TITLE: Correctional Psych: Links to 15 Articles on Addressing the Mental Health Needs of Justice-Involved Individuals in Custody & the Community
Thank you Dr. Pope.
-------- Forwarded Message --------
Correctional Psych: Links to 15 Articles on Addressing the Mental Health Needs of Justice-Involved Individuals in Custody & the Community
Psychiatric Services issued the following announcement about a curated collection of articles:
Correctional Psychiatry: Addressing the Mental Health Needs of
Justice-Involved Individuals in Custody and the Community
/Editor’s Choice provides essential curated collections from recent issues of Psychiatric Services/.
The legal aims of the correctional system are to protect the community and to punish, deter, and offer rehabilitation to the offender. These goals may be at odds with the aims of psychiatric providers working in such settings. Consequently, jails and prisons can be challenging settings for the provision of mental health services for patients, providers, and the correctional staff. Even so, encounters with the criminal justice system can create opportunities for individuals with a severe mental illness, a substance use disorder, or both to obtain needed treatment that may otherwise be unavailable or difficult to access or that an individual would not choose to pursue in the community. With the development of diversion models and community-based forensic programs, such patients now have access to unique treatment strategies addressing concomitant legal and mental health needs.
This collection provides an update regarding correctional mental health care. The provision of mental health services within correctional environments continues to pose unique challenges, such as limited access to medications that are readily available in the community. Diversion programs that transition justice-involved individuals with mental illness from traditional criminal justice pathways toward treatment may reduce the burden of severe mental illness within correctional facilities and the risks to patients in such settings. At the same time, patients may be hesitant to engage in systems that they perceive to be coercive or overbearing. Innovations in meeting the mental health needs of incarcerated and justice-involved patients remain vital due to the ongoing high prevalence of mental illness and barriers to care faced by these populations. /Brian Holoyda, M.D., M.P.H./ /Jacqueline Landess, J.D., M.D./ /Lisa B. Dixon, M.D., M.P.H. /
a) It's timely and vaguely related to the Iowa transgender material,
b) It's about a psychology professor,
c) It mentions Univ. of Florida turning over to the state government the mental health records of transgender students (!!)
See below.
Thank you Dr. Pope.
--- Forwarded Message ---
Subject: Psychology Prof Brought Millions to FL State U, Now Warns of Unsafe "Hostile Environment" for Black & LGBTQ Students, Faculty, & Staff
Date: Fri, 08 Dec 2023 07:01:51 -0800
From: [email protected]
The Tallahassee Democrat includes an article: “This professor brought millions to Florida State. Now he's leaving a 'hostile’ environment” by Walter R. Boot, Ph.D.
Here’s the author note:
Walter R. Boot, Ph.D., is a professor of psychology at Florida State University and has been a member of the FSU faculty since 2008.
Here are some excerpts:
In early 2022, “Don’t Say Gay'' became law based on the premise that the mere mention of LGBTQ people is dangerous. The run-up and aftermath of its passage involved hostile rhetoric painting queer and trans individuals as pedophiles and groomers, rhetoric that came not just from citizens but from state officials.
As it became increasingly clear that LGBTQ students, faculty, and staff at Florida State University had targets on their backs, I explained my concerns in an April 2022 email and made a simple request of FSU President Richard McCullough: give us a reason to stay.
<snip>
His response was something along the lines of, “If I say or do anything, I will be fired, and my replacement will be worse.” His office tells me that he disputes this account.
Later, I was told his refusal to express support was because “the University’s 501(c)(3) status limits the University’s participation in political advocacy.” My concerns were dismissed as mere politics. Since then, matters have only gotten worse.
In December 2022, the FBI alerted FSU to a threat of mass violence against gay people on campus. FSU has yet to acknowledge this threat publicly. We learned about it only through a newspaper article the next month after an arrest had been made.
Alarmed by this incident and concerned for campus safety, I again pressed President McCullough’s office to express support for queer and trans community members publicly. They did not.
Gov. DeSantis then demanded that universities turn over information about transgender students. Information requested included intimate information about treatments, surgeries, mental health diagnoses, and facilities that transgender students were referred to for care. FSU complied with this request, shifting its response from silence to active harm.
<snip>
Equality Florida and the Human Rights Campaign have issued travel advisories citing the very real perils of traveling to or living in Florida while queer or trans. At FSU, these perils are exacerbated by uncaring leadership.
