#baa — Public Fediverse posts

https://www.wacoca.com/videos/3170280/the-first-take/ THE FIRST TAKE: 【再放送】「CENTRAL2025」 4/6(SUN) – Echoes Baa ARCHIVE / THE FIRST TAKE #46SUN #Aooo #ARCHIVE #BAA #CENTRAL #CENTRAL_FEST #Chevon #echoes #EchoesBaa #FIRSTTAKE #FRUITSZIPPER #Luov #TFT #TheFirstTake #THEFIRSTTAKECHANNEL #TOMOO #YOASOBI #ファーストテイク #フェス #一発撮り #再放送CENTRAL2025 #音楽 #音楽番組

FA Cup: LFC are heavy favourites vs Barnsley at 20:45 CET. Expect a tight contest and confident home attack, with Barnsley chasing a surprise.

FC Liverpool 82.0%
Draw 13.3%
FC Barnsley 4.6%

#Football #Soccer #FACup #LIV #BAA #LIVBAA

Higher Ground....No need to count these sheep. There are 11. :) A beautiful modern blue sky with pops of white heading for the high spot in the meadow...makes me feel peaceful.

ART
https://fineartamerica.com/featured/higher-ground-white-sheep-art-sharon-cummings.html

#sheep #lamb #farm #farmhouse #farmanimals #animal #animals #newzealand #swiss #sitzerland #newzealand #travel #country #rustic #countryhumans #art #artwork #landscape #landscapes #baa #cute #fun #SharonCummingsArt #farming #farmers

EFL Cup: Lineups in for FC Barnsley vs Brighton & Hove Albion.

FC Barnsley 9.7%
Draw 20.5%
Brighton & Hove Albion 69.7%

#Football #Soccer #EFLCup #BAA #BHA #BAABHA

Peťo Kuric #SR dal Zdar boh 8B #Baňa #Milochov

https://climbnews.pohroma.de/2025/04/03/33177/

#ClimbNews #Baa #Milochov #SR

Well, I just ran headfirst into another wretched #BindingArbitration agreement.

I created a #Coursera account to take a #Go programming course, and of course their bloody TOS has a #BAA.

Jerks. :(

I guess I'm back to just reading a book, as the online courses are either too brief, don't have much in the way of exercises, are expensive, or are hiding behind stupid BAAs.

#Golang #LearnGo #LearningGo #VeryFrustrating

A quick follow-up to this. I eventually got a polite blow-off letter from them about how they strive to value customer privacy or some such. Very little I can do. Have to decide if a complaint to US government about possible HIPAA violations is worth it.

@psychotherapist @psychotherapists @psychology @socialpsych @psychiatry @infosec
#AI  #CollaborativeHumanAISystems #HumanAwareAI #artificialintelligence #psychology #counseling #socialwork #psychotherapy #EHR #medicalnotes #progressnotes @psychotherapist @psychotherapists @psychology @socialpsych @socialwork @psychiatry #mentalhealth #technology #psychiatry #healthcare #patientportal #HIPAA #dataprotection #infosec @infosec #doctors #hospitals #BAA #businessassociateagreement #coveredentities #privacy #HHS #OCR #fullscript

TITLE: Polite Example Letter to a Health-Related Website Endangering Your Privacy

*THIS* is the letter I wish more people would send to health-related websites and merchants when they observe a privacy problem!

fullscript.com is a service that dispenses non-pharma products to patients (like medical grade supplements) based upon doctor's orders. You have to be referred by a physician to get a patient account. They even have a way of integrating with EHR systems.

