Patients Googling their Doctor – A Coming Trend?

I came upon this interesting blog post the other day.

When Patients Googlestalk Their Doctors

Posted by Jacob Goldstein

Old doctors barely know what the Web is. Baby docs just out of residency would rather take a job in the Arctic than get rid of their Facebook page. And all of them are likely to get Googlestalked now and again by creepy patients.

That’s what a couple of Harvard psychiatrists say (albeit somewhat less glibly) in a commentary in this week’s JAMA.

“Many physicians over a certain age never envision their patients Web searching” for personal information about their doctor, write Tristan Gorrindo and James E. Groves. The older docs (naively) believe that “being absent from the Web is the surest way of avoiding disclosure of personal information on the Web.”

…..

Given how easy it is to go online and find housing records, divorces, bankruptcies and whatever pack of slanderous lies your bitter ex wrote on his/her blog, there’s only so much anybody — M.D. or otherwise — can do. Still, for the benefit of old and young alike, Gorrindo and Groves lay out a few common sense tips to help docs manage their online identity:

• Create your own Web page with basic information about your training and your practice.
• Search for yourself regularly. Use the form “John Q. Smith” or “John Smith, MD,” including quotation marks
• Go after sites that post slanderous material. (This WSJ story lists private companies that, for a fee, help deal with this sort of thing.)
• On social networking sites, use privacy controls to keep juicy bits out of sight of the general public.
• If you think a patient is searching for private information about you online, bring it up with the patient.

More here:

http://blogs.wsj.com/health/2008/07/08/when-patients-googlestalk-their-doctors/

This is a trend that may alarm clinicians.

While it seems perfectly reasonable to check if a clinician you plan to consult has any adverse commentary available on the Web it would seem very poor if patients start to abuse the information they find.

Potentially worse are sites the purport to rate clinician performance but which allow totally un-moderated and potentially damaging posting.

This is discussed further here.

Online Doctor Stalking: America’s New Pastime?

Kathryn Mackenzie, for HealthLeaders Media, July 15, 2008

We hear a lot about patient privacy and rights. With high-tech heavyweights like Google and Microsoft getting into the online personal health records game, it's likely that publishing medical information online will become the norm, rather than a futuristic pipe dream. Of course, patients will still want to know that their private information won't be accessed by the prying eyes of bosses, friends, neighbors, or relatives. And, through advertising pushes, test cases, and studies, the industry is working very hard to prove to patients that their medical data will remain private.

But what about the healthcare provider's right to privacy?

Many providers, especially those of a certain age, may not have any idea just how much of their personal information is easily accessible online to anybody—including their patients.

Anyone who comes into contact with patients, whether it be a physician or hospital executive, is accustomed to the dependency of patients in a clinical setting. Yes, we look to our doctors to cure what ails us, but we also want them to offer us comfort and support when we're feeling scared or sick. Some of us also want to know a little about our primary caregiver's history. Where did she graduate from, what do other patients think of her, where else does she practice? With the click of a mouse and few keystrokes, it's a breeze to get that information online at sites like ratemds.com and physicianreports.com. Unfortunately, it's also that easy to access far more personal information. Just by entering my doctor's name in Google or one of the dozens of other search sites, I can find out everything from where my doctor lives to her marital status to how much mortgage she pays.

More here:

I guess this issues is like all sorts of other relatively new technologies. There are often un-intended consequences which it takes time for an appropriate way of dealing with such problems to evolve. I suspect we are at the front of this curve!

David.

Data Security – A Pervasive and Difficult Problem.

In the last week or so the Poynter Review reported in the UK Treasury.

The background to the review is covered here.

The Poynter Review

On 20 November 2007, the Chancellor appointed Kieran Poynter, the Chairman and Senior Partner of PricewaterhouseCoopers, to investigate the circumstances that led to the significant loss of confidential personal data on Child Benefit recipients and other recent losses of confidential data and the lessons to be learnt. Kieran Poynter published his final report on 25 June 2008.

Media links

• Poynter Review final report, 25 June 2008 (PDF file 1.13MB)
• Poynter Review initial report, 17 December 2007 (PDF file 129KB)

After the review was published an opinion piece appeared in the London Financial Times.

