Hackers Demand Ransom from Two More Southern California Hospitals
Small Violations Of Medical Privacy Can Hurt Patients And Erode Trust
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FM","link":"/"}},"stateofhealth_163275":{"type":"posts","id":"stateofhealth_163275","meta":{"index":"posts_1591205157","site":"stateofhealth","id":"163275","score":null,"sort":[1458674030000]},"guestAuthors":[],"slug":"hackers-attack-two-more-southern-california-hospitals","title":"Hackers Demand Ransom from Two More Southern California Hospitals","publishDate":1458674030,"format":"standard","headTitle":"State of Health | KQED News","labelTerm":{"site":"stateofhealth"},"content":"\u003cp>Hackers demanded a ransom from two more Southern California hospitals last week and federal authorities are investigating the case.\u003c/p>\n\u003cp>Prime Healthcare Services Inc., a fast-growing national hospital chain, said the attackers infiltrated computer servers on Friday at two of its California hospitals, Chino Valley Medical Center in Chino and Desert Valley Hospital in Victorville.\u003c/p>\n\u003cp>The company said the cyberattack had not affected patient safety or compromised records on patients or staff.\u003c/p>\n\u003cp>Two sources familiar with the investigation said the hackers had demanded a ransom to unlock the hospital computer systems, similar to what happened\u003ca href=\"http://californiahealthline.org/news/state-attorney-general-says-health-care-lags-in-computer-security/\" target=\"_blank\"> last month at Hollywood Presbyterian Medical Center in Los Angeles\u003c/a>. Hollywood Presbyterian said it paid $17,000 in bitcoin to hackers to regain access to the institution’s computers.\u003c/p>\n\u003cp>Fred Ortega, a spokesman for Prime Healthcare, declined to comment on whether Prime received a ransom demand or paid any money, citing the ongoing investigation.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>“This is similar to challenges hospitals across the country are facing, and we have taken extraordinary steps to protect and expeditiously find a resolution to this disruption,” Ortega said. “The concern now is to let law enforcement do their thing and find the culprit.”\u003c/p>\n\u003cp>FBI spokeswoman Laura Eimiller said Tuesday “we are investigating a compromise of the network at these locations.” She declined to discuss specifics of the case. The FBI also has been investigating the attack at Hollywood Presbyterian.\u003c/p>\n\u003cp>Ortega said the two Prime hospitals affected remain operational and steps are being taken to restore their computer systems to full functionality. He said some IT systems were shut down by hospital staff as a preventive measure so malicious software didn’t spread further.\u003c/p>\n\u003cp>The company said it’s working with data security experts and the California Department of Public Health on the matter.\u003c/p>\n\u003cp>Prime Healthcare, based in Ontario, Calif., has acquired struggling hospitals across the country and has become one of the nation’s largest health systems. It runs 42 hospitals in 14 states. The company is led by its outspoken chairman and chief executive, Dr. Prem Reddy.\u003c/p>\n\u003cp>A series of high-profile data breaches in the past year have raised fresh questions about the ability of hospitals, health insurers and other medical providers to safeguard the vast troves of electronic medical records and other sensitive data they are stockpiling on millions of Americans.\u003c/p>\n\u003cp>Prime Healthcare has faced trouble over lapses on patient privacy in the past.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>In 2013, the company agreed to a $275,000 settlement to resolve \u003ca href=\"http://articles.latimes.com/2013/jun/11/business/la-fi-mo-prime-healthcare-patient-privacy-20130611\" target=\"_blank\">a federal investigation involving a breach of patient confidentiality\u003c/a>. Officials found that Prime’s Shasta Regional Medical Center had shared a woman’s medical files with journalists and sent an email about her treatment to all hospital employees.\u003c/p>\n\n","blocks":[],"excerpt":"The malware attack comes soon after a case where hackers demanded ransom from a Los Angeles hospital. ","status":"publish","parent":0,"modified":1458687514,"stats":{"hasAudio":false,"hasVideo":false,"hasChartOrMap":false,"iframeSrcs":[],"hasGoogleForm":false,"hasGallery":false,"hasHearkenModule":false,"hasPolis":false,"paragraphCount":15,"wordCount":464},"headData":{"title":"Hackers Demand Ransom from Two More Southern California Hospitals | KQED","description":"The malware attack comes soon after a case where hackers demanded ransom from a Los Angeles hospital. ","ogTitle":"","ogDescription":"","ogImgId":"","twTitle":"","twDescription":"","twImgId":"","schema":{"@context":"http://schema.org","@type":"Article","headline":"Hackers Demand Ransom from Two More Southern California Hospitals","datePublished":"2016-03-22T19:13:50.000Z","dateModified":"2016-03-22T22:58:34.000Z","image":"https://cdn.kqed.org/wp-content/uploads/2020/02/KQED-OG-Image@1x.png"}},"disqusIdentifier":"163275 http://ww2.kqed.org/stateofhealth/?p=163275","disqusUrl":"https://ww2.kqed.org/stateofhealth/2016/03/22/hackers-attack-two-more-southern-california-hospitals/","disqusTitle":"Hackers Demand Ransom from Two More Southern California Hospitals","nprByline":"Chad Terhune\u003cbr />\u003ca href=\"http://californiahealthline.org/\">California Healthline\u003c/a>","path":"/stateofhealth/163275/hackers-attack-two-more-southern-california-hospitals","audioTrackLength":null,"parsedContent":[{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003cp>Hackers demanded a ransom from two more Southern California hospitals last week and federal authorities are investigating the case.\u003c/p>\n\u003cp>Prime Healthcare Services Inc., a fast-growing national hospital chain, said the attackers infiltrated computer servers on Friday at two of its California hospitals, Chino Valley Medical Center in Chino and Desert Valley Hospital in Victorville.\u003c/p>\n\u003cp>The company said the cyberattack had not affected patient safety or compromised records on patients or staff.