They need to get security right.

~~~~~~~~~~~~~
To: Fullscript Support <[email protected]>

Dear Fullscript Team:

I have always appreciated being able to order from your excellent website.

Your service strives to supply patients with supplements and medicines ordered by doctors. As such, what is ordered can give insight into medical conditions that patients may have.

You may or may not be covered by HIPAA regulations, but I'm sure you will agree that ethically and as a matter of good business practice, Fullscript would want to maintain medical privacy of patients given that medical practices trust you.

This is why I'm concerned with the HIGH level of 3rd party tracking going on throughout your product catalogue. On your login page, the Firefox web browser displays a "gate" icon to let me know that information (I believe my email address) is being shared with Facebook. This is also the case with your order checkout page (see attached screenshot showing Facebook "gate" icon, as well as Privacy Badger and Ghostery plug-in icons in upper right-hand corner blocking multiple outbound data connections).

Privacy Badger is a web browser plugin that detects and warns of or stops (depending upon severity) outbound information from my web browser to 3rd party URLs. Directly below is Privacy Badger's report from your checkout page:

~~~~
Privacy Badger (privacybadger.org) is a browser extension that automatically learns to block invisible trackers. Privacy Badger is made by the Electronic Frontier Foundation, a nonprofit that fights for your rights online.

Privacy Badger blocked 23 potential trackers on us.fullscript.com:

insight.adsrvr.org
js.adsrvr.org
bat.bing.com
static.cloudflareinsights.com
script.crazyegg.com
12179857.fls.doubleclick.net
12322157.fls.doubleclick.net
googleads.g.doubleclick.net
connect.facebook.net
www.google-analytics.com
analytics.google.com
www.google.com
www.googletagmanager.com
fonts.gstatic.com
ad.ipredictive.com
trc.lhmos.com
snap.licdn.com
o927579.ingest.sentry.io
js.stripe.com
m.stripe.network
m.stripe.com
q.stripe.com
r.stripe.com
~~~

Please note that I was able to successfully checkout WITH Privacy Badger blocking protections on, so most of this outbound information was NOT necessary to the operation of your website.

There are several advertising networks and 3rd party data brokers receiving some kind of information.

I am aware that a limited amount of data sharing can be necessary to the operation of a website (sometimes). I am also aware that this all is not malicious -- web development and marketing does not usually talk to the legal department before deploying tools useful to gathering site usage statistics (Crazy Egg and Google Analytics). However, these conversations need to happen.

As for "de-identified" or "anonymized" data -- data brokers collect information across several websites, and so are able to reconstruct patient identities even if you don't transmit what would obviously be PHI (protected health information). As an example, if Google sees the same cookie or pixel tracking across multiple websites and just one of them sends a name, then Google knows my name. If Facebook is sent my email address (as looks to be the case), and I happen to have a Facebook account under that same email address, then Facebook knows who I am -- and can potentially link my purchases with my profile.

The sorts of computing device data that you are collecting and forwarding here may well qualify as PHI. Please see:

Use of Online Tracking Technologies by HIPAA Covered Entities and Business Associates
https://www.hhs.gov/hipaa/for-professionals/privacy/guidance/hipaa-online-tracking/index.html

This HHS and OCR guidance includes many 3rd party tracking technologies.

What I would really like to see happen is:

a) A thorough look at what information your website is sending out to what 3rd parties, along with an understanding of how data brokers can combine information tidbits from multiple websites to build profiles.

b) Use of alternative marketing analysis tools that help your business. For example, there are alternatives to Google Analytics that do not share all that data with Google and still give your marketing team the data they need.

c) An examination if you are sharing information about what products patients are clicking on and/or purchasing with 3rd parties. This would be especially problematic. (Crazy Egg tracks client progress through a website, but I'm unclear if they keep the information or just leave it with you.)

d) Use of alternative code libraries that are in-house. For example, web developers frequently utilize fonts.gstatic.com, but you could likely get fonts and other code sets elsewhere or store them in-house.

I appreciate you taking time to read this and working on the privacy concerns of your patients and affiliated medical practices.

Thanks.

~~~~~~
#AI #CollaborativeHumanAISystems #HumanAwareAI #artificialintelligence #psychology #counseling #socialwork #psychotherapy #EHR #medicalnotes #progressnotes @psychotherapist @psychotherapists @psychology @socialpsych @socialwork @psychiatry #mentalhealth #technology #psychiatry #healthcare #patientportal #HIPAA #dataprotection #infosec @infosec #doctors #hospitals #BAA #businessassociateagreement #coveredentities #privacy #HHS #OCR #fullscript

TITLE: Further Adventures in the HIPAA Silliness Zone

This short essay was inspired by a video I watched going over Microsoft legal agreements, the upshot of which is that they can harvest and use ALL of your data and creations (See *1 below in References). This inspires interesting HIPAA questions to say the least:

1) *IF* you have a HIPAA agreement with Microsoft, do they actually NOT harvest or use your data? How do they track that across all their applications and operating systems to tell?

