CIVIL WAR: Protecting Health Information Security

For this week, we were tasked list down questions where answers should be able to identify risks to securing electronic health information. The scenario is that we are part of a group practice that has decided to implement an electronic solution for clinical documentation. However, we came across many horror stories regarding health information security that have led to failed clinical information system implementations. How would you prevent this from happening to your group practice?

To facilitate my discussion, I prepared a short comic strip to lay down the facts and bring to your consciousness the risks in electronic health information. (No copyright infringement intended for the photos and are used for educational purposes only).

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In the scenario above, a breached in the information system happened when an outsider tried to access the system, delete, tamper, and corrupt all the health data stored in the system.

Many factors led to the breach such as blatant disregard for the security of the physical server, weak user authentication, security of the health information, lack of encryption, among others.

This could have been prevented or minimized should the ‘Avengers’ considered and discussed first and foremost the safety and security of the health information system. Here some of the questions that they should have considered answering when they developed the system.

  1. WHO: Who has access to the information? Who can edit and view the codes?
  2. When: When can they access the information?
  3. How: How can they access it? Would it be cloud based, local area network? Exclusive to a identified computer or network?
  4. Where: Where will the main server be stored? Is it safe?
  5. What: What encryption mechanism will be used? What is the back-up mechanism

By answering these questions, although loopholes may still persist, it is somehow reduced.

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The Night We Met

by Lord Huron
The Night We Met
I am not the only traveler
Who has not repaid his debt
I’ve been searching for a trail to follow again
Take me back to the night we met
And then I can tell myself
What the hell I’m supposed to do
And then I can tell myself
Not to ride along with you
I had all and then most of you
Some and now none of you
Take me back to the night we met
I don’t know what I’m supposed to do
Haunted by the ghost of you
Oh, take me back to the night we met
When the night was full of terrors
And your eyes were filled with tears
When you had not touched me yet
Oh, take me back to the night we met
I had all and then most of you
Some and now none of you
Take me back to the night we met
I don’t know what I’m supposed to do
Haunted by the ghost of you
Take me back to the night we met

Reasons Why You should (or shouldn’t) Watch It

If you’re only interested to know what is my take on the controversial series, “Thirteen Reasons Why”you can skip the lengthy post and just read the quoted text.

“13 Reasons Why” is obviously not a series intended for all audiences. And by groups of audience I don’t only mean according to age, but according their state of mental health. 13 reasons Why has a lot of sensitive scenes that for someone who is depressed, or had experienced the same fate as Hanah Baker could trigger or suggest a wrong method of handling their mental health problem. But for advocates, family, friends and support groups the story of Hanah Baker is a wake up call that we should do something. It is a good case study that shows (some but not all) the different factors that could contribute to one taking his/her life. And while you’re in it, try thinking of your friends, of your family, or colleagues and  acquiantances. Try to look for Hanah Baker in your own circle; listen, understand, and be there for her.

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13 Reasons Why revolves around the story of Hanah Baker, a high school girl, and the reasons why she took her own life. Before she died of suicide, she recorded 13 tapes intended to 13 different people she thought contributed to her death.

The series gathered a lot of controversies from the public as it showed sensitive scenes that could trigger someone to die of suicide or justify suicide as a means to end the suffering. The show had also shown detailed scenes of how the lead actress, Hanah Baker, slit her wrist and ended her life.

“13 Reasons Why” is obviously not a series intended for all audiences. It has target audiences and anyone who would want to watch it should watch with caution and should be open-minded about the film.

By target audience, I don’t only mean according to age, gender or social classification but according to their state of mental health. If by chance you are aware that you are depressed, or had experienced what Hannah Baker had experience then, by all means, I ask you to NOT watch the series. Even if you think that you are currently okay and that you are now emotionally and mentally stable, DO NOT watch the show as it will haunt you and feed you wrong messages. If you are unsure about the state of your well-being, then choose the safe side and do not watch the show. If you watched the show and you’re starting to see yourself in Hannah Baker’s shoes, you have to stop.

