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Volume 10, Issue 18 May 13, 2011
Obama Unveils Cybersecurity Plan
Long-awaited proposal gives DHS oversight
By Dave Boyer, The Washington Post
President Obama released Thursday his long-awaited proposal to protect the nation‘s computer networks from cyber-attacks, after more than two years of planning.
The plan would rely heavily on industry to devise its own set of standards, giving the Department of Homeland Security an oversight role but no authority to impose fines. And some parts of the proposal are still being worked out: For example, the definition of which industries qualify as ―critical infrastructure‖ is still under discussion.
A technology expert said Mr. Obama‘s proposal is remarkable for what‘s not included - authority for the president or the Department of Homeland Security to order a company to shut down its operations when under cyber-attack.
―The president himself may have killed the Internet ‗kill switch‘ idea,‖ said Gregory Nojeim, director of the Project on Freedom, Security and Technology at the Center for Democracy and Technology.
A senior White House official said the administration thinks the president has sufficient authority now to act in a cyber-emergency.
Stewart Baker, a former assistant secretary at DHS under President George W. Bush, panned the proposal as ―weak tea.‖
―The tea bag doesn‘t seem to have actually touched the water,‖ he said. ―The privacy and business groups that don‘t want us to do anything serious about the cybersecurity crisis have captured yet another White House.
―At a time when foreign governments and criminals don‘t just collect information on Americans, but have the ability to turn on the cameras and microphones in our homes while recording our keystrokes, the administration‘s proposal shows no sense of urgency.‖
National security officials have warned for years that the nation is too vulnerable to cyber-attacks that could cripple electrical grids, government operations and financial markets.
Intelligence and military chiefs have grown increasingly worried about cyberspies from China and Russia infiltrating military computer systems.
More at http://www.washingtontimes.com/news/2011/may/12/obama-propose-
plan-boost-cybersecurity/
Figure of the week
7.5 milliion The number of Facebook users estimated
by Consumer Reports magazine that are
under 13 years old. It also projects that
households spent $2.3 billion combatting
online viruses and had to replace more than
one million computers because of malicious
code.
Volume 10, Issue 18 May 13, 2011 Page 2
Health IT
EHRs Deemed 'Essential' To Pediatric
Healthcare
Electronic health records and other IT systems support
"medical home" concepts of information sharing, care coordination, and evidence-based medicine, said
American Academy of Pediatrics policy statement.
By Neil Versel, InformationWeek
The American Academy of Pediatrics (AAP) is calling electronic health records (EHRs) and other information technology "essential" to success of the medical home model of providing quality healthcare management for children. Likewise, IT systems must be able to support the goals of the medical home, according to the professional society.
"Medical home information-management systems must facilitate accurate, real-time collection, storage, retrieval, review, and communication of patient health information over time and across providers. For pediatrics, the core of such systems is a lifelong, electronic health record (EHR)," according to an AAP policy statement in the May issue of Pediatrics.
The patient-centered medical home--or, in the case of pediatrics, the family-centered medical home--is a concept that emphasizes care coordination and prevention, in which each person has an ongoing relationship with a primary care physician for health services at all stages of life. The idea is to
promote healthy behavior while also improving the quality, efficiency, and cost-effectiveness of care by automating the many repetitive tasks in healthcare and reducing redundant services such as duplicate diagnostic testing.
The AAP was among the organizations that developed this idea, along with the American Academy of Family Physicians, the American College of Physicians, and the American Osteopathic Association.
"The medical home model is the central organizing principle for healthcare management for all children, including those with special healthcare needs," said the policy statement, attributed to the AAP's Council on Clinical Information Technology.
"The medical home must centralize and support the primary-care relationship between the patient/family and healthcare provider through well-designed and well-implemented health information management," the statement continued. The technology, according to the AAP, should help pediatric practices apply the latest medical evidence in order to deliver high-quality services and coordinate care between primary and specialty providers. "To maximize the efficiency and safety of pediatric care, information systems must connect and facilitate clear communication among all partners within the care network," the council stated.
More at http://www.informationweek.com/news/healthcare/
EMR/229402846
Panel: Tech Not the Only Barrier to
Personalized Medicine
By Jessica Zigmond, ModernHealthcare.com
Several barriers are preventing the widespread use of personalized medicine, experts said Tuesday at a seminar in Washington hosted by research institute RTI International.
"The future is already here—it's only unevenly distributed," said Edward Abrahams, president of the Personalized Medicine Coalition, which represents the academic, industrial, patient, provider and payer communities. Abrahams described personalized medicine as the tailoring of medical treatments to the characteristics of each patient and said the field's movement is being driven by the public's expectation for safer, more effective drugs and faster times for a cure. He also said the goal should be to link diagnostics with therapeutics to achieve better outcomes.
Bradford Hesse, chief of the National Cancer Institute's Health Communication and Informatics Research Branch, emphasized the importance of moving data across systems and mentioned the concept of "populemics," which integrates the knowledge of molecular sciences with population sciences. Hesse said about 50% of cancer deaths could be prevented
through a variety of measures, including proper screening and personalized treatment.
During a question-and-answer period, the panelists identified the greatest challenges preventing personalized medicine from reaching its potential. Hesse said interoperability of data systems must be improved. Dr. Asif Dhar, the chief medical informatics officer at Deloitte Consulting, said there should be stronger partnerships between diagnostic and pharmaceutical companies. Abrahams cited the current regulatory and reimbursement systems as barriers to advancing personalized medicine. He called the regulatory system "unclear" and said diagnostic tests and drugs linked to diagnostic tests are less likely to be developed as reimbursement rates are pushed down. He also emphasized the need for provider education in the effort to advance patient-centered medicine. "Even when there are products on the market which represent breakthroughs, they're not necessarily likely to be used without massive marketing efforts," Abrahams said. "That's unfortunate because those marketing efforts are very expensive. So physician-healthcare provider education is very important."
More at http://bit.ly/mq8WUc
Volume 10, Issue 18 May 13, 2011 Page 3
Health IT - (cont.)
Drug Makers Replace Reps With Digital Tools
Big pharmaceutical companies have found
replacements for the army of sales representatives they've laid off in recent years:
digital sales tools that seek to sell doctors on
drugs without the intrusion of an office visit.
By Jeanne Whalen, The Wall Street Journal
Tens of thousands of pharmaceutical sales reps have been
eliminated in the U.S., creating a void that drug makers are now
increasingly filling with websites, iPad apps and other digital
tools to interact with doctors who prescribe their treatments.
Doctors can use the tools to ask questions about drugs, order free samples and find out which insurers cover certain treatments. Sometimes drug-company representatives will engage them in live chat, or phone them back if they have more questions.
The changes are designed to cut costs and to reach doctors in ways other than the traditional office visit, which many busy physicians say they find intrusive and annoying. In 2009, one of every five doctors in the U.S. was what the industry calls a "no see," meaning the doctor wouldn't meet with reps.
Just a year later, that jumped to one in four, according to Bruce Grant, senior vice president of Digitas, a digital marketing agency of Publicis Groupe SA that has created tools for companies including AstraZeneca PLC and Sanofi-Aventis SA. About three-quarters of industry visits to U.S. doctors' offices fail to result in a face-to-face meeting, he adds.
Most companies say they're using digital tools to supplement
personal sales calls, but widespread layoffs in the sector suggest
that technology is replacing, not just supplementing, human
reps.
Throughout the 1990s and early 2000s, drug companies spent
lavishly to increase their U.S. sales forces, an escalation most
companies came to regret as a burdensome arms race. Sales reps
with company cars and trunks full of free samples became a
ubiquitous, and expensive, industry symbol.
AstraZeneca set up a digital marketing group in 2009 and
substantially ramped up its work last year, says John McCarthy,
vice president of commercial strategy and operations in the U.S.
The group, which is primarily focused on marketing to health-
care providers as opposed to consumers, created "AZ
Touchpoints," a website doctors can use to ask questions, order
free samples and ask about insurance coverage. The site also
contains brochures and other "educational materials" that
doctors can print out.
Touchpoints gives doctors a number to call if they want to speak
to an AstraZeneca rep, or they can request a callback. Many of
these calls are handled by third-party contractors including TMS
Health, a call-center provider. If those reps can't answer the
doctor's questions, the call gets passed to an AstraZeneca staffer
with more scientific training, Mr. McCarthy says.
AstraZeneca, which sells the heartburn treatment Nexium and
the schizophrenia drug Seroquel, tracks what doctors view on
the site and uses that information to tailor content to the doctor
during subsequent interactions, Mr. McCarthy said.
Touchpoints has helped AstraZeneca cut its marketing costs and
"redirect our sales force to new products that need more of a
scientific discussion," he says. Last year, AstraZeneca said it
planned to eliminate 10,400 jobs by 2014, including thousands
of sales positions in Western markets. The company said the
cuts, amounting to about 16% of its work force, would help it
save $1.9 billion a year by 2014.
Many other drug giants are slashing their sales forces and experimenting with digital marketing. Sanofi-Aventis has www.ipractice.com, which offers services and information similar to AstraZeneca's Touchpoints, and Merck & Co. has www.merckservices.com.
Digital marketing isn't always as successful as the human variety. Mr. McCarthy says the websites aren't ultimately as "effective as having someone in the office."
