Data, technology, and culture

More from our Craig Workinger at HiMSS…

 

We are attending the HiMSS annual meeting this week and wanted to share a few observations. It’s a terrific event, and a reminder of how important personal contacts are in an age when we’re on our screens constantly.

Nearly every conversation here includes the issue of how to get data out of isolated, proprietary systems so it can be used more effectively. If data can be collected from many sources, then AI and machine learning tools can be applied to it, looking at both text and images to create a predictive system for clinicians. That offers a real opportunity to improve patient care.

This also seems to be driving talk of partnerships, another hot topic at the conference. People recognize there are lots of technologies trying to solve healthcare’s problems but they approach it in an isolated way. So they are trying to figure out how to make data actionable and link it to what others have. The idea of partnerships is a departure for big industry players who’ve mostly taken a go-it-alone approach in the past.

Interoperability is also getting a lot of buzz at HiMSS. Most people focus on its technological aspect but that’s only half the challenge. The other is culture.

From a technology perspective, there are lots of vendors battling for market share and holding on to data as part of their competitive strategy. But that’s running up against consumer behavior. People today get their health care from a variety of places – hospitals, outpatient centers, specialized clinics, even their home – and they are increasingly shopping around. Inevitably, they wind up in separate health systems, and none of them speak to each other. So the challenge is to get the data up a level so that it’s accessible to their doctor no matter where they go.

There are technologies that can do that, and more. But change is slow, and that’s where culture comes in. Many healthcare organizations are reluctant to change. Some still use fax machines and paper records. They want to be more efficient but are slow to embrace the technology that can help them get there. Of course, adoption has been the challenge for every technology innovation, from PCs to cell phones. Healthcare tech is no different.

Healthcare: Getting serious about multifactor authentication

The Time Has Come for Two-Factor Authentication in Health Care (iHealthBeat)

William Braithwaite — a health information privacy and security consultant and chair of the Healthcare Information and Management Systems Society’s identity management task force — noted that, no matter how long or complex passwords are, they’re still vulnerable to theft. “The real problem is that passwords are being stolen, not that they’re being broken,” he said.

European migrant crisis spurs interest in biometrics

Migrant crisis: EU considers locking up more failed asylum seekers (Financial Times)

EU countries should lock up more failed asylum seekers, according to hardline plans the bloc is considering to increase the number of deportations from Europe.

The proposal is one of a series of tough measures — ranging from increased use of fingerprints to more funding for detention centres — that interior ministers from across the EU will discuss at a meeting in Luxembourg on Thursday.

US: Iowa, Morpho Trust, and prototype digital ID’s

Iowa DOT Using Digital ID’s (WHOtv)

Iowa Department of Transportation Director Paul Trombino says Iowa is the first state to offer a prototype for digital licenses currently being used by Iowa DOT employees. The new licenses which will only be optional and not mandatory are fitted with even more secure technology than the card version.

Trombino explained, “I use a fingerprint to open up my phone that can help authorize that. You may have to make a facial movement so it`s not just looking at a picture in order to open up the biometric perspective, so only you can open that up.” If that isn’t secure enough, “The picture physically moves, so it`s not a static picture like your regular driver`s license,” said Trombino.

Not a bug, but a feature

Massive errors mar Aadhaar enrolment (Times of India)

The enrolment process for Aadhaar in Odisha is dogged by massive rejection of data due to errors. According to the directorate of census operations here, enrolled biometric data of 40 lakh people stand rejected by the Unique Identification Authority of India (UIDAI), the Aadhaar body, as on June 15.

Some facts:
Odisha is a state in eastern India. The wiki has its population at 43.73 million as of 2014.
1 lakh = 100,000
1 crore = 10,000,000
All numbers not quoted from the article are in more familiar units.

The article goes on to say a lot about the numbers. 31,700,000 out of 38,400,000 people (82%) of the eligible population have been registered successfully.

The 4 million rejected applications are divided as follows.

2 million were rejected because they were submitted by operators who have been barred from submitting applications. UID works by outsourcing enrollment to private operators who are then paid by the government for accepted applications. Operators who have submitted too many error-riddled or fraudulent applications have been banned from the market.

1 million have been rejected for being duplicate applications, as is proper.

That leaves 1 million true “errors,” or failed enrollments that are potentially valid and are described as those submitted on behalf of “very old people and children (between five to 10 years), whose finger prints and iris scans were not registered properly.” Now, it may turn out that some of these failed enrollments are duplicate applications as well and it will probably turn out that many (if not most) of these people can be enrolled on a second pass where extra care is taken during the enrollment process. Nevertheless describing 1 million failed enrollments out of 32.7 million presumably legitimate applications as “massive errors” seems uncharitable.

Also, UID contains a “Biometric Exception Clause” which allows for creating UID numbers for people whose biometrics cannot be enrolled. As of May 2015, across India, around 618,000 (0.07%) of UID numbers have been issued with biometric exceptions.