I will be leaving FSU at the end of this year. The purpose of my message is not to change the mind of members of the administration. Any additional efforts seem futile. It is to foreshadow the experience of anyone considering FSU as their home, particularly individuals who are Black, trans, gay or lesbian, queer, or who belong to any other group currently under siege by the state of Florida.
I brought millions of dollars of funding to FSU, volunteered for service roles demanding significant commitments, and stepped up to teach classes no one else could or would. I went above and beyond what is required again and again.
Yet, President McCullough remains unwilling to even offer a few words of public support for queer and trans members of the FSU community.
If you are considering FSU as your home, do not expect them to make any effort to support or protect you in an increasingly hostile and dangerous environment for people like us. Consider your options carefully. You deserve better than what FSU has to offer.
Ken Pope
Ken Pope, Nayeli Y. Chavez-Dueñas, Hector Y. Adames, Janet L. Sonne, and Beverly A. Greene
Speaking the Unspoken: Breaking the Silence, Myths, and Taboos That Hurt Therapists and Patients (APA, 2023)
Hector Y. Adames, Nayeli Y. Chavez-Dueñas, Melba J.T. Vasquez, & Ken Pope:
Succeeding as a Therapist: How to Create a Thriving Practice in a Changing World (APA, 2022)
Ken Pope, Melba J.T. Vasquez, Nayeli Y. Chavez-Dueñas, & Hector Y. Adames:
Ethics in Psychotherapy & Counseling: A Practical Guide, 6th Edition (Wiley, 2021)
“When people show you who they are, believe them the first time.”
—Maya Angelou
Fifi says " But the way out of it is to say 'I believe this fine gentleman/lady was before me'"
I do always try this (when I forget and cough or clear my throat) -- but it usually does not work -- I get the responses I described I guess designed to help me feel okay about my "racist" action. VERY hard to escape getting waived forwards!
Agree on the discomfort with COVID and coughs -- this predates it from my early 20s to now over 3 decades of shopping.
@admin Sorry, I deleted my post because I've never run into this and I suspect this is an American thing (not that there isn't racism in Canada and Quebec, there certainly is, it just often plays out differently than in the US). @EqualRightsAdvocates@blackmastodon
I'm a 54-year-old White guy in the USA and I have to infer that there must have been -- at one time not too long ago -- racist codes for "let the White person go first". I was never taught them, but I have to infer this from a few decades now of observing the following:
When I am standing in a small family-run store checkout line, and elderly Black people are in front of me, if I have a cough or need to clear my throat, something very strange happens. All eyes swivel backwards to look at me, and the elderly Black people in front of me all but fall over themselves to waive me to the FRONT OF THE LINE. Sometimes if I lock eyes with the shop keeper at the register, HE waives me forwards. At this point, there is NO POLITE GETTING OUT OF IT. I can try saying "I'm so sorry, I have a cold", or "you are clearly in front of me, please proceed", and none of it will work. Instead, I am given excuses to help ME feel better about myself. "Oh, no, I'm in no hurry", or "I have not quite decided if I have everything yet", or "the shopkeeper and I were just talking, we will be awhile, so please checkout first".
To be clear, I'm not the one being hurt (they are), but I AM mortified and embarrassed.
I've had to develop special procedures to combat this. I always stand a little further back in line, NEVER make eye contact with anyone, look intently at merchandise while waiting to checkout, and UNDER NO CIRCUMSTANCES ever clear my throat no matter how much I may need to.
I was reminded of this today when I (with plenty of room) passed an older Black woman in an aisle and merely nodded hello. She said "excuse me" and stepped backwards to give me more space. Huh.
Younger Black people don't do this (happily). Older Black people sometimes seem startled, like they have not encountered a White person coughing behind them in a long time -- but then their automatic training kicks in...
When I think about racism, I usually think about the more egregious examples (lynchings, denial of voting rights) but I have to wonder -- what was it like to just go on a mundane daily shopping trip in 1960?
QUESTION: Older folks reading this. Did/does this cough/throat-clear signal actually exist??
@admin@EqualRightsAdvocates@blackmastodon I’ve never noticed this happening to me, but I’m not sure whether that’s because I’m a woman, or that I’m about a decade younger, if it’s locale dependent. Or some intersection of those identities.
