Navigating Healthcare – Patient Safety and Personal Healthcare Management

Saving Healthcare Quality

Saving Healthcare Quality

The Incrementalist Graphic Fred Trotter

This week I am talking to Fred Trotter (@fredtrotter), CTO CareSet Systems – the first commercial Medicare Data company. Fred has a long and fascinating background that unlike many healthcare Cybersecurity experts started in the security field and transitioned to healthcare and healthcare data. You can read his musings on Hacking Healthcare here.

We talked about Fred’s coordination of the Save the Agency for Healthcare Research and Quality (AHRQ) data project that took off online using twitter and other social channels as an unofficial mechanism. The AHRQ and the National Guideline Clearinghouse (NGC) was expected to be taken offline earlier this year as part of budget cuts and there was a significant concern that the 1,500+ clinical guideline summaries currently available would disappear forever. Some of us might think its a simple thing to copy content thus preserving the material but as Fred explains it was not that simple

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In fact he contributes to the Internet Archive project (aka the Way back Machine) on a regular basis as one fo the important community projects that is workmen to preserve the digital history fo the web. Listen in to find out why the internet archive copy that was stored on this site was not enough and how Fred and the others used the insights and data from the Archive site to improve their data capture and storage. You can access the data on Guidelines here and the Quality Measures here – all sourced from this GitHub Project

We also talk about his history and involvement in the Health Care Industry Cybersecurity Task Force that was convened under President Obama’s administration by the DHS in March 2016. They issued their report to congress June 2017:  Report on Improving Cybersecurity in the Health Care Industry. Listen in to hear about the experience of bringing this diverse group together as they attempted to predict future attacks (Hint – many of the things they predicted came true that same year!)


Listen live at 4:00 AM, 12:00 Noon or 8:00 PM ET, Monday through Friday for the next two weeks at HealthcareNOW Radio. After that, you can listen on demand (See podcast information below.) Join the conversation on Twitter at #TheIncrementalist.


Listen along on HealthcareNowRadio or on SoundCloud

Saving Healthcare Quality was originally published on Dr Nick – The Incrementalist

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Summit

Keys to Successful Conferences

How do you describe the CNS Summit and what it offers – the word impossible springs to mind. Even the name can be a little misleading especially for medical folks who might look at that and think “Central Nervous System” but actually its stands for Collaborating for Novel Solutions

Innovation
CNS Summit Collaborating for Novel Solutions

This coming year will be the 10th year of the event and it continues to get better – testing new ideas and concepts for conferences to make the event valuable on multiple levels. The history and experience reminds me a lot of friendships and how they develop – the first interaction can be awkward and uncertain but intuitively you get a sense that the person you are talking to is someone who will be a friend pretty quickly (science suggests it is not minutes or seconds but a 1/10th of a second). Over time the relationship deepens and you learn more, and understand more, and how much you enjoy working with, learning from, sharing and sometimes just hanging out. So it is with the CNS Summit or more frequently know as “Summit”.

Photography
Photography Techniques from Experts

Where else can you come to a conference and get clever new ideas and techniques on how to use your mobile phone camera in interesting and creative ways from the incredibly talented and inspiration photographer Asa Mathat (recommend instagram @AsaMathat to get a sense of his incredible lens on the world and people). He is a renowned Photographer to the stars, creator of the big pink ribbon and at Summit – photographer for attendees as well!).

(Hint – Don’t think in traditional planes of movement and use your volume buttons as triggers and when you reach the end of your panorama, just reverse direction to switch it off).

CNSSummit Asa Mathat Photo Booth
Asa Mathat Photo Booth at Summit

Areas Covered

It hard to categorize the conference into a bucket – it benefits from being not too big so as not to overwhelm but large enough to attract an impressive diversity of participants and speakers. The mix includes leaders from the Pharmaceutical Industry, digital health, medical and device companies and technology companies.

Insights continued from cancer survivors who parlayed their personal experiences to focus on taming the data mountain in healthcare and science, the pharmaceutical executive who nearly died from a side effect of a drug that had a life changing effect on the personal trajectory that allowed for a rethinking the model of industrial production of pharmaceuticals.

