of individual social media services. Many well-meaning companies are rushing forward to transform th

In a study that is unlikely to find favor among privacy advocates, researchers from two academic institutions warned that increased efforts to protect the privacy of health data will hamper the adoption of electronic medical records systems. The study, conducted by researchers at MIT and the University of Virginia, said EMR adoption is often slowest in states with strong regulations for safeguarding the privacy of medical records. On average, the number of hospitals deploying EMR systems was up to 30% lower in states where health care providers are forced to comply with strong privacy laws than it was in states with less stringent privacy requirements. That's because privacy rules often made it harder and more expensive for hospitals to exchange and transfer patient information, thereby reducing the value of an EMR system, the study found.

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The Swiss government Friday noon announced that it will adopt the OECD standard on administrative assistance in tax matters, which is part of the OECD's Model Tax Convention. As a result Switzerland will exchange information with other governments in individual cases where "a specific and justified request has been made" for any form of tax offense. Accepting the standard will require renegotiating existing bilateral treaties. Requests from other governments, made according to the standard, will be honoured once new treaties go into effect. Ed. note: it was widely reported Friday that Switzerland has agreed to assist other governments in cases of tax evasion, not just fraud. While this may be the result of the 13 March announcement, Switzerland specifically states that it intends to adopt the convention "in accordance with Art. 26 of the OECD Model Tax Convention."

Wal-Mart Stores is striding into the market for electronic health records, seeking to bring the technology into the mainstream for physicians in small offices, where most of America's doctors practice medicine. Wal-Mart's move comes as the Obama administration is trying to jump-start the adoption of digital medical records with $19 billion of incentives in the economic stimulus package. The company plans to team its Sam's Club division with Dell for computers and eClinicalWorks, a fast-growing private company, for software. Wal-Mart says its package deal of hardware, software, installation, maintenance and training will make the technology more accessible and affordable, undercutting rival health information technology suppliers by as much as half. "We're a high-volume, low-cost company," said Marcus Osborne, senior director for health care business development at Wal-Mart. "And I would argue that mentality is sorely lacking in the health care industry." The Sam's Club offering, to be made available this spring, will be under $25,000 for the first physician in a practice, and about $10,000 for each additional doctor. After the installation and training, continuing annual costs for maintenance and support will be $4,000 to $6,500 a year, the company estimates. Wal-Mart says it had explored the opportunity in health information technology long before the presidential election. About 200,000 health care providers, mostly doctors, are among Sam Club's 47 million members. And the company's research showed the technology was becoming less costly and interest was rising among small physician practices, according to Todd Matherly, vice president for health and wellness at Sam's Club. The financial incentives in the administration plan - more than $40,000 per physician over a few years, to install and use electronic health records - could accelerate adoption. When used properly, most health experts agree, digital records can curb costs and i

A health care industry coalition on Monday released a prescriptive security framework that organizations can use to safeguard patient records as they increasingly move online. The framework, released by the Health Information Trust Alliance (HITRUST) -- which represents health care providers, pharmacies, insurers, biotech firms and medical device manufacturers -- is based on well-known standards such as COBIT, NIST and ISO 270001. But this is the first benchmark developed specifically for protecting health data. "It's tailored to protecting health information right out of the gate," Michael Wilson, vice president and chief information security officer of McKesson, the largest U.S. pharmaceutical distributor, told SCMagazineUS.com on Monday. "It's just a different sort of data. It's still structured [like other verticals], but there's a lot more of it in health care." The framework was created to improve adoption rates with regulations such as the Health Insurance Portability and Accountability Act (HIPAA) and increase patient confidence in the security of their information. It also arrives on the heels of the new $787 billion economic stimulus bill, about $20 billion of which is earmarked to encourage health care organizations to adopt electronic health records as a way to reduce the number of medical errors and save money. The stimulus bill, in itself, contains srict privacy and security regulations for patient information. The standards took about 18 months to devise and can be implemented by organizations of any size, according to HITRUST. "2009 will be a turning point for information security in the health care industry, when organizations will begin implementing the framework...and create a cascading effect that will impact and benefit the entire health care ecosystem," Daniel Nutkis, CEO of HITRUST, said in news release. Wilson said the framework also will enable companies such as McKesson to show their customers and business partners that they are taki

