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Yet Another Use for Surveillance Technology - Synchronicity swirls and other foolishness

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August 24th, 2009


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01:30 am - Yet Another Use for Surveillance Technology
I was talking with teaotter about healthcare, and one of her thoughts was how much money keeping down malpractice insurance would save. She mentioned several depositions that she has read for her job, where there was significant question about exactly what a patient and doctor had talked about, now that the patient was dead and the doctor was being sued for malpractice. It occurred to me that this would be another truly excellent use for ubiquitous on-the-job surveillance – if there was a camera and microphone in every room in a hospital or clinic, then if there was a question later, a lawyer could request the recording and there would be a record of the actual conversation. Similar footage of operations would be equally useful. Current medical privacy laws would keep such records seal unless there was some sort of legal case, but such recording would protect good doctors, help uncover bad ones, and more than anything else, would speed up and simplify the process of dealing with any sort of malpractice issue, since there wouldn't be any question as to what was said and done.

I know that many people are deeply suspicious of surveillance footage, and obviously it has no place in people's homes or most workplaces. However, for police, doctors, emergency services personnel, air traffic controllers, and anyone else who has others' lives and safety depending upon their professional skill and judgment, such surveillance seems perfectly reasonable, especially since such surveillance would be as useful at protecting doctors for unfair or misinformed lawsuits as it would be for helping to uncover incompetence. I could also see using it for politicians. We could be doing this now, a few dozen webcams would cover a small hospital and 50 Terabyte of storage would hold a year's worth of data for 30 cameras.

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Comments:


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From:feedle
Date:August 24th, 2009 01:54 pm (UTC)
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In the case of healthcare, I can see a huge problem right off the bat: how to do this while maintaining the strict patient confidentiality required by HIPAA.

As somebody who's worked on HIPAA compliance from a IT standpoint, I can tell you that making any such system HIPAA compliant would be a nightmare, as the cost of failure would be so high that you'd have your IT people / HIPAA compliance people scurrying for the exits.

Some clinics have actually removed security cameras from patient waiting rooms and corridors because of fears of them picking up patient medical information from just routine surveillance, and the implications of being sued if that information somehow got used.

Lastly, as a patient, I'm not sure how comfortable I would be discussing "personal problems" with a doctor wearing a wire, and I'm probably the least squeamish person I know in this area. It's bad enough getting patients to discuss problems with sexual and excretory anatomy in the privacy of a clinic treatment room: most people would freak if they had to be on-camera discussing their weird rash down there.
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From:mindstalk
Date:August 24th, 2009 03:29 pm (UTC)
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Problems somewhat addressable by patients filming their consultations/operations and controlling the recording.
[User Picture]
From:feedle
Date:August 24th, 2009 04:09 pm (UTC)
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That defeats the whole purpose of the proposal. A universal recording system with a clear chain of custody has a much greater chance of surviving court challenges and being in-line with privacy laws on both sides (after all, the doctor has rights too as both a human being and an employee under the law).

The two types of doctors that face the most lawsuits are OB/GYN and those who work with the elderly. Both are doctors that deal with people who might not be very comfortable with having their medical problems documented on "film", regardless of who was holding the actual media.

And without the system being "universal" (that is, everything recorded) it is useless for solving the stated problem.
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From:heron61
Date:August 24th, 2009 08:09 pm (UTC)
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It seems fairly easy to me - you have a secure (non-online) storage facility onsite and the recordings are never accessed without a bunch of legal paperwork being filled out. You'd also need a robust way to record all access to these recordings, so any abuse could be prosecuted. I don't see it as much more difficult than managing the fact that medical records are increasingly on-line. OTOH, getting people to be comfortable with these recordings would be substantially harder.
[User Picture]
From:feedle
Date:August 24th, 2009 08:33 pm (UTC)
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That is the inherent problem.

Health care organizations are already very risk-adverse as a rule, and HIPAA has made them be over vigilant in regards to people's medical records (and anything that could possibly constitute a "medical record", even secondary work products). Many medical office managers spend their nights staring at the ceiling coming up with what Bruce Schneier likes to call "movie plot scenarios": stuff that could only happen in a million years given the exact right circumstances and a whole lot of astounding good luck.

I even had a medical office that banned CRT displays: not because LCDs are more efficient, or emit less potentially harmful radiation.. but because they read an article on TEMPEST techniques and the "movie plot scenario" of somebody sniffing van Eck radiation off the monitors from a truck parked outside. What the motivation (financial or otherwise) would be behind this scenario was never even a factor; out went CRTs and in come LCDs.

I didn't have the heart to tell this hyper-attentive RN that Ethernet networks emit the same sort of radiation, and it would be just as trivial to sniff traffic that way.

The point is, I can see just this type of facility manager shitting one very large brick at the implications that all interactions would be recorded. A video is an awful lot more data than even an X-Ray slide, and even an office manager would understand the implications that it is, in fact, harder to secure terabytes than megabytes.
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From:kitten_goddess
Date:August 24th, 2009 04:10 pm (UTC)
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That would also be a good way to keep doctors from molesting their patients or engaging in abusive therapeutic practices. Surveillance technology, if applied to doctors, should also be applied to anyone doing any kind of healing or medical work (yes, Reiki healers and other alternative practitioners, I'm looking at you!)
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From:feedle
Date:August 24th, 2009 04:54 pm (UTC)
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There is nothing more abusive in Reiki than the amount charged for the "attunements". Making an honest living is one thing: charging thousands of dollars for what amounts to information any entry-level occultist already knows is obscene.
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From:onyxrising
Date:August 24th, 2009 04:24 pm (UTC)
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Did you see that information on police officers having to wear cameras? (I think it was in Britain, but I can't immediately recall.)

I think it was Malcolm Gladwell, in Blink, who mentioned malpractice suits, and the amount of time that doctors spend with patients. Malpractice suits are often a completely irrational thing, greatly affected by how much the patient likes the doctor. Patients who like the doctor who fucked up will often pick another doctor whom they didn't like to vent their anger on by suing.
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From:heron61
Date:August 24th, 2009 08:10 pm (UTC)
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Did you see that information on police officers having to wear cameras? (I think it was in Britain, but I can't immediately recall.)

Yep - it reduced paperwork and seemed generally like it worked even better than I had expected.

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