\u003c/p>\n\u003cp>Two sources familiar with the investigation said the hackers had demanded a ransom to unlock the hospital computer systems, similar to what happened\u003ca href=\"http://californiahealthline.org/news/state-attorney-general-says-health-care-lags-in-computer-security/\" target=\"_blank\"> last month at Hollywood Presbyterian Medical Center in Los Angeles\u003c/a>. Hollywood Presbyterian said it paid $17,000 in bitcoin to hackers to regain access to the institution’s computers.\u003c/p>\n\u003cp>Fred Ortega, a spokesman for Prime Healthcare, declined to comment on whether Prime received a ransom demand or paid any money, citing the ongoing investigation.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>","attributes":{"named":{},"numeric":[]}},{"type":"component","content":"","name":"ad","attributes":{"named":{"label":"fullwidth"},"numeric":["fullwidth"]}},{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>“This is similar to challenges hospitals across the country are facing, and we have taken extraordinary steps to protect and expeditiously find a resolution to this disruption,” Ortega said. “The concern now is to let law enforcement do their thing and find the culprit.”\u003c/p>\n\u003cp>FBI spokeswoman Laura Eimiller said Tuesday “we are investigating a compromise of the network at these locations.” She declined to discuss specifics of the case. The FBI also has been investigating the attack at Hollywood Presbyterian.\u003c/p>\n\u003cp>Ortega said the two Prime hospitals affected remain operational and steps are being taken to restore their computer systems to full functionality. He said some IT systems were shut down by hospital staff as a preventive measure so malicious software didn’t spread further.\u003c/p>\n\u003cp>The company said it’s working with data security experts and the California Department of Public Health on the matter.\u003c/p>\n\u003cp>Prime Healthcare, based in Ontario, Calif., has acquired struggling hospitals across the country and has become one of the nation’s largest health systems. It runs 42 hospitals in 14 states. The company is led by its outspoken chairman and chief executive, Dr. Prem Reddy.\u003c/p>\n\u003cp>A series of high-profile data breaches in the past year have raised fresh questions about the ability of hospitals, health insurers and other medical providers to safeguard the vast troves of electronic medical records and other sensitive data they are stockpiling on millions of Americans.\u003c/p>\n\u003cp>Prime Healthcare has faced trouble over lapses on patient privacy in the past.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>In 2013, the company agreed to a $275,000 settlement to resolve \u003ca href=\"http://articles.latimes.com/2013/jun/11/business/la-fi-mo-prime-healthcare-patient-privacy-20130611\" target=\"_blank\">a federal investigation involving a breach of patient confidentiality\u003c/a>. Officials found that Prime’s Shasta Regional Medical Center had shared a woman’s medical files with journalists and sent an email about her treatment to all hospital employees.\u003c/p>\n\n\u003c/div>\u003c/p>","attributes":{"named":{},"numeric":[]}}],"link":"/stateofhealth/163275/hackers-attack-two-more-southern-california-hospitals","authors":["byline_stateofhealth_163275"],"categories":["stateofhealth_2407"],"tags":["stateofhealth_2519","stateofhealth_2612"],"featImg":"stateofhealth_163280","label":"stateofhealth"},"stateofhealth_121441":{"type":"posts","id":"stateofhealth_121441","meta":{"index":"posts_1591205157","site":"stateofhealth","id":"121441","score":null,"sort":[1449772212000]},"guestAuthors":[],"slug":"small-violations-of-medical-privacy-can-hurt-patients-and-erode-trust","title":"Small Violations Of Medical Privacy Can Hurt Patients And Erode Trust","publishDate":1449772212,"format":"standard","headTitle":"State of Health | KQED News","labelTerm":{"site":"stateofhealth"},"content":"\u003cp>\"PPL WORLD WIDE,\" the Facebook post shouted, using text-speak for the word \"people.\" \"FRANCES ... IS HPV POSITIVE!\"\u003c/p>\n\u003cp>The public missive from January 2014 gave Frances' full name, along with the revelation that she had \u003ca href=\"http://www.cdc.gov/std/hpv/stdfact-hpv.htm\" target=\"_blank\">human papillomavirus\u003c/a>, a sexually transmitted disease that can cause genital warts and cancer. It also included her date of birth and ended with a plea to friends: \"PLZ HELP EXPOSE THIS HOE!\"\u003c/p>\n\u003cp>Within hours, a friend told Frances that a former high school pal who lived near her in northwest Indiana had shared a secret that only her family and a former boyfriend knew, she later said.\u003c/p>\n\u003cp>\"My heart fell to my stomach,\" said Frances, a dental assistant in her late 20s who asked that her last name not be used. \"I started crying immediately.\"\u003c/p>\n\u003cp>The Facebook poster was a patient care technician at the local hospital where Frances was treated, but the two were no longer friends.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>Frances complained to a nursing supervisor at the hospital, which sent her a letter of apology in March 2014.\u003c/p>\n\u003cp>Under the federal law called the \u003ca href=\"http://www.hhs.gov/ocr/privacy/hipaa/understanding/consumers/index.html\" target=\"_blank\">Health Insurance Portability and Accountability Act\u003c/a>, or HIPAA, it's illegal for health care providers to share patients' treatment information without their permission. The Office for Civil Rights, the arm of the Department of Health and Human Services responsible for enforcing the law, receives more than 30,000 reports about privacy violations each year.\u003c/p>\n\u003cp>The bulk of the government's enforcement — and the public's attention — has focused on a small number of splashy cases in which hackers or thieves have accessed the health data of large groups of people. But the damage done in these mass breaches has been mostly hypothetical, with much information exposed but little exploited.\u003c/p>\n\u003cp>As Frances discovered, it's often little-noticed, smaller-scale violations of medical privacy — the ones that affect only one or two people — that inflict the most harm.