Podcast appearances and mentions of Adam Tanner

Lukas Voss hosts Adam Tanner from NRC Health to discuss evolving healthcare employee experience strategies. Topics include shifting from annual surveys to real-time feedback, empowering managers to combat burnout, and aligning employee and patient experiences. Discover actionable insights to enhance engagement and drive meaningful change in healthcare. This episode is sponsored by NRC Health.

Many public spaces across the country now require negative COVID-19 tests for entry. But the cost of testing can vary widely, and some say they have had to spend hundreds of dollars to purchase tests.Adam Tanner explains some of the reasons for the drastic difference in at-home test prices. Read his piece 'How Much Should It Cost to Get Tested for COVID-19' on Consumer Reports.In participating regions, you'll also hear a local news segment that will help you make sense of what's going on in your community.Email us at considerthis@npr.org.

EX Blue Adam Tanner on the show -POST-Blackpool REACTION Talking Town- The Live fans showPOST-Blackpool REACTION Talking Town- The #itfc Live fan podcast show -#WeareTown-Ipswich Town F.CAll clips shown are courtesy of ITFC and Dan Palfrey and I do not claim ownership etc all rights to the club This show was recorded live and we welcome your participation. We want you to express your thoughts and feelings on all things Ipswich Town F.C This is your 100% unfiltered platform to discuss TownGot something to say?Tweet us - Martin https://twitter.com/HdrMartinGet involved directly on the show.How?Audio- Like the Radio Video- Appear on-screen with our Hosts -Live chat room- Put your opinions in the chat and discuss Ipswich Town F.C with likeminded Ipswich Town fans To appear on the show simply type LINK Audio or LINK video into the chatboxSupport the show (https://ko-fi.com/tottitfc/posts)

Welcome to the first edition of Ross meets - a series where producer Ross catches up with former Town players to talk about their careers from the ups and the downs  In the first episode he catches up with former Town midfielder Adam Tanner who spoke about his Liverpool goal, drugs ban and much more

Learning about what Adam Tanner is doing with his Choose Magazine to promote positivity!https://choosemagazines.com/https://www.facebook.com/Choose-Magazine-226526871596385/

In the fifteenth episode of Designing An MBA, we meet coast guard officer and new dad Adam Tanner, two unique perspectives from which he tells fascinating stories. I'll leave it to you to decide which one sounds more challenging! He not only talks about how family changes your perspective on the MBA, but how the MBA changes your perspective on family.

Personal health information often seems locked-down: protected by patient privacy laws, encased in electronic record systems (EHRs) and difficult to share or transport by and between physicians and hospitals. But as Adam Tanner argues in his latest book, Our Bodies, Our Data: How Companies Make Billions Selling Our Medical Records (Beacon Press, 2017), our medical information is anything but static. He describes a vast and growing industry of trade in patient data, emanating from EHRs to pharmacy and drug company sales records. These data – ostensibly stripped of identifying information – are sold and bought largely to help medical and pharmaceutical companies better market their products (as well as for some research). Tanner asks, are these data completely safe? Could they be re-identified and threaten patient privacy? How might this trade in data impact patient care and physician practice? While consumer data breaches plague other industries, Tanner urges us as consumers, medical practitioners and society to have a much-needed and informed conversation about this largely hidden circulation of health information. His book is a great start. Adam Tanner is a journalist, former foreign correspondent and leading expert on privacy and commercialization of personal data. His first book is entitled What Stays in Vegas: the World of Personal Data – Lifeblood of Big Businesses – and the End of Privacy as We Know It (Public Affairs, 2014). Currently, he is an associate at the Institute for Quantitative Social Science at Harvard University. Learn more about his work on his website Adamtanner.news and follow him on Twitter @DataCurtain Dana Greenfield, MD PhD is a resident physician in Pediatrics at the University of California, San Francisco. She completed her PhD in Medical Anthropology from UCSF/UC Berkeley in 2015 and MD at UCSF in 2018. Reach her at dana.greenfield@ucsf.edu or on Twitter @DanaGfield.   Learn more about your ad choices. Visit megaphone.fm/adchoices

Personal health information often seems locked-down: protected by patient privacy laws, encased in electronic record systems (EHRs) and difficult to share or transport by and between physicians and hospitals. But as Adam Tanner argues in his latest book, Our Bodies, Our Data: How Companies Make Billions Selling Our Medical Records (Beacon Press, 2017), our medical information is anything but static. He describes a vast and growing industry of trade in patient data, emanating from EHRs to pharmacy and drug company sales records. These data – ostensibly stripped of identifying information – are sold and bought largely to help medical and pharmaceutical companies better market their products (as well as for some research). Tanner asks, are these data completely safe? Could they be re-identified and threaten patient privacy? How might this trade in data impact patient care and physician practice? While consumer data breaches plague other industries, Tanner urges us as consumers, medical practitioners and society to have a much-needed and informed conversation about this largely hidden circulation of health information. His book is a great start. Adam Tanner is a journalist, former foreign correspondent and leading expert on privacy and commercialization of personal data. His first book is entitled What Stays in Vegas: the World of Personal Data – Lifeblood of Big Businesses – and the End of Privacy as We Know It (Public Affairs, 2014). Currently, he is an associate at the Institute for Quantitative Social Science at Harvard University. Learn more about his work on his website Adamtanner.news and follow him on Twitter @DataCurtain Dana Greenfield, MD PhD is a resident physician in Pediatrics at the University of California, San Francisco. She completed her PhD in Medical Anthropology from UCSF/UC Berkeley in 2015 and MD at UCSF in 2018. Reach her at dana.greenfield@ucsf.edu or on Twitter @DanaGfield.   Learn more about your ad choices. Visit megaphone.fm/adchoices