Data security is not just a matter of technology

By Kieran Poynter

Published: July 15 2008 18:57 | Last updated: July 15 2008 18:57

The recent spate of high-profile data security breaches and the regulatory responses to them have once again thrust issues of data management into the limelight. I have spent the past few months looking at the issue and talking to leaders from the private and public sectors about data security issues. What has emerged is that there is a decided lack of ownership when it comes to data security, which cuts across all organis­ations.

There is a widespread perception that information security is an information technology issue and that produces a tendency to focus on security safeguards such as encrypting data on laptops, preventing use of USB memory sticks, password protection and so on. However, even in these areas experience shows that there is a long way to go.

Technological measures risk creating a false sense of security. Most breaches are the result of quite mundane physical factors and are essentially caused by process failures and/or people simply not knowing what to do.

Organisations can have all the policies and processes they like, but if their culture and values, management systems and scrutiny are not joined up in a clear governance framework, this lack of integration lends itself to data security exposures.

As the volume and depth of personal information that organisations hold on their customers, employees – indeed, on all of us – continue to grow, so do the potential regulatory, legal and reputation risks associated with failing to keep that data secure. While more and more businesses are taking data security seriously, the fact remains that serious breaches are on the rise, as is malicious activity by criminals seeking access to companies’ personal data.

Organisations with weak data security are generally also weak in terms of wider risk management and governance. So a failure adequately to manage information security risks is often symptomatic of broader risk issues or a fragmented governance framework.

More here (subscription required):

http://www.ft.com/cms/s/0/525bc6ec-526d-11dd-9ba7-000077b07658.html?nclick_check=1

Poynter review: HMRC has radically reduced security risks

Richard Thurston | Jun 27, 2008 10:25 AM

HMRC has radically improved its data security measures since the breach which caused it to lose 25 million child benefit records in October last year.

PwC chairman Kieran Poynter, the man tasked to investigate what happened in the catastrophic HMRC data breach, has revealed that significant progress has been made since the disastrous information leakage last October

Those are the thoughts of Kieran Poynter, chairman of Price Waterhouse Coopers, whose review into the data breach was published yesterday.

The positive statement was published as part of a largely critical report which said there were "serious institutional deficiencies" and "no visible management of data security at any level" of HMRC.

But Poynter did take the opportunity to outline HMRC's achievements since the breach.

Among the more important he picked out were:

- Creating a new post of director of data security;
- Issuing clearer at-a-glance data security guidance, which gives examples of what can be sent by what mechanism, and in what circumstances;
- Mandatory attendance at a half-day information security workshop for all staff;
- A review of post room processes and practice to identify high risk security issues;
- Locking down write access to removable drives, with reversal of that policy only able to be made by a small number of designated personnel;
- A ban on the use of unencrypted laptops outside secure premises;
- The introduction of new controls for bulk data transmissions;
- Progress on developing a mechanism for secure electronic transfer of information with external partners.

"I am pleased to say that HMRC has significantly reduced the risk of further data loss since the incident," said Poynter.

More coverage is available here.

http://www.securecomputing.net.au/News/115363,poynter-review-hmrc-has-radically-reduced-security-risks.aspx

The broader picture is revealed in the following from the BBC.

MoD admits loss of secret files

More than 100 USB memory sticks, some containing secret information, have been lost or stolen from the Ministry of Defence since 2004, it has emerged.

The department also admitted that more than 650 laptops had been stolen over the past four years - nearly double the figure previously claimed.

The Liberal Democrats condemned the latest security breaches as evidence of "shocking incompetence".

But the MoD insisted its policies were "generally fit for purpose".

Previously the MoD had confirmed that 347 laptops were stolen between 2004 and 2007.

The Mod said it has no idea on when, where and how the memory sticks were lost.

Defence Secretary Des Browne issued revised figures after "anomalies in the reporting process" were discovered.

The official total is now 658 laptops stolen, with another 89 lost. Just 32 have been recovered.

In a separate response, ministers said 121 of the department's USB memory sticks had been taken or misplaced since 2004.

Some 26 of those went this year - including three which contained information classified as "secret" and 19 which were "restricted".

BBC security correspondent Frank Gardner said the incident was "embarrassing" for the MoD as they had no idea how or when they had been lost or stolen.

Liberal Democrat MP Sarah Teather received the information after tabling a question in parliament.