It could be a White Male thing... As I think about it, it's every few years -- but over 30 years that is long enough to pick-up on the pattern... I used to be kind of antsy and lost in my own thoughts, but that does not totally explain it -- who gives up their spot to the guy behind them just because he presents as in a hurry? Don't really know, but it's happened in Washington, DC in my twenties and early 30s; and in the Catonsville area on the Baltimore City/Baltimore County line the last 12 or so years (Frederick Avenue and Route 40). Hmmm... both are areas that used to be wealthy White, now mixed race, with a wealthy White population still living near by... Don't know.
I'm copying a public post below from an interesting Assistant Professor of Philosophy and Data Science at UNCC (not a medical doctor or psychologist).
Everything he is discussing is TENTATIVE but very interesting. I'm sending this out now because there is so little in the popular press about what can actually be done to help people with brain fog and other Long COVID symptoms. The research is still very early, and of course medical professionals should be consulted.
The article link from Nature Magazine describes brain damage caused by SARS-CoV-2 related to cell death and especially to synapse loss, leading to cognitive impairment.
The study in Bioelectric Medicine is extremely small, yet shows the potential of nicotine patches in the treatment of Long COVID symptoms including brain fog. (Another paper from the same publication also goes into why nicotine might help with Long COVID: https://bioelecmed.biomedcentral.com/articles/10.1186/s42234-023-00104-7 )
He then points to a study on the NIH PubMed site reporting the encouragement of synapse growth from psilocybin.
A comment in the discussion thread also links to a British Medical Journal article on Metformin improving Long COVID symptoms ( https://www.bmj.com/content/381/bmj.p1306 )
There's further speculation in the discussion thread that other psychoactive substances might be helpful. There are perhaps AI bots in the discussion thread discussing psilocybin microdosing, so be aware of that and maybe not get excited that so many "people" are discussing it.
From: <https://ourislandgeorgia.net/@Wolven/111412769611401616>
Dr. Damien P. Williams
@Wolven
…HUH. Long-COVID destroys synapses, and is a major contributor to the brainfog. <https://www.nature.com/articles/s41380-022-01786-2>
This goes some way to shining a light on the promising results they've been seeing in testing nicotine patches as treatment for long covid: nicotine effects synapse formation and receptivity (tests using patches because they don't habit-form and aren't, y'know, SMOKE [<https://bioelecmed.biomedcentral.com/articles/10.1186/s42234-023-00104-7>]).
But what's super interesting to me is that another thing that's also been shown to encourage synapse growth? Is psilocybin.
<https://pubmed.ncbi.nlm.nih.gov/34228959/>
From: <https://ourislandgeorgia.net/@Wolven/111412769611401616>
~~~
#psychology #counseling #socialwork #psychotherapy #research @[email protected] @[email protected] @[email protected] @[email protected] #Vaccines #COVID #longcovid #science #medicine #hospital #brainfog #sarscov2 #metformin #nicotine #nicotinepatch #psilocybin
@admin I'm not saying there might not be some legit research, just pointing out the whole French "smoking protects from Covid" idiocy that was making the rounds in the French media for a while and that one of the researchers involved in that is funded by the tobacco industry. @Wolven@psychotherapist@psychology@socialpsych@socialwork
TITLE: Polite Example Letter to a Health-Related Website Endangering Your Privacy
THIS is the letter I wish more people would send to health-related websites and merchants when they observe a privacy problem!
fullscript.com is a service that dispenses non-pharma products to patients (like medical grade supplements) based upon doctor's orders. You have to be referred by a physician to get a patient account. They even have a way of integrating with EHR systems.
They need to get security right.
To: Fullscript Support <[email protected]>
Dear Fullscript Team:
I have always appreciated being able to order from your excellent website.
Your service strives to supply patients with supplements and medicines ordered by doctors. As such, what is ordered can give insight into medical conditions that patients may have.
You may or may not be covered by HIPAA regulations, but I'm sure you will agree that ethically and as a matter of good business practice, Fullscript would want to maintain medical privacy of patients given that medical practices trust you.
This is why I'm concerned with the HIGH level of 3rd party tracking going on throughout your product catalogue. On your login page, the Firefox web browser displays a "gate" icon to let me know that information (I believe my email address) is being shared with Facebook. This is also the case with your order checkout page (see attached screenshot showing Facebook "gate" icon, as well as Privacy Badger and Ghostery plug-in icons in upper right-hand corner blocking multiple outbound data connections).
Privacy Badger is a web browser plugin that detects and warns of or stops (depending upon severity) outbound information from my web browser to 3rd party URLs. Directly below is Privacy Badger's report from your checkout page:
~~~~
Privacy Badger (privacybadger.org) is a browser extension that automatically learns to block invisible trackers. Privacy Badger is made by the Electronic Frontier Foundation, a nonprofit that fights for your rights online.