CNSSummit WoodyWhisky
Woody’s Whisky Tasting Selection

Of course for this Whisky Librarian, there is even a special highlight put on by Woody Woodaman – the whisky tasting that raises money for a fund set up in his wife’s name Betty Jean Memorial Scholarship Fund to support nurse training. The conference floor is always offers new concepts and technologies – everything from taste experiences to the highly popular hugging booth set up by friend and colleague Andrew Chacko.

Each year is an eye opening experience full of surprises that Amir Kalali the conference Chief Curator keeps close to his chest like a proud parent who know’s he’s picked the best birthday gift for their child and can’t wait to reveal it.

This year there were many mind blowing presentations – for me “Breaking the Logjam in Medical Imaging” by Mary Lou Jepsen from Openwater that pushed the boundaries of wearables by offering a path to an MRI wearable. Sounds far fetched – not if you approach the problem with a different lens and understand that our photo sensor chips have reached a sensitivity of a micron – the wavelength of infrared. Combine this with the fact that our bodies are translucent to red and near infrared light – but red light scatters but this is not random, it is deterministic and reversible if you can record a hologram of it. So with some clever use of relatively old technology that allowed us to move from overhead foils

CNSSummit OverheadFoils
Remember these Devices?

to LCD projectors we are all accustomed to. This now allows the generation of ultrasound waves from small devices and using the change in phase of the light as it passes through the red light (you all know the doppler shift experiment you learnt in physics at school) they are now able to find vasculature at higher resolution than MRI and fMRI and even have additional capabilities to differentiate between oxygenated and non-oxygenated blood as achieved with the fMRI

Absorption of Hemoglobin for fMRI
Mapping Oxygenation of Blood in Real-time

But the resolution is now down to a few microns which is at the size of neurons, meaning they have the ability to see into our bodies at the detail of our nervous system… real time!

Image Resolution of Neurons
Neuron level granularity of Imaging

Combined with the early science that shows we can reconstruct what we are thinking and seeing based on analysis of our brain activity (Reconstructing visual experiences from brain activity evoked by natural movies, Nature – pdf). Most exciting the project is driven by a challenge to deliver a low cost, better imaging solution, to everyone, given that 2/3 of humanity lacks access to imaging.

Final Conference Day

 

The highlight for me was the last day – which according to my research and discussions with others, is just like every other conference poorly attended with many people missing the best elements.

It included two amazing presentations by the compassionate and gentle Daniel Friedland (Leading Well from Within), the wonderful, funny and insightful Chris Hadnagy (Social Hacker and previous guest on my radio show) and Stephanie Paul’s fun and eye opening Improv experience and included Asa Mathat participating and recording the activities with his unique eye. This picture captures the fun and learning we had as we learnt and connected

CNSSummit LastDayFun

So my Incremental step for you is set aside Oct 31 – Nov 3, 2019 for Summit 2109 (It is the 10th anniversary so I’m imagining Amir and the guiding council is thinking hard about making this event super special) and you to will have the learning opportunity and fun as you find a new friend in CNS Summit

CNSSummit AsaMathatandNick

And one more Incremental step – if you are taking the time to go to a conference, don’t head out before it finishes but rather plan to enjoy the last sessions where organizers often try to save the best till last.

Summit was originally published on Dr Nick – The Incrementalist

Consumer Rights Driven Data Access

The Bluebutton Innovator

 

The Incrementalist - Mark Scrimshire

This week I am talking to Mark Scrimshire (@eKiveMark) a fellow Walking Gallery member and Entrepreneur in Residence at NewWave and on assignment as Medicare Blue Button 2.0 Innovator at CMS where he is designing and implementing the new API to enable 53 million Medicare Beneficiaries to share their claims information with the applications, services and research programs they choose to trust.