Personal health information often seems locked-down: protected by patient privacy laws, encased in electronic record systems (EHRs) and difficult to share or transport by and between physicians and hospitals. But as Adam Tanner argues in his latest book, Our Bodies, Our Data: How Companies Make Billions Selling Our Medical Records (Beacon Press, 2017), our medical information is anything but static. He describes a vast and growing industry of trade in patient data, emanating from EHRs to pharmacy and drug company sales records. These data – ostensibly stripped of identifying information – are sold and bought largely to help medical and pharmaceutical companies better market their products (as well as for some research). Tanner asks, are these data completely safe? Could they be re-identified and threaten patient privacy? How might this trade in data impact patient care and physician practice? While consumer data breaches plague other industries, Tanner urges us as consumers, medical practitioners and society to have a much-needed and informed conversation about this largely hidden circulation of health information. His book is a great start. Adam Tanner is a journalist, former foreign correspondent and leading expert on privacy and commercialization of personal data. His first book is entitled What Stays in Vegas: the World of Personal Data – Lifeblood of Big Businesses – and the End of Privacy as We Know It (Public Affairs, 2014). Currently, he is an associate at the Institute for Quantitative Social Science at Harvard University. Learn more about his work on his website Adamtanner.news and follow him on Twitter @DataCurtain Dana Greenfield, MD PhD is a resident physician in Pediatrics at the University of California, San Francisco. She completed her PhD in Medical Anthropology from UCSF/UC Berkeley in 2015 and MD at UCSF in 2018. Reach her at dana.greenfield@ucsf.edu or on Twitter @DanaGfield.   Learn more about your ad choices. Visit megaphone.fm/adchoices Support our show by becoming a premium member! https://newbooksnetwork.supportingcast.fm/medicine

Personal health information often seems locked-down: protected by patient privacy laws, encased in electronic record systems (EHRs) and difficult to share or transport by and between physicians and hospitals. But as Adam Tanner argues in his latest book, Our Bodies, Our Data: How Companies Make Billions Selling Our Medical Records (Beacon Press, 2017), our medical information is anything but static. He describes a vast and growing industry of trade in patient data, emanating from EHRs to pharmacy and drug company sales records. These data – ostensibly stripped of identifying information – are sold and bought largely to help medical and pharmaceutical companies better market their products (as well as for some research). Tanner asks, are these data completely safe? Could they be re-identified and threaten patient privacy? How might this trade in data impact patient care and physician practice? While consumer data breaches plague other industries, Tanner urges us as consumers, medical practitioners and society to have a much-needed and informed conversation about this largely hidden circulation of health information. His book is a great start. Adam Tanner is a journalist, former foreign correspondent and leading expert on privacy and commercialization of personal data. His first book is entitled What Stays in Vegas: the World of Personal Data – Lifeblood of Big Businesses – and the End of Privacy as We Know It (Public Affairs, 2014). Currently, he is an associate at the Institute for Quantitative Social Science at Harvard University. Learn more about his work on his website Adamtanner.news and follow him on Twitter @DataCurtain Dana Greenfield, MD PhD is a resident physician in Pediatrics at the University of California, San Francisco. She completed her PhD in Medical Anthropology from UCSF/UC Berkeley in 2015 and MD at UCSF in 2018. Reach her at dana.greenfield@ucsf.edu or on Twitter @DanaGfield.   Learn more about your ad choices. Visit megaphone.fm/adchoices

Personal health information often seems locked-down: protected by patient privacy laws, encased in electronic record systems (EHRs) and difficult to share or transport by and between physicians and hospitals. But as Adam Tanner argues in his latest book, Our Bodies, Our Data: How Companies Make Billions Selling Our Medical Records (Beacon Press, 2017), our medical information is anything but static. He describes a vast and growing industry of trade in patient data, emanating from EHRs to pharmacy and drug company sales records. These data – ostensibly stripped of identifying information – are sold and bought largely to help medical and pharmaceutical companies better market their products (as well as for some research). Tanner asks, are these data completely safe? Could they be re-identified and threaten patient privacy? How might this trade in data impact patient care and physician practice? While consumer data breaches plague other industries, Tanner urges us as consumers, medical practitioners and society to have a much-needed and informed conversation about this largely hidden circulation of health information. His book is a great start. Adam Tanner is a journalist, former foreign correspondent and leading expert on privacy and commercialization of personal data. His first book is entitled What Stays in Vegas: the World of Personal Data – Lifeblood of Big Businesses – and the End of Privacy as We Know It (Public Affairs, 2014). Currently, he is an associate at the Institute for Quantitative Social Science at Harvard University. Learn more about his work on his website Adamtanner.news and follow him on Twitter @DataCurtain Dana Greenfield, MD PhD is a resident physician in Pediatrics at the University of California, San Francisco. She completed her PhD in Medical Anthropology from UCSF/UC Berkeley in 2015 and MD at UCSF in 2018. Reach her at dana.greenfield@ucsf.edu or on Twitter @DanaGfield.   Learn more about your ad choices. Visit megaphone.fm/adchoices