Ms Teather said: "It seems that this government simply cannot be trusted with keeping sensitive information safe.

"This shows a shocking degree of incompetence."

Shadow defence secretary Liam Fox said: "To treat national security in such a cavalier fashion is unforgivable."

A Ministry of Defence spokesman said any loss of data was subject to a full inquiry and measures were being put into place to improve data protection.

Much more with multimedia here:

http://news.bbc.co.uk/1/hi/uk/7514281.stm

When one adds this to all the stories of loss of hospital records from the US it seems just no-one has worked out how to keep sensitive information safe. It seems it even happens in Wales!

NHS trusts lose confidential data

By Brian Meechan
BBC Wales political reporter

More than 150 incidents of data being lost at NHS trusts across Wales have put patient and staff details at risk.

Among the examples over a three year period, patient details from an entire children's ward in Wrexham were found on a piece of paper in a puddle.

In another revealed by BBC Wales after Freedom of Information (FOI) requests, a highly confidential child protection file was sent to the wrong address.

Health Minister Edwina Hart said she was "quite horrified" by the findings.

She said staff losing such data should be disciplined.

The cases were revealed in responses to BBC Wales to FOI requests to the trusts, which provide services through hospitals, health centres and clinics.

http://news.bbc.co.uk/2/hi/uk_news/wales/wales_politics/7509151.stm

As it almost always is, we find it is the people and the systems that have let us down and allowed the leaks of information to occur.

The story of what happened with the UK Customs Service makes a great and very educational read and describes well systemic failures and how they should be addressed once identified.

The reports are well worth a read – especially if you are a manager responsible for handling any sensitive information!

David.

Big Money To Be Saved with E-Prescribing

The following brief appeared a few days ago

E-prescriptions could cut federal expenses by $29 billion over next decade

Federal health expenditures could be reduced by up to $29 billion over the next decade if all Medicare prescriptions were transmitted electronically by 2010, according to a new study by Atlanta-based technology trade association AeA. But "eHealth 301: Electronic Prescriptions" notes that although e-prescribing has increased over the past several years, only two percent of all prescriptions were transmitted electronically in 2007.

Source: Telemedicine and e-Health News Alerts

The full .pdf file is found here.

http://www.aeanet.org/publications/AeA_CS_eHealth_ePrescribing.asp

A very big number – even if only half true makes a compelling case!

David.

Those Canny Scots are at IT Again!

Many reports of the Scottish Executive’s new E-Health Strategy this week.

Scotland commits to incremental e-health

01 Jul 2008

The Scottish government has pledged to further consolidate its SCI Gateway and SCI Store, and enhance its Emergency Care Summary Service, in its new e-health strategy for 2008-11.

The strategy lays out NHS Scotland’s approach to ‘electronic patient records and electronic communication becoming the primary means to manage healthcare information within the health system.’

While no specific budgetary commitment has been made, the Scottish Executive says it aims to boost the national e-health budget from the £40m spent in 2005/6 to £140m in 2010/11. In total it says NHS Scotland spent £225m on IM&T in 2006/2007.

It reiterates the commitment to stick to its current step-by-step approach and build on the systems already in use in Scotland: “We have already successfully implemented initiatives such as SCI Store, SCI Gateway and the Emergency Care Summary which help us to join systems and share information but we need to move further.”

Big bang approaches to e-health are rejected as risky and potentially disruptive: “An attempt to move to this new world in a single bound, even if achievable, would take a number of years and would be disruptive. NHS Scotland has to date chosen to approach this vision step-by-step; by building on what we have already successfully achieved, carefully addressing risks and resources to gain benefit from our effort as we go,” says the report.

Examples of exploiting existing systems includes using the SCI Gateway – a national system that integrates primary and secondary care systems - and SCI Store - an information repository which is integrated to other local systems - to support the information and reporting framework for the 18-week waits programme. This is envisaged to be completed by September

The Emergency Care Summary will also be enhanced over the next three years with additional items of patient information, such as a single medication record, and it will also be made available to a wider user base.

Lots more here:

http://www.ehealtheurope.net/news/3904/scotland_commits_to_incremental_e-health

Download the Strategy here e-health Strategy 2008.

The release is also covered here:

Scotland launches e-health strategy for 2008

Tuesday 1st July 2008

The Scottish government has launched its e-health Strategy 2008 at this year's NHS Scotland Event.