2) Do their HIPAA and regular legal departments even talk to each other?

3) If you have a HIPAA agreement for your work computers, but then access your data through home computers, are all bets off? (And what sole proprietors don't mix use of computers for both?)

**Now I don't really believe that Microsoft is doing all of this.** What I *THINK* is that their lawyers just wrote overly broad legalese to protect them from all situations. Still -- legally it leaves us hanging. I certainly don't know that they are NOT doing it.

Then, I start thinking on some of the other crazy security situations I've encountered the past few years:

-- The multi-billion dollar medical data sales vendor that bought a calendar scheduling system, then wrote a HIPAA BAA agreement in which the PROVIDER has to pay any financial damages and penalties if THEY slip-up and lose data. (*2). Gee, what could go wrong?

-- The new AI progress notes generator service that sends data to 3rd parties including Google Tag Manager, LinkedIn Analytics, Facebook Connect, and Gravatar (*3)

-- The countless data breaches currently hitting hospitals across the USA. (*4)

It's all really quite mind numbing if you are a small healthcare provider or sole practitioner. I suspect 99% of us have just tuned this all out as noise at this point. After all, do we have the time or money to take on the legal departments of multi-billion dollar corporations?

The net results of this will be helpless nonchalance, boredom, and a gradual shifting of liability to US when upon occasion data is actually leaked by our vendors. And, of course, ever more fear and uncertainty in professions already full of it. Oh, and client data flowing through data brokers everywhere.

So what can we do? At first glance, not much. We need to be pressuring our professional associations to take on (or further take on) data security concerns including liability of giant "subcontractors" and insurance companies versus small healthcare providers. We also need to be supporting HHS and Federal government efforts to stop 3rd party trackers, including cookies, web beacons, pixel tracking, etc. from being allowable on systems related to healthcare. (*5) Bonus points if the penalties can apply mainly to larger corporations rather than hitting small provider offices hard.

