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"One",
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",",
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"each",
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"an",
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".",
" ",
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",",
"which",
"proved",
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",",
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"-",
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"data",
"breaches",
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"records",
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"-",
"care",
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"patient",
"records",
".",
" ",
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"health",
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"spending",
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"security",
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"ensure",
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"-",
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"group",
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" ",
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"an",
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".",
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"the",
"cases",
",",
"lost",
"or",
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"phones",
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" ",
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"-",
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"credit",
"card",
"numbers",
".",
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"hands",
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",",
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"to",
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".",
" ",
"Tripathi",
",",
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",",
"did",
"nt",
"find",
"the",
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"laptop",
",",
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"cost",
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" ",
"not",
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"mention",
"600",
"hours",
"dealing",
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"the",
"fallout",
"and",
"the",
"intangible",
"cost",
"of",
"repairing",
"the",
"reputational",
"damage",
"that",
"followed",
".",
" ",
"In",
"many",
"ways",
",",
"it",
"got",
"off",
"easy",
".",
"In",
"October",
",",
"a",
"desktop",
"computer",
"containing",
"unencrypted",
"records",
"on",
"more",
"than",
"4",
"million",
"patients",
"was",
"stolen",
"from",
"Sutter",
"Health",
",",
"a",
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"system",
"based",
"in",
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".",
"A",
"rock",
"was",
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"through",
"a",
"window",
"to",
"gain",
"access",
"to",
"the",
"computer",
".",
"The",
"theft",
"is",
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"the",
"subject",
"of",
"two",
"class",
"-",
"action",
"suits",
",",
"each",
"of",
"which",
"seeks",
"$",
"1,000",
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"each",
"patient",
"record",
"breached",
".",
" ",
"The",
"stolen",
"computer",
"did",
"not",
"contain",
"patient",
"financial",
"records",
",",
"Social",
"Security",
"numbers",
",",
"health",
"plan",
"identification",
"numbers",
"or",
"actual",
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"records",
",",
"Sutter",
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".",
" ",
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"major",
"breaches",
" ",
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"federal",
"health",
"care",
"data",
"-",
"breach",
"notification",
"rules",
"took",
"effect",
"in",
"2009",
",",
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"and",
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"records",
"show",
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"the",
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"theft",
"was",
"exceeded",
"only",
"when",
"the",
"U.S.",
"militarys",
"health",
"insurance",
"program",
"lost",
"backup",
"tapes",
"in",
"September",
"containing",
"information",
"on",
"more",
"than",
"4.9",
"million",
"patients",
".",
" ",
"Last",
"year",
",",
"hard",
"drives",
"containing",
"health",
"histories",
",",
"financial",
"information",
"and",
"Social",
"Security",
"numbers",
"of",
"1.9",
"million",
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"Net",
"insurance",
"customers",
"disappeared",
"from",
"an",
"office",
".",
"State",
"regulators",
"launched",
"investigations",
"into",
"Health",
"Nets",
"security",
"procedures",
".",
" ",
"In",
"one",
"of",
"the",
"largest",
"cases",
"before",
"implementation",
"of",
"notification",
"rules",
",",
"government",