\u003c/p>\n\u003cp>Driven by personal animus, jealousy or a desire for retribution, small breaches involving sensitive health details are spurring disputes and legal battles across the country:\u003c/p>\n\u003cp>In Tampa, Fla., a nurse snooped in the medical records of her nephew's partner, and learned that she had delivered a baby and had put the child up for adoption. She gave a printout to another family member, and the secret was announced at a family funeral in 2013, the Tampa Bay\u003cem> Times\u003c/em> \u003ca href=\"http://www.tampabay.com/news/health/medical-records-breach-at-tampa-general-usf-exposes-womans-secrets/2129083\" target=\"_blank\">reported\u003c/a>. The nephew's partner complained to the hospital; the nurse admitted what she had done, was fired and \u003ca href=\"http://www.propublica.org/documents/item/2640424-Nadine-McNew-discipline.html\" target=\"_blank\">relinquished her Florida nursing license\u003c/a>.\u003c/p>\n\u003cp>And in New Jersey, a woman sued a local hospital this fall, alleging that one of its employees shared details about her 11-year-old son's attempted suicide with people at his school. The boy was subsequently \"bullied by his peers, called names and made fun of,\" her lawsuit says.\u003c/p>\n\u003cp>Even when small privacy violations have real consequences, the federal Office for Civil Rights rarely punishes health care providers for them. Instead, the office typically settles for pledges to fix any problems and issues reminders of what the privacy law requires. It doesn't even tell the public which health providers have reported small breaches — or how many.\u003c/p>\n\u003cp>Asked about some of the privacy violations highlighted in this report, OCR Director Jocelyn Samuels called them \"heartbreaking stories\" and \"the kinds of harm that HIPAA is intended to address.\"\u003c/p>\n\u003cp>She insisted her agency isn't afraid to pursue formal sanctions when they are warranted, but said its primary role is helping health providers to follow the law. \"Our preference is always to promote voluntary compliance,\" Samuels said.\u003c/p>\n\u003cp>For patients, Samuels' agency is usually the only place they can seek vindication. HIPAA does not give people the right to sue for damages if their privacy is violated. Patients who seek legal redress must find another cause of action, which is easier in some states than in others.\u003c/p>\n\u003cp>After being attacked on Facebook, Frances contacted Indianapolis lawyer \u003ca href=\"http://indianaprivacylaw.com/about-us/\" target=\"_blank\">Neal Eggeson\u003c/a>. He had won jury verdicts for people whose medical information was improperly disclosed. Eggeson contacted the hospital and, without filing suit, secured a confidential settlement for Frances. (He asked that the facility not be named in this story.) Frances' former friend no longer works there, she said.\u003c/p>\n\u003cp>Frances said she still hasn't fully recovered. She sees a therapist and has a hard time trusting others.\u003c/p>\n\u003cp>\"It's hard to even still deal with it,\" she said. \"I'll spend that extra gas money to go into another city to do grocery shopping or stuff like that, just so I don't have to see anybody from around the neighborhood.\"\u003c/p>\n\u003cp>\u003cstrong>Ties Of Friendship Led Lawyer To Privacy Practice \u003c/strong>\u003c/p>\n\u003cp>Eggeson, a litigator, was defending insurance companies in car accident cases when a \"friend of a friend of a friend\" referred a young man to him. The man, who is HIV-positive, had been sued over a $326 debt by the medical group that had been treating him. The group's court filing gave the man's name, home address, Social Security number and date of birth — and included a billing statement containing the phrase \"Last Diagnosis: HIV.\"\u003c/p>\n\u003cp>\"His first concern was getting the court record sealed, more than anything else,\" Eggeson said. \"I don't think he had any designs or visions beyond that.\"\u003c/p>\n\u003cp>A jury \u003ca href=\"http://indianaprivacylaw.com/trial-results/\" target=\"_blank\">awarded the man $1.25 million\u003c/a>.\u003c/p>\n\u003cfigure id=\"attachment_121444\" class=\"wp-caption alignright\" style=\"max-width: 400px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2015/12/eggeson-2-6f5ec7762055dfb04f0559ddb68ed99f4e6596e6.jpg\">\u003cimg class=\"size-thumbnail wp-image-121444\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2015/12/eggeson-2-6f5ec7762055dfb04f0559ddb68ed99f4e6596e6-400x300.jpg\" alt=\"Neal Eggeson works out of a tiny office in his suburban Indianapolis home.\" width=\"400\" height=\"300\" srcset=\"https://ww2.kqed.org/app/uploads/sites/27/2015/12/eggeson-2-6f5ec7762055dfb04f0559ddb68ed99f4e6596e6-400x300.jpg 400w, https://ww2.kqed.org/app/uploads/sites/27/2015/12/eggeson-2-6f5ec7762055dfb04f0559ddb68ed99f4e6596e6-800x600.jpg 800w, https://ww2.kqed.org/app/uploads/sites/27/2015/12/eggeson-2-6f5ec7762055dfb04f0559ddb68ed99f4e6596e6-1440x1080.jpg 1440w, https://ww2.kqed.org/app/uploads/sites/27/2015/12/eggeson-2-6f5ec7762055dfb04f0559ddb68ed99f4e6596e6-1180x885.jpg 1180w, https://ww2.kqed.org/app/uploads/sites/27/2015/12/eggeson-2-6f5ec7762055dfb04f0559ddb68ed99f4e6596e6-960x720.jpg 960w\" sizes=\"(max-width: 400px) 100vw, 400px\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">Neal Eggeson works out of a tiny office in his suburban Indianapolis home. \u003ccite>(AJ Mast for ProPublica)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>After that victory, Eggeson represented Abigail Hinchy, who alleged that a Walgreens pharmacist had snooped in her prescription records and shared the information with the father of Hinchy's child (the man was dating and later married the pharmacist). Among the data shared: Hinchy had stopped taking birth control pills shortly before she became pregnant. A jury ordered Walgreens and the pharmacist to pay Hinchy $1.44 million.\u003c/p>\n\u003cp>A copy of Walgreens' check is framed on the wall of Eggeson's home office, not far from his life-size Batman costume and \"Star Wars\" light sabers.\u003c/p>\n\u003cp>Among Eggeson's current clients is a couple who claim that when their son was in an ATV accident this August, a hospital worker posted a comment on Facebook before the hospital had told them the teen had died. Panicked relatives who saw the post began calling his parents for updates, adding stress to an already wrenching time.