Should individual states mandate that businesses comply with the Payment Card Industry's Data Security Standard (PCI DSS)? The answer is "yes," according to Nevada, which has passed a new law that, as of next year, requires businesses to comply with PCI when collecting or transmitting payment card information. Nevada is the first state to mandate full PCI compliance for businesses. Minnesota in 2007 incorporated only a portion of PCI in its Plastic Card Security Law. According to Nevada's new law, if a data collector doing business in that state accepts a payment card in connection with a sale of goods or services, the data collector shall comply with the current version of PCI DSS, as adopted by the PCI Security Standards Council or its successor organization, with respect to those transactions, not later than the date for compliance set forth in the Payment Card Industry (PCI) Data Security Standard or by the PCI Security Standards Council or its successor organization. Is it a Game-Changer? As states rush to adopt or strengthen privacy legislation, Nevada's move is seen by some observers as a potential "game-changer." But they question whether states should be in the business of mandating compliance with an industry standard.

Urging Privacy Protections with Health IT Privacy safeguards are needed if funds are to be provided for implementation of health IT systems in economic stimulus package. At today's news conference, the Coalition for Patient Privacy is releasing a letter sent to Congress advocating for the inclusion of privacy safeguards with any funding given to implement health IT systems in the proposed economic stimulus package. In the letter, the bipartisan coalition, representing over 30 organizations, individual experts and the Microsoft Corporation, welcomes the renewed commitment in Congress to protecting consumers over special interests, but makes clear that trust is essential to health IT adoption and participation, and only attainable with privacy protections. The coalition is calling on Congress to "A.C.T.", by providing: accountability for access to health records, control of personal information, and transparency to protect medical consumers from abuse. Consumer trust is essential to health IT adoption and participation, and only attainable with privacy safeguards. Through these three tenets, implementation of health IT is not only attainable, but would protect the right to privacy for consumers, employees, and providers.

The Supreme Court upheld a U.S. government crackdown on profanity on television, a policy that subjects broadcasters to fines for airing a single expletive blurted out on a live show. In its first ruling on broadcast indecency standards in more than 30 years, the high court handed a victory on Tuesday to the Federal Communications Commission, which adopted the crackdown against the one-time use of profanity on live television when children are likely to be watching. The case stemmed from an FCC decision in 2006 that found News Corp's Fox television network violated decency rules when singer Cher blurted out an expletive during the 2002 Billboard Music Awards broadcast and actress Nicole Richie used two expletives during the 2003 awards. No fines were imposed, but Fox challenged the decision. A U.S. appeals court in New York struck down the new policy as "arbitrary and capricious" and sent the case back to the FCC for a more reasoned explanation of its policy.

In my last post, Behavioral Targeting, I mentioned that I used a home-grown form of customer tracking when I worked on Wall Street. I explain a bit more about that in this post. I will describe more about the process in a second part to this post.
Early Adopters
The competition in the financial se

Today's post provides an example of an organizational change being discussed in many firms contemplating the use of social media, and its evolution to social business in a global economy. Adoption of "social" introduces new risks and opportunities to US corporations. The likelihood of doing business