His work extends back to 2010 when the initial concept of the Blue Button was conceptualized but it took several years before this started to really take off with the concept of View, Download and Transmit. One of the key Incremental Steps to get this interoperability rolled out centered on changing the positioning of HIPAA from a barrier to sharing and portability to an enabler. Ironic when you consider that it stands for “Health Insurance Portability and Accountability Act”! Listen in to find out the details behind the change and a key incremental step to progress – changing the messaging

Part of this changed messaging centers on the Office of Civil Rights (OCR) and the clear guidance to direct consumers to have the right to access their data in electronic format. As promised in the broadcast here is the Rights to Access Memo they issued in September 2015 and something I carry with me to all my medical appointments.

He shares his view on how to move toward interoperability and his incremental step connected with the Fast Healthcare Interoperability Resources (FHIR, pronounced “Fire”) set of Resources and removing complexity and simplifying the approach the is a recurring theme for Incremental Improvements.

Don’t let perfection stand in the way of progress

You can read more about the project in the FHIR Wiki he mentioned here. Listen in to hear Mark talk about the new project and how he is turning the oxymoron of Explanation of Benefits (EOB) which fails to provide insights to the people it is directed at and how the DaVinci project. The move from the old model of Fee for Service (FFS) to paying for outcomes is also driving a whole shift in data accessibility and utility and willingness to share which is exciting for our the consumer rights driven access movement.

Their Incremental steps to improvement include the huddle but listen in to hear what other incremental steps you may be missing that has added significantly to their team-based approach, coordination and success


Listen live at 4:00 AM, 12:00 Noon or 8:00 PM ET, Monday through Friday for the next two weeks at HealthcareNOW Radio. After that, you can listen on demand (See podcast information below.) Join the conversation on Twitter at #TheIncrementalist.


Listen along on HealthcareNowRadio or on SoundCloud

Consumer Rights Driven Data Access was originally published on Dr Nick – The Incrementalist

Interoperability in Healthcare

Getting to Nationwide Interoperability

Data
Free Flow Data Sharing

Unfortunately, the existing healthcare system incentives behavior that is in opposition to the goal of scalable, nationwide, vendor-neutral interoperability. Our model has multiple groups who have a vested interest in the control and ownership of data (for example Payors, Providers, Patients). Each has their own economic and commercial drivers and in many instances, these do not coincide with the open sharing of data. In a system that is driven by activity and delivering care (Fee for Service) sharing data could mean a reduction in work and income. Until our reimbursement system moves to a more holistic care model that focuses on wellness and outcomes and incentivizes behavior that delivers better health and outcomes for patients through cooperative and coordinated care and ultimately equitably rewards all the contributors to these outcomes we will remain stuck in the quagmire of limited interoperability.

The Patient at the Center of Data Exchange

I believe as do many others that the patient is at the center of everything we do and deliver in healthcare. By placing the patient and their information at the center of care we empower them and enable a model that moves away from the historical paternalistic delivery of healthcare to patient-centered and enabled care. It does come with challenges since many people contribute to that care and the current administrative and financial configuration focus the management and ownership of data with providers, healthcare systems and payors. While many patients want access to their data and some even want to own and manage it, many do not and are ill-equipped to be responsible for this data. What may emerge are independent services and providers who aggregate, manage, secure and service patient data on behalf of patients – much as banks do with our money. There are many technologies on the horizon that offer a potential path to achieve this and blockchain represents an interesting innovation of decentralized secured data that offers individualized control and dynamic revocation options for access.

Frictionless Data Flow

The key to an interconnected care model is the free flow of data between all the various areas that are responsible for delivering care. We moved away from the single index card medical record held by your personal physician who was the focal point of your care and care coordination to a distributed team-based model of care that encompasses multiple areas and people. The only way this team can deliver excellent care is through the frictionless flow of enhanced data and knowledge. This information flow must include the patient and all their family members that are authorized, interested and engaged in their care. Data should be shared with the patient’s consent with everyone concerned and available for as long as it is needed to deliver care but this access should be flexible enough to allow it to be revoked or removed when it is no longer needed or necessary

 

Interoperability in Healthcare was originally published on Dr Nick – The Incrementalist