When German drug maker Boehringer Ingelheim GmbH
launched the cardiovascular drug Pradaxa in the U.S., it put
together a digital-marketing package to target doctors, including
organizing webcasts for leading physicians to speak to other
physicians about the drug.
More at http://on.wsj.com/l02yHz
Volume 10, Issue 18 May 13, 2011 Page 4
Privacy and Security
Security Pros Launch Cybersecurity Index
By Robert Lemos, CSO, for NetworkWorld
Are attacks up, spending on network defenses down, or national hacking on the rise? The Index of Cybersecurity could help indicate the general trend in the risks to corporate networks and information in the future.
The index, launched by two security professionals, is a survey that attempts to gauge the state of cybersecurity by measuring the overall sentiment of operational experts. Much like the consumer confidence index that measures U.S. citizen's optimism of their economic future, the index focuses on experts' overall perception of current threats and defenses.
The index is an experiment that could prove to be a useful way to gauge the overall security situation online, says Dan Geer, the co-creator of the index and the chief security officer of In-Q-Tel, the investment arm of the Central Intelligence Agency. While Geer has attempted to create other indices based on measures of threat, good data was not always available, he said.
"It is not like we are overwhelmed with useful numbers; we are short on them," he says. His conclusion: Focus on the data that you know you can get.
"Maybe we shouldn't be trying to measure the concrete, but trying to measure the opinion of people who know something," he says. "Because it may well be that the opinion of people that
know something may have more coherence than anything we know how to measure, or have the permission to measure, on a wide scale."
The cybersecurity index measures the outlook of 300 or so security operations managers -- from chief risk officers and chief security information officers to academicians and security firm chief scientists. The index measures their responses over time. Questions vary from whether certain threats--such as malware, insider threats, or industrial espionage--have become worse to whether information sharing and defenses have improved. Each respondent answers on a five-point scale: falling fast, falling, static, rising, or rising fast.
Geer and co-creator Mukul Pareek, a risk professional who asked that his company not be identified, believe that the cybersecurity risk index could have practical uses. Cyber risk insurers could use the metric as a way to hedge their risks, for example.
"This is something that we do not have an answer to yet," Pakeet says. "But it is clearly at the top of our minds, we are thinking about it. In the coming months, we should come up with some ideas" about how to use the index.
In April, the index rose to 1,021.6, up 2 percent from the March baseline of 1,000, indicating that experts' perception of the cybersecurity situation has worsened.
More at http://bit.ly/kQrEWa
Domestic Surveillance Court Approved 100% of
2010 Warrant Requests
By David Kravets, wired.com
The secretive Foreign Intelligence Surveillance Court approved all 1,506 government requests to electronically monitor suspected ―agents‖ of a foreign power or terrorists on US soil last year, according to a Justice Department report released via the Freedom of Information Act.
The two-page report, which shows about a 13 percent increase in the number of applications for electronic surveillance between 2009 and 2010, was obtained by the Federation of American Scientists and published Friday.
―The FISC did not deny any applications in whole, or in part,‖ according to the April 19 report to Sen. Majority Leader Harry Reid, (D-NV.)
The 11-member court denied two of 1,329 applications for domestic-intelligence surveillance in 2009. The FBI is the primary agency making those requests.
Whether the FISA court, whose business is conducted behind closed doors, is rubber stamping the requests is a matter of debate.
―That‘s been a traditional concern that the court might have become a rubber stamp and that its approval is only a formality,‖ Steven Aftergood, the director of the Project on Government Secrecy for the Federation of American Scientists, said in a telephone interview.
―The government‘s argument, and it‘s also an argument that has been made occasionally by the judges, is in fact that the Justice Department has grasped the court‘s expectations so well that the only applications they submit to the court are ones that are likely to meet its approval.‖
The court, set up in 1978, issues warrants for domestic surveillance that are unlike the warrants issued in criminal investigations.
The secret court warrants, under the authority of the Foreign Intelligence Surveillance Act, grant the government broad authority to secretly monitor the electronic communications of persons in the United States, generally for intelligence purposes only.
The targets of a FISA warrant may never learn of the surveillance. Whereas subjects of non-FISA warrants may challenge the warrants and evidence gathered if it is used in a criminal prosecution.
More at http://bit.ly/j6hBMZ
Volume 10, Issue 18 May 13, 2011 Page 5
Privacy and Security - (cont.)
Facebook Applications Accidentally Leaking
Access to Third Parties
By Nishant Doshi, Symantec Connect
Third parties, in particular advertisers, have accidentally had access to Facebook users‘ accounts including profiles, photographs, chat, and also had the ability to post messages and mine personal information. Fortunately, these third-parties may not have realized their ability to access this information. We have reported this issue to Facebook, who has taken corrective action to help eliminate this issue.
Facebook applications are Web applications that are integrated onto the Facebook platform. According to Facebook, 20 million Facebook applications are installed every day.
Symantec has discovered that in certain cases, Facebook IFRAME applications inadvertently leaked access tokens to third parties like advertisers or analytic platforms.
We estimate that as of April 2011, close to 100,000 applications were enabling this leakage. We estimate that over the years, hundreds of thousands of applications may have inadvertently leaked millions of access tokens to third parties.
Access tokens are like ‗spare keys‘ granted by you to the
Facebook application. Applications can use these tokens or keys
to perform certain actions on behalf of the user or to access the
user‘s profile.
Each token or ‗spare key‘ is associated with a select set of
permissions, like reading your wall, accessing your friend‘s
profile, posting to your wall, etc.
By default, most access tokens expire after a short time, however the application can request offline access tokens which allow them to use these tokens until you change your password, even when you aren‘t logged in.
How does the access token get leaked?
By default, Facebook now uses OAUTH2.0 for authentication. However, older authentication schemes are still supported and used by hundreds of thousands of applications.
When a user visits apps.Facebook.com/appname , Facebook first sends the application a limited amount of non-identifiable information about the user, such as their country, locale and age bracket. Using this information, the application can personalize the page.
Needless to say, the repercussions of this access token leakage are seen far and wide. Facebook was notified of this issue and has confirmed this leakage. Facebook notified us of changes on their end to prevent these tokens from getting leaked.
There is no good way to estimate how many access tokens have already been leaked since the release Facebook applications back in 2007.
More at http://bit.ly/lt5v1K
Apple and Google Defend Their Handling of
Data
Congressional testimony centers around what
"location" really means, and who's responsible for how apps behave.
By Erica Naone, HealthLeaders Media
Apple and Google are scrambling to regain trust after revelations about the way smart phones and tablets handle users' location data.
In a U.S. Senate subcommittee hearing held today, representatives from Apple and Google stressed that their companies had streamlined and clarified their handling of location-based data. But a key unanswered question is how they'll let third-party app providers share that information.
The problem is that users enjoy location-based services, but most don't understand what happens to the data they share in exchange for using those services. Senators wondered if location data was being stored securely enough to protect users.
They pointed to the lack of privacy policies for many mobile
apps, and noted that even when users are aware of what happens to their data, they may find it difficult to control.
For example, until Apple's update to iOS last week, someone who opted out of location services wasn't actually turning off all of his device's location-based sharing. Apple said the problem was due to a bug that has since been corrected.
Guy "Bud" Tribble, vice president of software technology for
Apple, testified that "Apple does not track customers' locations.
Apple has never done so and has no plans to do so."
Tribble said that the location information found on phones
represented a portion of a crowd-sourced database that Apple
maintains in order to process location information more rapidly
than is possible through GPS alone.
The company stores the locations of cell towers and Wi-Fi hot
spots collected from millions of devices. User devices note which
towers and hot spots they can connect to, and use that to quickly
deduce location. He said that the information stored on iPhones
was never a user's location.
More at http://www.technologyreview.com/computing/37554/?
nlid=4459&a=f
Volume 10, Issue 18 May 13, 2011 Page 6
Information Sharing
U.S. Intelligence Connects The Dots On Bin
Laden
Intelligence agencies are leveraging new
surveillance technologies and IT architectures to facilitate information sharing in their anti-
terrorism and other national security efforts.
By John Foley, InformationWeek
A bullet killed Osama bin Laden, but U.S. intelligence is what
did him in.
The counterterrorism mission that caught up to al Qaeda's
leader was a multi-agency intelligence effort that, for a change,
worked as planned. The CIA, the National Geospatial-
Intelligence Agency (NGA), the National Security Agency (NSA),
and the Office of the Director of National Intelligence all played
a part. James Clapper, the U.S. director of national intelligence,
called their work "a more remarkable example of focused
integration, seamless collaboration, and sheer professional
magnificence."
That's a 180-degree turnaround from what the nation's spy
agencies, under intense pressure since their failings on 9/11,
have been hearing for much of the past decade. The attempted
bombing of Northwest Airlines flight 253, en route from
Amsterdam to Detroit, on Dec. 25, 2009, showed that gaping
intelligence holes still existed. President Obama fumed that the
incident was "totally unacceptable." And the embarrassing leak
of Department of Defense and State Department documents via
Wikileaks showed that the feds couldn't protect their own
databases, let alone U.S. citizens.