Personal health information often seems locked-down: protected by patient privacy laws, encased in electronic record systems (EHRs) and difficult to share or transport by and between physicians and hospitals. But as Adam Tanner argues in his latest book, Our Bodies, Our Data: How Companies Make Billions Selling Our Medical Records (Beacon Press, 2017), our medical information is anything but static. He describes a vast and growing industry of trade in patient data, emanating from EHRs to pharmacy and drug company sales records. These data – ostensibly stripped of identifying information – are sold and bought largely to help medical and pharmaceutical companies better market their products (as well as for some research). Tanner asks, are these data completely safe? Could they be re-identified and threaten patient privacy? How might this trade in data impact patient care and physician practice? While consumer data breaches plague other industries, Tanner urges us as consumers, medical practitioners and society to have a much-needed and informed conversation about this largely hidden circulation of health information. His book is a great start. Adam Tanner is a journalist, former foreign correspondent and leading expert on privacy and commercialization of personal data. His first book is entitled What Stays in Vegas: the World of Personal Data – Lifeblood of Big Businesses – and the End of Privacy as We Know It (Public Affairs, 2014). Currently, he is an associate at the Institute for Quantitative Social Science at Harvard University. Learn more about his work on his website Adamtanner.news and follow him on Twitter @DataCurtain Dana Greenfield, MD PhD is a resident physician in Pediatrics at the University of California, San Francisco. She completed her PhD in Medical Anthropology from UCSF/UC Berkeley in 2015 and MD at UCSF in 2018. Reach her at dana.greenfield@ucsf.edu or on Twitter @DanaGfield.   Learn more about your ad choices. Visit megaphone.fm/adchoices

In 2017, the fact that companies have access to personal data about us is common knowledge. But the data available to companies goes beyond just what websites you browse and where you’ve checked in on social media. Your (anonymized) medical information can be sold to drug companies to promote drugs - and to sell those to doctors in a process that is, shockingly, legal. Adam Tanner, a writer-in-residence at Harvard’s Institute for Quantitative Social Science, has written a book on this called “Our Bodies, Our Data: How Companies Make Billions Selling Our Medical Records.” We talk with him about the alarming trade in health data.

A spoonful of sugar may help the medicine go down… but what about a spoonful of Splenda? And what if the medicine you were taking with that sugar was a little less private than you thought? This week we’ve got stories about healthcare, artificial sweeteners, and the math behind our fears. First up, if you think that Sweet’N Low is healthier than sugar… you might want to reconsider. It turns out, the health benefits of sugar substitutes aren’t exactly clear-cut. We talk with University of Manitoba researcher Meghan Azad about how artificial sweeteners have proven unable to combat weight gain, diabetes, and heart disease. Then, a conversation with Carolyn Thomas about how sugar substitutes made their way into American households. Do you get scared when your plane takes off? It’s a common reaction, even though airline travel is one of the safest ways to travel. Eugenia Cheng, a mathematician at the School of the Art Institute of Chicago, explains the math behind our fears… and how we might be able to overcome them. If you think Facebook has too much of your personal information, wait until you hear what the pharmaceutical industry knows about you. Adam Tanner, author of the book, “Our Bodies, Our Data: How Companies Make Billions Selling Our Medical Records” tells us that your (anonymized) medical information might just be sold to drug companies. He dives into how this process happens, and why it remains legal.

On the surface, artificial sweeteners seem like a no-brainer for anyone trying to lose weight. But, before you reach for the Sweet’N Low, listen to the complex history, and possible negative health effects, of sugar substitutes.

Medical information stays between a patient and their doctor, right? Author Adam Tanner tells us that may not be the case.

CDT President & CEO Nuala O'Connor sits down to discuss why Trump's executive order stopping the application of Privacy Act provisions to non-US persons is a critical mistake. She was originally part of the team at the Department of Homeland Security that helped develop the policy, and examines the dangers of it's repeal with host Brian Wesolowski. Then author and researcher Adam Tanner calls in to give us an understanding of the huge market out there for personal health data and who it is really benefitting. He details his new book, "Our Bodies, Our Data" and shares eye-opening insights most consumers don't know. More on Privacy Act repeal: http://bit.ly/penstrokecdt More on "Our Bodies, Our Data:" http://bit.ly/ourbodiesdata More on Nuala: http://bit.ly/privacyma More on Adam: http://bit.ly/datacurtain More info on our host, Brian: bit.ly/cdtbrian Attribution: sounds used from Psykophobia, Taira Komori, BenKoning, Zabuhailo, bloomypetal, guitarguy1985, bmusic92, and offthesky of freesound.org.