"health",
"data",
"was",
"at",
"risk",
"in",
"2006",
"when",
"a",
"laptop",
"with",
"data",
"on",
"26.5",
"million",
"veterans",
"was",
"stolen",
"from",
"a",
"government",
"employees",
"home",
".",
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"computer",
"equipment",
"was",
"recovered",
",",
"and",
"the",
"FBI",
"said",
"the",
"sensitive",
"files",
"were",
"nt",
"accessed",
".",
" ",
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"another",
"California",
"case",
",",
"Stanford",
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"in",
"Palo",
"Alto",
"blamed",
"a",
"subcontractor",
"used",
"by",
"an",
"outside",
"vendor",
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"a",
"privacy",
"breach",
"that",
"led",
"to",
"the",
"posting",
"online",
"of",
"medical",
"information",
"for",
"thousands",
"of",
"emergency",
"room",
"patients",
".",
" ",
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"data",
"of",
"20,000",
"patients",
",",
"including",
"names",
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"diagnosis",
"codes",
",",
"remained",
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"a",
"commercial",
"website",
"for",
"nearly",
"a",
"year",
"until",
"it",
"was",
"discovered",
"in",
"August",
"and",
"taken",
"down",
".",
" ",
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"spreadsheet",
"included",
"names",
",",
"diagnosis",
"codes",
",",
"account",
"numbers",
",",
"admission",
"and",
"discharge",
"dates",
",",
"and",
"billing",
"charges",
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"patients",
"seen",
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"Hospitals",
"emergency",
"room",
"during",
"a",
"six",
"-",
"month",
"period",
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"2009",
",",
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"Gary",
"Migdol",
",",
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"and",
"Clinics",
".",
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"did",
"not",
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"Security",
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",",
"birth",
"dates",
",",
"credit",
"card",
"numbers",
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"other",
"information",
"used",
"to",
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"theft",
",",
"he",
"said",
",",
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"the",
"hospital",
"is",
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"free",
"identity",
"protection",
"services",
"to",
"affected",
"patients",
".",
" ",
"Lagging",
"in",
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" ",
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"-",
"fifth",
"of",
"the",
"publicly",
"disclosed",
"breaches",
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"last",
"seven",
"years",
"have",
"involved",
"health",
"care",
"providers",
",",
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"a",
"database",
"kept",
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"Diego",
"-",
"based",
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"Rights",
"Clearinghouse",
".",
" ",
"The",
"increasing",
"digitization",
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"medical",
"data",
"are",
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"new",
"problems",
",",
"as",
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"travels",
"more",
"easily",
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"the",
"dozens",
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"contractors",
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"is",
"more",
"easily",
"lost",
"or",
"accidentally",
"posted",
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".",
" ",
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"computer",
"was",
"password",
"-",
"protected",
",",
"the",
"data",
"on",
"patients",
"was",
"not",
"encrypted",
",",
"drawing",
"criticism",
"from",
"privacy",
"and",
"computer",
"security",
"experts",
".",
" ",
"On",
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"computer",
"in",
"which",
"data",
"are",
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",",
"a",
"user",
"would",
"typically",
"have",
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"enter",
"another",
"password",
"in",
"addition",
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"the",
"computers",
"general",
"password",
"to",
"access",
"that",
"specific",
"data",
".",
" ",
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"is",
"highly",
"recommended",
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"federal",
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",",
"Verizon",
"health",
"care",
"and",
"data",
"security",
"expert",
"Dr.",
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"industry",
"lags",
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"-",
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",",