So the elimination of the world's most-dangerous terrorist is a
much-needed proof point that the U.S. Intelligence Community
(IC) -- comprising the four agencies involved in the bin Laden
mission and a dozen others -- is up to the monumental security
challenges facing our nation. While details are still emerging on
the intelligence that led to bin Laden, the foundation has been
laid by IC member agencies over the past few years in the form
of new surveillance, analysis, and information-sharing
capabilities.
Of the $80 billion that the IC spent on intelligence operations in fiscal 2010, $27 billion went to military intelligence -- the Defense Intelligence Agency, for example -- and the balance to non-military intelligence agencies such as the CIA and FBI. One takeaway from the Navy SEAL's successful raid on bin Laden‘s Pakistan hideout is that it was a joint effort between non-military U.S. intelligence agencies and the Pentagon. "This operation was the best of both worlds," Army Lt. Col. Tony Schaffer told Fox News.
More at http://bit.ly/kIboTw
Intelligence Fusion Got bin Laden
By Stephen Losey, Federal Times
The daring raid that killed Osama bin Laden represents a
triumph for thousands of anonymous federal intelligence
employees, and a validation for scores of reforms made to the
battered intelligence community over the last decade.
The government's inability to prevent the Sept. 11 attacks,
accurately assess Iraq's weapons of mass destruction
capability, and stop the failed Christmas Day underwear
bomber in 2009 drew harsh criticism and prompted drastic
overhauls of the nation's intelligence operations.
The government created an Office of the Director of National
Intelligence (ODNI) to oversee all 16 intelligence agencies,
rebuilt the analyst workforce that withered during the post-
Cold War 1990s, recruited operators and analysts with crucial
Middle Eastern language skills and cultural knowledge, and
broke down walls — both cultural and structural — that kept
agencies from sharing vital information with one another.
As details of the mission in Abbottabad, Pakistan, emerged last
week, several former and current intelligence officials told
Federal Times that those reforms are now yielding big returns.
"This is the cumulative effect of a lot of small, medium and big
things," said a former senior intelligence official who asked
that his name not be printed.
"But at the end of the day, it's a lot of small things, like the
emphasis on collaboration — squishy as that may be — that
ultimately changes the way people behave and the way
organizations perform."
The 9/11 commission concluded that intelligence agencies'
deep cultural resistance to sharing information with one
another contributed to their failure to uncover that terrorist
plot.
But now, several agencies worked together to collect and
analyze the data identifying the Abbottabad compound, and
support the commandos that stormed it on May 2, local
Pakistan time. Experts say this demonstrates that intelligence
agencies are capable of effectively cooperating with one
another.
More at http://www.federaltimes.com/article/20110509/
Volume 10, Issue 18 May 13, 2011 Page 7
Points of View
Robert Vamosi: Gadgets Degrade Our
Common Sense
By Shelley Portet, Silicon.com
Interview
In a world where gadgets are growing more sophisticated,
human behavior is changing - and not in a good way.
That is what Robert Vamosi, author of When Gadgets Betray
Us argues in his book, which examines the dangers of our
growing dependence on technology.
As gadgets develop the ability to multitask seemingly endless
functions, Vamosi argues that people are increasingly unable
to think for themselves.
"Instead of lifting our heads, looking around and thinking for
ourselves," Vamosi writes, some of us no longer see the world
as human beings have for thousands of years and simply
accept whatever our gadgets show us.
He documents how one woman narrowly missed being hit by a
train after she followed sat-nav directions over a railway track.
While she got out of her car to open the level-crossing gate, a
speeding train drove straight through her vehicle. While this
may be an extreme case, Vamosi argues that we are developing
a culture of dependence on technology to the detriment of our
common sense.
Take the keyless car-locking systems fitted in many modern
cars.
"With gadgets we believe that a new technology - such as anti-
theft circuitry in our cars - somehow trumps all the real-world
experience we've gained over the years," Vamosi writes.
"Instead, we should be layering our defenses - such as parking
in well-lit spaces, using a physical lock on the steering wheel or
brake pedal and applying anti-theft technology - adding rather
than subtracting security."
Vamosi told silicon.com that people take comfort in the
beeping sound of the anti-theft car-locking system and in the
flashing light on the dashboard.
"We think that security has all been taken care of. But you're
never ever going to be able to keep the bad guy out," he said.
"You just have to make it really hard for them to get in so they
give up and walk away and try somebody else - so layering
security is really important."
More at http://bit.ly/mogxiq
Facebook Could Be Planning a Visual
Dashboard of Your Life
The data entered by millions of social-network users
could be turned into revealing infographics.
By Christopher Mims, Technology Review
Ever wondered just how much coffee you drank last year, or
which movies you saw, and when? New Web and mobile apps
make it possible to track, and visualize, this personal
information graphically, and the trend could be set to expand
dramatically.
This is because Facebook recently acquired one of the leading
personal-data-tracking mobile apps and hired its creators. The
social-networking giant could be gearing up to offer users ways
to chart the minutiae of their lives with personalized
infographics.
Nick Felton and Ryan Case, two New York-based designers,
have pioneered turning the mundane contours of an everyday
life into a kind of visual narrative. Each year, Felton publishes
an "annual report" on his own life: an infographic that charts
out his habits and lifestyle in great detail.
Felton and Case have also created a mobile app, called
Daytum, that lets users gather personal data and represent it
using infographics.
Daytum already has 80,000 users, whose pages provide a
detailed snapshot of everything from coffee drinking habits to
baseball stadium visits. The app gives users the ability to easily
record their own information, whatever it might be, and
display it in an attractive manner, whether or not they are a
designer.
Daytum is part of a larger trend in tracking personal
information. But traditional personal tracking applications
tend to revolve around medical data, sleep schedules, and the
like. In Felton's creative visualizations, even something as
mundane as how many concerts he attended in the past year
becomes a kind of art. "I think there's storytelling potential in
data," he says.
More at http://bit.ly/lvTNn4
Volume 10, Issue 18 May 13, 2011 Page 8
Points of View - (cont.)
Balance of Better Care, Privacy in Federal
ACO Proposal
By Helen Pfister & Susan Ingargiola, Manatt Health Solutions
CMS, estimating that one-and-a-half to four million Medicare
beneficiaries will receive care from health care providers
participating in accountable care organizations within the
program's first three years, is proposing to provide ACOs with
Medicare claims and other data under the Medicare Shared
Savings Program, authorized under the Affordable Care Act.
The agency's proposal to share Medicare data with ACOs
reflects the important role of health information in health care
delivery reform, and has important implications for patient
privacy.
The MSSP is designed to restructure the way Medicare
beneficiaries' health care is organized and incentivized,
resulting in the three-part aim of better care for individuals,
better health for populations and lower growth in
expenditures.
Under the program, health care providers would join together
to create ACOs that would take responsibility for improving
the quality of care and lowering the costs of a group of at least
5,000 beneficiaries. To succeed, ACOs will have to coordinate
their beneficiaries' care, an activity that will require investment
in health IT infrastructure and redesigned care processes.
Central to ACOs' efforts will be access to information about
their beneficiaries' health and health care, on which they can
base quality assessment and improvement, population health
and provider performance evaluation activities.
While CMS intends for ACOs to independently produce much
of the data to perform these activities, the agency recognizes
that it has a wealth of information -- including data about the
services and supplies that beneficiaries receive from health
care providers within and outside the ACO -- that can help
ACOs understand the totality of care provided to their
beneficiaries.
By proposing to give this information to ACOs, CMS is taking
an important step forward to make valuable Medicare data
more widely available for quality and efficiency improvement
purposes.
More at http://buswk.co/ikcSuM
iPhone Can Diagnose Stroke Quickly,
Accurately
By Healthcare IT News Staff
Doctors can make a stroke diagnosis using an iPhone
application with the same accuracy as if they use a medical
computer workstation, according to new research from the
University of Calgary's Faculty of Medicine.
Researchers say this technology can be particularly useful in
rural medical settings. This allows for real-time access to
specialists such as neurologists, regardless of where the
physicians and patients are located. Neuro-radiologists in the
study looked at 120 recent consecutive noncontrast computed
tomography (NCCT) brain scans and 70 computed tomography
angiogram (CTA) head scans that were obtained from the
Calgary Stroke Program database. Scans were read by two
neuro-radiologists, on a medical diagnostic workstation and on
an iPhone. The research is published in the May 6th edition of
Journal of Medical Internet Research. The study was designed
by Dr. Mayank Goyal, and involved the iPhone software
technology originally developed by Dr. Ross Mitchell, PhD, and
his team at the Hotchkiss Brain Institute (HBI), then further
enhanced and commercialized by Calgary Scientific Inc.
"This iPhone app allows for advanced visualization and our
studies show it is between 94 percent and 100 percent
accurate, compared to a medical workstation, for diagnosing
acute stroke," says Mitchell who is from the University of
Calgary's Faculty of Medicine. "In a medical emergency,
medical imaging plays a critical role in diagnosis and
treatment, time is critical in acute stroke care, every minute
counts."
Fellow HBI member, Dr. Mayank Goyal who is also the
director of research in the department of radiology and one of
the neuro-radiologists in the study who analyzed the data.
"Time is critical for diagnosing stroke and starting treatment.
There are definitely benefits for doctors to have the ability to
analyze and diagnose these images from virtually anywhere.