13 reasons Why has a lot of sensitive scenes that for someone who is depressed, or had experienced the same fate as Hanah Baker could trigger or suggest a wrong method of handling their mental health problem. (Spoiler) Especially on the last episode where Hanah Baker already sought the help of a health professional, but still failed and still decided to take her own life, it might give (or is giving) a wrong message that it becomes justifiable already that she took her own life because she did everything and that everything failed her. Suicidal is a difficult state to be in and a sensitive topic, and the series should have been cautious to not lead the story to dying of suicide as it might be mimic by someone watching the show. It should have given hope and second chances so that people who were feeling like Hanah Baker would hold on and continue to live.

If you are experiencing emotional crisis and in need of immediate assistance, please call the HOPELINE at (02) 804-4673 or 0917 558 4673, or you may visit a psych facility or clinic nearest you. Here is the database of the nearest psych clinic in the Philippines: bit.ly/MHPHServiceDatabase.

Suicide should never be portrayed as the solution and should not be justified as the only way out. The series somehow delivered the wrong message, and will somehow make you feel that it was okay for Hanah Baker to take her life because she was bullied, she was raped, she wasn’t heared of, her friends failed her, her guidance counselor failed her, society failed her– her life was difficult and that taking her life away is a justifiable choice, and you can just blame anybody and somebody about it.

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It was also insensitive for the show to repeatedly describe victims of suicide as selfish, fame-whores, over reacting, and individuals looking for attention. Notions that were never resolved or corrected at the end of the show. 

“Suicide isn’t selfish. It’s sad, yes, but not selfish. It’s selfish of those left behind to try to make light of the deceased’s situation. Suicide is not a selfish act. It’s not for attention. It’s for relief. As sad as that sounds, it is. Someone who commits suicide, who goes> all in> for an act that takes it all away, is looking for a way to feel better. At the point when someone is suicidal, they aren’t thinking about other people, but they aren’t thinking about themselves either. (Which, by definition, rules out their SELFishness.) They are lost, confused, and consumed by a dark feeling that takes away their ability to truly think about the world around them. They get swept up in a bad place and, sometimes, unfortunately, can’t find their way out” (Sarah Laughon, 2014)

What’s missing in the series also is that it failed to emphasize that Hanah Baker may actually be suffering from depression and post-traumatic stress disorder. The series could have used it as a medium to raise awareness on this topic and help people understand it better.

But for advocates, family, friends and support groups the story of Hanah Baker is a wake up call for us to be sensitive, vigilant, and kind to people around us. It is a good case study that showed (only some, not all) factors that could contribute to one taking his/her life.

The series slaps you in the face of the existing and still unresolved problem in the society: the culture of bullying in schools (not limited to high school), lack of/insufficient policy and system in schools to protect the kids, the lack of support systems from the family or friends, and the stigmas attached to mental health.

These gaps in the society could be, for advocates and experts, be looked into and targetted to save a Hanah Baker. A lot has been done, but still, a lot is left for us to do.

Since the release of “13 Reasons Why” it caused a lot of discussion in schools, news, and social media about mental health. It was a timely topic to portray in an international TV series to raise awareness about mental health and suicide, but it could’ve been done better and more sensitive. I do not want to call the series a piece of trash as, for me, it somehow invalidates and denies thefact that somehow there are Hanah Bakers in this world who needs help, but a work in progress. And no, I do not want it to be taken down (as many people already have watched it), rather I’d that Netflix should release a more sensitive version of it and a follow-up story to correct the stigma and misconceptions in the first season, and put a better closure and hope to those who were affected by it.

And if this post made you curious and decide to watch “13 Reasons Why”, my only advice is for you to watch it with caution and an open mind. And while you’re on it, try thinking of your friends, of your family, or colleagues and acquaintances. Try to look for Hanah Baker in your own circle; listen, understand, and let them know you’ll be there for her. 
Because after all, we do not want to end up listening to tapes and being told we’re too late.

Bonus thought: My colleagues in the medical field had been wondering why the series showed Hanah Baker slitting her arms longitudinally and wondered if that could actually caused her to die. My theory is that the producers intentionally showed is it in that way so that in case there will be someone who would mimic the act, they would least likely die of hemorrhage and will just pass out. Just a theory though.

Sino ang tamang leader

From 2016 Facebook post.

Nakakalungkot na pagkatapos ng eleksyon na ito ang mas tatatak sa isipan ko (at ng mas maraming Pilipino) ay ang mga eskandalo, alegasyon, at kapalpakan ng nga kandidato, at hindi ang mga plano at plataporma nila sa bansa (hal. plataporma sa kalusugan).

