Cue The Black Helicopters

I don't want to cut short any discussion on my last couple involuntary treatment posts, but I wanted to let people know we've got a new Shrink Rap News column up over on Clinical Psychiatry News. My titles over there tend to run on the wordy side, but it's called "RAND Report Signals Threat to Patient Privacy." It's about a recently published think tank report discussing the state of the art of current digital surveillance sources, how they can be analyzed and interpreted and potential applications in national security systems. It's relevant to Shrink Rap because one of the sources they mention----quite transiently and in passing, but it's there----is medical information. And once a person is identified through this Big Data analysis, the report suggests they could be arrested, put under surveillance or taken in for interrogation. Whoa, there's one application of an EMR I never anticipated!

To my knowledge none of this is happening yet, but five years ago I never expected we'd ever hear about anything like PRISM. Go over and read.

Meanwhile, over on KevinMD today there's a similar post by T. J. Derham entitled "How Edward Snowden and PRISM affect health care social media" in which he encourages doctors to still be involved in social media and health care IT systems in spite of PRISM. I'm not sure I'm totally sold on the argument. I want Roy to think about this and put up a Shrink Rap News post pro- or con. Read the KevinMD post here.

I'm going to have to invent new Blogger labels for posts like this now. What should they be? #nsa? #blackchopper? #dontquestionmebro?

Why You Should Care About FISA

I know everybody's been concerned about the fiscal cliff lately, but meanwhile something important has slipped under the radar that could be more serious than that for all of us.

Last week both houses of Congress overwhelmingly passed a five year extension to the Foreign Intelligence Surveillance Act (FISA), the law which allows warrantless eavesdropping, wiretapping and monitoring of anyone who may represent a threat to national security. The renewal has been signed into law already by President Obama.

Under this act, government investigators can datamine telephone, email and other online communications pretty much at will. Congress voted down proposed amendments to allow mandatory annual reporting of how often this is done or who this is being done to.

I know this sounds a bit histrionic, but consider this statement from Rand Paul last week:

“Some may ask well, why go to such great lengths to protect records? Isn’t the government just interested in the records of bad people?” Paul said. “Well, to answer this question, you must imagine your Visa statement and imagine what information is on your Visa statement. From your Visa statement, the government may be able to ascertain what magazines you read, whether you drink and how much, whether you gamble and how much, whether you’re a conservative, a liberal, a libertarian, whom do you contribute to, who is your preferred political party, whether you attend a church, a synagogue or a mosque, whether you see a psychiatrist, what type of medication do you take.” (emphasis added)

So this isn't something that, as a mental health professional, you can just shrug off since you're not 'one of the bad guys.'  Particularly now since the public and the government have pressing interests in liberalizing the flow of information between public safety and mental health systems in light of all the recent shootings. The FISA extension grants that authority. If a mental health patient could be deemed a general threat to public safety (read: national security)...well..think about it. Read the full Rand Paul link.

I know everybody is concerned about CPT code changes and impending reimbursement issues, but there's other stuff going on too right now. If you would like to know how your Congressman voted on this issue, you can read the roster here.

[My first post about this topic was in April 2006. It was the seventh of nearly 2000 blog posts we've put up. Seven years later, nothing much has changed.]