Privacy Badger blocked 23 potential trackers on us.fullscript.com:
insight.adsrvr.org
js.adsrvr.org
bat.bing.com
static.cloudflareinsights.com
script.crazyegg.com
12179857.fls.doubleclick.net
12322157.fls.doubleclick.net
googleads.g.doubleclick.net
connect.facebook.net
www.google-analytics.com
analytics.google.com
www.google.com
www.googletagmanager.com
fonts.gstatic.com
ad.ipredictive.com
trc.lhmos.com
snap.licdn.com
o927579.ingest.sentry.io
js.stripe.com
m.stripe.network
m.stripe.com
q.stripe.com
r.stripe.com
~~~
Please note that I was able to successfully checkout WITH Privacy Badger blocking protections on, so most of this outbound information was NOT necessary to the operation of your website.
There are several advertising networks and 3rd party data brokers receiving some kind of information.
I am aware that a limited amount of data sharing can be necessary to the operation of a website (sometimes). I am also aware that this all is not malicious -- web development and marketing does not usually talk to the legal department before deploying tools useful to gathering site usage statistics (Crazy Egg and Google Analytics). However, these conversations need to happen.
As for "de-identified" or "anonymized" data -- data brokers collect information across several websites, and so are able to reconstruct patient identities even if you don't transmit what would obviously be PHI (protected health information). As an example, if Google sees the same cookie or pixel tracking across multiple websites and just one of them sends a name, then Google knows my name. If Facebook is sent my email address (as looks to be the case), and I happen to have a Facebook account under that same email address, then Facebook knows who I am -- and can potentially link my purchases with my profile.
The sorts of computing device data that you are collecting and forwarding here may well qualify as PHI. Please see:
Use of Online Tracking Technologies by HIPAA Covered Entities and Business Associates
<https://www.hhs.gov/hipaa/for-professionals/privacy/guidance/hipaa-online-tracking/index.html>
This HHS and OCR guidance includes many 3rd party tracking technologies.
What I would really like to see happen is:
a) A thorough look at what information your website is sending out to what 3rd parties, along with an understanding of how data brokers can combine information tidbits from multiple websites to build profiles.
b) Use of alternative marketing analysis tools that help your business. For example, there are alternatives to Google Analytics that do not share all that data with Google and still give your marketing team the data they need.
c) An examination if you are sharing information about what products patients are clicking on and/or purchasing with 3rd parties. This would be especially problematic. (Crazy Egg tracks client progress through a website, but I'm unclear if they keep the information or just leave it with you.)
d) Use of alternative code libraries that are in-house. For example, web developers frequently utilize fonts.gstatic.com, but you could likely get fonts and other code sets elsewhere or store them in-house.
I appreciate you taking time to read this and working on the privacy concerns of your patients and affiliated medical practices.
Thanks.
~~~~~~
#AI #CollaborativeHumanAISystems #HumanAwareAI #artificialintelligence #psychology #counseling #socialwork #psychotherapy #EHR #medicalnotes #progressnotes @[email protected] @[email protected] @[email protected] @[email protected] @socialwork @[email protected] #mentalhealth #technology #psychiatry #healthcare #patientportal #HIPAA #dataprotection #infosec @[email protected] #doctors #hospitals #BAA #businessassociateagreement #coveredentities #privacy #HHS #OCR #fullscript
TITLE: Further Adventures in the HIPAA Silliness Zone
This short essay was inspired by a video I watched going over Microsoft legal agreements, the upshot of which is that they can harvest and use ALL of your data and creations (See *1 below in References). This inspires interesting HIPAA questions to say the least:
IF you have a HIPAA agreement with Microsoft, do they actually NOT harvest or use your data? How do they track that across all their applications and operating systems to tell?
Do their HIPAA and regular legal departments even talk to each other?
If you have a HIPAA agreement for your work computers, but then access your data through home computers, are all bets off? (And what sole proprietors don't mix use of computers for both?)
Now I don't really believe that Microsoft is doing all of this. What I THINK is that their lawyers just wrote overly broad legalese to protect them from all situations. Still -- legally it leaves us hanging. I certainly don't know that they are NOT doing it.