We were pleasantly surprised at our ability to detect subtle
findings on the CT scan, which are often very critical in patient
management, using this software," he says.
More at http://bit.ly/mBZjG9
Volume 10, Issue 18 May 13, 2011 Page 9
Points of View - (cont.)
Why the „Vast Wasteland‟ Speech Was a
Failure
By Aaron Barnhart, The Kansas City Star
Fifty years ago this week, Newton N. Minow delivered one of
the most electrifying speeches ever given by a bureaucrat of the
U.S. government.
Minow, a Chicago lawyer and backer of John F. Kennedy, was
the new president‘s appointee to head the Federal
Communications Commission, or FCC.
At his coming-out address — May 9, 1961, at the National
Association of Broadcasters‘ annual convention — he lectured
TV executives about using the airwaves to print money without
giving back anything of value to the public.
Everyone remembers the two words that entered the cultural
lexicon afterward: ―vast wasteland.‖
But few remember why Minow‘s sermonette caused such a
sensation at the time. Even fewer can recall the sweeping
promises the FCC chairman made in that speech or that he
failed to deliver on any of them.
―Yours is a most honorable profession,‖ he began. ―Anyone in
the broadcasting business has a tough row to hoe.‖
The compliments ended there. The TV industry raked in huge
profits in 1960, Minow noted, ―despite a recession throughout
the country.‖
That profit, he added, was achieved with public property. After
all, we the people license the airwaves to broadcasters to serve
―the public interest, convenience and necessity,‖ as stated in
the 1934 Telecommunications Act that created the FCC.
Regarding that ―public interest,‖ Minow told the TV station
owners, they were failing.
―I invite each of you to sit down in front of your television set
when your station goes on the air and stay there, for a day,
without a book, without a magazine, without a newspaper,
without a profit-and-loss sheet or a rating book to distract
you,‖ he said. ―I can assure you that what you will observe is a
vast wasteland.‖
Minow then surveyed that ―vast wasteland‖: the violent
Westerns, the aggressive commercials, the mindless soaps,
game shows and kids TV … on and on as his hearers shifted in
their seats.
More at http://bit.ly/j6pYro
Pentagon‟s Failure to Share Biometric Data
Prevents DHS and FBI from Identifying
Terrorists
Pentagon uses biometric devices that aren't
compatible with FBI, DHS
By Laurel Adams, iWatch News
The Department of Homeland Security, FBI and Pentagon all
rely on biometric data—face, fingerprint, iris, palm and
fingerprint records—to identify criminals, terrorists and
national security threats.
But the Pentagon‘s failure to adopt uniform standards for
information sharing means that data on criminals and
terrorists could fail to reach agencies that could prevent them
from getting into the United States.
Biometric systems are used by the military in both Iraq and
Afghanistan to screen non-U.S. people to protect U.S. soldiers.
In 2007, DOD said it would begin sharing its unclassified
biometric information with departments that have counter-
terrorism missions. To do so, DOD adopted standards for its
biometric data collection to facilitate information sharing with
other agencies.
A review by the Government Accountability Office found that
the Pentagon has not applied its own standards thoroughly.
The Army‘s primary collection device in Iraq and Afghanistan
does not adhere to the standards, and as a result, cannot share
information with federal agencies like the FBI and DHS. This
device alone accounts for 13 percent of the 4.8 million
biometric records maintained by DOD.
The Pentagon said it is in the process of updating the
standards again but it has no process or timeline for
implementing the changes. It has not communicated its plans
for the new standards to other agencies, which makes it
difficult for them to purchase compatible biometric devices.
―DOD limits its, and federal partners‘ ability, to identify
potential criminals or terrorists who have biometric records in
other federal systems,‖ the GAO report said.
More at http://bit.ly/lMPG85
Volume 10, Issue 18 May 13, 2011 Page 10
Points of View - (cont.)
The Distribution Democracy and the Future
of Media
By Om Malik, GigaOm
A few hours ago, a friend of mine emailed me, lamenting a
story that CNN was passing off as breaking news, even though
it was far from being either news or newsworthy.
His displeasure reminded me of a conversation I had with
serial entrepreneur and startup guru Steve Blank when he
came to my office to tape an interview. As we sat there waiting
for the cameras to roll, we talked about what media is in this
post-broadband, always-on world.
I told Steve that the problem with most media companies is
they define themselves by the product they hawk. Music
television, CNN, Breaking News, The New York Times, The
Wall Street Journal, ESPN or whatever — these are all
products that define the media companies behind them.
And therein lies the problem. Unless media corporations stop
defining themselves by their products, they are going to be
unable to navigate the big shift that is changing the rules of the
game — what I call the ―democratization of distribution.‖
Let‘s talk about the television business for a minute. During
the early days of television, access to spectrum determined
who owned and operated the networks. CBS and ABC became
the gatekeepers of attention — whether it was through 60
Minutes, Wide World of Sports or some other such program.
Hit programs essentially ensured that viewers ―attention‖
switched from one channel to another, and with it, the
advertising dollars.
Then came analog cable and we saw the emergence of more
media entities — for example, HBO, ESPN and CNN — which
siphoned away attention from broadcast networks to all these
new entities. With digital cable, attention got sliced and diced
even more, but still the scarcity of ―spectrum‖ inside the cable
network pipes meant that there was finite amount of channels
available.
Then came broadband, which essentially removed any channel
scarcity. The distribution, which had been in the hands of a few
large media conglomerates, was suddenly available to
everyone.
Today anyone, even talentless acts such as Rebeca Black can
upload their video to YouTube and become instant celebrities.
Justin Bieber, too, is a product of this channel-less revolution.
More at http://bit.ly/mAsD5j
The End Of The Destination Web And The
Revival Of The Information Economy
By Brian Solis, Fast Company
In recent weeks journalism and the future of all media have
once again gone under the knife. Experts on either side of new
media debated whether or not Twitter's CNN moment truly
was indicative of the future of journalism. Twitter's role in the
spread of online dialogue speculating the death of Osama Bin
Laden was studied at great depths to better understand when
and where news actually surfaces, how it's validated, and how
news travels across the Web and in real life. Perhaps nothing
visualized the power of a single Tweet with such dramatic
effect as the network graph developed by SocialFlow.
Twitter is becoming a veritable human seismograph as it
measures and records events as they unfold. But for this
discussion, I'd like to focus not on the future of journalism, but
instead on human behavior and the reality of the social effect.
In doing so, we will identify the click paths and the sharing
patterns of the informed and connected to learn how to design
vibrant information exchanges on the traditional Web as well
as in social networks.
The End of the Destination Web and the Revival of the
Information Economy
In hindsight, the days of Web 1.0 seem like an era long gone. I
think back to the early days of the Web and I struggle to think
about what fashion, cars and popular music thrived as the Web
radically transformed the then information economy. It's as
distant as the behavior that embraced it.
For many, Web 1.0 was empowering. But to access
information, we were reliant on our willingness to visit
desirable websites for insight, entertainment, and news. Home
pages, bookmarks and email subscriptions helped people
manage the information overload that overwhelmed
consumers with so much great content. Over the years, portals
helped us manage the content by aggregating content from the
sites and topics we preferred. We were then gifted with RSS
feeds and readers to enhance the way relevant information found us.
More at http://bit.ly/iXOI67
Volume 10, Issue 18 May 13, 2011 Page 11
Points of View - (cont.)
Healthcare IT Roadmap: Starting Small,
Scaling for Growth
By Mansoor Kahn, Diagnosis One
On March 31, The Centers for Medicare & Medicaid Services
(CMS) proposed new regulations for Accountable Care
Organizations (ACOs). While they are complex – and in excess
of 400 pages in length – it is clear that technology will play a
significant role in implementing ACOs.
Institutions already creating ACOs have begun implementing
electronic medical records (EMRs) and ancillary
documentation solutions. However, for the multiple stages of
meaningful use requirements, hospitals and provider groups
must begin the process of integrating substantive population,
provider, panel, patient, and problem area-analytics into their
planning processes and workflows.
As providers assume greater financial responsibility for patient
health outcomes, and they push to execute on the objectives of
error reduction, standardization and improved coordination,
the need for a stronger technology backbone that helps
manage a population and individual patients is even greater
than ever before.
Throughout the process, it is critical to examine scalable
approaches for applying analytics to these processes to
improve patient care through patient-driven order sets,
automation reminders, and/or personalized patient education
materials.
Clinical IT needs at an ACO
Going forward, if healthcare systems are to successfully
execute on the above-mentioned objectives of error reduction,
standardization, and improved coordination, they will require
additional information technologies (IT). In general, two sets
of technologies are needed. First, systems are required to
capture, standardize and structure health information and
transactions. Representative solutions include EMRs, Picture
Archiving and Communication systems (PACS), and
Computerized Physician Order Entry (CPOE). These solutions
serve as the informatics backbone- making data available in
more places, removing the known errors associated with the
absence or miscommunication of information, and helping to
increase clinician productivity.
The second set of solutions is analytics and clinical decision
support. These systems interpret longitudinal data to inform
care providers and health system planners.
More at http://zd.net/mlEXbx
4 Trends Shaping the Emerging
“Superfluid” Economy
By Venessa Miemis , emergent by design
Humanity and technology continue to co-evolve at an ever
increasing pace, leaving traditional institutions (and mindsets)
calcified and out of date.
