Steve's Tech Talk

One Downside of Being a Geek

I or people I know closely have been on the receiving end of a number of medical procedures recently, nearly all of which included interesting scans of various body parts, usually including the the insides.  In each case, I've asked specifically what it would take to get a copy of each of these images.  In each case, I've been rebuffed.  Most recently, I was able to talk to the MD who did the scan about the file format (which I knew about), and when he realized I knew more than most people, he said, "Thank God for [that file format] - it's made life so much easier for us." to which I thought, "When you say, 'us' you really mean doctor and aren't including me, the patient."  From my point of view, this is harder than it's ever been.

There are two hurdles that prevent this from happening.  The first is technical. 

Hurdle the First - Technical

Even if I bring in a thumbdrive, an SD card, a memory stick, a burnable CD or even a floppy, there is a huge chance that:

1. The medical device won't accept the medium
2. The medical software won't include an export to device feature
3. The technician doesn't know how to use that feature properly
   

In addition, until people smarten up and learn to turn off autorun on their machines (and that ain't gonna happen anytime soon), I wouldn't let any old user's thumbrive anywhere near a medical device that I was about to have used on me.  People are just too sloppy and the last thing I want is someone else's Michaelangelo virus taking out the machine that's about to bombard me with radiation.  In most cases, this is not going to be an issue because a lot of the medical machinery are running a flavor of UNIX.

Hurdle the Second - Legal

Medical image files usually contain meta information about the patient.  If I'm given one of these files and somehow it gets into the hands of someone who shouldn't have it (and mind you - I would consider this my fault), the hospital could be held liable unless it were provable that I was the one who let the file out.  If I want to be a gold digger, I could intentionally try to get the file out and then blame the hospital.  Fraudulent?  Yes.  Expensive to the hospital?  Yes.  Would I ever do it myself?  No, but the risk that someone might is enough of a hurdle.

Yet it's so enticing - in every case, I've been offered a print out of the imagery that I could scan myself.  But why?  The data has already been sampled?  Why create another two levels of degradation when those juicy bytes are just waiting right there?!

What I'd like to see is a records/imagery access station at the hospital.  I come in with a storage device that the hospital will support (and for now, let's just say it's USB Mass Storage), walk up, present identification to a staff member, sign a consent form, get a smart card and a 1 time PIN.  I sit down at a PC, plug in the smart card, plug in my storage device, enter the PIN and I get a menu of the recent scans I've had done.  I select the ones I want and they get copied to my drive with new metadata indicating that this transaction happend with my authorization.  When I pull the smartcard, the PIN is invalidated and I walk away with the images I want.  As I walk away, the workstation reboots itself into a known good state, hopefully immune to anything that can be thrown at it.

On a similar geeky note, there's a pack and ship store that I go to frequently and it's a bit of a hassle to fill out the destination address for the nice person at the counter and then have them type it in - especially when that information is usually in my PDA.  I should be able to beam that right across to his machine, but of course, there's no IrDA port on his machine.  I'm now wondering what it would take to convince them to do this for me.  They're probably more willing to pop an IrDA dongle into the visible USB port on their machine than the hospital is to take a thumbdrive.