Adam Tanner is the author of "Our Bodies, Our Data", which tells the story of a hidden dark market in drug prescription and other medical data. In recent years hackers have been able to steal health data on a massive scale -- remember Anthem? In this second part of our interview, we explore the implications of hacked medical data. If hackers get into a data brokers' drug databases and combine with previously stolen medical insurance records, will they rule the world? Transcript Inside Out Security: Today, I'd like to welcome Adam Tanner. Adam is a writer-in-residence at Harvard University's Institute for Quantitative Social Science. He's written extensively on data privacy. He's the author of What Stays In Vegas: The World of Personal Data and the End of Privacy As We Know It. His articles on data privacy have appeared in Scientific American, Forbes, Fortune, and Slate. And he has a new book out, titled "Our Bodies, Our Data," which focuses on the hidden market in medical data. Welcome, Adam. Adam Tanner: Well, I'm glad to be with you. IOS: We've also been writing about medical data privacy for our Inside Out Security blog. And we're familiar with how, for example, hospital discharge records can be legally sold to the private sector. But in your new book, and this is a bit of a shock to me, you describe how pharmacies and others sell prescription drug records to data brokers. Can you tell us more about the story you've uncovered? AT: Basically, throughout your journey as a patient into the healthcare system, information about you is sold. It has nothing to do with your direct treatment. It has to do with commercial businesses wanting to gain insight about you and your doctor, largely, for sales and marketing. So, take the first step. You go to your doctor's office. The door is shut. You tell your doctor your intimate medical problems. The information that is entered into the doctor's electronic health system may be sold, commercially, as may the prescription that you pick up at the pharmacy or the blood tests that you take or the urine tests at the testing lab. The insurance company that pays for all of this or subsidizes part of this, may also sell the information. That information about you is anonymized.  That means that your information contains your medical condition, your date of birth, your doctor's name, your gender, all or part of your postal zip code, but it doesn't have your name on it. All of that trade is allowed, under U.S. rules. IOS: You mean under HIPAA? AT: That's right. Now this may be surprising to many people who would ask this question, "How can this be legal under current rules?" Well, HIPAA says that if you take out the name and anonymize according to certain standards, it's no longer your data. You will no longer have any say over what happens to it. You don't have to consent to the trade of it. Outsiders can do whatever they want with that. I think a lot of people would be surprised to learn that. Very few patients know about it. Even doctors and pharmacists and others who are in the system don't know that there's this multi-billion-dollar trade. IOS:Right … we've written about the de-identification process, which it seems like it's the right thing to do, in a way, because you're removing all the identifiers, and that includes zip code information, other geo information. It seems that for research purposes that would be okay. Do you agree with that, or not? AT: So, these commercial companies, and some of the names may be well-known to us, companies such as IBM Watson Health, GE, LexisNexis, and the largest of them all may not be well-known to the general public, which is Quintiles and IMS. These companies have dossiers on hundreds of millions of patients worldwide. That means that they have medical information about you that extends over time, different procedures you've had done, different visits, different tests and so on, put together in a file that goes back for years. Now, when you have that much information, even if it only has your date of birth, your doctor's name, your zip code, but not your name, not your Social Security number, not things like that, it's increasingly possible to identify people from that. Let me give you an example. I'm talking to you now from Fairbanks, Alaska, where I'm teaching for a year at the university here. I lived, before that, in Boston, Massachusetts, and before that, in Belgrade, Serbia. I may be the only man of my age who meets that specific profile! So, if you knew those three pieces of information about me and had medical information from those years, I might be identifiable, even in a haystack of millions of different other people. IOS: Yeah …We have written about that as well in the blog. We call these quasi-identifiers. They're not the traditional kind of identifiers, but they're other bits of information, as you pointed out, that can be used to sort of re-identify. Usually it's a small subset, but not always. And that this information would seem also should be protected as well in some way. So, do you think that the laws are keeping up with this? AT: HIPAA was written 20 years ago, and the HIPAA rules say that you can freely trade our patient information if it is anonymized to a certain standard. Now, the technology has gone forward, dramatically, since then. So, the ability to store things very cheaply and the ability to scroll through them is much more sophisticated today than it was when those rules came into effect. For that reason, I think it's a worthwhile time to have a discussion now. Is this the best system? Is this what we want to do? Interestingly, the system of the free trade in our patient information has evolved because commercial companies have decided this is what they'd want to do. There has not been an open public discussion of what is best for society, what is best for patients, what is best for science, and so on. This is just a system that evolved. I'm saying, in writing this book, "Our Bodies, Our Data," that it is maybe worthwhile that we re-examine where we're at right now and say, "Do we want to have better privacy protection? Do we want to have a different system of contributing to science than we do now?" IOS: I guess what also surprised me was that you say that pharmacies, for example, can sell the drug records, as long as it's anonymized. You would think that the drug companies would be against that. It's sort of leaking out their information to their competitors, in some way. In other words, information goes to the data brokers and then gets resold to the drug companies. AT: Well, but you have to understand that everybody in what I call this big-data health bazaar is making money off of it. So, a large pharmacy chain, such as CVS or Walgreen's, they may make tens of millions of dollars in selling copies of these prescriptions to data miners. Drug companies are particularly interested in buying this information because this information is doctor-identified. It says that Dr. Jones in Pittsburgh prescribes drug A almost all the time, rather than drug B. So, the company that makes drug B may send a sales rep to the doctor and say, "Doctor, here's some free samples. Let's go out to lunch. Let me tell you about how great drug B is." So, this is because there exists these doctor profiles on individual doctors across the country, that are used for sales and marketing, for very sophisticated kind of targeting. IOS: So, in an indirect way, the