\u003c/p>\n\u003cp>\"It wouldn't have changed the outcome,\" said John Stuck, the boy's father, \"but just the feeling of, 'What in the heck? What do they know that we don't?' — that's what freaked me out I think the most.\"\u003c/p>\n\u003cp>When Eggeson files lawsuits, he argues that privacy breaches amount to medical malpractice.\u003c/p>\n\u003cp>While Indiana courts have been receptive to such arguments, courts in Ohio, Minnesota and other states have ruled that health providers are not liable for the actions of workers who snoop in medical records outside the scope of their jobs.\u003c/p>\n\u003cp>This summer, a Los Angeles jury ruled against a patient who sued UCLA and the Regents of the University of California after a romantic rival \u003ca href=\"http://www.propublica.org/documents/item/2640622-Lozano-motion.html\" target=\"_blank\">accessed and shared her medical records\u003c/a>. The rival was a temporary worker in the office of a private practice physician affiliated with UCLA's Santa Monica hospital. The doctor acknowledged improperly sharing his password and settled his part of the lawsuit.\u003c/p>\n\u003cp>Eggeson said it's distressing that more states aren't like Indiana.\u003c/p>\n\u003cp>\"Privacy protections should be the same regardless of what state you're in,\" he said. \"There is something wrong with an employer providing the means, providing the access, and providing the tools by which an employee can commit this crime and then being able to hold up their hands and say, 'It's not our fault.' \"\u003c/p>\n\u003cp>\u003cstrong>Federal Focus On Large Breaches Draws Criticism\u003c/strong>\u003c/p>\n\u003cp>The vast majority of the federal Office for Civil Rights' enforcement work has been directed at large-scale medical data breaches, whether or not they result in any demonstrable real-world harm.\u003c/p>\n\u003cp>Health providers are \u003ca href=\"http://www.hhs.gov/ocr/privacy/hipaa/administrative/breachnotificationrule/\" target=\"_blank\">required to notify\u003c/a> the office within 60 days of breaches affecting at least 500 people, and also must share details with the media and contact those potentially affected. OCR's website \u003ca href=\"https://ocrportal.hhs.gov/ocr/breach/breach_report.jsf\" target=\"_blank\">makes public a list\u003c/a> of these cases, highlighting them on what industry insiders dub the Wall of Shame.\u003c/p>\n\u003cp>Rarely do small privacy breaches get anywhere near the same attention, except when they involve celebrities or high-profile individuals.\u003c/p>\n\u003cp>Organizations have to report them to OCR only once a year. Even then, the agency doesn't post them online. HHS has rejected requests under the Freedom of Information Act for information about them.\u003c/p>\n\u003cp>Since 2009, OCR has received information about 1,400 large breaches. During the same time, more than 181,000 breaches affecting fewer than 500 individuals have been reported.\u003c/p>\n\u003cp>In September, the HHS inspector general issued a \u003ca href=\"http://oig.hhs.gov/oei/reports/oei-09-10-00511.asp\" target=\"_blank\">pair\u003c/a> of \u003ca href=\"http://oig.hhs.gov/oei/reports/oei-09-10-00510.asp\" target=\"_blank\">reports\u003c/a> that criticized the Office for Civil Rights, including its handling of small breaches. The inspector general said OCR did not investigate the small breaches reported to it or log them in its tracking system.\u003c/p>\n\u003cp>\"OCR does not record that information and therefore it's not available for staff to be able to look over time\" for repeat offenders, said Blaine Collins, regional inspector general for evaluation and inspections in San Francisco. \"Boy, that's critical for monitoring and oversight.\"\u003c/p>\n\u003cp>Samuels said that her agency is implementing the inspector general's recommendations to improve oversight. \"We are constantly looking for ways to better serve the public and improve our operations,\" she said.\u003c/p>\n\u003cp>\u003cstrong>Pain Doctor Gives Private Investigator Patient's Records \u003c/strong>\u003c/p>\n\u003cp>Peter Brabeck, a 73-year-old retired petrophysicist who had worked for the oil giant BP, turned to OCR in September 2011 when he found himself in the midst of a nightmare.\u003c/p>\n\u003cp>It began a year earlier when Brabeck's brother complained to the Medical Board of California that Dr. Steven Mangar, a pain doctor in Salinas, California, had overprescribed controlled substances to Peter. The medical board accused Mangar of prescribing drugs without examining him and sought to take disciplinary action against Mangar's license.\u003c/p>\n\u003cfigure id=\"attachment_121442\" class=\"wp-caption aligncenter\" style=\"max-width: 1919px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2015/12/peterbrabeck19_enl-575ad639c4601d5d6b9b68344536b4a4d936d76e-e1449772177155.jpg\">\u003cimg class=\"wp-image-121442 size-full\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2015/12/peterbrabeck19_enl-575ad639c4601d5d6b9b68344536b4a4d936d76e-e1449772177155.jpg\" alt=\"The Medical Board of California accused Peter Brabeck's doctor in 2011 of overprescribing him controlled substances. Afterward, Brabeck, who lives near Carmel, Calif., learned the doctor had hired a private investigator and gave him Brabeck's medical records.\" width=\"1919\" height=\"1279\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">The Medical Board of California accused Peter Brabeck's doctor in 2011 of overprescribing him controlled substances. Afterward, Brabeck, who lives near Carmel, California, learned the doctor had hired a private investigator and gave him Brabeck's medical records. \u003ccite>(Ramin Rahimian for ProPublica)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>Mangar reacted by hiring a private investigator to dig up dirt on Brabeck — and gave the investigator all of Brabeck's medical records. When Mangar refused to pay the investigator, he approached Brabeck's brother and showed him the records. The investigator then offered to sell the records to Peter Brabeck, who within days complained to the Office for Civil Rights.