A new paradigm is emerging, where everything is increasingly
connected and the nature of collaboration, business and work
are all being reshaped. In turn, our ideas about society, culture,
geographic boundaries and governance are being forced to
adapt to a new reality.
While some fear the loss of control associated with these shifts,
others are exhilarated by the new forms of connectivity and
commerce that they imply. Transactions and interactions are
growing faster and more frictionless, giving birth to what I call
a ―superfluid‖ economy.
Business will not return to usual. So let‘s discuss 4 key
concepts to help us better understand the shifts that are
underway:
1. Quantifying and mapping everything
Technological acceleration isn‘t just a phrase. Whether looked
at through the lens of the Law of Accelerating Returns or the
trend described as Moore‘s Law, computing capabilities
continue to increase exponentially. Our devices are becoming
smaller yet more powerful. Cost continues to drop.
This may lead to technologies becoming so tiny that they
simply fade into the background experience of our lives.
So what? What is the purpose of faster, more powerful
technology? What are we trying to accomplish?
Think about it this way: The whole of human history has been
spent trying to understand ourselves, our environment and
what it all means. Whereas a guru might advise ―Know
thyself,‖ a technologist might suggest ―Quantify thyself.‖
Technology tackles the challenge of self knowledge through the
pursuit of full-systems quantification - creating a simulation
and map of everything.
More at http://bit.ly/lfRUMJ
Volume 10, Issue 18 May 13, 2011 Page 12
Points of View - (cont.)
Technology: A Binary Goldmine
By Richard Walters, Financial Times
Displaying up-to-the-minute information on everything from
train times to cinema schedules, apps have in short order
become a ubiquitous feature of smartphones. To most users,
they are simply useful and entertaining tools.
As well as providing users with information, however, these
mobile software applications are also insatiable data-gatherers.
Even the most mundane apps often collect a surprising
amount from handsets just to do their jobs.
This has put them at the forefront of a fast-evolving science
based on the business use of consumer data. If there is
commercial advantage to be gained, it seems, almost nothing is
too insignificant to be collected and analysed.
Take an app launched recently by Color, one of the most
ambitious and best financed of the crop of start-ups that has
sprung up in Silicon Valley to cash in on the smartphone
boom.
Pictures taken by users are mixed into streams with those
taken by others who are nearby, or with whom users are often
in contact, building ad hoc social networks.
The software taps deeply into handsets, drawing on
components such as Global Positioning System chips,
gyroscopes and accelerometers to pinpoint where they are,
how fast they are moving and which way up they are being
held.
The lighting conditions in pictures taken with the gadgets,
along with the digital ―fingerprints‖ of surrounding noises
coming through their microphones, provides other useful
crumbs of information.
Thus informed, Color can work out precisely who the user is
walking down the street with, says Bill Nguyen, the serial
entrepreneur behind the company.
Such innovations are the tip of a data iceberg. Smartphones,
social networks and other accoutrements of modern digital life
are generating vast new data sets that are revving up the digital
economy.
Accompanying all this is a trend that has given the technology
lexicon a new term: big data. Rather than sampling only small
parts of the digital data deluge, modern companies have a new
option: they can study all of it.
The ability to capture and analyse this mass of information is
throwing up business ideas and altering the relationship
between businesses and their customers.
It is also stoking simmering privacy concerns. When Steve
Jobs, Apple chief executive, was forced to apologise last week
over the handling of data about the location of iPhone and iPad
owners, it touched a raw public nerve and resulted in
immediate Congressional hearings in Washington.
Color says it plans to use the information it collects to create
new services for its customers.
By combining it with data from social networks, says DJ Patil,
chief product officer, it can tell its users: ―Here are people who
are near you, and here is how you might know them.‖ He says
the company has no plans, at least for now, to use the
information for other purposes, such as sending targeted
advertising to customers.
However, with the tide of digital information rising fast – and
more sophisticated ways being found to make business use of
it – many companies are already being drawn into the new
world of sophisticated data collection and analysis.
Some are using it to tailor their own products more precisely to
the preferences of their users; others to target advertising of
their products more accurately. Some are also selling the data
they gather from their customers to the brokers and
aggregators who act as middlemen in data markets that have
sprung up to recycle such information.
A new consensus is needed to govern the use of this
increasingly valuable commodity, says Michele Luzi of
management consultancy Bain & Company, which conducted a
study for the World Economic Forum on the issue.
More at http://on.ft.com/iV6mGf
Page 13 Volume 10, Issue 18 May 13, 2011
New Reports and Papers
The Consumer Platform for Health IT
Advancing Patient and Family Engagement Through
Techonology
By Staff Writer, Consumer Partnership for eHealth
Members of the Consumer Partnership for eHealth (CPeH)
have been working for more than five years to advance patient-
centered, consumer-focused health IT (information
technology).
We believe our nation is at a pivotal moment for transforming
our health care system with the support of better information.
This platform outlines a vision for how health IT can help
patients, and how consumer groups can work alongside other
stakeholders to improve health outcomes.
Consumers are the most significant untapped resource in
health care. We are eager to be partners in advancing and
using technology — which empowers us in so many areas of
our lives — to participate more actively in matters of health. As
we move toward new care delivery and payment models, the
collection and sharing of information with all stakeholders,
and especially consumers, will be paramount.
Health IT is a critical enabler of the kind of information
Digital Agenda: eHealth Survey Shows Most
Hospitals Online but Telemedicine Services
Not Fully Deployed
By RAPID Press Release Service
More than 90% of European hospitals are connected to
broadband, 80% have electronic patient record systems, but
only 4% of hospitals grant patients online access to their
electronic records, according to the results of a survey
conducted for the European Commission.
European hospitals are more advanced than US hospitals in
terms of external medical exchange, but they lag behind in
using eHealth to view laboratory reports or radiology images.
The survey provides useful data for the work of the EU eHealth
Task Force on assessing the role of information and
communications technologies (ICT) in health and social care,
which is due to suggest ways for ICT to speed up innovation in
healthcare to the benefit of patients, carers and the healthcare
sector.
The EU eHealth Task Force met for the first time in Budapest
on 10th May on the margins of eHealth week (10-12 May)
The deployment of eHealth technologies in Europe, with a view
to improving the quality of health care, reducing medical costs
and fostering independent living for those needing care, is a
key objective of the Digital Agenda for Europe, which for
example sets a 2015 deadline for giving patients online access
to their medical data.
eHealth applications have a growing role in Europe's hospitals,
according to the survey but there are still wide variations in
take-up, with Nordic countries taking the lead.
Large, public and university hospitals are generally more
advanced in eHealth terms than smaller, private ones.
The survey data was collected from 906 general public, private
or university hospitals.
The survey was carried out in 2010 in all 27 EU Member
States, plus Croatia, Iceland, and Norway.
More at http://bit.ly/mIAvnA
sharing that is crucial for continuously improving
the health of individuals and populations, as well as the nation.
Achieving better care, healthier communities, and more
affordability will require the utilization of all our collective
resources, and consumers have critical assets to bring to policy
making tables and to individual decision-making processes.
By involving consumers actively in the policy-making process,
they are able to contribute critical information and potential
solutions that other stakeholders might never consider. As a
result, consumers participating at the policy level become
invested in new approaches and will help ensure their success.
Full engagement of consumers in leadership and decision-
making roles at the policy and governance levels is essential,
not just for gaining their trust and buy-in, but also for
maximizing the likelihood of meeting patient and consumer
needs.
When we think about a truly patient-centered health care
system, we expect that:
Clinical information and information contributed by the
individual is used to provide holistic care.
More at http://bit.ly/kfXTi9
Volume 10, Issue 18 May 13, 2011 Page 14
Reports and Papers - (cont.)
Docs Say e-Prescribing Too Much Effort
By Mary Mosquera, Government Health IT
Many physicians view electronic prescribing systems as
awkward and the information unreliable so they are reluctant
to use them.
If physicians believe that these tools are not worth the extra
effort, then providers miss out on access to important patient
information that could reduce medication errors.
For example, these systems can list medications prescribed by
other providers. This and other e-prescribing features have the
potential to improve care coordination and pharmacy
efficiency.
E-prescribing systems supply formulary information that can
help to decrease insured patients‘ drug costs, according to a
study released May 5 by the Agency for Healthcare Research
and Quality.
While most of the practices said they already had information
about formulary, the list of generic and brand name
prescription drugs approved by a health plan, from other
sources, only about half had access to their patients‘
medication histories.
The report studied 24 physician practices using e-prescribing
systems.
The providers said that the electronic tools to view and use the
patient information were cumbersome in some systems and
the data not always relevant enough for them to expend the
extra effort.
Among the recommendations, the report called for increased
health insurer and Medicaid program participation in e-
prescribing as Medicare already does, along with more
accurate and complete medication history and formulary
information to make systems more valuable to physicians.
Also, public and private efforts to develop and establish
additional technical standards and standardizing drug names
should accelerate e-prescribing.
For example, RxNorm, a technical standard for medication
names, can help e-prescribing vendors reconcile medication
histories from multiple sources.