Nakakalungkot na ang eleksyon ngayon ay hindi “Piliin ang tama”, bagamat ay “Choose the less evil” na.

Nakakalungkot na ang sistema na ng pagpili ng karamihan sa susunod na Presidente ng Pilipinas ay sa pamamagitan na ng “elimination method”, at hindi na dahil “mas maganda ang plano niya sa Pilipinas!” “Why should you NOT vote for him”, at hindi na “Why should you vote for me” ang kampanya ngayon.

Wag daw botohin si ito dahil ito, wag daw botohin si ganyan dahil ganyan. Sino pala ang iboboto?

Basta, wag iboto si ito.

Ang eleksyon nga naman talaga ay labasan ng baho, at hindi ng mga plano. Nakakalungkot. Siguro nga ay mas importante yun at mas ikauunlad ng bansa.

We prefer to pull other people down, than to push ourselves up. That is excellence for us.

I dream that someday Filipinos will have a healthy discourse on plans, and visions for the country; I dream that someday my newsfeed will be filled with platforms, plans, and positive and constructive criticisms; I dream that someday there will be less memes, name calling, trash talks, and BS. Well, maybe I might be too young or too naive to realize this has always been the elections in the Philippines.

Siguro nga ay dati pa to. Siguro nga ay ganito talaga tayo. Kaya nga siguro hirap tayong umasenso. Nakakalungkot.

#SulongPinas #TayoAngSagot #TayoAngPagbabago#PrayforthePhilippines #EleksyonSaPinas #SanaMataposNa

W;T (Margaret Edson)

(Draft) I just had the most EPIC experience in watching a theater play today.

[/] Hinarang ng Guard.
[/] Natawagan ang cast.
[/] Sinundo ng staff.
[/] Diniscountan ang ticket.
[/] AT Pinaupo sa front row center seat.

I thought that was the highlight of my theater experience for the month April but my experience and realization after watching the show was awesome.

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I was supposed to watch W;T the day after when I got stuck with my homework and decided to run to Trinity University of Asia to watch there and then. I did not realize that the security of the TUA is very strict that they are demanding for tickets before I can actually enter the campus. Of course, since it’s an impromptu decision, I wasn’t able to buy one. So I tried calling the number in the poster asking how I can enter, (or buy a ticket for me to enter the campus). That was 5:50 pm, 10 minutes before the start of the show.

Fortunately, the phone rang and someone answered the phone. The universe must be playing games with me, the person on the other end of the line was the cast/ producer of the show, Francis Mattheau. Fortunately, though, Francis was very accommodating and find people to help me (actually fetch me) from the entrance going to the theater house.

Fortunate events after fortunate events, the staff told me that the price ticket for today’s run, since it was a TUA sponsored event, was at P300.00 pesos only (Original P1000). And it did not end there, she even ushered me to the front row!

I must have done something great to deserve this. Thank you to the cast and staff!

Now on the play.

 

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Best seat in the house! ❤

 

CAST

Tami Monsod played the role of Vivian Bearing, a brilliant and uncompromising professor of English Literature diagnosed with a terminal ovarian cancer. She specializes in the Holy Sonnets of John Donne famously know for his literary pieces on death, poetry, and the use of “;” instead of “,”.  Ms. Tami Monsod nailed tremendously the role of Vivian. Sobrang galing, at madadala ka talaga. She had an amazing interpretation of Vivian Bearing. Her act was very precise and you can really see and feel that she gave all her heart (and hair) to give justice to the role. There were a lot of scenes that I would already want to stand from where I’m sitting and hug her.

 

Mikkie Bradshaw played the role of Susie Monahan, a registered nurse, and chief nurse in charge of Vivian. I met Mikkie Bradshaw from Fun Home where she played the role of Middle-Aged Alison (I’m so glad she remembered me). She was my favorite character then, and again in this play. I am so amazed by how she transformed from a middle-aged confused kid to a compassionate and very kind nurse. I will never forget the last scene with her and the dead body of Vivian where I almost lost control and planned to go up to the stage to hug and comfort her. Susie highlighted the most significant trait of the Nurses in the health care community which is compassion. They are smart, reliable, and compassionate. A trait that is often lost by people in this field.