drug companies can learn about the other drug companies' sales patterns, and then say, "Oh, let me go in there and see if I can take that business away." Is that sort of the way it's working? AT: In essence, yes. The origins of this trade date back to the 1950s. In its first form, these data companies, such as IMS Health, what they did was just telling companies what drugs sold in what market. Company A has 87% of the market. Their rival has 13% of the market. When medical information began to become digitized in the 1960s and '70s and evermore since then, there was a new opportunity to trade this data. So, all of a sudden, insurance companies and middle-men connecting up these companies, and electronic health records providers and others, had a product that they could sell easily, without a lot of work, and data miners were eager to buy this and produce new products for mostly the pharmaceutical companies, but there are other buyers as well. IOS:  I wanted to get back to another point you mentioned, in that even with anonymized data records of medical records, with all the other information that's out there, you can re-identify or at least limit, perhaps, the pool of people who that data would apply to. What's even more frightening now is that hackers have been stealing health records like crazy over the last couple of years. So, there's a whole dark market of hacked medical data that, I guess, if they got into this IMS database, they would have the keys to the kingdom, in a way. Am I being too paranoid here? AT: Well, no, you correctly point out that there has been a sharp upswing in hacking into medical records. That can happen into a small, individual practice, or it could happen into a large insurance company. And in fact, the largest hacking attack of medical records in the last couple of years has been into Anthem Health, which is the Blue Cross Blue Shield company. Almost 80 million records were hacked in that. So even people that did... I was hacked in that, even though I was not, at the time, a customer of them or had never been a customer of them, but they... One company that I dealt with outsourced to someone else, who outsourced to them. So, all of a sudden, this information can be in circulation. There’s a government website people can look at, and you'll see, every day or two, there are new hackings. Sometimes it involves a few thousand names and an obscure local clinic. Sometimes it'll be a major company, such as a lab test company, and millions of names could be impacted. So, this is something definitely to be concerned about. Yes, you could take these hacked records and match them with anonymized records to try to figure out who people are, but I should point out that there is no recorded instance of hackers getting into these anonymized dossiers by the big data miners. IOS: Right. We hope so! AT: I say recorded or acknowledged instance. IOS: Right. Right. But there's now been sort of an awareness of cyber gangs and cyber terrorism and then the use of, let's say, records for blackmail purposes. I don't want to get too paranoid here, but it seems like there's just a potential for just a lot of bad possibilities. Almost frightening possibilities with all this potential data out there. AT: Well, we have heard recently about rumors of an alleged dossier involving Donald Trump and Russia. IOS: Exactly. AT: And information that... If you think about what kind of information could be most damaging or harmful to someone, it could be financial information. It could be sexual information, or it could be health information. IOS: Yeah, or someone using... or has a prescription to a certain drug of some sort. I'm not suggesting anything, but that... All that information together could have sort of lots of implications, just, you know, political implications, let's say. AT: I mean if you know that someone takes a drug that's commonly used for a mental health problem, that could be information used against someone. It could be used to deny them life insurance. It could be used to deny them a promotion or a job offer. It could be used by rivals in different ways to humiliate people. So, this medical information is quite powerful. One person who has experienced this and spoken publicly about it is the actor, Charlie Sheen. He tested positive for HIV. Others somehow learned of it and blackmailed him. He said he paid millions of dollars to keep that information from going public, before he decided finally that he would stop paying it, and he'd have to tell the world about his medical condition. IOS: Actually I was not aware of the payments he was making. That's just astonishing. So, is there any hope here? Do you see some remedies, through maybe regulations or enforcement of existing laws? Or perhaps we need new laws? AT: As I mentioned, the current rules, HIPAA, allows for the free trade of your data if it's anonymized. Now, I think, given the growth of sophistication in computing, that we should change what the rule is and to define our medical data as any medical information about us, whether or not it's anonymized. So, if a doctor is writing in the electronic health record, you should have a say as to whether or not that information is going to be used elsewhere. A little side point I should mention. There are a lot of good scientists and researchers who want data to see if they can gain insights into disease and new medications. I think people should have the choice whether or not they want to contribute to those efforts. So, you know, there's a lot of good efforts. There's a government effort under way now to gather a million DNA samples from people to make available to science. So, if people want to participate in that, and they think that's good work, they should definitely be encouraged to do so, but I think they should have the say and decide for themselves. And so far, we don't really have that system. So, by redefining what patient data is, to say, "Medical information about a patient, whether or not it's anonymized," I think that would give us the power to do that. IOS: So effectively, you're saying the patient owns the data, is the owner, and then would have to give consent for the data to be used. Is that, about right? AT: I think so. But on the other hand, as I mentioned, I've written this book to encourage this discussion. The problem we have right now is that the trade is so opaque. Companies are extremely reluctant to talk about this commercial trade. So, they do occasionally say that, "Oh, this is great for science and for medicine, and all of these great things will happen." Well, if that is so fantastic, let's have this discussion where everyone will say, "All right. Here's how we use the data. Here's how we share it. Here's how we sell it." Then let people in on it and decide whether they really want that system or not. But it's hard to have that intelligent policy discussion, what's best for the whole country, if industry has decided for itself how to proceed without involving others. IOS: Well, I'm so glad you've written this book. This will, I'm hoping, will promote the discussion that you're talking about. Well, this has been great. I want to thank you for the interview. So, by the way, where can our listeners reach out to you on social media? Do you have a handle on Twitter? Or Facebook? AT: Well, I'm @datacurtain  and I have a webpage, which is http://adamtanner.news/ IOS: Wonderful. Thank you very much, Adam.