The Center for Studying Health System Change, prepared the
report, Experiences of Physician Practices Using E-
Prescribing: Access to Information to Improve Prescribing
Decisions, for AHRQ, an agency of the Health and Human
Services Department.
More at http://bit.ly/ikhkTT
Most California Docs Using EHRs: Report
By Joseph Conn, Modern Healthcare
A majority (55%) of California primary-care physicians now
use electronic health-record systems, according to a new report
(PDF) from the California HealthCare Foundation.
The 41-page report, "The State of Health Information
Technology in California," also showed, as has been found in
similar surveys, that when it comes to IT adoption, the size of a
physician practice matters.
For example, just 20% of solo practitioners have adopted an
EHR, compared with 39% of practices with two to five
physicians, 64% of groups with between six and 50 doctors,
and 80% of groups that have 51 or more physicians. For all
medical specialties and practice sizes, 48% of physicians in
California have implemented EHR systems, according to the
foundation.
Lesser forms of computerized assistance are in wider use at
California practices: More than seven in 10 practices in the
state (72%), including a majority (58%) of solo practices, have
implemented some form of decision-support tool for diagnosis
and treatment recommendations.
Meanwhile, hospitals' use of IT varied widely by EHR
application.
For example, almost 90% of California hospitals either have or
are installing clinical decision-support systems, according to
the report, but just 40% have computerized order entry
systems. Nearly one-third (32%) of hospitals currently have an
electronic clinical documentation system in place; one-quarter
are either implementing one or are contracting to have one
built.
Thirty-six percent of hospitals have CPOE implemented in at
least one unit. A large majority—89%—of California hospitals
have an electronic lab-reporting system fully implemented in
at least one unit.
Data for the CHCF report came from seven separate sources,
including CHCF-funded research, HIMSS Analytics, the
American Hospital Association and Harris Interactive.
More at http://bit.ly/mD0Rii
Volume 10, Issue 18 May 13, 2011 Page 15
Reports and Papers - (cont.)
U.S. Healthcare IT Market to Surge
By Healthcare IT News Staff
The healthcare IT market in the U.S. is anticipated to grow at a
compound annual growth rate (CAGR) of over 24 percent
during 2012-2014, says a new report from global market
research and information analysis company RNCOS.
The U.S. healthcare IT industry has been taking huge strides
for the past few years. Currently, the U.S. healthcare IT market
is highly fragmented with local vendors, known for their legacy
systems, retaining a strong position.
As it is still at its development stage, various companies are
making hefty investments in the country.
The U.S. Healthcare IT Market Analysis report provides
extensive study of the U.S. healthcare IT market and has
included detail description of the factors driving the growth of
the industry.
Among several factors discussed in the report, consolidation of
the industry has been identified as the critical factor for the
surging revenue of the healthcare IT industry. It is also
considered important due to the fact that, it helps in
technology exchange and development of advanced and
technologically innovative healthcare services.
Mergers and acquisition activities in the healthcare IT space
will continue to be strong in coming quarters. During 2008
and Q3 - 2009, 112 mergers and acquisitions related to the
healthcare IT market were completed across the globe, major
were from the U.S.
Researchers segmented the report into IT hardware, IT
software, and IT services and includes topics such as mhealth
and ehealth.
The report also provides information of the key competitors in
the market along with their business information and areas of
expertise. It provides segment level analysis of the industry
along with the emerging trends that may shape up with the
betterment of economic conditions.
Researchers say the report will help consultants, industry
analysts and vendors get an in-depth knowledge of the current,
past and future performance of the industry.
The report also provides an extensive research on the recent
trends of the U.S. healthcare IT industry along with impartial
analysis considering the impact of financial crisis on its
performance.
More at http://bit.ly/joukgx
Law Enforcement Use of Global Positioning
(GPS) Devices to Monitor Motor Vehicles:
Fourth Amendment Considerations
By Alison Smith, Congressional Research Service
As technology continues to advance, what was once thought
novel, even a luxury, quickly becomes commonplace, even a
necessity. Global Positioning System (GPS) technology is one
such example. Generally, GPS is a satellite-based technology
that discloses the location of a given object. This technology is
used in automobiles and cell phones to provide individual
drivers with directional assistance. Just as individuals are
finding increasing applications for GPS technology, state and
federal governments are as well. State and federal law
enforcement use various forms of GPS technology to obtain
evidence in criminal investigations. For example, federal
prosecutors have used information from cellular phone service
providers that allows real-time tracking of the locations of
customers‘ cellular phones. Title III of the Omnibus Crime
Control and Safe Streets Act of 1958 (P.L. 90-351) regulates the
interception of wire, oral, and electronic communications.
As such, it does not regulate the use of GPS technology affixed
to vehicles and is beyond the scope of this report.
The increased reliance on GPS technology raises important
societal and legal considerations. Some contend that law
enforcement‘s use of such technology to track motor vehicles‘
movements provides for a safer society. Conversely, others
have voiced concerns that GPS technology could be used to
reveal information inherently private. Defendants on both the
state and federal levels are raising Fourth Amendment
constitutional challenges, asking the courts to require law
enforcement to first obtain a warrant before using GPS
technology.
Subject to a few exceptions, the Fourth Amendment of the U.S.
Constitution requires law enforcement to obtain a warrant
before conducting a search or making a seizure. Courts
continue to grapple with the specific issue of whether law
enforcement‘s use of GPS technology constitutes a search or
seizure, as well as the broader question of how the Constitution
should address advancing technology in general.
More at http://bit.ly/kje0CT
Volume 10, Issue 18 May 13, 2011 Page 16
Reports and Papers - (cont.)
Telecom Investments: The Link to U.S. Jobs
and Wages
By Michael Mandel, Progressive Fix
America‘s job drought is really America‘s capital spending
drought. As of the first quarter of 2011—a year and a half after
the recession officially ended—business capital spending in the
U.S. is still 23 percent below its long-term trend. If domestic
businesses are not expanding and investing, they are not going
to create jobs.
The weakness in domestic capital spending is both perplexing
and disturbing.
It‘s accepted wisdom that we needed to work off the
aftereffects of the housing and consumption bubbles, but very
few economists believe that the U.S. suffered from an excess of
business capital spending in the years leading up to the
financial crisis. And there‘s no sign of a credit crunch for large
businesses, which mostly seem to have access to sufficient
funds to invest if they wanted.
However, there is one important exception to the investment
drought: the communications sector.
To keep up with the communications boom and soaring
demand for mobile data, PPI estimates that telecom and
broadcasting companies have stepped up their investment in
new equipment and software by 45 percent since 2005, after
adjusting for price changes (see the chart ―Communications:
No Investment Drought‖).
By comparison, overall private real spending on nonresidential
equipment and software is only up by 6 percent over the same
stretch.
In fact, the big telecom companies head the list of the
businesses investing in America (see the table ―Investment
Heroes‖).
According to PPI‘s analysis of public documents, AT&T
reported $19.5 billion in capital spending in the U.S. in 2010,
tops among nonfinancial companies.
Next was Verizon, with $16.5 billion in domestic capital
spending in 2010. Comcast was seventh on the list, with about
$5 billion in domestic capital spending (companies such as
Google and Intel were a bit further down the list.).
More at http://bit.ly/mAzXEa
Nothing to Hide
The False Tradeoff between Privacy and Security
By Daniel J. Solove, George Washington University Law School
Abstract
"If you've got nothing to hide," many people say, "you
shouldn't worry about government surveillance." Others argue
that we must sacrifice privacy for security. But as Daniel J.
Solove argues in this book, these arguments and many others
are flawed. They are based on mistaken views about what it
means to protect privacy and the costs and benefits of doing
so.
In addition to attacking the "Nothing-to Hide Argument,"
Solove exposes the fallacies of pro-security arguments that
have often been used to justify government surveillance and
data mining.
These arguments - such as the "Luddite Argument,"the "War-
Powers Argument," the "All-or-Nothing Argument," the
"Suspicionless-Searches Argument," the "Deference
Argument," and the "Pendulum Argument" - have skewed law
and policy to favor security at the expense of privacy.
The debate between privacy and security has been framed
incorrectly as a zero-sum game in which we are forced to
choose between one value and the other. But protecting
privacy isn't fatal to security measures; it merely involves
adequate oversight and regulation.
The primary focus of the book is on common pro-security
arguments, but Solove also discusses concrete issues of law
and technology, such as the Fourth Amendment Third Party
Doctrine, the First Amendment, electronic surveillance
statutes, the USA-Patriot Act, the NSA surveillance program,
and government data mining.
More at http://bit.ly/ml5MJi
Volume 10, Issue 18 May 13, 2011 Page 17
Reports and Papers - (cont.)
An Economic Argument for Electronic
Privacy
By Jake Spratt, University of Denver
Abstract
This Article proposes an economic framework with which to
analyze the U.S.‘s electronic privacy laws in the context of
international privacy standards. A key assumption is that
electronic privacy generally exists in tension with the speed
and convenience of e-commerce: if privacy protections are too
strong, e-commerce will suffer. At the same time, however, this
Article shows that consumers expect a certain basic level of
privacy when they conduct electronic transactions.