The vision for e-health supports the goals as set out in the Better Health Better Care Action Plan.

The plan aims to exploit the power of electronic information to help ensure that patients get the right care, involving the right clinicians, at the right time, to deliver the right outcomes. It is therefore as much about transforming traditional processes as it is about technology.

Nicola Sturgeon said: "Building for the future means an investment in new technology. Our eHealth Strategy demonstrates how we intend to harness the opportunities of new technology to enhance patient care.

More details are found here:

http://www.hospitaliteurope.com/default.asp?title=Scotlandlaunchese-healthstrategyfor2008&page=article.display&article.id=12067

Coverage from the GP perspective is here:

Scottish GPs to get choice of systems

30 Jun 2008

The Scottish government is to set up a national framework contract for GP systems and launch a procurement for an IT system or systems to replace GPASS, according to its new e-health strategy.

The plan means Scottish practices are likely to be brought under a Scottish version of England’s GP Systems of Choice (GPSoC) agreement with boards given flexibility about how to meet the needs of community staff. In addition a procurement will be launched for a system to replace GPASS although it is unclear whether this will involve one or more systems. Plans to procure a system that covers both primary and community staff appear to have been dropped.

The e-health strategy for Scotland was launched by Scottish health secretary Nicola Sturgeon last week at the NHS Scotland Event held to celebrate 60 years of the NHS in Scotland.

The deputy first minister told the conference the three year strategy from 2008 to 2011 would enable Scotland to build the platform for an electronic patient record to support patients and improve their experience of care throughout the healthcare journey.

More here:

http://www.ehiprimarycare.com/news/3900/scottish_gps_to_get_choice_of_systems

There is not much to really add. Scotland has worked steadily and incrementally and it is really paying off as their capabilities and range of available applications increases.

Well worth a browse.

David.

Queensland Health Loses its CIO.

It seems there has been a major policy shift at Queensland Health. It now seems it is mandatory to have a clinician as the CIO to assist with the implementation of clinical systems.

Qld Health takes a turn for worse

Abstracted from The Australian Financial Review

Richard Ashby is the new acting CIO at the IT and telco division of Queensland Health. The appointment follows the sudden departure of Paul Summergreene, who had only stepped into the CIO role less than 12 months earlier. Under a restructuring, it is apparently a requirement for the office holder to also have a clinical background.

More here:

http://www.businessspectator.com.au/bs.nsf/Article/Qld-communications-take-turn-for-worse-GRTSE?OpenDocument

The full details are here:

http://www.misaustralia.com/viewer.aspx?EDP://20080722000030050602&magsection=news-headlines-list&portal=_misnews&section=news&title=Qld+Health+take+turn+for+worse&source=/_xmlfeeds/mis/news/feed.xml

and here:

http://www.misaustralia.com/viewer.aspx?EDP://1216606621587&magsection=news-headlines-list&portal=_misnews&section=news&title=Qld+health+sacks+CIO&source=/_xmlfeeds/mis/news/feed.xml

This is not a bad idea, just as long as the individual appointed has both a strong clinical background, a strong understanding of how technology can be used to improve the health system, and the managerial skills to have the health sector come with him on the necessary journey of implementation and change. I hope Dr Ashby has all three!

Being a CIO for a State Health System is a real challenge! Sadly the incumbents often do not last long enough to get the job done.

David.

The Most Important Report on e-Health and Quality and Safety for 2008.

The following report was released a few weeks ago.

The Impact of eHealth on the Quality & Safety of Healthcare

Friday, 27 June 2008

A Systemic Overview & Synthesis of the Literature Report for the NHS Connecting for Health Evaluation Programme

Josip Car, Ashly Black, Chantelle Anandan, Kathrin Cresswell, Claudia Pagliari, Brian McKinstry, Rob Procter, Azeem Majeed and Aziz Sheikh

- There have been substantial developments in information technology hardware and software capabilities over recent decades and there is now considerable potential to apply these technological developments in relation to aspects of healthcare provision.

- Of particular international interest is the deployment of eHealth applications - that is the use of information technology in healthcare contexts - with a view to improving the quality, safety and efficiency of healthcare.

