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On The Uncanny Language of Medical Instagram

Oooh, something on the Awl I have expertise in. From a HIPAA perspective, sharing these photos doesn't really come close to grey area because the photos are (purported to be) de-identified. By definition, if health information is de-identified it is no longer individually identifiable health information or protected health information, and it is no longer covered by HIPAA. So the consent is more ass-covering and/or a polite heads up than required by the law that it cites. (The privacy rule requires that authorizations be maintained by the covered entity for six years. I have serious doubts that the docs are handing them over to whoever runs their privacy programs.)

There are 18 identifiers, and if all 18 are stripped**, then the information is considered de-identified. HOWEVER, one of the identifiers is "All elements of dates (except year) for dates directly related to an individual, including birth date, admission date, discharge date, date of death; and all ages over 89 and all elements of dates (including year) indicative of such age, except that such ages and elements may be aggregated into a single category of age 90 or older" and most digital photography collects meta data which includes the timestamp of when the photo was taken; some like to throw location in there for good measure, which is another identifier. Maybe the program just uploads the image without the metadata? That would keep Figure 1 out of having to keep PHI on its servers, which is presumably its goal (so as to avoid being a so-called business associate, having tons of HIPAA responsibilities of its own).

Docs on the site still have other issues to consider. First, if the original photo with all the metadata is on their phone, then that sucker better be encrypted with a good password (we HIPAA people are on the other side of the FBI and CIA when it comes to phone encryption). Second, tons of hospitals have "though shall not photograph patients" policies. This doesn't seem like the type of thing that one would want to face a peer review panel over. And finally, there are the professional board rules regarding professionalism. What level of snark is considered "unprofessional" is up to interpretation, but it should be lingering in the back of user's heads.

I have no doubt that a site like this is useful and informative. And I have no doubt that it offers hours of entertainment for pathologists, surgeons, and other weirdos, but if you're a doc and you're thinking about using it, consult your friendly neighborhood privacy officer for guidance on how to ensure you don't run afoul of all of the regs that keep people like me employed.

**You can also hire a statistician to deidentify, but that seems a little extreme in this case.

Posted on October 17, 2014 at 5:53 pm 0

On Polly Asks: New York Magazine Wants Me to Write Ask Polly For Them. Should I Tell Them to Piss Off?

Technical question: is there an RSS feed? Otherwise I may have good intentions about seeking out Ask Polly, but forget because it's not in my Feedly.

Posted on August 20, 2014 at 5:20 pm 0

On Ask Polly: My Boyfriend Won't Stop Raging About My Sexual History

@Pity_Kitty@twitter Well, he did say something about being an asshole.

Posted on June 12, 2014 at 5:50 pm 0

On Ask Polly: I Have Absolutely No Idea What I Need to Be Happy

@CasualElegance Along those lines, I recently read an answer regarding finding a dream job by Mike Rowe, who used to host Dirty Jobs on the Discovery Channel. https://www.facebook.com/TheRealMikeRowe/photos/a.151342491542569.29994.116999698310182/773932499283562/

Posted on June 5, 2014 at 3:57 pm 1

On How Bookstores Survive

My favorite bookstore cats are at Moby Dickens in Taos, New Mexico. They seem to always be playing in the window by the front door.

The current kitties there are Tony and Mabel (picture on website here: http://www.mobydickens.com/#!about-moby/c1enr) though my favorite kitty name ever may be their predecessor Ibid.

Posted on April 14, 2014 at 5:33 pm 0

On Ask Polly: My Boyfriend Thinks I'm Ugly

@Sharilyn Neidhardt I really couldn't agree more. I dated a guy I thought was My One True Love who made a couple of bad comments about my weight and never once told me that I was beautiful. (Once he told me that we'd have beautiful children because they were from me, but that's about as close as it got.) His stated reason for breaking up with me was my weight.

Fast forward to the first time I had sex with my now husband, where he said over and over and over again, "I love this body." It was supposedly a one night stand and he had NO idea that this was the perfect thing to say to me. It was honest and of no bullshit. Every now and then I'll catch him staring at me appreciatively. I know that I'm not a supermodel or even a plus sized model. But I also know that my husband thinks that I'm beautiful. And I thought that wasn't important when I was sobbing uncontrollably about my ex, but it IS important for your partner to think that you're hot.

Posted on April 3, 2014 at 11:57 pm 1

On Ask Polly: My Mom Keeps Guilting Me About Visiting For Christmas!

@Olivia2.0 Nope. I'm looking forward to a week at the ranch with my family. The fights are usually about what sort of food we're making, but otherwise, it's a pretty decent time.

Sooner or later we'll make the trek to spend Christmas with my husband's family, and that will be a little more stressful, because my husband has an awkward relationship with his dad. I think there was a lot of judgment on both sides when my husband was in his 20s and 30s, but I think both of them are pretty ok with what my husband is doing with his life now.

Posted on December 19, 2013 at 12:34 pm 0

On Chico Hamilton, 1921-2013

http://www.youtube.com/watch?v=h1wCnCuA1hw My favorite Chico Hamilton, especially the latter part starting at around 7:30. I grew up listening to him.
It occurs to me that I made the same comment when you guys talked about him turning 90.

Posted on November 27, 2013 at 10:49 am 0

On Goats Besweatered

Modern Farmer is the most important addition to my RSS feed in the last three years.

Posted on November 26, 2013 at 9:38 pm 0

On Ask Polly: If I Dump My Needy Girlfriend, I'm Afraid I'll Ruin Her Life!

...and for the love of all that you find sacred, don't try to remain friends to help her with the breakup.

Posted on November 26, 2013 at 6:11 pm 3