India: Income tax department sees value in UID

I-T department exploring ways to seed PAN with Aadhaar (Live Mint)

The income tax department is exploring ways to hasten the pace of seeding permanent account number, or PAN, with the unique identity number Aadhaar, a move that will weed out duplicate PANs and help the government’s drive against tax evaders.

This would allow the Income Tax Department to maintain its own ID numbering system for its own purposes — they may tax entities such as corporations that don’t have biometrics, after all — while harnessing Aadhaar for detecting tax fraud among individuals.

Biometrics aid in aid delivery

IOM Uses Biometrics to Aid Displaced in Democratic Republic of the Congo (MENAFN)

The lack of identity documents for IDPs in the Eastern DRC poses a challenge in targeting humanitarian assistance. Almost 80 per cent of adults living in sites having no form of identity documents. In response IOM launched a biometric registration pilot project in eight displacement sites around the city of Goma in June 2014.

Between June 2014 and April 2015 IOM took the fingerprints of nearly 16000 IDPs. In the context of food distributions the collected information is used to ensure that humanitarian aid reaches the most vulnerable and avoids duplication and fraud.

Biometrics are an inexpensive, fast and accurate way of setting up ad hoc ID systems from scratch. Those interested in development and disaster recovery, take note.

US: Social Security Number is an unreliable identity management technology

Should We Kill the Social Security Number? (Huffington Post)

That’s right: Social Security numbers were not intended for identification. They were made to track how much money people made to figure out benefit levels. That’s it. Before 1972, the cards issued by the Social Security Administration even said, “For Social Security purposes. Not for Identification.” The numbers only started being used for identification in the 1960s when the first big computers made that doable. They were first used to identify federal employees in 1961, and then a year later the IRS adopted the method. Banks and other institutions followed suit. And the rest is history.

Author: Adam Levin, Former Director New Jersey Division of Consumer Affairs; Chairman of Credit.com and Identity Theft 911.

There’s a lot of good data in the article about just how much fraud is perpetrated against the IRS, fraud that is at least partly due to over-reliance on the Social Security number for ID purposes.

Biometrics against criminal aliases

Suspect in deputy deaths arrested in Utah in 2003 (Boston Herald)

Police in West Valley City, Utah, said they took a fingerprint from a man using the name Marcelo Marquez during a misdemeanor hit-and-run arrest in 2003. Court records show that he pleaded guilty, received a year of probation and was fined about $500.

However, Utah authorities never connected him to his real name or his previous criminal record.

In Utah, fingerprint data is entered into a biometric database for all people booked into jail. But for those who are cited and released, police take a print from a single finger that’s kept in state criminal records.

Unless there’s a request from an investigator, the print is not run against the biometric database to determine whether the person has a prior record outside Utah or is using an alias, said Alice Moffat, director of the Bureau of Criminal Identification.

Biometrics are a great way to root out criminal aliases, but only if procedures are in place to run the biometric search.

Turkey looks to biometrics to enable structural change

Upcoming reforms in Turkey to ban any actions against statehood (Trend)

UPDATE:
Via twitter, @canmutlu writes that the article linked above refers to biometric national ID cards rather than (as the article states, twice) passports.

This rings true from a practical standpoint, and based upon this short article from Planet Biometrics: Turkey’s PM unveils biometric ID card plan.

We very much appreciate his pointing this out.

UPDATE II:
It looks like someone at Trend got the message, as well.

New biometric identity cards to be issued in Turkey (Trend)

IDC Comment: Biometric Identification in Financial Applications

International Data Corporation (IDC) Analyst: Banks should precede with caution (IDC)

“While improving authorization experience is attractive and will help adoption of mobile banking services, financial institutions should not just blindly commit to mass market biometric identification solutions, especially those provided by third parties via publicly-available APIs”, says Andrei Charniauski, Research Manager at IDC Financial Insights.

Passwords vs. biometrics (GCN)

The password by itself actually is a pretty good tool. It is simple to use, easy to implement and can be reasonably strong. The problem is one of scale. For a user juggling passwords for multiple accounts and for administrators juggling many users, the system quickly becomes unwieldy, and strong security begins to break down. In addition, the steady growth in computing power erodes password security by making dictionary and brute force attacks more practical.

Biometrics – the use of physical traits such as fingerprints, irises, faces or voices to identify persons – is more complex, but is becoming more practical. It offers the promise of better security based on the premise that there is only one you.

Yet it has its drawbacks…

See also:
January 17, 2012 More on the Awesomeness of Passwords

Who should pay for public sector biometrics?

CALIFORNIA: Bill could boost vehicle fees for fingerprint ID programs (Manteca Bulletin)

Counties will be allowed to increase vehicle registration fees to pay for fingerprint identification programs under a bill that advanced to the governor’s desk Monday.

A law passed in 1997 created the Cal-ID program, allowing counties to charge $1 surcharges on vehicle registration fees to fund programs to identify people under arrest and human remains with fingerprints. Assemblyman Marc Levine, D-San Rafael, says his bill will help the programs keep up with advancements in technology.

This article caught my eye, because these kinds of biometric systems can really help save a lot of law enforcement resources especially in a state as large as California. These systems however, do cost money.