Thanks,
Michael Reeder LCPC
Baltimore, MD

~~~~~~~~~~~~~~~~~~~~~~~
REFERENCES:

(*1)
The following video walks through the Microsoft Services Agreement and Microsoft Privacy Agreement to explain how Microsoft reserves the rights to use all data that you transmit through their services, or create or store in their apps (including data stored on OneDrive). It also collects information from all the programs used on your Windows machine. (This would seem to mean they can harvest data from your local hard drive, but I'm not sure.)

Microsoft Now Controls All Your Data
https://m.youtube.com/watch?v=1bxz2KpbNn4&pp=ygUkTWljcm9zb2Z0IG5vdyBjb250cm9scyBhbGwgeW91ciBkYXRh
"("Data"), how we use your information, and the legal basis we use to process your Personal Information. The Privacy Statement also describes how Microsoft uses your content, i.e. Your communications with other people; the submissions you send to Microsoft through the Services; and the files, photographs, documents, audio, digital works, live streams, and videos that you upload, store, transmit, create, generate, or share through the Services, or any input you submit to generate content ("Your Content")."

(*2)
Full Slate: Last I checked their HIPAA, privacy, and BAA agreements. Although they reserve the right to change these agreements without notification and just post them to their website, so who knows at this point. https://www.fullslate.com

(*3)
Autonotes.ai: In fairness, they claim that no HIPAA data should be input into their system, even though you are writing progress notes. As of 7/30/23 they sent some sort of data to Google Tag Manager, LinkedIn Analytics, Facebook Connect, Gravatar which was severe enough that the Ghostery browser plug-in felt compelled to block or flag the transmissions. I hope they have changed this.

It should be pointed out that services similar to Full Slate and Autonotes claim that data sent to 3rd parties is not PHI and/or necessary to the operation of the service. This all could be true. I find that when Privacy Badger, or Ghostery, or my Pihole DNS server block these 3rd party transmissions that the vast majority of the time services work just fine.

Please also see Use of Online Tracking Technologies by HIPAA Covered Entities and Business Associates
https://www.hhs.gov/hipaa/for-professionals/privacy/guidance/hipaa-online-tracking/index.html

This HHS and OCR guidance includes the sorts of 3rd party tracking technologies often referred to as non-PHI, or de-identified. My non-lawyer mind is suspicious that violations could be found at several services.

(*4)
Just take a look at any of the daily headlines on Becker's Hospital Review:
https://www.beckershospitalreview.com/cybersecurity.html

(*5)
Hospital associations sue HHS over pixel tracking ban
https://www.beckershospitalreview.com/healthcare-information-technology/hospital-associations-sue-hhs-over-pixel-tracking-ban.html

--

#AI #CollaborativeHumanAISystems #HumanAwareAI #artificialintelligence #psychology #counseling #socialwork #psychotherapy #EHR #medicalnotes #progressnotes @psychotherapist @psychotherapists @psychology @socialpsych @socialwork @psychiatry #mentalhealth #technology #psychiatry #healthcare #patientportal #HIPAA #dataprotection #infosec @infosec #doctors #hospitals #BAA #businessassociateagreement #Microsoft #coveredentities #privacy #HHS #OCR

Private, vetted email list for mental health professionals: https://www.clinicians-exchange.org
Open Mastodon instance for all mental health workers: https://mastodon.clinicians-exchange.org
.
*Warning on AI and Data in mental health: ‘Patients are drowning’**
*https://www.digitalhealth.net/2023/10/warning-on-ai-and-data-in-mental-health-patients-are-drowning/

I'm always a bit skeptical of presentations from tech company CEOs on
how their product areas are necessary in the mental health field.

That said, this article has a few good points:

/"Umar Nizamani, CEO, International, at NiceDay, emphasised that AI will
inevitably become an essential tool in mental health care: 'I am very
confident AI will not replace therapists – but therapists using AI will
replace therapists not using AI.'"//
/
I am beginning to think this also -- for better or worse.  I took a VERY
fast 60 second look at NiceDay and it appears to be another
all-encompassing EHR, but with a strong emphasis on data.  Lots of tools
and questionnaires and attractive graphs for therapists to monitor
symptoms.  (I need to take a longer look later.)  So data-driven could
be very good, if it does not crowd out the human touch.

/"Nizamani said there had been suicides caused by AI, citing the case of
a person in Belgium who died by suicide after downloading an anxiety
app.  The individual was anxious about climate change. The app suggested
'if you did not exist' it would help the planet, said Nizamani."//
/
YIKES...  So, yes, his point that care in implementation is needed is
critical.  I worry at the speed of the gold-rush.

/"He [//Nizamni] //called on the industry to come together to ensure
that mental health systems using AI and data are 'explainable’,
'transparent', and 'accountable'." //
/
This has been my biggest focus so far, coming from an Internet security
background when I was younger.

See: https://nicedaytherapy.com/

/"Arden Tomison, CEO and founder of Thalamos"/ spoke on how his company
automates and streamlines complex bureaucracy and paperwork to both
speed patients getting help and extract the useful data from the forms
for clinicians to use.  More at: https://www.thalamos.co.uk/

/"Dr Stefano Goria, co-founder and CTO at Thymia, gave an example of
'frontier AI': 'mental health biomarkers' which are 'driving towards
precision medicine' in mental health. Goria said thymia’s biomarkers
(e.g. how someone sounds, or how they appear in a video) could help
clinicians be aware of symptoms and diagnose conditions that are often
missed."//
/
Now **THIS** is how I'd like to receive my AI augmentation.  Give me
improved diagnostic tools rather than replacing me with chatbots or
over-crowding the therapy process with too much automated tool data
collection (some is good).  I just want this to remain in the hands of
the solo practitioner rather than being a performance monitor on us by
insurance companies.  I want to see empowered clinicians.

Take a look at this at: https://thymia.ai/#our-products

*Warning on AI and Data in mental health: ‘Patients are drowning’**
*https://www.digitalhealth.net/2023/10/warning-on-ai-and-data-in-mental-health-patients-are-drowning/

--
*Michael Reeder, LCPC
*
*Hygeia Counseling Services : Baltimore / Mt. Washington Village location*

#AI  #CollaborativeHumanAISystems #HumanAwareAI #chatbotgpt #chatgpt
#artificialintelligence #psychology #counseling #socialwork
#psychotherapy #EHR #medicalnotes #progressnotes
@psychotherapist @psychotherapists
@psychology @socialpsych @socialwork
@psychiatry #mentalhealth #technology #psychiatry #healthcare
#patientportal
#HIPAA #dataprotection #infosec @infosec #doctors #hospitals
#BAA #businessassociateagreement #NiceDay #NiceDayTherapy #/Thalamos
#//Thymia///
.
.
NYU Information for Practice puts out 400-500 good quality health-related research posts per week but its too much for many people, so that bot is limited to just subscribers. You can read it or subscribe at @PsychResearchBot
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Since 1991 The National Psychologist has focused on keeping practicing psychologists current with news, information and items of interest. Check them out for more free articles, resources, and subscription information: https://www.nationalpsychologist.com
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TITLE: Iowa health system warns against using ChatGPT to draft patient
letters

Apparently some people have to be told that using AI services in the
cloud to compose medical letters is a violation of HIPAA.

Now what I would like to see with all the AI-assisted EHR systems
currently being developed (EPIC, Oracle, Amazon, etc.) is not only BAA
contracts in place with the tech companies, but also:

a) Separate AI systems that don't share data with the main AI system.
(So the Hospital AI database would be separate from the general AI
database), or

b) Much better: Separate AI software and databases that are held
internal to the Hospital's own computer servers with restricted Internet
access to the outside.

This is wholly feasible, yet somehow I have a low trust level of it
occurring.

For any private practice people out there playing with AI on a small
office scale, I'm not a lawyer, but what I would recommend are a) AI
systems that can be run on a desktop (not in the cloud), and b) cutting
them off from Internet or severe restrictions on where those desktops
can call out to since you likely don't know what's in the code of the AI
you downloaded!