- Whilst these eHealth technologies have considerable potential to aid professionals in delivering healthcare, the use of these new technologies may also introduce significant new unanticipated risks to patients.

- Also of concern is that even when high quality interventions are developed, they frequently fail to live up to their potential when deployed in the "real world"; a major factor contributing to this paradox is professional resistance to the introduction and use of poorly designed applications.

- Given that the NHS is now committed to the largest eHealth-based modernisation programme in the world, it is appropriate and timely to critically review the international eHealth literature with a view to identifying lessons that can usefully be learnt with respect to the future development, design, deployment and evaluation of eHealth applications.

Download The Impact of eHealth on the Quality & Safety of Healthcare (.pdf, 7.220 KB).

More here:

http://www.ehealthnews.eu/content/view/1209/62/

A useful presentation is also available here.

www.pcpoh.bham.ac.uk/publichealth/cfhep/events/Claudia_Pagliari_Impact_of_eHealth.pdf

This is one of those reports that simply has to be read to be appreciated – at the very least the introductory 28 pages are vital and must not be missed by anyone interested in where e-Health is at present and where it probably needs to move.

It is good that those involved are now moving on with the following.

NHS Connecting for Health's NHS Care Record Service Evaluation Begins

Saturday, 12 July 2008

NHS Connecting for Health, the flagship NHS IT programme, is to be evaluated by a national team of researchers led by the University of Edinburgh. The £1.5m study, which begins on 1st September 2008, will run until December 2010 and also involves researchers from the Universities of Nottingham, LSE, School of Pharmacy and the NHS. It will evaluate specifically the adoption of the NHS' Care Record Service which is being implemented in hospitals throughout England.

More here:

http://www.ehealthnews.eu/content/view/1230/27/

The key lesson I take from my reading is that it seems very likely use of Health IT can make a difference to quality and safety of patient care (it is assumed efficiency and care co-ordination is doable and valuable – certainly in countries with high levels of administrative complexity like the USA) but that the hard academic work is yet to be done to prove that is actually the case.

The situation in academic e-Health in Australia is, I fear typical, where both funds and career paths are problematic. Until this is fixed and we can do the trials that are needed to link the use of technology to really improved clinical outcomes in the real world the debate will continue. I wonder will I last long enough to see that happy day?

David.

David Gonski AC Appointed As NEHTA Independent Chair.

Mr David Gonski AC has been appointed as the first independent chair of the National E-Health Transition Authority.

More details are available here.

http://www.nehta.gov.au/index.php?option=com_content&task=view&id=335&Itemid=144

Just why a lawyer and listed company director, and Chancellor of UNSW, is a good choice for this role totally eludes me. I wish him luck but can’t for the life of me see how someone with no apparent record in health or technology is the right person for this role.

The number of directorships he holds also makes one wonder how much time and focus NEHTA can expect.

I do not subscribe to the theory that any good manager can manage anything! Indeed, I see part of the decay of our Health System as being related to the systematic exclusion of health expertise from the management of health service entities.

If Mr Gonski’s role is to try and get the badly flawed NEHTA IEHR proposal through COAG, and funded, then he needs to know – right up front – he has been handed a poison chalice in my view.

The only upside is that it seems a well constituted Reference Forum (with real sector expertise and wide representation) is about to be announced by NEHTA. If this forum can have the influence it should there just may be hope yet. This is, of course, only three years to late!

Life is always lively in e-Health!

David.

Useful and Interesting Health IT Links from the Last Week – 20/07/2008

Again, in the last week, I have come across a few reports and news items which are worth passing on.

These include first:

Electronic records help doctors, patients work together

Electronic records help doctors, patients work together

by Connie Midey - Jul. 15, 2008 12:00 AM
The Arizona Republic

When Jesus Saavedra sits down with his doctor, his vital signs - taken just moments before - are displayed on a computer monitor in the exam room.

So are notes from previous visits, results from lab tests and his answers to a series of questions, including whether he uses a seat belt (he does) or smokes (he doesn't).

The order for a prescription he needs travels via the doctor's computer at the Carl T. Hayden VA Medical Center in Phoenix, where the Buckeye Army veteran receives outpatient health care, directly to the on-site pharmacy, where a robot will fill it.

Saavedra, 56, even signs consent forms electronically. Encounters with paper are rare during his appointments with physician Mervin Myrvik, a specialist in internal medicine and the Phoenix VA medical center's chief of informatics.