Indian Supreme Court issues two-pronged UID decision

It’s been a while since we’ve dealt with the topic of India’s UID project here. This post picks up with current events. Newer readers can catch up by sifting back through the India label (also located in the post footer).

Nandan Nilekani: Supreme Court decision on Aadhaar vindicates our stand Nandan Nilekani (Economic Times)

Earlier this month, UIDAI approached the Apex Court, challenging a Bombay High Court order which had ordered the Agency to share biometric data to help solve an ongoing criminal investigation.

But it’s hard to see how this part of the Supreme Court decision isn’t a set-back.

SC: Withdraw Orders Making Aadhaar Must for any Service (Indian Express)

In a clear direction that a person’s information is private and cannot be misused, the Supreme Court on Monday directed the Centre to withdraw immediately the instruction, if any, issued by it for making Aadhaar card mandatory for citizens to avail of government services…

If UID is going to bring the power of biometrics to radically curtail the use of ghost recipients of direct transfers, making it mandatory could certainly help. Then again, there are other incentives that can be brought to bear. Most people would rather get a subsidy for propane directly deposited into a bank account rather than wait in line at a government store.

Also, putting a legal wall between the welfare system and criminal justice system should increase participation.

UID enrollment continues apace

Little signs of let-up in rush for unique Aadhaar ID (The Hindu)

Over a month after the Centre put on hold its ambitious scheme of transferring cooking gas subsidy to the bank account of the household, something for which it had made Aadhaar number a pre-requisite, there are little signs of any let-up in the rush in the State for getting the unique identity number.

“People continue to come [to get Aadhaar] like before,” says M.R.V.Krishna Rao, Joint Director of Census Operations & Controlling Officer, Directorate of Census Operations here.

Nilekani out at UIDAI

Aadhaar loses its unique identity, Nandan Nilekani to quit (Financial Express)

ique Identification Authority of India (UIDAI) chairman Nandan Nilekani on Friday said he would resign from his job by March end to join mainstream politics and contest the Lok Sabha election on a Congress ticket, causing many to wonder if his absence at the helm would derail the Aadhaar project, vital for slashing India’s subsidy expenditure and increasing the efficacy of welfare programmes.

Also from the Financial Express…

Editorial: End of Aadhaar?

See also this post from September 2011 for some background on Nandan Nilekani and the UID project: India: Is UID Under Siege?. At the time, we said…

Nandan Nilekani is the animating spirit of the UID project. He knows technology through education and experience among the founding generation of Unisys. He knows management, evidenced by his rise to become CEO of that firm. He knows India (inasmuch as India is “knowable”), having attended Indian schools at every level of his education and having lived in several places there. And he knows government through his service on various committees and advisory groups. He is, perhaps, the only person capable of pulling this off.

Hopefully, as he has indicated elsewhere, the UID project no longer requires Nandan Nilekani to sustain it.

Leap-frogging in Nigeria

Here’s another example of biometrics being used to leap-frog the technologies and methods other countries have used in the past to build an ID infrastructure. Even if the Nigerian government had the resources to attempt a paper-heavy, labor-intensive duplication of the systems some countries built in the early twentieth century, it isn’t at all clear that it could produce a better outcome than cheaper biometrics.

NIGERIA: Banks to Start Biometric Customer Registration on Friday (Daily Times)

“There will be teething problems, but we will learn from it. The biometric initiative is being pursued by the Bankers’ Committee,” the Access Bank boss said.

The Director, Corporate Communications Department, CBN, Mr. Ugochukwu Okoroafor, said the biometric system, when fully operational, would help to improve credit in the economy and boost the nation’s macro- economy.

Okoroafor said, “Nigeria runs on cash; there is no identity. We don’t know who is who. We are now going into identity confirmation. We can now create a credit system that will power our economy.

“Banks don’t want to lend because of identity issue. We want to move Nigeria from cash system to credit system that has identity.”

India: UIDAI & NPR still at it

This is a “dog bites man” story but it has been a while since we dropped in on the India ID effort…

Govt likely to allow UIDAI to start enrolment in NPR states (CNBC India)

Government is likely to allow on Thursday UIDAI, which issues unique identification numbers to residents, to start enrolments in areas other than 18 states and union territories allocated to it for the purpose.

According to an official source, the Cabinet Committee on Unique identification Authority of India (UIDAI) will discuss a proposal of the Planning Commission to allow UIDAI to start enrolments in states and union territories which were not part of its mandated operations.

UIDAI proposal not taken up by Cabinet due to paucity of time (Business Standard)

A Cabinet Committee could not discuss today the proposal to allow UIDAI to start enrolments in areas other than 18 states and union territories allocated to it, due to paucity of time.

According to an official source, the Cabinet Committee on Unique identification Authority of India (UIDAI) meeting scheduled for today to discuss the proposal was not held as the meeting of the Cabinet took time to decide on LPG cylinder issue and other matters.

Both the committees are headed by Prime Minister Manmohan Singh.

For some background on the UIDAI-NPR bad blood, see ID Rivalry Reignites in India.