Then, I start thinking on some of the other crazy security situations I've encountered the past few years:
-- The multi-billion dollar medical data sales vendor that bought a calendar scheduling system, then wrote a HIPAA BAA agreement in which the PROVIDER has to pay any financial damages and penalties if THEY slip-up and lose data. (*2). Gee, what could go wrong?
-- The new AI progress notes generator service that sends data to 3rd parties including Google Tag Manager, LinkedIn Analytics, Facebook Connect, and Gravatar (*3)
-- The countless data breaches currently hitting hospitals across the USA. (*4)
It's all really quite mind numbing if you are a small healthcare provider or sole practitioner. I suspect 99% of us have just tuned this all out as noise at this point. After all, do we have the time or money to take on the legal departments of multi-billion dollar corporations?
The net results of this will be helpless nonchalance, boredom, and a gradual shifting of liability to US when upon occasion data is actually leaked by our vendors. And, of course, ever more fear and uncertainty in professions already full of it. Oh, and client data flowing through data brokers everywhere.
So what can we do? At first glance, not much. We need to be pressuring our professional associations to take on (or further take on) data security concerns including liability of giant "subcontractors" and insurance companies versus small healthcare providers. We also need to be supporting HHS and Federal government efforts to stop 3rd party trackers, including cookies, web beacons, pixel tracking, etc. from being allowable on systems related to healthcare. (*5) Bonus points if the penalties can apply mainly to larger corporations rather than hitting small provider offices hard.
Thanks,
Michael Reeder LCPC
Baltimore, MD
REFERENCES:
(*1)
The following video walks through the Microsoft Services Agreement and Microsoft Privacy Agreement to explain how Microsoft reserves the rights to use all data that you transmit through their services, or create or store in their apps (including data stored on OneDrive). It also collects information from all the programs used on your Windows machine. (This would seem to mean they can harvest data from your local hard drive, but I'm not sure.)
Microsoft Now Controls All Your Data
[https://m.youtube.com/watch?v=1bxz2KpbNn4&pp=ygUkTWljcm9zb2Z0IG5vdyBjb250cm9scyBhbGwgeW91ciBkYXRh](https://m.youtube.com/watch?v=1bxz2KpbNn4&pp=ygUkTWljcm9zb2Z0IG5vdyBjb250cm9scyBhbGwgeW91ciBkYXRh)
"("Data"), how we use your information, and the legal basis we use to process your Personal Information. The Privacy Statement also describes how Microsoft uses your content, i.e. Your communications with other people; the submissions you send to Microsoft through the Services; and the files, photographs, documents, audio, digital works, live streams, and videos that you upload, store, transmit, create, generate, or share through the Services, or any input you submit to generate content ("Your Content")."
(*2)
Full Slate: Last I checked their HIPAA, privacy, and BAA agreements. Although they reserve the right to change these agreements without notification and just post them to their website, so who knows at this point. <https://www.fullslate.com>
(*3)
Autonotes.ai: In fairness, they claim that no HIPAA data should be input into their system, even though you are writing progress notes. As of 7/30/23 they sent some sort of data to Google Tag Manager, LinkedIn Analytics, Facebook Connect, Gravatar which was severe enough that the Ghostery browser plug-in felt compelled to block or flag the transmissions. I hope they have changed this.
It should be pointed out that services similar to Full Slate and Autonotes claim that data sent to 3rd parties is not PHI and/or necessary to the operation of the service. This all could be true. I find that when Privacy Badger, or Ghostery, or my Pihole DNS server block these 3rd party transmissions that the vast majority of the time services work just fine.
Please also see Use of Online Tracking Technologies by HIPAA Covered Entities and Business Associates
<https://www.hhs.gov/hipaa/for-professionals/privacy/guidance/hipaa-online-tracking/index.html>
This HHS and OCR guidance includes the sorts of 3rd party tracking technologies often referred to as non-PHI, or de-identified. My non-lawyer mind is suspicious that violations could be found at several services.
(*4)
Just take a look at any of the daily headlines on Becker's Hospital Review:
<https://www.beckershospitalreview.com/cybersecurity.html>
(*5)
Hospital associations sue HHS over pixel tracking ban
<https://www.beckershospitalreview.com/healthcare-information-technology/hospital-associations-sue-hhs-over-pixel-tracking-ban.html>
--
#AI #CollaborativeHumanAISystems #HumanAwareAI #artificialintelligence #psychology #counseling #socialwork #psychotherapy #EHR #medicalnotes #progressnotes @[email protected] @[email protected] @[email protected] @[email protected] @[email protected] @[email protected] #mentalhealth #technology #psychiatry #healthcare #patientportal #HIPAA #dataprotection #infosec @[email protected] #doctors #hospitals #BAA #businessassociateagreement #Microsoft #coveredentities #privacy #HHS #OCR
I'm always a bit skeptical of presentations from tech company CEOs on
how their product areas are necessary in the mental health field.