The NHS at 70

Healthcare, NHS

The crown jewels of British society

The NHS was the crown jewels of British society providing healthcare to every member of society no matter who they were, where they came from and what personal resources they had. It was the great leveler of society creating a single standard of care and service that was accessible to rich, poor and disenfranchised and it was well loved.
To me personally, it was my guide and educator – I was lucky to attend one of the great London medical schools – The Royal Free Hospital School of Medicine. The “Free” hospital created to treat all comers and the original medical school (The London School of Medicine for Women) for women created in an era when women were not admitted to British Medical schools

That hospital and the NHS provided me with a first-class medical school education, access to groundbreaking research that included the early work and discoveries around HIV/AIDS, Hemophilia, Liver disorders and beyond.
The staff in every department were friends, colleagues and members of a community that were family and all pulled in the same direction – that of the patient. I spent time working in different areas during my time, staffing the manual telephone switchboard, helping the porters and security staff, nurses, technologists, and maintenance and quickly realized the well-oiled NHS machine demanded a family of committed people to make it work and deliver outstanding care each and every day.

What Could We Do Better

As we know today, and probably knew 70 years ago and before, healthcare is as much about our environment and resources as it is about medical treatments, technology, and innovation. We know that 60-80% of health is attributable to lifestyle but fail to take account of this in the NHS and in the majority of health systems from around the world.

 

We need a WellCare system not Healthcare

 

The system spends large sums of money providing medications to the population but fails to take account of the most basic needs of the population and acknowledge that food is also a drug. What we put into our bodies contributes to our health and well-being. Failing to acknowledge and manage these elements of health with sleep as the foundation and exercise and nutrition built on top has created a system that treats the failing of these issues at great financial and personal patient cost. Investing in the prevention would create a WellCare system and not the Healthcare System that the NHS is.

Manage and Allocate the Limited Resources with Transparency

It’s an unpleasant fact that few want to address or even acknowledge but the reality of treating people is that in this day and age of innovation, scientific progress and developments we could spend every last penny on treating patients. There is an unlimited supply of possible treatments and a never-ending procession of people needing those treatments. But not all treatments are created equally – some don’t work, some are harmful and in the cases of those that do work there is the wide disparity in the effectiveness and cost. Any healthcare system needs a means of assessing the effectiveness of treatments that includes the financial and resource cost linked to the improvements. The problem with a “free” (the NHS is not free – it is simply free at the point of care, paid for through taxation of the individuals) is the inducement of un-economic behavior by individuals looking for every last treatment option no matter the cost or effectiveness. That path is unsustainable and breaks the system and ultimately harms patients.

Enable Informed Decision Making for Everyone

Doctors Die Differently and do so because they understand the economic and personal tradeoffs between treatments and quality of life. In the data presented by the Johns Hopkins Study of a Lifetime we see a big discrepancy in treatment choices between doctors and everyone else. We make our choices in the context of the knowledge of effectiveness weighed against the personal cost of treatments and quality of life impact. An open an honest assessment of treatment that is clinically effective would level the disparity in treatment choices selected by patients. As a society, we struggle to discuss end of life but it is a reality that everyone faces and we must find ways to educate and support people through all aspects of life and death.

Technology and innovation is essential to the future of the NHS

The future of a scalable meritocratic system accessible to all that does not bankrupt society will be dependent on technology and innovation. Humans remain the core constituents of any compassionate caring system and technology is a supporting player. But as Michael Dell put it:

Technology has always been about enabling human potential

Michael Dell, Dell
Technology has always been about Enabling Human Potential

Technology does not replace the human beings or interaction but rather augments it in ways that extend our capabilities and improves the accessibility and economics.

It is an impossible task for humans to process the amount of data currently being generated about our patients, the knowledge derived from research and advances in science and put it into the context of treatments at the point of care when it is needed most.

We have expanded beyond the human brains capacity to absorb, process and apply the knowledge and must rely on technology to augment the brains abilities and place information into the context of the individual patient and the care choices available.

