Healthcare Data Security Strategies; Proactive or Reactive?

It should come as no shock to anyone reading this that security in the Healthcare industry is a huge issue. With the introduction of flashy new tech comes the burden of making sure that it is not compromised. This is by no means an isolated issue as security is paramount in a variety of other verticals but the sensitive and personal nature of the data held by Healthcare organizations means that breaches receive a lot of media attention. The question is whether it is more effective to guard against incoming attacks or proactively analyze data to prevent future breaches from being as effective.

Before I start, it's important to note that the main cause of Healthcare data breaches occur due to lost or stolen devices (68%) rather than hacking [1]. This issue will progressively worsen due to organizations embracing the mobility trend and so it is much easier (although by no means easy to start with) to protect the data held on these devices rather than the devices themselves. With this being said, a blog post about locking up your devices and keeping a firm eye on them would be pretty short and dull so I'd like to concentrate on hacking and malicious attacks.

Healthcare organizations will continue to invest in defensive measures against cyber crime but it is becoming increasingly important to invest in the analysis of these threats and the prediction of future potential breaches. This will run in parallel to the evolving technologies enabling hackers to maliciously gain access to the organizations data.

With the ever growing popularity of Big Data & Analytics, it is crucial that attacks are not treated as independent events and instead the data and information should be collected until there is a significant mass to analyze previous attacks and prepare for what's to come. This intelligence will then (hopefully) enable the user to identify when the organization is under attack a lot quicker and then respond more efficiently.

I'd like to conclude this blog post by highlighting that although security measures are evolving as are hacking techniques, the biggest variable factor is the user - whether it be due to insufficient training, snooping or a blatant disregard for protocol. There is a vicious cycle whereby as security measures become more sophisticated, they may become less user friendly, prompting users to find easier workarounds which then make the system vulnerable. In my personal opinion, organizations should invest further into training and user friendly interfaces whilst maintaining secure access to data in the background.

Best Regards,

Jonathan Cordwell
Research Analyst, Healthcare Strategy
ResearchNetwork, CSC

1. HIT Consultant, 68% of Healthcare Data Breaches Due to Device Loss or Theft, Not Hacking, 11/04/2014: http://hitconsultant.net/2014/11/04/healthcare-data-breaches-device-theft-loss/

Google Glass in Healthcare: Rad or Fad?

There seems to be a lot of hype around Google Glass at the moment and its potential impact in the healthcare sector. It is expected that shipments of the product will increase from half a million units in 2012 to 6.6 million in 2016 [1]. 

As I analyse commentary on this revolutionary product, I get the overwhelming feeling that this is viewed as a step towards innovation rather than innovation itself although this is expected as it's still early days in the product development life cycle and apps are still in production. Regardless of concerns, the numbers seem to be pointing towards widespread adoption and if successful this is an exciting shift towards "The Hospital of the Future".

Philips Healthcare and Accenture have already seen the potential and have collaborated to explore the possibilities in Healthcare [2] as it's clear that Google Glass won't be hitting the catwalk anytime soon and so targeting enterprises is a much more appropriate option.

The Huffington Post recently published a slide deck on 15 ways Google Glass will transform the healthcare industry [3]. I wanted to evaluate each of the points in terms of my views on whether I think they are accurate and practical so without further ado, let's get the ball rolling...

Virtual Dictation
Rating: 5/10
If the aim is to simply record a conversation then yes this would work but audio files are only useful for litigation purposes. The real value comes from transcribing the conversation and if Siri is anything to go by then we are still a way off perfecting this. Once the kinks are perfected however then yes it will be useful.

Telemedicine
Rating: 7/10
So here's the scenario; you're carrying out minor surgery and need the guidance of an expert. You stream what you're viewing to the expert who is on a tablet while the both of you are talking to each other. This has the potential to be very impactful providing variables such as Internet connection don't get in the way. However, in a similar vain to virtual dictation, video conferencing still has a lot of issues. Very rarely have I attended a Google Hangout that hasn't had at least one minor hiccup and when this technology is in a pressurized situation such as a surgery then minor hiccups could risk lives. 

Resident Training
Rating: 10/10
In a safe environment, Google Glass would be a perfect way to show trainees not only what a practitioner sees on a daily basis but also a better visualization of techniques and visa versa, the teacher will be better able to critique.