Adam Tanner is the author of "Our Bodies, Our Data", which tells the story of a hidden dark market in drug prescription and other medical data. Adam explains how the sale of "anonymized" data is a multi-billion dollar business not covered by HIPPA rules. In this first part of our interview, we learn from Adam how the medical data brokers got started and why it's legal. Transcript Inside Out Security: Today, I'd like to welcome Adam Tanner. Adam is a writer-in-residence at Harvard University's Institute for Quantitative Social Science. He's written extensively on data privacy. He's the author of What Stays In Vegas: The World of Personal Data and the End of Privacy As We Know It. His articles on data privacy have appeared in Scientific American, Forbes, Fortune, and Slate. And he has a new book out, titled "Our Bodies, Our Data," which focuses on the hidden market in medical data. Welcome, Adam. Adam Tanner: Well, I'm glad to be with you. IOS: We've also been writing about medical data privacy for our Inside Out Security blog. And we're familiar with how, for example, hospital discharge records can be legally sold to the private sector. But in your new book, and this is a bit of a shock to me, you describe how pharmacies and others sell prescription drug records to data brokers. Can you tell us more about the story you've uncovered? AT: Basically, throughout your journey as a patient into the healthcare system, information about you is sold. It has nothing to do with your direct treatment. It has to do with commercial businesses wanting to gain insight about you and your doctor, largely, for sales and marketing. So, take the first step. You go to your doctor's office. The door is shut. You tell your doctor your intimate medical problems. The information that is entered into the doctor's electronic health system may be sold, commercially, as may the prescription that you pick up at the pharmacy or the blood tests that you take or the urine tests at the testing lab. The insurance company that pays for all of this or subsidizes part of this, may also sell the information. That information about you is anonymized.  That means that your information contains your medical condition, your date of birth, your doctor's name, your gender, all or part of your postal zip code, but it doesn't have your name on it. All of that trade is allowed, under U.S. rules. IOS: You mean under HIPAA? AT: That's right. Now this may be surprising to many people who would ask this question, "How can this be legal under current rules?" Well, HIPAA says that if you take out the name and anonymize according to certain standards, it's no longer your data. You will no longer have any say over what happens to it. You don't have to consent to the trade of it. Outsiders can do whatever they want with that. I think a lot of people would be surprised to learn that. Very few patients know about it. Even doctors and pharmacists and others who are in the system don't know that there's this multi-billion-dollar trade. IOS:Right … we've written about the de-identification process, which it seems like it's the right thing to do, in a way, because you're removing all the identifiers, and that includes zip code information, other geo information. It seems that for research purposes that would be okay. Do you agree with that, or not? AT: So, these commercial companies, and some of the names may be well-known to us, companies such as IBM Watson Health, GE, LexisNexis, and the largest of them all may not be well-known to the general public, which is Quintiles and IMS. These companies have dossiers on hundreds of millions of patients worldwide. That means that they have medical information about you that extends over time, different procedures you've had done, different visits, different tests and so on, put together in a file that goes back for years. Now, when you have that much information, even if it only has your date of birth, your doctor's name, your zip code, but not your name, not your Social Security number, not things like that, it's increasingly possible to identify people from that. Let me give you an example. I'm talking to you now from Fairbanks, Alaska, where I'm teaching for a year at the university here. I lived, before that, in Boston, Massachusetts, and before that, in Belgrade, Serbia. I may be the only man of my age who meets that specific profile! So, if you knew those three pieces of information about me and had medical information from those years, I might be identifiable, even in a haystack of millions of different other people. IOS: Yeah …We have written about that as well in the blog. We call these quasi-identifiers. They're not the traditional kind of identifiers, but they're other bits of information, as you pointed out, that can be used to sort of re-identify. Usually it's a small subset, but not always. And that this information would seem also should be protected as well in some way. So, do you think that the laws are keeping up with this? AT: HIPAA was written 20 years ago, and the HIPAA rules say that you can freely trade our patient information if it is anonymized to a certain standard. Now, the technology has gone forward, dramatically, since then. So, the ability to store things very cheaply and the ability to scroll through them is much more sophisticated today than it was when those rules came into effect. For that reason, I think it's a worthwhile time to have a discussion now. Is this the best system? Is this what we want to do? Interestingly, the system of the free trade in our patient information has evolved because commercial companies have decided this is what they'd want to do. There has not been an open public discussion of what is best for society, what is best for patients, what is best for science, and so on. This is just a system that evolved. I'm saying, in writing this book, "Our Bodies, Our Data," that it is maybe worthwhile that we re-examine where we're at right now and say, "Do we want to have better privacy protection? Do we want to have a different system of contributing to science than we do now?" IOS: I guess what also surprised me was that you say that pharmacies, for example, can sell the drug records, as long as it's anonymized. You would think that the drug companies would be against that. It's sort of leaking out their information to their competitors, in some way. In other words, information goes to the data brokers and then gets resold to the drug companies. AT: Well, but you have to understand that everybody in what I call this big-data health bazaar is making money off of it. So, a large pharmacy chain, such as CVS or Walgreen's, they may make tens of millions of dollars in selling copies of these prescriptions to data miners. Drug companies are particularly interested in buying this information because this information is doctor-identified. It says that Dr. Jones in Pittsburgh prescribes drug A almost all the time, rather than drug B. So, the company that makes drug B may send a sales rep to the doctor and say, "Doctor, here's some free samples. Let's go out to lunch. Let me tell you about how great drug B is." So, this is because there exists these doctor profiles on individual doctors across the country, that are used for sales and marketing, for very sophisticated kind of targeting. IOS: So, in an indirect way, the drug companies can learn about the other drug