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"health",
"care",
"system",
"needs",
"a",
"lot",
"of",
"work",
"at",
"being",
"more",
"secure",
",",
"Tippett",
"said",
".",
" ",
"In",
"most",
"cases",
",",
"Tippett",
"said",
",",
"computer",
"thieves",
"are",
"simply",
"looking",
"to",
"make",
"a",
"little",
"cash",
"reselling",
"the",
"stolen",
"computer",
"itself",
".",
"Sometimes",
"they",
"may",
"try",
"to",
"ransom",
"the",
"computer",
"back",
"to",
"its",
"original",
"owner",
".",
"If",
"the",
"data",
"itself",
"is",
"accessed",
",",
"usually",
"by",
"organized",
"crime",
"operations",
",",
"he",
"said",
"criminals",
"would",
"generally",
"try",
"to",
"use",
"it",
"to",
"blackmail",
"prominent",
"people",
"with",
"potentially",
"embarrassing",
"diagnoses",
"or",
"steal",
"patients",
"identities",
"to",
"fraudulently",
"bill",
"health",
"insurers",
"for",
"medical",
"procedures",
"that",
"were",
"nt",
"really",
"performed",
".",
" ",
"Cleanup",
"complicated",
" ",
"Cleaning",
"up",
"after",
"such",
"breaches",
"can",
"be",
"difficult",
".",
" ",
"Tripathi",
",",
"of",
"eHealth",
"Collaborative",
",",
"went",
"to",
"work",
"assembling",
"a",
"crisis",
"team",
"of",
"lawyers",
"and",
"customers",
"and",
"a",
"chief",
"security",
"officer",
".",
"The",
"biggest",
"headache",
",",
"he",
"says",
",",
"was",
"deciphering",
"how",
"much",
"about",
"the",
"breach",
"his",
"nonprofit",
"needed",
"to",
"disclose",
".",
" ",
"Health",
"organizations",
"are",
"required",
"by",
"federal",
"law",
"to",
"report",
"data",
"breaches",
"that",
"affect",
"more",
"than",
"500",
"people",
"to",
"the",
"Department",
"of",
"Health",
"and",
"Human",
"Services",
".",
"The",
"departments",
"Office",
"of",
"Civil",
"Rights",
"publishes",
"the",
"equivalent",
"of",
"a",
"data",
"breach",
"Wall",
"of",
"Shame",
"on",
"its",
"website",
" ",
"which",
"now",
"includes",
"385",
"breaches",
"affecting",
"more",
"than",
"18",
"million",
"people",
".",
" ",
"Tripathi",
"said",
"he",
"quickly",
"discovered",
"just",
"how",
"many",
"ways",
"there",
"were",
"to",
"count",
"to",
"500",
".",
"The",
"law",
"requires",
"disclosure",
"only",
"in",
"cases",
"that",
"pose",
"a",
"significant",
"risk",
"of",
"financial",
",",
"reputational",
"or",
"other",
"harm",
"to",
"the",
"individual",
"affected",
".",
"His",
"team",
"spent",
"hours",
"poring",
"over",
"a",
"backup",
"of",
"the",
"stolen",
"laptop",
"files",
".",
"Of",
"the",
"nearly",
"14,000",
"patient",
"records",
"on",
"the",
"stolen",
"laptop",
",",
"most",
"records",
"did",
"not",
"warrant",
"disclosure",
".",
"In",
"2,777",
"cases",
",",
"for",
"instance",
",",
"a",
"record",
"listed",
"only",
"a",
"patients",
"name",
".",
" ",
"Liability",
"issues",
" ",
"Complicating",
"matters",
"were",
"liability",
"rules",
".",
"In",
"the",
"eyes",
"of",
"the",
"law",
",",
"Tripathis",
"nonprofit",
"is",
"a",
"contractor",
"that",
"acts",
"on",
"behalf",
"of",
"health",
"providers",
".",
"The",
"legal",
"burden",
"of",
"protecting",
"patient",
"data",
"actually",
"falls",
"on",
"his",
"clients",
":",
"the",
"physicians",
"and",
"hospitals",
"who",
"entrusted",
"his",
"nonprofit",
"with",
"their",
"files",
".",
" ",
"The",
"laws",
"create",
"a",
"perverse",
"outcome",
",",
"he",
"says",
".",
"It",
"was",
"our",
"fault",
",",
"but",
"from",
"a",
"federal",
"perspective",
",",
"it",
"was",
"nt",
"our",
"breach",
".",
" ",
"Tripathi",
"narrowed",
"down",
"the",
"group",
"of",
"patients",
"whose",
"data",
"put",
"them",
"at",
"serious",
"risk",
"for",
"identity",
"theft",
"to",
"998",
"people",
"across",
"seven",
"physician",
"practices",
".",
"Only",
"one",
"practice",
"broke",
"the",
"500",
"-",
"patient",
"threshold",
"requiring",
"disclosure",
"on",
"the",
"Department",
"of",
"Health",
"and",
"Human",
"Services",
"website",
".",
" ",
"His",
"office",
"got",
"to",
"work",
"notifying",
"the",
"affected",
"patients",
"of",
"the",
"data",
"breach",
".",
"They",
"offered",
"free",
"credit",
"monitoring",
" ",
"though",
"less",
"than",
"10",
"percent",
"took",
"them",
"up",
"on",
"the",
"option",
" ",
"spending",
"a",
"total",
"of",
"$",
"6,000",
".",
" ",
"In",
"the",
"aftermath",
",",
"Tripathi",
"says",
"his",
"company",
"destroyed",
"all",
"patient",
"data",
"on",
"mobile",
"devices",
"and",
"temporarily",
"prohibited",
"employees",
"from",
"removing",
"patient",
"data",
"from",
"clients",
"offices",
".",
"The",
"company",
"mandates",
"that",
"all",
"data",
"be",
"encrypted",
",",
"and",
"employees",
"are",
"required",
"to",
"tell",
"health",
"providers",
"what",
"data",
"they",
"will",
"need",
"to",
"access",
"and",
"how",
"they",
"plan",
"to",
"use",
"it",
".",
" ",
"Breaches",
"are",
"going",
"to",
"be",
"one",
"of",
"the",
"big",
"challenges",
"as",
"more",
"physicians",
"and",
"hospitals",
"adopt",
"electronic",
"health",
"records",
",",
"Tripathi",
"says",
".",
"Were",
"entering",
"a",
"brave",
"new",
"world",
".",
";"
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