A government that fails to provide this certain level of privacy
effectively weakens the e-commerce industry. This Article
concludes the United States has failed to guarantee sufficient
privacy protections and that, by learning from the E.U. and
Canada, the U.S. can increase both personal privacy and the
effectiveness of e-commerce by enacting comprehensive
electronic privacy laws.
Introduction
The technological revolution and the emergence of mass
communications have irreversibly changed the face of personal
privacy. Although traditional threats to privacy still exist, such
as involuntary disclosure of personal information in newsprint,
―our privacy is peculiarly menaced by the evolution of modern
society, with its burgeoning technologies of surveillance and
inquiry.‖
There is no greater example of these ―burgeoning technologies‖
than the World Wide Web, which enables tens of millions of
people across the world to freely exchange massive amounts of
information almost instantly. While this incredible
advancement has enabled explosive economic growth, the
technology has not come without a price.
The Internet‘s rapid growth in scale, scope, and usage has led
to a dramatic increase in the number of public disclosures of
personal information. ―[E]-commerce companies often require
physical and email addresses, phone numbers, zip codes,
birthdays, gender identification, and other miscellaneous
information merely to set up an online account.‖
Many of these disclosures are not necessary to complete the
desired transactions, yet most users voluntarily relinquish
their private information without a second thought.
More at http://bit.ly/ma2EsK
Navigating News Online
By Kenny Olmstead, Amy Mitchell & Tom Rosenstiel, Project for Excellence in Journalism
Whatever the future of journalism, much of it depends on
understanding the ways that people navigate the digital news
environment -- the behavior of what might be called the new
news consumer.
Despite the unprecedented level of data about what news
people consume online and how they consume it,
understanding these new metrics has often proven elusive. The
statistics are complicated, sometimes contradictory, and often
introduce new information whose meaning is not clear.
To shed more light on Web news behavior, the Pew Research
Center's Project for Excellence in Journalism has conducted an
in-depth study of detailed audience statistics from the Nielsen
Company. The study examines the top 25 news websites in
popularity in the United States, delving deeply into four main
areas of audience behavior: how users get to the top news sites,
how long they stay during each visit, how deep they go into a
site, and where they go when they leave.
Overall, the findings suggest that there is not one group of
news consumers online but several, each of which behaves
differently. These differences call for news organizations to
develop separate strategies to serve and make money from
each audience.
The findings also reveal that while search aggregators remain
the most popular way users find news, the universe of referring
sites is diverse.
Social media is rapidly becoming a competing driver of traffic.
And far from obsolete, home pages are usually the most
popular page for most of the top news sites.
What users do with news content, the study also suggests,
could significantly influence the economics of the news
industry.
Understanding not only what content users will want to
consume but also what content they are likely to pass along
may be a key to how stories are put together and even what
stories get covered in the first place.
Volume 10, Issue 18 May 13, 2011 Page 18
Reports and Papers - (cont.)
The Social Life of Health Information, 2011
By Susannah Fox, Pew Internet
Overview
The internet has changed people‘s relationships with
information. Our data consistently show that doctors, nurses,
and other health professionals continue to be the first choice
for most people with health concerns, but online resources,
including advice from peers, are a significant source of health
information in the U.S.
As broadband and mobile access spreads, more people have
the ability – and increasingly, the habit – of sharing what they
are doing or thinking. In health care this translates to people
tracking their workout routines, posting reviews of their
medical treatments, and raising awareness about certain
health conditions.
These are not yet mainstream activities, but there are pockets
of highly-engaged patients and caregivers who are taking an
active role in tracking and sharing what they have learned.
About the Survey
This report is based on a national telephone survey of 3,001
adults conducted by Princeton Survey Research Associates
International between August 9 and September 13, 2010,
among a sample of 3,001 adults, age 18 and older. Interviews
were conducted in English and Spanish.
A combination of landline and cellular random digit dial
(RDD) samples was used to represent all adults in the
continental United States who have access to either a landline
or cellular telephone. For results based on the total sample,
one can say with 95% confidence that the error attributable to
sampling is plus or minus 2.5 percentage points. For results
based on internet users (n=2,065), the margin of sampling
error is plus or minus 2.9 percentage points.
Summary of Findings
The internet has changed people‘s relationships with
information. Our data consistently show that doctors, nurses,
and other health professionals continue to be the first choice
for most people with health concerns, but online resources,
including advice from peers, are a significant source of health
information in the U.S.
These findings are based on a national telephone survey
conducted in August and September 2010 among 3,001 adults
in the U.S. The complete methodology and results are
appended to this report.
More at http://bit.ly/miyjha
The National Progress Report on E-
Prescribing and Interoperable Healthcare
By Surescripts
Introduction
The need for the secure and timely electronic exchange of
clinical health information has been identified as fundamental
for supporting ongoing improvements in the quality and
efficiency of healthcare.
The combination of an aging population and higher demands
for healthcare through recent reform efforts is accelerating the
demand and adoption of health-related technology.
Government incentive programs consider the use of such
technology to be critical toward promoting a more efficient and
more collaborative environment for patient care.
Measuring the adoption and use of health information
technology will be essential to determine if such technology is
living up to its promise.
As the most established form of electronic clinical message
exchange, electronic prescribing (e-prescribing) can serve as a
valuable bellwether for assessing the overall use of health-
related technology.
As evidenced through e-prescribing‘s high rates of growth, the
electronic exchange of healthcare information is on a path to
becoming mainstream.
As the organization that manages the nation‘s e-prescription
network, Surescripts has been in an ideal position to observe
and report on the growth of e-prescribing through its annual
National Progress Report on E-Prescribing.
This year‘s report tracks the adoption and use of e-prescribing
between 2008 and 2010. For 2010, the Report offers analysis
of statistical trends and underlying factors that extend beyond
e-prescribing.
Future editions of the Report will feature qualitative and
quantitative analysis on a broader set of factors driving the
overall interoperability of the nation‘s healthcare system.
More at http://bit.ly/kT6rBm
Volume 10, Issue 18 May 13, 2011 Page 19
Reports and Papers - (cont.)
United States Government Accountability
Office: Many Department of Justice Agents
Refusing to Use Information-Sharing Tools
By M. Bernhart, Fierce Government IT
Only 65 percent of agents at Justice Department law
enforcement components use deconfliction databases to
determine roles and responsibilities during an investigation,
according to a Government Accountability Office survey.
Underutilization of deconfliction databases contributes to
jurisdictional confusion across DOJ components.
Over one-third of agents surveyed at the Bureau of Alcohol,
Tobacco, Firearms and Explosives, the Drug Enforcement
Administration, the FBI and U.S. Marshals Service reported a
disagreement over roles and responsibilities in the past 5
years. Of those, 78 percent admitted the disagreement
negatively affected the investigation to some degree, according
to a GAO report (.pdf) dated April 2011 but released publically
May 9. Of the 30 percent of agents not using deconfliction
databases, some said they preferred interpersonal
communication, lacked deconfliction databases in their region
or found them unnecessary. Five percent of respondents did
not know if they had accessed a deconfliction database in the
past 5 years, found report authors.
Deconfliction databases help coordinate investigations to
ensure that agents are not pursuing the same targets. The
databases contain information on cross-jurisdiction
investigations and facilitate information sharing among
agencies. If two components are investigating the same target,
an agent can use the database to contact the other component
and discuss the case. "Deconfliction databases are [an]
important and proven mechanism of collaboration," asserted
Lee J. Lofthus, assistant attorney general for administration at
DOJ, in a written response to the report author, Eileen
Larence. However, Lofthus provided no information on how
DOJ could improve the use of deconfliction databases among
agents.
"Although the DOJ components have mechanisms in place to
monitor how well components are coordinating, the scope of
these mechanisms limits DOJ's ability to identify some
problems," wrote Larence. DOJ agreed to GAO's
recommendations to better identify and diagnose
disagreements and work to limit opportunities for such
disagreements by soliciting input from field agents on areas for
improvement.
DOJ plays a key role in federal efforts to investigate and
prosecute violent crime through its four law enforcement
components: ATF, DEA, the FBI, and USMS. The FBI serves as
a federal investigative body with jurisdiction over violations of
numerous categories of federal criminal law, among other
things. The FBI‘s mandate is established in 28 U.S.C. 533,
which authorizes the Attorney General to ―appoint officials to
detect and prosecute crimes against the United States.‖ The
Attorney General delegated broad investigative authority to
the FBI.4 As a result, the Director of the FBI is responsible for
investigating violations of laws—including criminal drug
laws—of the United States and collecting evidence in cases in
which the United States is or may be a party in interest, except
in cases in which such responsibility is by statute or otherwise
exclusively assigned to another investigative authority.
Because of the FBI‘s broad responsibilities for investigating
many of the violations of the laws of the United States, in a
number of instances, the FBI‘s investigative jurisdiction
overlaps with that of the other DOJ law enforcement
components.
Gangs: All four DOJ components focus on different aspects of
gang enforcement as part of their broader missions. Within
DOJ, the FBI focuses primarily on investigating violent,
multijurisdictional gangs whose activities constitute criminal
enterprises by identifying, investigating, and prosecuting the
leadership and key members of violent gangs; disrupting or
dismantling gangs‘ criminal enterprise; and recovering illegal
assets through seizures and forfeitures. ATF primarily focuses
on efforts to reduce the occurrence of firearms, arson, and
explosives-related crime, including such crimes committed by
gang members. The primary focus of DEA‘s enforcement
efforts is on the links between gangs and drug trafficking.