~~~~
*Iowa health system warns against using ChatGPT to draft patient letters*
https://www.beckershospitalreview.com/cybersecurity/iowa-health-system-warns-against-using-chatgpt-to-draft-patient-letters.html

/Iowa City-based University of Iowa Health Care is warning employees
against the use of ChatGPT for its potential to violate HIPAA.../

--

#AI  #CollaborativeHumanAISystems #HumanAwareAI #chatbotgpt #chatgpt
#artificialintelligence #psychology #counseling #socialwork
#psychotherapy #EHR #medicalnotes #progressnotes
@psychotherapist @psychotherapists
@psychology @socialpsych @socialwork
@psychiatry #mentalhealth #technology #psychiatry #healthcare
#patientportal
#HIPAA #dataprotection #infosec @infosec #doctors #hospitals
#BAA #businessassociateagreement

.
.
NYU Information for Practice puts out 400-500 good quality health-related research posts per week but its too much for many people, so that bot is limited to just subscribers. You can read it or subscribe at @PsychResearchBot
.
Since 1991 The National Psychologist has focused on keeping practicing psychologists current with news, information and items of interest. Check them out for more free articles, resources, and subscription information: https://www.nationalpsychologist.com
.
EMAIL DAILY DIGEST OF RSS FEEDS -- SUBSCRIBE:
http://subscribe-article-digests.clinicians-exchange.org
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READ ONLINE: http://read-the-rss-mega-archive.clinicians-exchange.org
It's primitive... but it works... mostly...

All,

(See article link above & below)
https://www.beckershospitalreview.com/cybersecurity/aha-hhs-should-withdraw-health-data-tracking-rule.html

This issue strikes me as a potential emergency. All American health professionals need to be writing our professional associations to demand that they oppose what The American Hospital Association is trying to do here.