Selecting the innovations that deliver the most value

Innovation impacts each and every area of the NHS and will continue to do so but the challenge will be to select the innovations that deliver the most value to the largest number of people based on scientific peer reviews.

Innovation is not confined to the clinical treatment but extends to every element of the NHS system and the delivery of wellness care. It is changing the design of facilities to include features that improve care and outcomes – for example by adding natural light and open spaces.

Innovation is allowing patients the option to access their care team at any time and from any location – for example bringing the care team to the patient as we used to do with home visits but now using technology to extend the reach and scalability.

Innovation is building rooms and beds that can be efficiently and effectively cleaned between visits while maintaining comfort and welcoming surroundings. It is using available data to predict potential health issues before they occur and reaching out to patients helping to guide them to better healthier choices and wellness. Innovation is allowing parents to stay with their child in the hospital when they are sick and in need of care in comfortable and caring surroundings.

Innovation is offering dignity and compassion to those facing death and offering realistic options for no treatment and hospice care.

What can Britain and the NHS learn from the rest of the world?

Over 700 years ago, China had village doctors who were paid by the villagers when they were well but received no money when the patients were sick. This is the principle of wellness over sickness care. In Norway, they have a wide and uniform implementation of a digital health record that is accessible to everyone that needs it including the patient – tied together with a unique patient identifier designed for that purpose. One Citizen, one record.

The European Union allows citizens to cross borders and different health systems but to receive urgent care while traveling and administers the cross-country charges, managing fees and removing the patient from worrying about payments while they are sick and abroad.

Look also to Africa and the innovation that takes place on a continent with access to far fewer resources and technology to see what’s possible with the existing technology. Small incremental steps in using technology to boost healthcare services such as text messaging have been wildly successful and yet remain simple, easy to implement and understand and accessible through all social groups in society.

In Rwanda, they have integrated drone delivery for hard-to-reach locations, offering lifesaving support that was previously almost impossible. Expect to see more of this and bi-directional capabilities for resources, tests, and samples as well as lifesaving treatments.

Finally, in Korea, they have a culture of celebrating aging and the elderly that includes dignity in end of life and the inclusion of everyone in the family and their health. Korean culture sees the 60th and 70th birthday as a big family affair and the inclusion and the universal expectation that roles reverse once parents age, and that it is an adult child’s honorable duty to care for his or her parents’ health.”

A version of this appeared previously here

The NHS at 70 was originally published on Dr Nick – The Incrementalist

Change Behavior, Change the World

Change Behavior, Change the World

The Incrementalist Graphic Adam Pelligrini

This week I am talking to Adam Pelligrini,(@adampelligrini) the General Manager and SVP for Fitbit Health Solutions. Adam has had a long career in the Digital Health coming from the Digital Health group for Walgreens Boots Alliance where he built a range of digital and mHealth platforms. He recently ran and hosted the highly successful FitBit Captivate conference where over 300 employers, health systems and health organizations from around the country gathered in Chicago to hear about the latest innovation in wearable personalized health technology. You can read more about it here.

The new digital space and innovations in wearables are an exploding and Adam shares his insights into what it takes to be successful in the wearable space. FitBit’s focus is on an open platform and incorporating behavioral change into the DNA of the company and these solutions have been instrumental in getting 6.8 Million people participating in population health programs with their devices!

Connecting Data Wearables

They found Incremental steps to getting people engaged in the United Healthcare Motion Program which was founded on the principle of connecting people to their data and making it simple. Their program was focused on simple small steps of  “FIT – Frequency, Intensity and Tenacity” that were tied to rewards back to the individual

 

 

Listen in to find out how they managed to record 6.5 Billion nights of sleep and added 2.9 Million participants to a new female health tracking feature with just native word of mouth!


Listen live at 4:00 AM, 12:00 Noon or 8:00 PM ET, Monday through Friday for the next two weeks at HealthcareNOW Radio. After that, you can listen on demand (See podcast information below.) Join the conversation on Twitter at #TheIncrementalist.