companies' sales patterns, and then say, "Oh, let me go in there and see if I can take that business away." Is that sort of the way it's working? AT: In essence, yes. The origins of this trade date back to the 1950s. In its first form, these data companies, such as IMS Health, what they did was just telling companies what drugs sold in what market. Company A has 87% of the market. Their rival has 13% of the market. When medical information began to become digitized in the 1960s and '70s and evermore since then, there was a new opportunity to trade this data. So, all of a sudden, insurance companies and middle-men connecting up these companies, and electronic health records providers and others, had a product that they could sell easily, without a lot of work, and data miners were eager to buy this and produce new products for mostly the pharmaceutical companies, but there are other buyers as well. IOS:  I wanted to get back to another point you mentioned, in that even with anonymized data records of medical records, with all the other information that's out there, you can re-identify or at least limit, perhaps, the pool of people who that data would apply to. What's even more frightening now is that hackers have been stealing health records like crazy over the last couple of years. So, there's a whole dark market of hacked medical data that, I guess, if they got into this IMS database, they would have the keys to the kingdom, in a way. Am I being too paranoid here? AT: Well, no, you correctly point out that there has been a sharp upswing in hacking into medical records. That can happen into a small, individual practice, or it could happen into a large insurance company. And in fact, the largest hacking attack of medical records in the last couple of years has been into Anthem Health, which is the Blue Cross Blue Shield company. Almost 80 million records were hacked in that. So even people that did... I was hacked in that, even though I was not, at the time, a customer of them or had never been a customer of them, but they... One company that I dealt with outsourced to someone else, who outsourced to them. So, all of a sudden, this information can be in circulation. There’s a government website people can look at, and you'll see, every day or two, there are new hackings. Sometimes it involves a few thousand names and an obscure local clinic. Sometimes it'll be a major company, such as a lab test company, and millions of names could be impacted. So, this is something definitely to be concerned about. Yes, you could take these hacked records and match them with anonymized records to try to figure out who people are, but I should point out that there is no recorded instance of hackers getting into these anonymized dossiers by the big data miners. IOS: Right. We hope so! AT: I say recorded or acknowledged instance. IOS: Right. Right. But there's now been sort of an awareness of cyber gangs and cyber terrorism and then the use of, let's say, records for blackmail purposes. I don't want to get too paranoid here, but it seems like there's just a potential for just a lot of bad possibilities. Almost frightening possibilities with all this potential data out there. AT: Well, we have heard recently about rumors of an alleged dossier involving Donald Trump and Russia. IOS: Exactly. AT: And information that... If you think about what kind of information could be most damaging or harmful to someone, it could be financial information. It could be sexual information, or it could be health information. IOS: Yeah, or someone using... or has a prescription to a certain drug of some sort. I'm not suggesting anything, but that... All that information together could have sort of lots of implications, just, you know, political implications, let's say. AT: I mean if you know that someone takes a drug that's commonly used for a mental health problem, that could be information used against someone. It could be used to deny them life insurance. It could be used to deny them a promotion or a job offer. It could be used by rivals in different ways to humiliate people. So, this medical information is quite powerful. One person who has experienced this and spoken publicly about it is the actor, Charlie Sheen. He tested positive for HIV. Others somehow learned of it and blackmailed him. He said he paid millions of dollars to keep that information from going public, before he decided finally that he would stop paying it, and he'd have to tell the world about his medical condition. IOS: Actually I was not aware of the payments he was making. That's just astonishing. So, is there any hope here? Do you see some remedies, through maybe regulations or enforcement of existing laws? Or perhaps we need new laws? AT: As I mentioned, the current rules, HIPAA, allows for the free trade of your data if it's anonymized. Now, I think, given the growth of sophistication in computing, that we should change what the rule is and to define our medical data as any medical information about us, whether or not it's anonymized. So, if a doctor is writing in the electronic health record, you should have a say as to whether or not that information is going to be used elsewhere. A little side point I should mention. There are a lot of good scientists and researchers who want data to see if they can gain insights into disease and new medications. I think people should have the choice whether or not they want to contribute to those efforts. So, you know, there's a lot of good efforts. There's a government effort under way now to gather a million DNA samples from people to make available to science. So, if people want to participate in that, and they think that's good work, they should definitely be encouraged to do so, but I think they should have the say and decide for themselves. And so far, we don't really have that system. So, by redefining what patient data is, to say, "Medical information about a patient, whether or not it's anonymized," I think that would give us the power to do that. IOS: So effectively, you're saying the patient owns the data, is the owner, and then would have to give consent for the data to be used. Is that, about right? AT: I think so. But on the other hand, as I mentioned, I've written this book to encourage this discussion. The problem we have right now is that the trade is so opaque. Companies are extremely reluctant to talk about this commercial trade. So, they do occasionally say that, "Oh, this is great for science and for medicine, and all of these great things will happen." Well, if that is so fantastic, let's have this discussion where everyone will say, "All right. Here's how we use the data. Here's how we share it. Here's how we sell it." Then let people in on it and decide whether they really want that system or not. But it's hard to have that intelligent policy discussion, what's best for the whole country, if industry has decided for itself how to proceed without involving others. IOS: Well, I'm so glad you've written this book. This will, I'm hoping, will promote the discussion that you're talking about. Well, this has been great. I want to thank you for the interview. So, by the way, where can our listeners reach out to you on social media? Do you have a handle on Twitter? Or Facebook? AT: Well, I'm @datacurtain  and I have a webpage, which is http://adamtanner.news/ IOS: Wonderful. Thank you very much, Adam.