Augmented Reality
Rating: 5/10
I can only express my personal opinion here as a non-practitioner but if vital signs are constantly in the corner of my eye, this could possibly distract me and also obscure peripheral vision.

EMS Communications
Rating: 8/10
Streaming images from the field back to the ER will prepare the awaiting doctors and nurses for what to expect. For one way video conferencing, it works well but my only concern is Internet connectivity out in the field, which may make it more of a distraction and hindrance.

Surgical Training
Rating: 10/10
Google Glass seems to be made for training purposes whereby everything the surgeon sees can be streamed to a large monitor as they talk through their actions. As long as these are standard procedures then I don't see any issues with this.

Improved Rounds
Rating: 3/10
The theory here is that medical records can be brought up whilst attending to patients on rounds. Although theoretically this sounds beneficial, it is compromising the human aspect of doctor-patient interactions. Personally, if I'm dealing with a doctor, I want them to be EITHER talking to me OR looking at my records, not both at the same time. Multi-tasking in this environment will fail to improve the end user experience.

Improving The Patient Experience
Rating: 1/10
The article seems to lose focus at this point. It seems to circle back to the telemedicine point, which I've already covered. Therefore, I'm going to rate this on its title; Improving The Patient Experience. I'd like you to picture something in your mind for a moment; imagine you're on a date with someone and you're chatting about your hobbies, your family, your travels etc. Now picture the same scene where your date is wearing Google Glass and already knows everything about you as they're reading up about you at the table therefore negating the requirement for your input. Does it sound awkward to you? It certainly does to me.

Procedure Analysis
Rating: 10/10
This goes back to training, which I've already commented on.

Patient Communications
Rating: 1/10
The article tries to convince the reader that Google Glass will improve alerts for patients. So instead of a pager buzzing to signal that the nurse is required at a patient's bed, Google Glass will flash up in the nurse's vision? Are nurses not busy enough?! Not only does this compromise whatever the nurse is currently working on but I imagine that a lot of nurses won't have the time to have a conversation remotely between visiting other patients and the mounds of paperwork they have on their desks.

Improved Visibility
Rating: 10/10
This (once again) goes back to training for future on-demand videos from different angles. Not much more to be said.

Telemedicine for Acute Patients
Rating: 8/10
This is a similar point to 'EMS Communications' in that Google Glass can help diagnose stroke sufferers quickly and organize the setting to properly receive the patient at the hospital. As previously stated, one way video conferencing will work well with Google Glass providing the Internet connection is reliable.

Patient Care Instruction
Rating: 10/10
Recording instructions that doctors have given so that the patient can re-visit it if unclear works well. It's a more sophisticated way of putting a Dictaphone on the table, making two copies and giving one to the patient. In this case, providing both the doctor and patient talk clearly, it will greatly reduce inaccurate instructions.

Faster Access to Information
Rating: 5/10
Yes, bringing up a patient record will more than likely be faster than accessing it on a tablet or mobile device but once again, I do not buy into the sales pitch that it gives the doctor more time with the patient. If I hold up a tablet to cover half of my face, that does not constitute still spending time with the patient. Once again, multi-tasking in this environment will not put the patient at ease.

Compliance
Rating: 9/10
As previously mentioned, audio recordings will enable a full record of what has been said in the event of a litigation case. Then it's just a case of storing them all and making them secure!

In a Jerry Springer-esque way, I'd like to leave you with my final thoughts. Theoretically, yes Google Glass has a lot of very useful applications and features that will speed up interactions and better inform practitioners. However it runs the risk of compromising the human aspect that a lot of patients require to feel confident about the future of their health. I hope that doctors and nurses will attach a glasses strap onto their Google Glass devices so that when the time comes where a personal one on one interaction is needed, they can put them down and focus.

Best Regards,

Jonathan Cordwell

Research Analyst, Healthcare Strategy

ResearchNetwork, CSC

1. InformationWeek Healthcare, Google Glass Gains Momentum In Healthcare June 18, 2014: http://www.informationweek.com/healthcare/mobile-and-wireless/google-glass-gains-momentum-in-healthcare/d/d-id/1278648
2. Philips, Experience the future of wearable technology - Philips Healthcare: http://www.healthcare.philips.com/main/about/future-of-healthcare/index-video.wpd
3. Huffington Post, How Google Glass Will Transform Healthcare, October 17, 2014: http://www.huffingtonpost.com/vala-afshar/how-google-glass-will-tra_b_6003100.html