I had a chance to talk to Mikkie after the show and I asked her how was it playing the role of Susie. She said it was very different, and difficult at the same time. She needed to squeeze her brains out to understand some of the lines since there was a deep literary poem, and she had to act to be genuinely kind.

Bibo Reyes played the role of Jason Posner, M.D. Of all the characters, he was the character I relate myself so well. He was an oncologist, a scientist, a researcher. He studies and conducts research to save lives of many people (such as I). But in doing so, forgets the life of the human being in front of him. He was so into his research that he went almost desperate just to make his research succeed. Like many researchers and doctors nowadays, often, we see patients as mere cases studies and good sources of data that we forget that it’s a life of a human being that we’re dealing with. Bibo was so effective with his role, aside from his charm that captivated the audience that very moment he stepped out of the stage, he delivered his lines and gave an awesome portrayal of an aspiring Oncologist, ambitious scientist, inhumane doctor, and desperate human being wanting to help mankind but forgets to be a human.

Other casts include Raymund Concepcion as Harvey Kelekian/ E.M. Ashford/ Mr. Bearing, Francis Mattheu, Jillian Ita-as, Anikka Estrada, and John de Lima as the Lab Technicians/ Students/ Fellows.

Story

“It is not my intention to give away the plot; but I think I die at the end.” – Margaret Edson, Wit

The story revolved around the last remaining days of Vivian Bearing, a great professor of English Literature. She was diagnosed with stage 4 ovarian cancer and had to undergo a chemotherapy treatment– an unguaranteed and experimental chemotherapy treatment. It was a narration of her life: as a student in English literature, as an uncompromising professor, as a daughter, as a patient, as a subject for a case study.

The story is very moving as it captures and marries English literature, through words and sonnets; and health science, through data and research. I like how the play showcased the commonalities of the two fields and their common differences.

It reminds every literary major, health sciences experts, and human beings in the audience to be human. To never forget, as we strive for greatness and optimum knowledge, to be kind. Sometimes, as literary majors, we are too overwhelmed by understanding and interpreting life and death into words that we forgot about life, and to live. Sometimes, as health researchers, we are too perplexed by the wonders of the human body that we forgot to be human, and that who we’re dealing with are humans.

We must always strive, not to be great, but to be kind. “Now is a time for, dare I say it, kindness. I thought being extremely smart would take care of it. But I see I have been found out.” ― Vivian Bearing, Wit

After going out of the theater teary-eyed and extremely moved, I highly recommend that you watch this play, “W;t: A play by Margaret Edson”. It is the first time that the play is being adapted in Asia brough to you by Twin Bill. They still have five remaining shows: April 29 (3:00 pm and 8:00 pm), April 30 (3:00 pm), May 2 (8:00 pm) and May 3 (6:00 pm) at Mandell Hall, Trinity University of Asia.

#TheaterAppreciation #AprilTheater #Wit

 

Holy Sonnets: Death, be not proud
Death, be not proud, though some have called thee
Mighty and dreadful, for thou art not so;
For those whom thou think’st thou dost overthrow
Die not, poor Death, nor yet canst thou kill me.
From rest and sleep, which but thy pictures be,
Much pleasure; then from thee much more must flow,
And soonest our best men with thee do go,
Rest of their bones, and soul’s delivery.
Thou art slave to fate, chance, kings, and desperate men,
And dost with poison, war, and sickness dwell,
And poppy or charms can make us sleep as well
And better than thy stroke; why swell’st thou then?
One short sleep past, we wake eternally
And Death shall be no more; Death, thou shalt die.

—-Photo opportunity with the cast—-

Movie Review: Sunday Beauty Queen,

 

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Photo (c) Tuko Film Productions, Artikulo Uno

What interest me after watching Sunday Beauty Queen is why the movie was titled as such, and why the plot of the movie pivoted on what the Hong Kong OFWs do during Sundays. I asked my friends after watching the film on what they think was the documentary’s objective.