"It's a very impressive system," Saavedra says. "It even (graphs) my weight changes. They don't want you to miss that."

One of medicine's most enduring icons - the folder brimming with a patient's records - is being replaced by electronic health records, and perhaps nowhere are the changes more apparent than in the VA Health Care System.

At 153 VA hospitals nationwide, a computerized patient record system implemented in 1998 holds electronic files for the 5.5 million veterans treated, 70,000 of them in the Phoenix area. The system operates on the VA's VistA software program, a bundle of about 20,000 regularly updated programs.

VistA is short for Veterans Health Information Systems and Technology Architecture.

"Electronic health records have made a difference," Myrvik says, in the way health-care providers work and in outcomes for patients.

More here:

http://www.azcentral.com/arizonarepublic/arizonaliving/articles/2008/07/15/20080715electronicrecords0715.html

This is a useful reminder that, with time and the right level of investment, it is possible to implement a really rich EHR system that makes a real clinical difference. It’s worth remembering it is possible!

Second we have:

Open source health IT solutions

An open source developer community, Open Health Tools (OHT), has announced a collaborative effort to develop common healthcare IT products and services.

Its 26 members consist of national health agencies, government-funded organisations and agencies, major healthcare providers, international standards organisations and companies from Australia, Canada, the United Kingdom and the United States.

The members include NHS Connecting for Health, BT, IBM, Oracle and HL7, among others. Formed in November 2007, OHT's mission is to provide software tools and components that will accelerate the implementation of electronic health information interoperability platforms, which improve patient quality of care, safety and access to electronic health records (EHR).

The results will be available under an open source agreement so anyone may use them to provide interoperable healthcare platforms that will link clinics, hospitals, pharmacies and other points of care to make healthcare systems more efficient.

OHT's health interoperability framework will use standardised, open interfaces and a set of reusable software components that can be assembled into systems and products by health systems and vendors.

OHT is open to membership from any organisation and the results of member efforts are made available under a commercially friendly open source license.
More here:

http://www.mediaforfreedom.com/ReadArticle.asp?ArticleID=10472

This is an initiative that we are all going to hear more about over the next 2-3 years. Worth making sure you are across their activities and can take advantage of the ideas they develop.

Third we have:

Old-fashioned docs inspire new 'medical homes'

States, the federal government and private insurers are experimenting with an idea to cut costs and make patients happier: Paying primary-care doctors extra money to oversee and coordinate patients' care.

The pay boost rewards doctors who reshape their practices to recreate an era when a trusted family physician helped patients through hospitalizations, coordinated specialist care and provided routine screenings. Such efforts may save money by reducing hospitalizations, ER visits and disease.

Dubbed "medical homes," the concept is a modern twist on an idea first promoted in the 1960s. Under most pilot projects being tested, primary-care doctors who have established medical homes will receive additional fees — ranging from just a few dollars a month per patient to more than $35,000 a year per doctor — from states, Medicare or other insurers.

Medicare this year will choose eight states to test whether paying primary-care doctors more per month to treat patients with chronic illnesses in medical home settings results in better care and lower costs than traditional practices.

The concept aims to change rushed doctor's appointments and fragmented specialist care by creating patient care "teams," which could include nurse practitioners, nutritionists or other medical staff. Medical homes also offer longer office hours, electronic medical records and same-day appointments.

More here:

http://www.usatoday.com/news/health/2008-07-13-medical-homes_N.htm

Interesting to see continuing discussion in the mainstream US Media on the Medical Home concept and the linkage of the use of this approach to deployment of EHR services. There is no doubt that EHRs can assist in the care co-ordination and information management roles that GPs perform.

Fourth we have:

Queensland goes offline

Tony Koch and Mitchell Bingemann | July 16, 2008

A WORKER operating a backhoe on a building site at Molendinar on the Gold Coast threw Queensland's communications network into chaos yesterday morning by severing a fibre optic cable.

The Optus network collapsed, rendering landline and mobile phones to and from Queensland useless and leaving internet services blacked out. Automatic teller machines and EFTPOS services were also affected.

Tempers frayed at major business premises where communication was stopped. At Brisbane airport, lines of travellers stretched for more than 100m as they waited hours for their tickets and luggage to be manually processed.