\u003c/p>\n\u003cp>\"Here we have not only a gross violation of [HIPAA] laws protecting the confidentiality of every patient's medical history, but in my mind far worse,\" Brabeck wrote in his complaint. \"Here is a deliberate attempt, born of vengeance, with malice aforethought to inflict great harm on his own patient.\"\u003c/p>\n\u003cp>Two years later, the Office for Civil Rights \u003ca href=\"http://www.propublica.org/documents/item/2640638-Peter-Brabeck-OCR.html\" target=\"_blank\">wrote back\u003c/a>, saying it was \"pleased to inform\" Brabeck that his complaint has been resolved. It said it had provided Mangar's clinic, the Pacific Pain Care Institute, with guidance on how to comply with privacy rules. It said Mangar had acknowledged that he \"impermissibly disclosed\" Brabeck's personal health information to the private investigator.\u003c/p>\n\u003cp>OCR also said that Mangar had agreed to provide Brabeck with free credit monitoring.\u003c/p>\n\u003cp>Brabeck, who lives near Carmel, California, said he never actually received the credit monitoring. More importantly, he was left with a sense that the agency didn't take his case seriously.\u003c/p>\n\u003cp>\"I made very clear in my letter that it was an act of vengeance and retaliation,\" he said. \"That's why I was so surprised at how lightly they dismissed the whole thing.\"\u003c/p>\n\u003cp>Mangar did not return calls for comment. California's medical board placed his \u003ca href=\"http://www.propublica.org/documents/item/2640992-Mangar-Probation.html\" target=\"_blank\">license on probation\u003c/a> in 2012 and is \u003ca href=\"http://www.propublica.org/documents/item/2641001-Mangar-Petition.html\" target=\"_blank\">now seeking to revoke it\u003c/a>, saying he violated his probation and provided negligent care to other patients. Earlier this year, federal and state investigators served \u003ca href=\"http://www.ksbw.com/news/central-california/salinas/salinas-doctors-office-raided/31265102\" target=\"_blank\">search warrants\u003c/a> at Mangar's office and home. Monterey County Deputy District Attorney Amy Patterson said Brabeck's concerns are part of a much broader investigation that she could not discuss because it is ongoing.\u003c/p>\n\u003cp>OCR director Samuels said Brabeck's case predated her arrival at the agency. But she said it was consistent with \"our general principles\" in terms of the nature of the injury, the number of individuals affected and a provider's lack of prior HIPAA violations. She also said the doctor agreed to apologize, which \"can be very powerful in terms of remedying the damage that has been done.\"\u003c/p>\n\u003cp>Brabeck said he didn't get an apology: \"No. Absolutely not.\"\u003c/p>\n\u003cp>\u003cem>NPR correspondent Alison Kodjak contributed to this report.\u003c/em>\u003c/p>\n\u003cp>\u003cem>ProPublica is a nonprofit newsroom based in New York. This story is part of a yearlong examination into the security of medical information. Has your medical privacy been compromised? Help ProPublica investigate by filling out a \u003c/em>\u003ca href=\"https://www.propublica.org/getinvolved/item/has-your-medical-privacy-been-compromised\" target=\"_blank\">\u003cem>short questionnaire\u003c/em>\u003c/a>\u003cem>. You can also read other stories in the\u003c/em> \u003ca href=\"https://www.propublica.org/series/patient-privacy\" target=\"_blank\">\u003cem>Policing Patient Privacy series\u003c/em>\u003c/a>\u003cem>.\u003c/em>\u003c/p>\n\u003cdiv class=\"fullattribution\">Copyright 2015 ProPublica. To see more, visit npr.org\u003c/div>\n\u003cp>[ad floatright]\u003c/p>\n\u003cp> \u003c/p>\n\n","blocks":[],"excerpt":"Breaches that expose the health details of just a patient or two are proliferating nationwide. Regulators focus on larger privacy breaches and rarely take action on small ones, despite their harm.","status":"publish","parent":0,"modified":1449797012,"stats":{"hasAudio":false,"hasVideo":false,"hasChartOrMap":false,"iframeSrcs":[],"hasGoogleForm":false,"hasGallery":false,"hasHearkenModule":false,"hasPolis":false,"paragraphCount":57,"wordCount":2208},"headData":{"title":"Small Violations Of Medical Privacy Can Hurt Patients And Erode Trust | KQED","description":"Breaches that expose the health details of just a patient or two are proliferating nationwide. Regulators focus on larger privacy breaches and rarely take action on small ones, despite their harm.","ogTitle":"","ogDescription":"","ogImgId":"","twTitle":"","twDescription":"","twImgId":"","schema":{"@context":"http://schema.org","@type":"Article","headline":"Small Violations Of Medical Privacy Can Hurt Patients And Erode Trust","datePublished":"2015-12-10T18:30:12.000Z","dateModified":"2015-12-11T01:23:32.000Z","image":"https://cdn.kqed.org/wp-content/uploads/2020/02/KQED-OG-Image@1x.png"}},"disqusIdentifier":"121441 http://ww2.kqed.org/stateofhealth/?p=121441","disqusUrl":"https://ww2.kqed.org/stateofhealth/2015/12/10/small-violations-of-medical-privacy-can-hurt-patients-and-erode-trust/","disqusTitle":"Small Violations Of Medical Privacy Can Hurt Patients And Erode Trust","nprByline":"Charles Ornstein","nprImageAgency":"Ramin Rahimian for ProPublica","nprStoryId":"459091273","nprApiLink":"http://api.npr.org/query?id=459091273&apiKey=MDAxOTAwOTE4MDEyMTkxMDAzNjczZDljZA004","nprHtmlLink":"http://www.npr.org/sections/health-shots/2015/12/10/459091273/small-violations-of-medical-privacy-can-hurt-patients-and-corrode-trust?ft=nprml&f=459091273","nprRetrievedStory":"1","nprPubDate":"Thu, 10 Dec 2015 11:27:00 -0500","nprStoryDate":"Thu, 10 Dec 2015 04:59:00 -0500","nprLastModifiedDate":"Thu, 10 Dec 2015 10:43:38 -0500","nprAudio":"http://pd.npr.org/anon.npr-mp3/npr/me/2015/12/20151210_me_small_violations_of_medical_privacy_can_hurt_patients_and_corrode_trust.mp3?orgId=199135797&topicId=1128&d=209&p=3&story=459091273&t=progseg&e=459166698&seg=4&ft=nprml&f=459091273","nprAudioM3u":"http://api.npr.org/m3u/1459169819-64cc5c.m3u?orgId=199135797&topicId=1128&d=209&p=3&story=459091273&t=progseg&e=459166698&seg=4&ft=nprml&f=459091273","path":"/stateofhealth/121441/small-violations-of-medical-privacy-can-hurt-patients-and-erode-trust","audioUrl":"http://pd.npr.org/anon.npr-mp3/npr/me/2015/12/20151210_me_small_violations_of_medical_privacy_can_hurt_patients_and_corrode_trust.mp3?orgId=199135797&topicId=1128&d=209&p=3&story=459091273&t=progseg&e=459166698&seg=4&ft=nprml&f=459091273","audioTrackLength":null,"parsedContent":[{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003cp>\"PPL WORLD WIDE,\" the Facebook post shouted, using text-speak for the word \"people.