Listen along on HealthcareNowRadio or on SoundCloud

Change Behavior, Change the World was originally published on Dr Nick – The Incrementalist

Consumer Level Insights to Healthcare

Posted in bigdata, HealthIT, Incremental, Innovation, obesity, Population Health, SDoH by drnic on October 2, 2018

How Much you Travel Can Predict Your Health-Related Behavior

The Incrementalist Graphic Won Chung

This weeks interview was an opportunity to catch up with Dr Won Chung – an Emergency Room doctor and co-founder of Carrot Health – a company focusing on bringing consumer level insights, data and analysis to medicine

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His clinical career has been centered on the Emergency Room which as he describes is primarily focused on treating Accidents and Emergencies but as he has discovered where an awful lot of what happens in the Emergency room is not impacting the long term health of patients. We know that our personal behavior and the social determinants of health (SDoH) (such as gender, marriage and other consumer attributes) are not only important to health but actually are the major components of differential health outcomes and by most estimates contribute 60-80%. I make this point frequently in my presentations:

In a recurring theme on the show – the incremental insight that got him here happened when he was attending business school where he met his co-founder Kurt Waltenbaugh where they were discussing the data missing to manage patients better. As he puts it

if I knew details of what you were buying in the supermarket I could predict you HB1Ac before you even enter my clinical office

Once again – the adjacent possible discussion was the foundation for the company as they realized together that they could gather the missing data from other sources especially retail and help answer those questions.

Listen in to hear our discussion on their insights into Diabetes – a chronic disease affecting 10% of the population (that’s 30 Million people in the US) and a whole lot more that are are pre-diabetic. Hear about the two groups of patients and the correlation between the how much you travel and the success or failure of your diabetes management. Hear how pet ownership and your civic responsibility are also linked and find out which car you drive is linked to your success in managing diabetes. We talk about marriage and its effects on health offering some new and more granular insights into the benefits of marriage – the results will surprise you

You can read more about this insight here


Listen live at 4:00 AM, 12:00 Noon or 8:00 PM ET, Monday through Friday for the next two weeks at HealthcareNOW Radio. After that, you can listen on demand (See podcast information below.) Join the conversation on Twitter at #TheIncrementalist.


Listen along on HealthcareNowRadio or on SoundCloud

Consumer Level Insights to Healthcare was originally published on Dr Nick – The Incrementalist

Improving Healthcare’s Security Posture

Blackhat

Healthcare’s Security Posture

As part of my interview series from BlackHat I spoke with Mike Weber VP Coalfire Labs – they are a large Cybersecurity Systems provider focused on securing transactions in the cloud working with all if not most of the cloud providers. Coalfire just released their Penetration Risk Report that included a special section on Healthcare. Not surprisingly the news wasn’t good showing that healthcare had the worst “External Posture” with the least security for anything that can be seen by an attacker – external facing systems such as routers, firewalls etc.

Healthcare

The biggest issue was with legacy systems and many instances upgrades installed but the legacy and unsecured systems remain in use.

Healthcare

Listen in to the interview and hear Mike’s thoughts on Incremental Steps to combat the Security challenges faced in healthcare. As he and others have pointed out Medical records are high risk because they have such a long shelf life offering a rich vein to exploit for anyone able to steal these records.

 

Incremental Steps for Improving Healthcare’s Security Posture

 

  • Upgrade Old Systems and Importantly plan retirement for old systems as part of the upgrade
  • Consolidated Your audit program to Decrease Audit Fatigue
  • Prioritize Your “Crown Jewel’s” of the data and Systems you are protecting

Here’s the short list:

  1. Personal data is the top target (highest value) – medical identity information has a smaller market
  2. Platform Access – and the ability to install ransomware
  3. Encrypt everything

Encrypt

Improving Healthcare’s Security Posture was originally published on Dr Nick – The Incrementalist

Incremental Steps to Health

Incremental Steps to Health

The Incrementalist Graphic Khan Siddiqui

This week I am talking to Dr Khan Siddiqui (@DrKhan ) radiologist, programmer, serial entrepreneur, and Founder, CTO, and CMO of HIGI – the company that is taking the concepts of consumer engagement and tracking to the next level and creating actionable insights that patients and their care team can use

Much of Khan’s journeys mirrors my journey into the space of Digital Health – starting as a programmer in school where he was building applications on a PDB-11 using punch cards and continuing on through his early work on the Electronic Health Record mining data and applying machine learning and deep learning as far back as 2005 to healthcare data.