I will be writing ACA, and -- time permitting -- will publish more on this later.

The problem in a nutshell is that every time hospitals -- or any other medical source -- make use of 3rd party trackers like Google Analytics, they provide data that can identify a patient. It is a HIPAA violation. They will argue that -- depending upon what is provided -- it does not actually give away enough information to identify the patient, but that is a bogus argument. Google Analytics (and many other outside tech tools) collect databases of information so they can put together profiles over time.

So -- for example -- if a hospital gives Google Analytics a web browser cookie showing that the client logged into their site, the cookie MIGHT just identify the web browser without the client name. BUT -- when that same client goes and logs into their Google account later (for which they have previously given their name), Google can observe the same "anonymous" cookie in the web browser and deduce that this is the same person who logged into the hospital website. If it happens to be an abortion clinic, then Google knows roughly the services provided. If the hospital sends the cookie from psychotherapist John Smith LCPC's telehealth page, then Google knows that the patient sees psychotherapist John Smith.

If hospitals need the tools that Google and other tech companies are providing, they need to buy internal versions of such to run on their own systems. If hospitals need to do marketing, then they need to run the 3rd party trackers only on the most public parts of their websites. therapyappointment.com is a good example of being a good citizen about this -- they run about eight 3rd party trackers on their home page, but only 1 tracker once a therapist has logged in. And that one tracker is for Amazon Cloud Services -- arguably a tracker that is necessary to the operation of their website.

I could see narrow exceptions allowing for 3rd party trackers that might make sense (AHA is making heavy use of these fringe cases in the article). Most of the time its a big problem.

I'm disgusted that the AHA is taking this position. It means they have NO respect for the data privacy they supposedly support!

-- Michael

@rsstosecurity @infosec
#security #healthcare #doctors #itsecurity #hacking #doxxing #psychotherapy #securitynews #psychotherapist #mentalhealth #psychiatry #hospital #socialwork #datasecurity #webbeacons #cookies #HIPAA #privacy #datanalytics #healthcaresecurity #healthitsecurity #patientrecords #telehealth #netneutrality #socialengineering #AHA #americanhospitalassociation #APA #americanpsychologicalassociation #ACA #americancounselingassociation #NASW #nationalassociationofsocialworkers #AMA #americanmedicalassociation #EHR #medicalnotes #progressnotes @psychotherapist @psychotherapists @psychology @socialpsych @socialwork @psychiatry #technology #healthcare #patientportal
#HIPAA #dataprotection #infosec #doctors #hospitals #BAA #businessassociateagreement #congress #senate #lobbying

Private, vetted email list for mental health professionals: https://www.clinicians-exchange.org
Open LEMMY instance for all mental health workers: https://lem.clinicians-exchange.org
.

TITLE: Coming to a doc near you

*Oracle announces new generative AI services for healthcare organisations**
*https://www.digitalhealth.net/2023/09/oracle-announces-new-generative-ai-services-for-healthcare-organisations/

This AI will follow along and take the session notes for the doctor by
listening to the office visit.  It will also bring up charts and records
through voice command and prompt the doctor to do routine things during
the office visit.  It's due out early next year.

This could be very helpful.

However I can imagine a few kinks in the office visit process initially:

Patient: "Doctor, my knee hurts"

AI: "REMEMBER TO MAKE A FOLLOW-UP APPOINTMENT"

Patient: "What was that?!"

Doctor: "Oh pay no attention -- that is just the new AI system everyone
has to consent to for treatment.  It will help us during the session."

AI: "HAVE YOU EXAMINED THE KNEE X-RAY YET?"

Doctor: "AI, pull up the knee x-ray"

Patient: "This is my first visit, there is no knee x-ray yet."

AI: "REMEMBER TO SCHEDULE A KNEE X-RAY"

Doctor & Patient Together: "We don't know if we need a knee x-ray yet!"

Patient: "It started hurting yesterday"

Doctor: "Jump up on the table and I'll take a look at it"

AI: "SHALL I SUMMON A NURSE TO WATCH TO GUARD AGAINST ALLEGATIONS OF
IMPROPRIETY?"