"Consumers are often oblivious to the fact that some businesses share a great deal of their personal information with other businesses who deliver targeted behavioral advertising, says Anzen analysts Megan Brister and Jordan Prokopy. In an e-mail interview with IT Business Edge editor Lora Bentley, Brister and Prokopy say most consumers are just not aware of the business practices of companies that use personal information for profit. The Federal Trade Commission recently held meetings with consumer and privacy advocates, business and government leaders to discuss privacy, regulatory, and business issues of online behavioral advertising. It plans plan to ramp up efforts to protect consumers and possibly push for tougher legislation to protect consumers. One issue, Brister and Prokopy say, is the lack of transparency by companies that engage in behavioral advertising. These companies have been slow to adopt clear data-management policies and even when they do have policies, they are often written in language that is difficult to understand. Fortunately for consumers, some type of regulation appears to be on the way. The FTC appears eager to penalize businesses who lack transparency regardless of whether the consumer actually experienced any real negative effects as a result, Brister and Prokopy say."

"Lora Bentley spoke with Anzen analysts Megan Brister and Jordan Prokopy via e-mail regarding behavioral advertising - what companies are doing, what regulators want to do and what we, as advertising consumers, need to know. With their coworker Miyo Yamashita, the analysts recently wrote a guest opinion for IT Business Edge. Bentley: Why are so many concerned about privacy when it comes to behavioral advertising? What is it about the Internet that convinces consumers that information they share there is not being used? Brister and Prokopy: Most concerns stem from the lack of transparency around data disclosure practices. While consumers may value a Web site's product and service offerings, they are generally unaware that businesses share their information with an extensive group of other businesses in order to deliver targeted advertising. This group includes news Web sites, advertising networks, profiling services, and Web analytics providers, to name a few. As Pamela Jones Harbour, a Commissioner at the Federal Trade Commission (FTC), discussed at the FTC Roundtable earlier this week, there is an asymmetry between consumer perceptions and business realities. Once consumers are informed of businesses' data handling practices, they will want to have more control over how businesses manage their information. As we discuss in our article, some businesses engaged in online behavioral advertising have been slow to adopt transparent consumer data management policies. This is a concern particularly for vulnerable groups, such as minors or non-English speaking consumers, because they may not understand legally written policies. Consumer advocacy groups argue that without knowledge and control over the collection, use, and disclosure of data, Web sites may misuse or expose sensitive data about consumers' health, lifestyles and finances."

"Despite concerns from some privacy groups and U.S. lawmakers about behavioral advertising, most large advertising networks generally comply with a set of privacy and data-handling standards adopted by the Network Advertising Initiative a year ago, the NAI said in a report released Wednesday." ...NAI, whose members include Google, Yahoo and Advertising.com, should be praised for doing a compliance report after skipping it for several years, said Ari Schwartz, vice president and chief operating officer CDT. However, the group should consider using a third party to audit compliance of its privacy guidelines, instead of having NAI staff do the audits, he said. In addition, while NAI members appear to be following most of the guidelines, some of the privacy safeguards are "weak," including the data retention standard, he said. "There's no maximum for data retention -- they just have to state what their data retention policy is," Schwartz added. The NAI report doesn't lessen the need for new privacy laws, Schwartz said. Several online advertising networks are not members of NAI, and the recent public pressure has led to the NAI updating 8-year-old guidelines last year and issuing a compliance report for the first time in several years, although the group had promised regular reports, he said. "It seems that when there's regulatory pressure, they actually do comply with what they said they were going to do," he said. "We certainly wouldn't want to see any regulatory pressure lifted."

Worth a read. The story changes quite a bit from the top to bottom of the story.

"Can personal medical data that has been stripped of its identifiers to protect privacy later be used to identify a specific person? That is the question that the Health and Human Services Department is hoping a research contractor can answer. HHS intends to hire a contractor to demonstrate either the "ability or inability" to re-identify data from a data set that has been de-identified under the Health Information Portability and Accountability Act (HIPAA) Privacy Rule, according to a Jan. 4 notice on the Federal Business Opportunities Web site. De-identification and re-identification of patient data have become hot issues in the discussion about how to protect patient privacy while advancing adoption of electronic health records. The Obama administration is distributing at least $17 billion in incentive payments to doctors and hospitals who buy and use digital systems for medical data."