\" \"FRANCES ... IS HPV POSITIVE!\"\u003c/p>\n\u003cp>The public missive from January 2014 gave Frances' full name, along with the revelation that she had \u003ca href=\"http://www.cdc.gov/std/hpv/stdfact-hpv.htm\" target=\"_blank\">human papillomavirus\u003c/a>, a sexually transmitted disease that can cause genital warts and cancer. It also included her date of birth and ended with a plea to friends: \"PLZ HELP EXPOSE THIS HOE!\"\u003c/p>\n\u003cp>Within hours, a friend told Frances that a former high school pal who lived near her in northwest Indiana had shared a secret that only her family and a former boyfriend knew, she later said.\u003c/p>\n\u003cp>\"My heart fell to my stomach,\" said Frances, a dental assistant in her late 20s who asked that her last name not be used. \"I started crying immediately.\"\u003c/p>\n\u003cp>The Facebook poster was a patient care technician at the local hospital where Frances was treated, but the two were no longer friends.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>","attributes":{"named":{},"numeric":[]}},{"type":"component","content":"","name":"ad","attributes":{"named":{"label":"fullwidth"},"numeric":["fullwidth"]}},{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>Frances complained to a nursing supervisor at the hospital, which sent her a letter of apology in March 2014.\u003c/p>\n\u003cp>Under the federal law called the \u003ca href=\"http://www.hhs.gov/ocr/privacy/hipaa/understanding/consumers/index.html\" target=\"_blank\">Health Insurance Portability and Accountability Act\u003c/a>, or HIPAA, it's illegal for health care providers to share patients' treatment information without their permission. The Office for Civil Rights, the arm of the Department of Health and Human Services responsible for enforcing the law, receives more than 30,000 reports about privacy violations each year.\u003c/p>\n\u003cp>The bulk of the government's enforcement — and the public's attention — has focused on a small number of splashy cases in which hackers or thieves have accessed the health data of large groups of people. But the damage done in these mass breaches has been mostly hypothetical, with much information exposed but little exploited.\u003c/p>\n\u003cp>As Frances discovered, it's often little-noticed, smaller-scale violations of medical privacy — the ones that affect only one or two people — that inflict the most harm.\u003c/p>\n\u003cp>Driven by personal animus, jealousy or a desire for retribution, small breaches involving sensitive health details are spurring disputes and legal battles across the country:\u003c/p>\n\u003cp>In Tampa, Fla., a nurse snooped in the medical records of her nephew's partner, and learned that she had delivered a baby and had put the child up for adoption. She gave a printout to another family member, and the secret was announced at a family funeral in 2013, the Tampa Bay\u003cem> Times\u003c/em> \u003ca href=\"http://www.tampabay.com/news/health/medical-records-breach-at-tampa-general-usf-exposes-womans-secrets/2129083\" target=\"_blank\">reported\u003c/a>. The nephew's partner complained to the hospital; the nurse admitted what she had done, was fired and \u003ca href=\"http://www.propublica.org/documents/item/2640424-Nadine-McNew-discipline.html\" target=\"_blank\">relinquished her Florida nursing license\u003c/a>.\u003c/p>\n\u003cp>And in New Jersey, a woman sued a local hospital this fall, alleging that one of its employees shared details about her 11-year-old son's attempted suicide with people at his school. The boy was subsequently \"bullied by his peers, called names and made fun of,\" her lawsuit says.\u003c/p>\n\u003cp>Even when small privacy violations have real consequences, the federal Office for Civil Rights rarely punishes health care providers for them. Instead, the office typically settles for pledges to fix any problems and issues reminders of what the privacy law requires. It doesn't even tell the public which health providers have reported small breaches — or how many.\u003c/p>\n\u003cp>Asked about some of the privacy violations highlighted in this report, OCR Director Jocelyn Samuels called them \"heartbreaking stories\" and \"the kinds of harm that HIPAA is intended to address.\"\u003c/p>\n\u003cp>She insisted her agency isn't afraid to pursue formal sanctions when they are warranted, but said its primary role is helping health providers to follow the law. \"Our preference is always to promote voluntary compliance,\" Samuels said.\u003c/p>\n\u003cp>For patients, Samuels' agency is usually the only place they can seek vindication. HIPAA does not give people the right to sue for damages if their privacy is violated. Patients who seek legal redress must find another cause of action, which is easier in some states than in others.\u003c/p>\n\u003cp>After being attacked on Facebook, Frances contacted Indianapolis lawyer \u003ca href=\"http://indianaprivacylaw.com/about-us/\" target=\"_blank\">Neal Eggeson\u003c/a>. He had won jury verdicts for people whose medical information was improperly disclosed. Eggeson contacted the hospital and, without filing suit, secured a confidential settlement for Frances. (He asked that the facility not be named in this story.) Frances' former friend no longer works there, she said.\u003c/p>\n\u003cp>Frances said she still hasn't fully recovered. She sees a therapist and has a hard time trusting others.\u003c/p>\n\u003cp>\"It's hard to even still deal with it,\" she said. \"I'll spend that extra gas money to go into another city to do grocery shopping or stuff like that, just so I don't have to see anybody from around the neighborhood.