One said that the movie tries to show the story of the OFW in Hong Kong, their struggles, their stories abroad and their stories back in the Philippines. It is no smooth sailing adventure working abroad. The movie showed the different problems encountered by OFWs in Hong Kong, and OFWs in general. There are harsh employers, there are kind employers, and there are employers that treat domestic helpers as a family. Stories were shared on how they were treated by their employers. Some employers give them proper treatment– decent sleeping quarters, eating with their employers; while others treat them far worse than animals– horrible sleeping areas, left-over food. We do know a little about the life and struggles of OFW until this documentary.

Another said that the movie simply wants to feature Hong Kong OFW’s weekly activity, Beauty Contest, and how it harnessed camaraderie amongst themselves, and how such activity helped keep their sanity intact. It’s unbearable to imagine one’s mental torture living away from their family, dealing with problems of their foster family, problems on how to survive with their daily lives, how they were there for each other, as one family, and on how someday after watching and counting several airplanes, the next plane would be their ride home.

Domestic Helpers are also torn with the life they have and the life they are sharing with their new found family. Two stories that struck us the most are the stories of MJ. Mr. Jack, a sick old man, and his family were very good to MJ, and MJ also saw them as a family. Mr. Jack is very supportive of MJ and her Sunday events. And it broke our heart when Mr. Jack died, it was Sunday when he died. Another story was of Cherrie Mae Bretana where he gave up (at the last minute) a good opportunity in Japan for her employer’s son. It simply shows how Filipinos sometimes give themselves selflessly even to people they don’t share the same blood with.

Another said it’s a call to action– rights for all domestic helpers in Hong Kong. There were many harsh laws and regulations described in the film. Among which are the 14-day mandatory placement after being terminated by the employer, optional live-out policy for domestic helpers, poor (to no) 8-hour working policy, and the lack of support of the embassies and government of both countries to domestic helpers and OFWs.

I agree with all that my friends said, but I felt something is missing. I can’t seem to find the connection of everything to one another, especially of the title Sunday Beauty Queen. I felt there are symbolisms or a deeper meaning with the title and with what the documentary tries to portray.

Then I remembered the scene of Mr. Leo during one of the Sunday practices with the Beauty Queen. He was narrating his experience when one time he was asked what was his job in Hong Kong. He narrated, ‘When people asks me what my job here in Hong Kong is, I would answer that I am a manager. Then people would stare at you from head to toe. Then I would show them my iPhone. Yes, I am a manager. Manager of my employer.’

I realized maybe that was the connection to everything. Sunday Beauty Queen struck a balance in portraying the struggles and challenges of Domestic Helpers and breaking the stigma attached to Domestic Helpers. Domestic Helpers are not prostitutes but are moral and decent workers. Domestic Helpers are not slaves but Queens.

I remember there is one interview in the documentary where one of the Hong Kong employers said, “Domestic Helpers are very important here in Hong Kong. I can barely imagine what will happen to us without them.”

And Sunday Beauty Queen reminds us of that. Sunday Beauty Contest reminds them of that. It is more than just a Beauty Pageant, an income generating pageant, an advocacy-driven activity, a camaraderie event– it is a weekly reminder that they are important. That after a week long of hard work there is that one day in a week that would make them feel like they rule the world, that they could strut in the runway with pride like real Queens of this world because they really are. Not only on Sundays but every day.

I hope this film pushes us to make effort to value and protect our Queens, our beloved Overseas Filipino Workers. (r)

 

 

Duterte’s War on Drugs

Yung bawat bukas mo ng TV at pagbabasa ng newsfeed ay puro patayan na ang nabababasa mo. Everyday, like it’s just part of the norm. What’s more alarming is the kind of thinking these events is spreading to everyone (see comment section)—that it is okay to kill, as long as your killing ‘what you think’ is a bad guy. Putting matters in your hands like there is no due process.

This is not okay. ‪#‎PresidentDuterte‬, take a stand on this, make it stop, whoever is behind this. I believe your words are too powerful to stop this. Stop the spread of hopelessnes and lack of faith in humanity,‪#‎StopExtraJudicialKilling‬. Let’s make our country a better place.

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The New York Times article featuring the Philippines on its bloody battle on drugs. View full article on GMA News.

To #PresidentDuterte, supporters of this extrajudicial killing, and citizens of the Philippines, here is a thought to ponder for all of us.

Maybe we should re-think what we know about drugs, addiction, isolation and think of social recovery, re-connection, and hope.