Doctor: "NO!"

Doctor: "It does look a bit red.  Does this hurt?"

Patient: "A bit when you touch there and I bend it."

AI: "SHALL I SCHEDULE THE KNEE X-RAY NOW?"

Doctor: "SHUT UP!  AI -- Silent mode now!"

Office visits are going to be fun the next few years while this gets sorted.

-- Michael

~~
#AI  #CollaborativeHumanAISystems #HumanAwareAI #chatbotgpt #chatgpt
#artificialintelligence #psychology #counseling #socialwork
#psychotherapy #EHR #medicalnotes #progressnotes
@psychotherapist @psychotherapists
@psychology @socialpsych @socialwork
@psychiatry #mentalhealth #technology #psychiatry #healthcare
#patientportal
#HIPAA #dataprotection #infosec @infosec #doctors #hospitals
#BAA #businessassociateagreement

.
.
NYU Information for Practice puts out 400-500 good quality health-related research posts per week but its too much for many people, so that bot is limited to just subscribers. You can subscribe at @PsychResearchBot

EMAIL LIST: https://www.clinicians-exchange.org & LEMMY: https://lem.clinicians-exchange.org
.
I'm a bit behind on this news cycle, so you may have read about these
issues. _My point is to tie them to data privacy and OUR clinical
practices._

**THIS BELOW** is one of the main reasons /I keep throwing a fit about
data leaks from HIPAA BAA subcontractors/ - whether or not they end up
being legally PHI, and despite the fact that not too many therapists are
interested in the topic.

*If an Attorney General is willing to go after unredacted medical
records* in-state or out-of-state, /then they are certainly *_capable of
getting data from data brokers and marketing firms_* (or Google,
Facebook, LinkedIn, Twitter, etc.)./

Closer-to-home -- It's not too much of a stretch to speculate if
psychotherapists in blue states will get subpoenas for chart records
pertaining to clients who moved to a red state shortly after counseling,
then got in trouble for whatever the legal medical issue of the moment
is (abortion, birth control, transgender concerns, fertility clinic
involvement, etc.).

*Here’s why Tennessee’s AG wants access to reproductive medical records
— including for out-of-state abortions**
*https://wpln.org/post/heres-why-tennessees-ag-wants-access-to-reproductive-medical-records-including-for-out-of-state-abortions/
/"State attorneys general in 18 states — including Tennessee’s — are
fighting with the Biden Administration over medical records related to
reproductive care."//
/
*Tennessee A.G. weaponizes private medical records in GOP campaign
against trans people**
*https://the-rachel-maddow-show.simplecast.com/episodes/tennessee-ag-weaponizes-private-medical-records-in-gop-campaign-against-trans-people
/Maddow podcast recording.  Talks about attorneys general from 16 states
writing a letter to President Biden asserting their right to go after
medical records located outside their states.//
/
*Biden’s HIPAA expansion for abortion draws criticism, lawsuit threats **
*https://www.politico.com/news/2023/07/18/biden-hipaa-expansion-abortion-00106694
/Biden administration trying to shield abortion medical record data
located in blue states from red state Attorney General probes.//
/

In case you are interested, here are some of my past articles on medical
data privacy and various vendors:
*
hipaalink.net security initial testing*
https://lem.clinicians-exchange.org/post/49122
*
Nearly All Hospital Websites Send Tracking Data to 3rd Parties,
Endangering Pt Privacy—Common Recipients: Alphabet, Meta, Adobe, AT&T*
https://lem.clinicians-exchange.org/post/24598
*
To become an Amazon Clinic patient, first you sign away some privacy,You
agreed to what? The ‘HIPAA authorization’ for Amazon’s new low-cost
clinic offers the tech giant more control over your health*
https://lem.clinicians-exchange.org/post/24603
*
FTC, HHS warn health providers not to use tracking tech in websites, apps*
https://lem.clinicians-exchange.org/post/44657
*
Would you want #AI used to help write a medical or psychotherapy chart
note?**(Ongoing Poll)*
https://mastodon.clinicians-exchange.org/@admin/110799586045837116
*
AWS rolls out generative AI service for healthcare documentation software*
https://lem.clinicians-exchange.org/post/57450