That said, this article has a few good points:
/"Umar Nizamani, CEO, International, at NiceDay, emphasised that AI will
inevitably become an essential tool in mental health care: 'I am very
confident AI will not replace therapists – but therapists using AI will
replace therapists not using AI.'"//
/
I am beginning to think this also -- for better or worse. I took a VERY
fast 60 second look at NiceDay and it appears to be another
all-encompassing EHR, but with a strong emphasis on data. Lots of tools
and questionnaires and attractive graphs for therapists to monitor
symptoms. (I need to take a longer look later.) So data-driven could
be very good, if it does not crowd out the human touch.
/"Nizamani said there had been suicides caused by AI, citing the case of
a person in Belgium who died by suicide after downloading an anxiety
app. The individual was anxious about climate change. The app suggested
'if you did not exist' it would help the planet, said Nizamani."//
/
YIKES... So, yes, his point that care in implementation is needed is
critical. I worry at the speed of the gold-rush.
/"He [//Nizamni] //called on the industry to come together to ensure
that mental health systems using AI and data are 'explainable’,
'transparent', and 'accountable'." //
/
This has been my biggest focus so far, coming from an Internet security
background when I was younger.
/"Arden Tomison, CEO and founder of Thalamos"/ spoke on how his company
automates and streamlines complex bureaucracy and paperwork to both
speed patients getting help and extract the useful data from the forms
for clinicians to use. More at: https://www.thalamos.co.uk/
/"Dr Stefano Goria, co-founder and CTO at Thymia, gave an example of
'frontier AI': 'mental health biomarkers' which are 'driving towards
precision medicine' in mental health. Goria said thymia’s biomarkers
(e.g. how someone sounds, or how they appear in a video) could help
clinicians be aware of symptoms and diagnose conditions that are often
missed."//
/
Now THIS is how I'd like to receive my AI augmentation. Give me
improved diagnostic tools rather than replacing me with chatbots or
over-crowding the therapy process with too much automated tool data
collection (some is good). I just want this to remain in the hands of
the solo practitioner rather than being a performance monitor on us by
insurance companies. I want to see empowered clinicians.
@admin@psychotherapist@psychology@socialpsych@infosec
We need cross-discipline digital literacy. AI advances that improve one discipline are often exploited in others. When you celebrate diagnosis mental health biomarkers (how someone sounds, or how they appear in a video), this information is coveted by data brokers who would love to sell it. MH video is unacceptable until security improves. Even then, it will be risky.
Apparently some people have to be told that using AI services in the
cloud to compose medical letters is a violation of HIPAA.
Now what I would like to see with all the AI-assisted EHR systems
currently being developed (EPIC, Oracle, Amazon, etc.) is not only BAA
contracts in place with the tech companies, but also:
a) Separate AI systems that don't share data with the main AI system.
(So the Hospital AI database would be separate from the general AI
database), or
b) Much better: Separate AI software and databases that are held
internal to the Hospital's own computer servers with restricted Internet
access to the outside.
This is wholly feasible, yet somehow I have a low trust level of it
occurring.
For any private practice people out there playing with AI on a small
office scale, I'm not a lawyer, but what I would recommend are a) AI
systems that can be run on a desktop (not in the cloud), and b) cutting
them off from Internet or severe restrictions on where those desktops
can call out to since you likely don't know what's in the code of the AI
you downloaded!
*Iowa health system warns against using ChatGPT to draft patient letters*
<https://www.beckershospitalreview.com/cybersecurity/iowa-health-system-warns-against-using-chatgpt-to-draft-patient-letters.html>
/Iowa City-based University of Iowa Health Care is warning employees
against the use of ChatGPT for its potential to violate HIPAA.../
--
#AI #CollaborativeHumanAISystems #HumanAwareAI #chatbotgpt #chatgpt
#artificialintelligence #psychology #counseling #socialwork
#psychotherapy #EHR #medicalnotes #progressnotes
@[email protected] @[email protected]
@[email protected] @[email protected] @[email protected]
@[email protected] #mentalhealth #technology #psychiatry #healthcare
#patientportal
#HIPAA #dataprotection #infosec @[email protected] #doctors #hospitals
#BAA #businessassociateagreement
.