"The last quarter of 2009 should be partly remembered in the advertising community as a juncture when big agencies -- namely Omnicom Media Group, The Nielsen Company, and WPP -- announced consumer data mergers. The deals entailed the marriages of offline and online data and appeared to reveal a potentially major stepping stone in the evolution of "hyper-targeting." Some of the agencies have trumpeted their newfound ability to create consumer segments related to behavioral elements such as "passion points" (e.g., shown interest in electronics, photography, fantasy football, etc.), as well as geographic location, beverage preferences, favorite social media sites, activity levels at the sites, and so on. Augustine Fou, group chief digital officer for Omnicom's Healthcare Consultancy Group and a ClickZ columnist, said that while increased hyper-targeting would likely result from the data marriages, unresolved issues remain before the use of combined online/offline data is widely adopted by brands. "For example, as diverse data sets begin to be integrated, it will become painfully apparent what data can be integrated -- or not -- and specific tradeoffs will have to be made to move forward," he explained. "In particular, privacy policies of sites and ad networks will need to be revisited." The growing ability for marketers to target online ads using data gathered offline has generally raised concern among consumer privacy advocates. To that end, Fou suggested that brands are cautiously optimistic about hyper-targeting and slightly wary of public/consumer perception. "

Marriage of offline and online data sources to target advertising may make tracking more interesting for consumers and advertisers alike.

In advanced markets, the firm believes the promise of mobile payments driven by NFC technology is at least four years away from reaching mass adoption. "The biggest hurdle is the need to change user behavior by convincing consumers to pay with mobile phones instead of cash and cards," said Sandy Shen, research director at Gartner.

URAC, the leading health care accreditation and education organization, announced today the recent Healthcare Information and Management Systems Society (HIMSS) annual conference raised important questions about consumer privacy and security around electronic health records (EHR). (Logo: http://www.newscom.com/cgi-bin/prnh/20030501/URACLOGO ) "There is no doubt that electronic health records are coming. The question is whether or not consumers' privacy is a key issue or an afterthought," said Alan P. Spielman, President and CEO of URAC. "A lot of forces are driving the push for EHR. However, it is important that standards go hand-in-hand with policy so that it doesn't become the Wild West with every vendor and health care provider using different terms." The rules set by the Health Insurance Portability and Accountability Act (HIPAA) are integral to the widespread adoption of EHR. However, the rules can be confusing for consumers and providers. URAC was the first organization to offer HIPAA Privacy Accreditation. The organization now offers comprehensive standards for both HIPAA Privacy and HIPAA Security accreditation. These standards are applicable to all personal health information storage formats and exchanges claims transactions and are designed for many different types of health care organizations including both Covered Entities (CE) and Business Associates (BA). They also require an ongoing compliance program that identifies, tracks and makes the necessary changes in response to a federal or state regulatory change.

The California State Senate approved today SB 20, legislation by State Senator Joe Simitian (D-Palo Alto), which aims to strengthen existing privacy protection laws for California consumers. The new law builds on legislation authored by Simitian in 2002 that requires a business or government agency that incurs a data breach to provide notice to the individual(s) whose information was compromised. More than 40 states have adopted similar legislation since that time, largely based on the California measure. "No one likes to get the news that information about them has been stolen," said Simitian, "but when it happens, people are entitled to get a notice they can understand, and that helps them decide what to do next." "The premise is simple," added Simitian. "What you don´t know can hurt you. Ignorance is not bliss. And you can´t protect yourself if you don´t know you´re at risk." Simitian said his latest proposal (SB 20), "is designed to make a good law even better." California´s current security breach notification law (AB 700, Simitian -2002) requires notice to consumers when their information has been compromised, but does not require data holders to provide any standard set of information about the nature of the breach. SB 20 will enhance consumer knowledge about security breaches by requiring that the notification contain specified information, including the type of personal information breached and the date of the breach.