Radio reports indicated that Optus was refusing until late yesterday to explain the collapse of its system, while media organisations were inundated with complaints about Optus.

The system went down at 7.53am and was restored after midday when technicians repaired the damaged cable.

More here:

http://www.australianit.news.com.au/story/0,24897,24028241-15306,00.html

Another amazing piece of news. It seems really very poor that links as vital as this were not duplicated and switch over tested on a regular basis. The impact makes it clear just how dependent we have all become in network communications to conduct ordinary life and business.

The fact that the cable was cut just 2 meters away from a marker alerting diggers that the cable was there – as shown by a Optus photo of the site – shows there are some pretty dumb backhoe drivers around!

The more we treat the Internet as something like water and electricity in daily life the more important it is we have contingency plans for failure. Hospitals have had generators for years – I wonder how well they can cope with network outages.

Fifth we have:

Guidelines on card rort reporting

Karen Dearne | July 15, 2008

SMALL businesses remain outside the purview of the federal Privacy Commissioner at a time when they face soaring credit card breaches.

Commissioner Karen Curtis will shortly release voluntary guidelines on reporting data breaches for use by companies and government agencies as an interim measure ahead of the Rudd Government's overhaul of the 20-year-old Privacy Act.

It's not yet clear whether the voluntary guide will involve public notification of breaches, or the industry's preferred need-to-know position. "My office is still working through issues such as this prior to the guide's release during Privacy Awareness Week, the last week in August," Ms Curtis said.

"However, in the consultation draft, it was suggested the preferred method was direct notification either by phone, letter, email or in person to affected individuals.

"Indirect notification, either by website information, posted notices or the media, should generally occur only where direct notification could cause further harm, is prohibitively expensive, or contact information is not known."

More here:

http://www.australianit.news.com.au/story/0,24897,24020190-5013044,00.html

Two points here. First it seems clear to me you are entitled to know promptly if someone has let your private information out of their control and second all organisations holding personal data (including health data) need to proactively ensure such leaks and loss do not happen – and a reasonable penalty regime should be in place to focus the mind of all data custodians.

Without pressure we seem likely to receive the ‘Mushroom Treatment’.

Silence golden on security slip-ups

Karen Dearne | July 15, 2008

A STAGGERING 96 per cent of technology decision makers don't think the public should be told when data breaches occur, according to a survey by email and web security specialist Clearswift.

But 82 per cent of respondents do say affected customers should be informed, and only 28 per cent oppose mandatory data breach notification laws.

Clearswift Asia-Pacific managing director Peter Croft says companies fear airing their dirty laundry in public will lead to a loss of customer confidence, while proposed disclosure legislation would be expensive and create work for the technology department.

"Unfortunately, some businesses are unaware of the depth of feeling on this issue," Croft says. "People like to know they can trust the organisations that deal with their personal and financial information.

"Banks like to keep news of breaches to themselves, but they are out of touch with their customers' expectations. They should be much more open about how good they are at handling other people's information."

More here:

http://www.australianit.news.com.au/story/0,24897,24019443-24169,00.html

Sixth we have:

Video sports have Wii effect

• Saved

Dan Harrison, Health
July 13, 2008

Interactive sports video games such as the Nintendo Wii are better for children than conventional computer games, but do not tackle the epidemic of childhood obesity, British research shows.

The study, published in the British Journal of Sports Medicine, found that playing virtual sports such as tennis, boxing and bowling on Nintendo Wii burned more than 50% more energy than playing sedentary computer games such as Xbox.

But the children used much less energy playing virtual sports than they would in the real versions. Real boxing burns more than twice as much energy as Wii boxing. Real tennis is 77% more demanding than the electronic version, and conventional bowling uses almost 15% more calories than the virtual kind.

The study authors calculated that in a typical week, a child who played Wii sports would use about 2% more energy than one playing sedentary computer games.

They said the increase was "trivial," and the activity was not intense enough to be counted in the recommended daily amount of physical activity. But the games could play a role in weight management and were preferable to sedentary games.

More here:

http://www.smh.com.au/news/technology/video-sports-have-wii-effect/2008/07/12/1215887493421.html

I must say I think the authors are being somewhat spoiled sports about this. Anything that gets people up an moving – even a little bit – is better than nothing and, of course, if choosing a game to purchase for children it seems hard not to think this might be a slightly preferred choice.