.
NYU Information for Practice puts out 400-500 good quality health-related research posts per week but its too much for many people, so that bot is limited to just subscribers. You can read it or subscribe at @[email protected]
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Since 1991 The National Psychologist has focused on keeping practicing psychologists current with news, information and items of interest. Check them out for more free articles, resources, and subscription information: <https://www.nationalpsychologist.com>
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It's primitive... but it works... mostly...
I didn't realize this was going to become a series... (Part of the
GHOSTS IN THE MACHINE Series Apparently)
So I watched a "theoretical" YouTube video yesterday in which they
report from multiple sources on a story linking TikTok influencer Hailey
Lujan to possibly being a government Psyop. At the very least, she says
lots of pro-Army things and gets to play with $100,000s of dollars in
cool hardware that civilians just don't normally get access to.
Apparently the Army is targeting the first-person shooter gamer
community (there is some evidence they may be better at piloting drones
than pilots) -- quoted to be about 93-96% male, young, and many of them
lonely. The term "parasocial" is getting thrown around here -- which is
a one-sided relationship, sometimes quite intense, usually referring to
relationships between celebrities and their audience. The video quotes
some research that the subset of these young men who are almost always
online "are almost never interacting with young women -- instead there
is a trend of parasocial relationships forming...".
The joke I now have with my wife is that YouTube's algorithm will start
flooding our joint account with "E-Girls" dressed in camouflage.
[And, well ick -- this strange story is now starting to intersect with
my other essay series about "Sigma Males" and that bogus personality
type being associated with very similar lonely young men. See: https://mastodon.clinicians-exchange.org/@admin/109705551829241507 ]
Given the number of articles online about Army recruiting on TikTok, and
that Hailey Lujan reportedly has a LinkedIn profile as being in the army
with Psyops ( https://www.linkedin.com/in/hailey-lujan-a2707819a ), I'm
not sure how "theoretical" it really is.
I'm not 100% sure I'm against this sort of influence campaign but I need
to know more. We do need recruits in the USA Armed Forces and they are
missing their recruiting targets a lot recently.
First Sent: 6/5/23
TITLE: GHOSTS IN THE MACHINE
<https://m.youtube.com/watch?v=VA4e0NqyYMw>
This has been out for a year, but I had not seen it.
This is supposedly put out by the the US Army's PSYOPS (Psychological
Operations) unit out of Fort Bragg.
**The video is intended as a recruiting tool.**
Well -- it's creepy -- I'll give them that.
I suppose if we want recruits angry and ready to do anything to
manipulate the world -- it is successful.
And I find myself both getting angry towards the end, AND trying to
catch what subliminal messaging they are inserting.
What do you think about this kind of recruiting, assuming that is what
it is?
Fair warning -- It is disturbing, threatening, and creepy.
<https://m.youtube.com/watch?v=VA4e0NqyYMw>
Michael Reeder LCPC
Baltimore, MD
#psychology #neurology #socialwork #psychiatry @[email protected]
@[email protected] @[email protected] #mentalhealth
#psychotherapists @[email protected] #PSYOPS #goarmy
#manipulation #army #armyrecruiting #recruiting #creepy #war #weapons
#USA #cyberwar #lonely
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<<https://mastodon.clinicians-exchange.org/tags/psychotherapist>>
#military <<https://mastodon.clinicians-exchange.org/tags/military>>
#militarypsych
<<https://mastodon.clinicians-exchange.org/tags/militarypsych>>
#militarypsychology
<<https://mastodon.clinicians-exchange.org/tags/militarypsychology>>
#militarycounseling
<<https://mastodon.clinicians-exchange.org/tags/militarycounseling>> #APA
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#militaryhealth
<<https://mastodon.clinicians-exchange.org/tags/militaryhealth>>
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It's primitive... but it works... mostly...
This instance proved uniquely unpopular despite lots of marketing. I'll get around to removing the links to it in bot posts and emails and Mastodon graphics eventually.
It might have made sense to keep it open if Lemmy was going to offer private forums for vetted members anytime in the near future (therapists like privacy in discussions) but this objective is barely on the developer's radars.
I am definitely keeping https://mastodon.clinicians-exchange.org open and would encourage you to join that site if you are in need of a Mastodon instance and work at all broadly speaking in the field of mental health.
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This issue strikes me as a potential emergency. All American health professionals need to be writing our professional associations to demand that they oppose what The American Hospital Association is trying to do here.