\"\u003c/p>\n\u003cp>\u003cstrong>Ties Of Friendship Led Lawyer To Privacy Practice \u003c/strong>\u003c/p>\n\u003cp>Eggeson, a litigator, was defending insurance companies in car accident cases when a \"friend of a friend of a friend\" referred a young man to him. The man, who is HIV-positive, had been sued over a $326 debt by the medical group that had been treating him. The group's court filing gave the man's name, home address, Social Security number and date of birth — and included a billing statement containing the phrase \"Last Diagnosis: HIV.\"\u003c/p>\n\u003cp>\"His first concern was getting the court record sealed, more than anything else,\" Eggeson said. \"I don't think he had any designs or visions beyond that.\"\u003c/p>\n\u003cp>A jury \u003ca href=\"http://indianaprivacylaw.com/trial-results/\" target=\"_blank\">awarded the man $1.25 million\u003c/a>.\u003c/p>\n\u003cfigure id=\"attachment_121444\" class=\"wp-caption alignright\" style=\"max-width: 400px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2015/12/eggeson-2-6f5ec7762055dfb04f0559ddb68ed99f4e6596e6.jpg\">\u003cimg class=\"size-thumbnail wp-image-121444\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2015/12/eggeson-2-6f5ec7762055dfb04f0559ddb68ed99f4e6596e6-400x300.jpg\" alt=\"Neal Eggeson works out of a tiny office in his suburban Indianapolis home.\" width=\"400\" height=\"300\" srcset=\"https://ww2.kqed.org/app/uploads/sites/27/2015/12/eggeson-2-6f5ec7762055dfb04f0559ddb68ed99f4e6596e6-400x300.jpg 400w, https://ww2.kqed.org/app/uploads/sites/27/2015/12/eggeson-2-6f5ec7762055dfb04f0559ddb68ed99f4e6596e6-800x600.jpg 800w, https://ww2.kqed.org/app/uploads/sites/27/2015/12/eggeson-2-6f5ec7762055dfb04f0559ddb68ed99f4e6596e6-1440x1080.jpg 1440w, https://ww2.kqed.org/app/uploads/sites/27/2015/12/eggeson-2-6f5ec7762055dfb04f0559ddb68ed99f4e6596e6-1180x885.jpg 1180w, https://ww2.kqed.org/app/uploads/sites/27/2015/12/eggeson-2-6f5ec7762055dfb04f0559ddb68ed99f4e6596e6-960x720.jpg 960w\" sizes=\"(max-width: 400px) 100vw, 400px\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">Neal Eggeson works out of a tiny office in his suburban Indianapolis home. \u003ccite>(AJ Mast for ProPublica)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>After that victory, Eggeson represented Abigail Hinchy, who alleged that a Walgreens pharmacist had snooped in her prescription records and shared the information with the father of Hinchy's child (the man was dating and later married the pharmacist). Among the data shared: Hinchy had stopped taking birth control pills shortly before she became pregnant. A jury ordered Walgreens and the pharmacist to pay Hinchy $1.44 million.\u003c/p>\n\u003cp>A copy of Walgreens' check is framed on the wall of Eggeson's home office, not far from his life-size Batman costume and \"Star Wars\" light sabers.\u003c/p>\n\u003cp>Among Eggeson's current clients is a couple who claim that when their son was in an ATV accident this August, a hospital worker posted a comment on Facebook before the hospital had told them the teen had died. Panicked relatives who saw the post began calling his parents for updates, adding stress to an already wrenching time.\u003c/p>\n\u003cp>\"It wouldn't have changed the outcome,\" said John Stuck, the boy's father, \"but just the feeling of, 'What in the heck? What do they know that we don't?' — that's what freaked me out I think the most.\"\u003c/p>\n\u003cp>When Eggeson files lawsuits, he argues that privacy breaches amount to medical malpractice.\u003c/p>\n\u003cp>While Indiana courts have been receptive to such arguments, courts in Ohio, Minnesota and other states have ruled that health providers are not liable for the actions of workers who snoop in medical records outside the scope of their jobs.\u003c/p>\n\u003cp>This summer, a Los Angeles jury ruled against a patient who sued UCLA and the Regents of the University of California after a romantic rival \u003ca href=\"http://www.propublica.org/documents/item/2640622-Lozano-motion.html\" target=\"_blank\">accessed and shared her medical records\u003c/a>. The rival was a temporary worker in the office of a private practice physician affiliated with UCLA's Santa Monica hospital. The doctor acknowledged improperly sharing his password and settled his part of the lawsuit.\u003c/p>\n\u003cp>Eggeson said it's distressing that more states aren't like Indiana.\u003c/p>\n\u003cp>\"Privacy protections should be the same regardless of what state you're in,\" he said. \"There is something wrong with an employer providing the means, providing the access, and providing the tools by which an employee can commit this crime and then being able to hold up their hands and say, 'It's not our fault.' \"\u003c/p>\n\u003cp>\u003cstrong>Federal Focus On Large Breaches Draws Criticism\u003c/strong>\u003c/p>\n\u003cp>The vast majority of the federal Office for Civil Rights' enforcement work has been directed at large-scale medical data breaches, whether or not they result in any demonstrable real-world harm.\u003c/p>\n\u003cp>Health providers are \u003ca href=\"http://www.hhs.gov/ocr/privacy/hipaa/administrative/breachnotificationrule/\" target=\"_blank\">required to notify\u003c/a> the office within 60 days of breaches affecting at least 500 people, and also must share details with the media and contact those potentially affected. OCR's website \u003ca href=\"https://ocrportal.hhs.gov/ocr/breach/breach_report.jsf\" target=\"_blank\">makes public a list\u003c/a> of these cases, highlighting them on what industry insiders dub the Wall of Shame.\u003c/p>\n\u003cp>Rarely do small privacy breaches get anywhere near the same attention, except when they involve celebrities or high-profile individuals.\u003c/p>\n\u003cp>Organizations have to report them to OCR only once a year. Even then, the agency doesn't post them online. HHS has rejected requests under the Freedom of Information Act for information about them.\u003c/p>\n\u003cp>Since 2009, OCR has received information about 1,400 large breaches. During the same time, more than 181,000 breaches affecting fewer than 500 individuals have been reported.