USMS‘s role is to apprehend gang members who have been
criminally charged but not arrested.
More at http://bit.ly/mSGJF6
Page 20 Volume 10, Issue 18 May 13, 2011
Internet Governance
US-China Talks Conclude with Wide
Differences Remaining in Areas Such As
Human Rights
By Associated Press
Sharp U.S. criticism of China‘s human rights record
overshadowed the results achieved at annual high-level
meetings between the world‘s two largest economies aimed at
resolving disputes over trade and foreign policy. After two days
of talks, the two sides announced a range of modest
agreements aimed at increasing sales opportunities for U.S.
companies in China.
But there was no breakthrough on a key U.S. demand — letting
China‘s currency rise in value at a faster rate against the dollar.
The currency issue gained new urgency in the view of
American manufacturers with release of a Chinese government
report showing that China‘s trade surplus with the world had
surged in April.
Secretary of State Hillary Rodham Clinton told reporters at a
closing news conference Tuesday that the United States had
made its concerns known on a range of sensitive issues,
including human rights. ―We discussed everything, whether it
was something sensitive to us or sensitive to them ... including
human rights,‖ Clinton said. ―We made our concerns very
clear.‖
In an interview published Tuesday on the website of The
Atlantic magazine, Clinton said China‘s human rights record
was ―deplorable‖ and that history was not on the side of
governments that resist democracy. The Clinton magazine
interview, which took place April 7, focused on the democracy
protests that have rocked the Middle East and North Africa.
Asked at the news conference whether those uprisings against
authoritarian governments had come up during the two days of
talks, Clinton said the two countries had discussed the
uprisings, with U.S. officials making the point that America
―supports the aspirations‖ for more freedom and opportunity.
Clinton and Vice President Joe Biden had raised the issue of
human rights during the opening session of the Strategic and
Economic Dialogue talks and the White House said President
Barack Obama also had discussed human rights concerns
during his meeting with leaders of the Chinese delegation late
Monday.
More at http://wapo.st/kCzMbu
US in New Push to Break China Internet
Firewall
By Shaun Tandon, AFP
The United States plans to pump millions of dollars into new
technology to break through Internet censorship overseas
amid a heightened crackdown on dissent in China, officials
have said.
State Department officials said they would give $19 million to
efforts to evade Internet controls in China, Iran and other au-
thoritarian states which block online access to politically sensi-
tive material.
Michael Posner, the assistant secretary of state in charge of
human rights, said funding would support cutting-edge tech-
nology that acts as a "slingshot" -- identifying material that
countries are censoring and throwing it back at them.
"We're responding with new tools. This is a cat-and-mouse
game. We're trying to stay one step ahead of the cat," Posner
said. The announcement came shortly after the United States
and China wrapped up wide-ranging annual talks in which
Secretary of State Hillary Clinton showed exasperation at Bei-
jing's intensifying clampdown on domestic critics.
China routinely blocks sites that present non-official view-
points on topics such as Tibet's exiled leader the Dalai Lama,
the banned Falungong spiritual movement and the 1989
Tiananmen crackdown on pro-democracy protesters.
More recently, Chinese authorities blocked search results for
"Hillary Clinton" after she gave a speech championing Internet
freedom and for "Jasmine," an allusion to pro-democracy up-
risings sweeping the Arab world.
"In effect, we're going to be redirecting information back in
that governments have initially blocked," Posner said.
"This can be done through email or posting it on blogs or RSS
feeds or websites that the government hasn't figured out how
to block," he said.
The funding comes out of $30 million which the US Congress
allocated in the current fiscal year for Internet freedom.
The failure until now to spend the money led lawmakers to
accuse the State Department of kowtowing to China. A recent
Senate committee report called for another government body
to be put in charge of the funds.
More at http://bit.ly/jU1JL0
Page 21 Volume 10, Issue 18 May 13, 2011
Calendar of Events
MAY 15-17 Global 2011 Security Asia. The conference seeks to discuss the challenges that
governments and homeland security professionals face in their fight against terrorism
and to offer possible technological solutions to counter the lurking threats. Highly
qualified and established experts in the homeland security industry will be assembled
to present a well-balanced program covering geopolitical and technological topics.
Location: Singapore
More at http://www.globalsecasia.com/
MAY 17 8:00 -10:00 AM. Broadband Census News LLC will host a panel discussion titled
"AT&T - T-Mobile: Going Big or Going Home?". Breakfast will be served. This
event is open to the public. The price to attend is $47.12. This event is also sponsored
by the National Cable & Telecommunications Association (NCTA),
Telecommunications Industry Association (TIA) and USTelecom.
Location: Washington, D.C.
More at http://www.eventbrite.com/
MAY 17 12:00 NOON - 1:30 PM. The Information Technology and Innovation Foundation
(ITIF) will host a panel discussion titled "Waves of Innovation: Spectrum
Allocation in the Age of the Mobile Internet". The speakers will be Charles
Jackson (George Washington University), Matthew Hussey (office of Sen. Olympia
Snowe (R-ME)), Thomas Hazlett (George Mason University), Steven Crowley, and
Richard Bennett (ITIF).
Location: Washington, D.C.
More at http://www.itif.org/node/2273/signups
MAY 17 "Meaningful Use" Session for Hospitals in New York City At the request of
HANYS and Greater New York Hospital Association (GNYHA), the New York State
Department of Health has arranged for the Centers for Medicare and Medicaid
Services (CMS) to hold in New York City an informational session for hospitals on the
Medicare and Medicaid Electronic Health Record Incentive Payment Program, also
called the ―meaningful use‖ program, on May 17. HANYS and GNYHA have requested
officials from the Office of the National Coordinator for Health Information
Technology (ONC) participate as well.
Location: To be announced
More at http://www.hanys.org/news/index.cfm?storyid=2034
MAY 19 12:00 NOON - 1:00 PM. The Information Technology and Innovation Foundation
(ITIF) will host a panel discussion titled "Life in the Cloud: A View of Cloud
Computing for Personal, Business and Government Use". The speakers will
be Jeff Bergeron (HP), Karen Kerrigan (Small Business and Entrepreneurship
Council), and Robert Atkinson (ITIF).
Location: Washington, D.C.
More at http://bit.ly/iuu9p7
May
Sun Mon Tue Wed Thu Fri Sat
24 25 26 27 28 29 30
01 02 03 04 05 06 07
08 09 10 11 12 13 14
15 16 17 18 19 20 21
22 23 24 25 26 27 28
29 30 31 01 02 03 04
Featured Conference of the
Week
FEI 2011: Front End of
Innovation—Innovate in a
Networked Ecosystem
MAY 16-17, 2011
The globally recognized and trusted
source for advancing innovation
worldwide, FEI ensures you keep your
edge. The 2011 event uses experiences,
collaboration, and content to get to the
underlying value you need to achieve
more.
Location: Seaport World Trade
Center, Boston, MA.
More at http://www.iirusa.com/feiusa/
fei-home.xml
May
Sun Mon Tue Wed Thu Fri Sat
24 25 26 27 28 29 30
01 02 03 04 05 06 07
08 09 10 11 12 13 14
15 16 17 18 19 20 21
22 23 24 25 26 27 28
29 30 31 01 02 03 04
Page 22 Volume 10, Issue 18 May 13, 2011
Sites Compendium www.arstechnica.com
www.europa.eu
www.fastcompany.com
www.federaltimes.com
www.fiercegovernmentit.com
www.ft.com
www.google.com
www.govhealthit.com
www.healthcareitnews.com
www.ihealthbeat.org
www.informationweek.com
www.iwatchnews.org
www.kansascity.com
www.modernhealthcare.com
www.nationalpartnership.org
www.networkworld.com
www.pewinternet.org
www.surescripts.com
www.symantec.com
www.technologyreview.com
www.washingtonpost.com
www.whitehouse.gov
www.wsj.com
www.zdnet.com
Book Review
Pulse: The New Science of Harnessing
Internet Buzz to Track Threats and
Opportunities
The ultimate guide to mining the Internet for real
-time assessment of trends and data
By Douglas W. Hubbard
Showing how the Internet can be an incredible tool for
businesses and others to measure trends in real time, Pulse
describes tools for
inexpensive and real
time measurement
m e t h o d o l o g i e s
businesses can start
using right away.
This timely book
also puts this
emerging science in
perspective and
explains how this
new measurement
instrument will
profoundly change
decision making in
b u s i n e s s a n d
government.
Shows how the Internet can be used as an incredibly powerful
measurement tool
Reveals how to mine the Internet to measure and forecast
business progress
Written by leading expert in business analytics and
performance management
Pulse reveals how the Internet is evolving into a tool for
measuring and forecasting trends in society, the economy,
public opinion and even public health and security.
It is an absolutely essential book for every business leader to
turn a powerful, underutilized tool to its complete potential.
More at http://bit.ly/jpjQoK
Research and Selection: Stefaan Verhulst
Production: Kathryn Carissimi & Lauren Hunt
Please send your questions, observations and suggestions to
The views expressed in the Weekly Digest do not
necessarily reflect those of the Markle Foundation.