Microsoft Kinect

Listen to his story of a turnabout of shared innovation at Microsoft where the work the healthcare team had done on image analytics was applied to the Kinect bar and gaming solving one of the challenging problems of “missing body parts”

He was involved in the early work of Microsoft Health Vault and like others believed in the mission of sharing clinical data with patients and getting them engaged was a key requirement to solving health challenges – many of which are tied up with personal behavior. Frustrated by the lack of uptake compared to the Xbox gaming system he took this experience with him to found Higi and replicate the gaming user engagement and bring this to healthcare

Listen in to gain a different perspective to Xbox gaming and how healthcare has contributed and learned from this world.


Listen live at 4:00 AM, 12:00 Noon or 8:00 PM ET, Monday through Friday for the next two weeks at HealthcareNOW Radio. After that, you can listen on demand (See podcast information below.) Join the conversation on Twitter at #TheIncrementalist.


Listen along on HealthcareNowRadio or on SoundCloud

Incremental Steps to Health was originally published on Dr Nick – The Incrementalist

Unbreakable Encryption

Encryption Algorithms Under Siege

NewImage

Over the course of history, the development and subsequent breaking of encryption standards have been a constant cycle. As new keys were developed so they were broken and the speed of with which new keys were broken has increased. Modern day encryption “Data Encryption Standard” or DES was launched int he 70’s with a 56-bit key (64 bits but with 8 parity bits). This encryption was cracked in 1999 and with the likelihood, looming NIST launched a new search for encryption standards giving rise to Advanced Encryption Standard (AES) (aka Rijndael) with 256-bit keys and is under attack both cryptographically and by brute force of faster computers including as and when they arrive. As a result, NIST is seeking new proposals for cryptographic standards to replace AES when it is broken – but with the advent of Quantum computing this will be broken too

Unbreakable Encryption

NewImage

I spoke with John Prisco, President & CEO for QuantumXchange who in his words are pioneering unbreakable encryption. I know what you’re thinking – the idea of something being unbreakable/unhackable seems impossible and I was dubious as well.

But here’s what’s interesting – the foundation of the technology is the Heisenberg (no not that Heisenberg) uncertainty principle

 

You have to go deep into theoretical quantum physics to understand the background to this and while no expert I’m fascinated by the quantum world. This explanation in the Encyclopedia Brittanica is helpful comparing the concept to measuring the pressure of air in your tires TL;dr you can’t because as soon as you attach the pressure gauge you change the pressure. Essentially you can never know with perfect accuracy both of the position and velocity of a particle. It is impossible to determine accurately both the position and the direction and speed of a particle at the same instant.  You could learn more from the always brilliant Richard Feynman video Lecture: Probability and Uncertainty in Quantum Mechanics

Cryptography

Single Photon Based Encryption Keys

That uncertainty is a physical property, not a mathematical derivation (the foundation of encryption). QuantumXchange uses the quantum properties of single photons (light) to exchange data between two locations, with keys derived from the exchanged quantum information. The keys are Tamper Evident: Any attempt to intercept (look at or break) the key will change the state thanks to Heisenberg Uncertainty Principle causing a change in quantum state thereby corrupting the key – in which case those keys are rejected and a new pair created.

All this takes place on “Dark Fiber” from Boston to Washington DC and offering this up to customers in the healthcare and financial services markets and have examples already in play of oil rigs using their Quantum Keys to secure the huge numbers of IoT devices that are used in critical infrastructure and control for oil drilling and production

This concept is especially important for Healthcare data which has the longest shelf life of any data in the industry so protecting it over extended periods of time is essential if we are to maintain patients privacy and confidentiality

Here’s the Interview:

 

Unbreakable Encryption was originally published on Dr Nick – The Incrementalist