I'm not posting this to be political (although it certainly is) --*I'm
posting it as a legit medical records concern for all of us regardless
of each individual reader's political positions.  We need -- as
therapists -- to care about data leaks and privacy.*

+++++++++++
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#transgender
@psychotherapist @psychotherapists
@psychology @socialpsych @socialwork
@psychiatry #mentalhealth #technology #psychiatry #healthcare
#patientportal
#HIPAA #dataprotection #infosec @infosec #doctors #hospitals
#amazon #BAA #businessassociateagreement

TITLE: When Your HIPAA BAA Subcontractor Most Likely Means Well

Therapists are going to have to make an effort to educate our own BAA subcontractors about privacy.

Amongst therapists, privacy has always been paramount.

On the Internet, tracking has gone through several understandings. First, early webmasters were excited to get free website use statistics from Google Analytics. Then followed several years of tactics to effectively market ads following client computers around the Internet. Now, there is an awareness of that data as valuable in-and-of-itself.

Recently there is a new awareness that data other than name, SSI, address, & diagnosis CAN be considered PHI (Protected Health Information) when it is specific enough to ID the patient. Also when a data aggregator (tracking the same client across the Net) can obtain & combine data from multiple websites to build a composite file on the client. Browser cookies, pixels, beacons, mobile application identifiers, Adobe Flash technology, and IP address geolocation data can all be used -- in conjunction with websites visited -- to figure out specific individuals. ( See "Use of Online Tracking Technologies by HIPAA Covered Entities and Business Associates" from HHS at https://www.hhs.gov/hipaa/for-professionals/privacy/guidance/hipaa-online-tracking/index.html )

Also growing is an awareness that this data can be used for something other than just targeted advertising -- like in the recent Washington Post story in which the Planned Parenthood website was inadvertently sending data to Facebook and others -- which in theory could be used by hostile state governments to prosecute women for their medical choices. (See "You scheduled an abortion. Planned Parenthood’s website could tell Facebook." https://wapo.st/3Nyf6sr ) (Brick & mortar stores can also contribute. See "What Walmart’s tech investments mean for workers and shoppers" https://wapo.st/3J86PeE )

Therapists are going to have to make an effort to educate our own BAA subcontractors about privacy -- especially in cases where its not clear if HIPAA laws are being broken. Especially in cases where the subcontractors -- coming from the Internet world -- might not know better.

There are the more egregious cases (like BetterHelp sharing clear PHI data) -- situations in which therapists should walk or run away from the company. (See "FTC fines BetterHelp $7.8M, alleges it shared consumers' health info with advertisers" https://www.modernhealthcare.com/digital-health/ftc-betterhelp-consumer-health-info-facebook-snapchat-advertisers )

Then there are less clear cases where we need to change the mindset of our BAA subcontractors if possible.

Many of them may not understand the evolving definition of PHI. Their marketing/webdev teams may not talk with legal. They may just put together a required data consent policy with everything in it including the kitchen sink whether or not they actually collect it to "cover themselves". This needs tuning for their HIPAA clients. They may communicate with sites for legit use known to track (like fonts.google.com which provides fonts and is used by about every webmaster on earth).

If you want to see some of the URLs that your BAA subcontractors communicate with, You can double-check them by installing Ghostery and Privacy Badger in the Firefox browser (and maybe others) and checking which connections they warn you about or block when you go to those sites. This won't tell you WHAT data is communicated, only that SOME data is communicated (and if these services think they are a security risk). Knowing what data is actually sent would require someone with expertise in a packet sniffing software such as Wire Shark.

-- Michael

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Michael Reeder, LCPC
michael(at)hygeiacounseling.com

#psychology #counseling #socialwork #psychotherapy
@psychotherapist @psychology @socialpsych @socialwork #HIPAA #BAA #hack #datasecurity #legal #psychiatry @psychiatry #webdev #cookies #dataprivacy #security #beacons #Ghostery #PrivacyBadger #privacy #medical