I will be writing ACA, and -- time permitting -- will publish more on this later.
The problem in a nutshell is that every time hospitals -- or any other medical source -- make use of 3rd party trackers like Google Analytics, they provide data that can identify a patient. It is a HIPAA violation. They will argue that -- depending upon what is provided -- it does not actually give away enough information to identify the patient, but that is a bogus argument. Google Analytics (and many other outside tech tools) collect databases of information so they can put together profiles over time.
So -- for example -- if a hospital gives Google Analytics a web browser cookie showing that the client logged into their site, the cookie MIGHT just identify the web browser without the client name. BUT -- when that same client goes and logs into their Google account later (for which they have previously given their name), Google can observe the same "anonymous" cookie in the web browser and deduce that this is the same person who logged into the hospital website. If it happens to be an abortion clinic, then Google knows roughly the services provided. If the hospital sends the cookie from psychotherapist John Smith LCPC's telehealth page, then Google knows that the patient sees psychotherapist John Smith.
If hospitals need the tools that Google and other tech companies are providing, they need to buy internal versions of such to run on their own systems. If hospitals need to do marketing, then they need to run the 3rd party trackers only on the most public parts of their websites. therapyappointment.com is a good example of being a good citizen about this -- they run about eight 3rd party trackers on their home page, but only 1 tracker once a therapist has logged in. And that one tracker is for Amazon Cloud Services -- arguably a tracker that is necessary to the operation of their website.
I could see narrow exceptions allowing for 3rd party trackers that might make sense (AHA is making heavy use of these fringe cases in the article). Most of the time its a big problem.
I'm disgusted that the AHA is taking this position. It means they have NO respect for the data privacy they supposedly support!
This AI will follow along and take the session notes for the doctor by
listening to the office visit. It will also bring up charts and records
through voice command and prompt the doctor to do routine things during
the office visit. It's due out early next year.
This could be very helpful.
However I can imagine a few kinks in the office visit process initially:
Patient: "Doctor, my knee hurts"
AI: "REMEMBER TO MAKE A FOLLOW-UP APPOINTMENT"
Patient: "What was that?!"
Doctor: "Oh pay no attention -- that is just the new AI system everyone
has to consent to for treatment. It will help us during the session."
AI: "HAVE YOU EXAMINED THE KNEE X-RAY YET?"
Doctor: "AI, pull up the knee x-ray"
Patient: "This is my first visit, there is no knee x-ray yet."
AI: "REMEMBER TO SCHEDULE A KNEE X-RAY"
Doctor & Patient Together: "We don't know if we need a knee x-ray yet!"
Patient: "It started hurting yesterday"
Doctor: "Jump up on the table and I'll take a look at it"
AI: "SHALL I SUMMON A NURSE TO WATCH TO GUARD AGAINST ALLEGATIONS OF
IMPROPRIETY?"
Doctor: "NO!"
Doctor: "It does look a bit red. Does this hurt?"
Patient: "A bit when you touch there and I bend it."
AI: "SHALL I SCHEDULE THE KNEE X-RAY NOW?"
Doctor: "SHUT UP! AI -- Silent mode now!"
Office visits are going to be fun the next few years while this gets sorted.
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If you ever wonder why psychotherapists sometimes stop taking insurance
in the United States, there are lots of reasons. Low pay is the typical
one.
Hassle is another.
I'm trying to catch-up on billing this fine Sunday afternoon. The last
thing I need is a billing rabbit hole to get stuck in...
Today's rabbit hole -- trying to figure out why once of my insurance
panels keeps paying significantly different rates on the same CPT 90837
billing code (the code for a roughly one hour session). A LARGE
difference in fact.
Took a long time... drum roll...
I'm paid LESS for POS 02 (place of service telehealth AWAY from home)
versus POS 10 (place of service telehealth AT home).
Cause, yeah -- that makes sense.
So, yes, I'm required to code whether or not a client is at home for
telehealth. Why? No idea. (I suppose I do need to know the address
in case I need to send an ambulance or something.)
This all was made especially fun by:
a) The insurance company does not publish a rate schedule. No way to
know if I'd get a check or a claw-back if I inquire about the discrepancy.
b) The client has co-insurance. So the co-insurance rate varies by
place of service (POS) too. Client pays a percentage (%) of the total
amount I'm due.
It's crazy-making. And "crazy" is a term I usually avoid. Except when
discussion the American health system.