What do new techniques of capturing your personal data mean to your privacy?

Is there anyone that believes that we still have a measure of privacy?  Not only are there cameras everywhere, not only is big data a part of almost every business, but the uses of the this data, not by the NSA, but by corporate America, are becoming ever more sophisticated.After all, it’s what we say we want.  Better customer service, better consumer satisfaction and greater personalization. After all, when you look up something on Amazon or Google and then you see ads for that item within seconds, on every website you visit, maybe it seems to go a bit too far.No place is better at this, particularly in the bricks and mortar world, than Las Vegas. A place where money and service are as one, where loyalty still seems to matter and where the world of tech and the world of touch come together, as in few other places.This is the backdrop for an Adam Tanner's look at big data, in What Stays in Vegas: The World of Personal DataLifeblood of Big Business and the End of Privacy as We Know It.My conversation with Adam Tanner:

Apple introduces a smartwatch.  Lululemon reports fashionable earnings.  And Activision Blizzard meets its Destiny.   Our analyst discuss those stories and share some stocks on their radar.  Plus, we talk with Adam Tanner, author of What Stays in Vegas:  The World of Personal Data  - Lifeblood of Big Business - and the End of Privacy as We Know It.

BLAME SALLY is one of the most powerful word-of-mouth success stories in recent years.. Each of the four women put her individual career aside to start Blame Sally in the San Fransisco Bay-area when they were in their late thirties and forties � the age at which bands are traditionally supposed to break up and begin solo careers. Their latest CD is "Speeding Ticket and a Valentine" released on Ninth Street Opus.Water." THE TWILITE BROADCASTERS continues the longstanding tradition of two part rural harmony vocals with simple acoustic string instrument accompaniment once common in the Southern part of the United States (starting in the 1930's). The irinfluences include The Monroe Brothers,The Louvin Brothers, The Stanley Brothers, Jim and Jesse, and more but have a sound that is uniquely theirs. Adam Tanner and Mark Jackson formed the group in 2009 in Weaverville, North Carolina. They have just released a new recording called "The Trail of Time."