The critics here seem even worse – but then I suppose a small risk exist that some may worry about the body image excessively. I suspect if the Wii game can cause a problem so can all other signals being received by children however.

Wii Fit raises obesity furore

Asher Moses
July 18, 2008 - 9:00AM

Nintendo's Wii Fit game has attracted the ire of childhood obesity experts for telling healthy kids they are fat, which might cause eating disorders and self-esteem issues.

The game assesses players' fitness levels based on their body mass index, labelling them underweight, ideal weight, overweight or obese.

The BMI is a statistical measure of a person's weight relative to height, but experts say this is not an appropriate measure for children because it does not account for their age or stage of development.

The $149.95 Wii Fit was launched in Australia in May and includes a weight- and motion-sensitive balance board, which players can use for yoga, muscle workouts, aerobic exercises and balance games.

More here:

http://www.smh.com.au/news/articles/wii-fit-raises-obesity-furore/2008/07/17/1216163018848.html

Last we have our slightly technical note for the week:

Tape storage, high and low, gets more dense

HP and Sony doubled the density of their DAT data storage tapes while IBM and Sun introduced 1T-byte enterprise tape drives.

Stephen Lawson (IDG News Service) 16/07/2008 08:12:45

Two classes of tape storage are jumping to higher densities this week, potentially saving time and money at enterprises as well as small and medium-size businesses.

Hewlett-Packard and Sony on Tuesday announced a coming generation of DAT (Digital Audio Tape) media with twice the capacity of the current technology and a higher transfer speed. On Monday, Sun Microsystems introduced an enterprise-class tape drive that can pack 1T byte on a current type of tape, and on Tuesday IBM also announced a 1T-byte tape drive system.

Along with demand for hard-drive storage that has to be immediately accessible, the need for tape to reliably back up and archive older information is growing fast, according to IDC analyst Robert Amatruda. Higher capacity per tape cartridge can save space, power and money and even allow companies to save more old data, he said. In addition to greater density, the new tape technologies offer faster transfer speeds.

The next generation of DAT, called DAT 320, will be able to hold 320G bytes of data on one cartridge. It was jointly developed by HP and Sony over the past two years and should be generally available in the first half of next year, according to Bob Conway, manager of the tape product marketing team at HP. The new technology will also allow for back up from disks at speeds as high as 86G bytes per hour with 2:1 data compression, he said. Data is typically transferred to DAT decks via USB (Universal Serial Bus) or serial or parallel SCSI.

…..

To achieve the new density on a tape the same size as its predecessor, DAT 160, the companies changed the basic formula of DAT for the first time, from metal particle tape to metal evaporated tape. They also developed narrower tracks, Conway said. The companies will license the DAT 320 technology to anyone for a nominal fee.

HP and Sony's openness will help ensure there are multiple suppliers of media and components, Amatruda said. HP made 55 percent of low-end tape deck shipments worldwide in the first quarter of this year and Sony made 7 percent, he said.

Although there are a growing number of external hard-drive products available for SMB backups, they aren't as reliable as tape, he said.

"At the end of the day, maintaining hard drives is not really data protection," Amatruda said. And it can be important to have old data set aside for disaster recovery or in case of an event like a tax audit.

"If you can't produce critical data that you use to run your business ... you can be in real trouble," he said. The improved efficiency of the new tapes will probably convince more companies to use them for longer term archiving, he added.

More here:

http://www.computerworld.com.au/index.php?id=1630184913&eid=-255

Backup is an important issue that needs to be addressed carefully when acquiring and managing patient data. This is a useful reminder that the technology is getting better – with the 160 Gig drives now of the order of $1000 using a USB interface. At this price and with tape only $20-30 each there is no excuse not to have such an insurance policy in place.

http://www.smh.com.au/news/upgrade/survive-the-backup/2008/07/14/1215887537523.html

Survive the back-up

• Saved

Adam Turner

uly 15, 2008

Next

If you're not using an off-site back-up system, you're taking your digital life in your hands by not protecting data against fire and theft, as well as hardware failure. It needs to be backed up off-site - preferably at an enterprise-grade data centre.

This article is also worth a browse on the same general topic.

More next week.

David.