\u003c/p>\n\u003cp>In September, the HHS inspector general issued a \u003ca href=\"http://oig.hhs.gov/oei/reports/oei-09-10-00511.asp\" target=\"_blank\">pair\u003c/a> of \u003ca href=\"http://oig.hhs.gov/oei/reports/oei-09-10-00510.asp\" target=\"_blank\">reports\u003c/a> that criticized the Office for Civil Rights, including its handling of small breaches. The inspector general said OCR did not investigate the small breaches reported to it or log them in its tracking system.\u003c/p>\n\u003cp>\"OCR does not record that information and therefore it's not available for staff to be able to look over time\" for repeat offenders, said Blaine Collins, regional inspector general for evaluation and inspections in San Francisco. \"Boy, that's critical for monitoring and oversight.\"\u003c/p>\n\u003cp>Samuels said that her agency is implementing the inspector general's recommendations to improve oversight. \"We are constantly looking for ways to better serve the public and improve our operations,\" she said.\u003c/p>\n\u003cp>\u003cstrong>Pain Doctor Gives Private Investigator Patient's Records \u003c/strong>\u003c/p>\n\u003cp>Peter Brabeck, a 73-year-old retired petrophysicist who had worked for the oil giant BP, turned to OCR in September 2011 when he found himself in the midst of a nightmare.\u003c/p>\n\u003cp>It began a year earlier when Brabeck's brother complained to the Medical Board of California that Dr. Steven Mangar, a pain doctor in Salinas, California, had overprescribed controlled substances to Peter. The medical board accused Mangar of prescribing drugs without examining him and sought to take disciplinary action against Mangar's license.\u003c/p>\n\u003cfigure id=\"attachment_121442\" class=\"wp-caption aligncenter\" style=\"max-width: 1919px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2015/12/peterbrabeck19_enl-575ad639c4601d5d6b9b68344536b4a4d936d76e-e1449772177155.jpg\">\u003cimg class=\"wp-image-121442 size-full\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2015/12/peterbrabeck19_enl-575ad639c4601d5d6b9b68344536b4a4d936d76e-e1449772177155.jpg\" alt=\"The Medical Board of California accused Peter Brabeck's doctor in 2011 of overprescribing him controlled substances. Afterward, Brabeck, who lives near Carmel, Calif., learned the doctor had hired a private investigator and gave him Brabeck's medical records.\" width=\"1919\" height=\"1279\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">The Medical Board of California accused Peter Brabeck's doctor in 2011 of overprescribing him controlled substances. Afterward, Brabeck, who lives near Carmel, California, learned the doctor had hired a private investigator and gave him Brabeck's medical records. \u003ccite>(Ramin Rahimian for ProPublica)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>Mangar reacted by hiring a private investigator to dig up dirt on Brabeck — and gave the investigator all of Brabeck's medical records. When Mangar refused to pay the investigator, he approached Brabeck's brother and showed him the records. The investigator then offered to sell the records to Peter Brabeck, who within days complained to the Office for Civil Rights.\u003c/p>\n\u003cp>\"Here we have not only a gross violation of [HIPAA] laws protecting the confidentiality of every patient's medical history, but in my mind far worse,\" Brabeck wrote in his complaint. \"Here is a deliberate attempt, born of vengeance, with malice aforethought to inflict great harm on his own patient.\"\u003c/p>\n\u003cp>Two years later, the Office for Civil Rights \u003ca href=\"http://www.propublica.org/documents/item/2640638-Peter-Brabeck-OCR.html\" target=\"_blank\">wrote back\u003c/a>, saying it was \"pleased to inform\" Brabeck that his complaint has been resolved. It said it had provided Mangar's clinic, the Pacific Pain Care Institute, with guidance on how to comply with privacy rules. It said Mangar had acknowledged that he \"impermissibly disclosed\" Brabeck's personal health information to the private investigator.\u003c/p>\n\u003cp>OCR also said that Mangar had agreed to provide Brabeck with free credit monitoring.\u003c/p>\n\u003cp>Brabeck, who lives near Carmel, California, said he never actually received the credit monitoring. More importantly, he was left with a sense that the agency didn't take his case seriously.\u003c/p>\n\u003cp>\"I made very clear in my letter that it was an act of vengeance and retaliation,\" he said. \"That's why I was so surprised at how lightly they dismissed the whole thing.\"\u003c/p>\n\u003cp>Mangar did not return calls for comment. California's medical board placed his \u003ca href=\"http://www.propublica.org/documents/item/2640992-Mangar-Probation.html\" target=\"_blank\">license on probation\u003c/a> in 2012 and is \u003ca href=\"http://www.propublica.org/documents/item/2641001-Mangar-Petition.html\" target=\"_blank\">now seeking to revoke it\u003c/a>, saying he violated his probation and provided negligent care to other patients. Earlier this year, federal and state investigators served \u003ca href=\"http://www.ksbw.com/news/central-california/salinas/salinas-doctors-office-raided/31265102\" target=\"_blank\">search warrants\u003c/a> at Mangar's office and home. Monterey County Deputy District Attorney Amy Patterson said Brabeck's concerns are part of a much broader investigation that she could not discuss because it is ongoing.\u003c/p>\n\u003cp>OCR director Samuels said Brabeck's case predated her arrival at the agency. But she said it was consistent with \"our general principles\" in terms of the nature of the injury, the number of individuals affected and a provider's lack of prior HIPAA violations. She also said the doctor agreed to apologize, which \"can be very powerful in terms of remedying the damage that has been done.\"\u003c/p>\n\u003cp>Brabeck said he didn't get an apology: \"No. Absolutely not.\"\u003c/p>\n\u003cp>\u003cem>NPR correspondent Alison Kodjak contributed to this report.\u003c/em>\u003c/p>\n\u003cp>\u003cem>ProPublica is a nonprofit newsroom based in New York. This story is part of a yearlong examination into the security of medical information. Has your medical privacy been compromised? Help ProPublica investigate by filling out a \u003c/em>\u003ca href=\"https://www.propublica.org/getinvolved/item/has-your-medical-privacy-been-compromised\" target=\"_blank\">\u003cem>short questionnaire\u003c/em>\u003c/a>\u003cem>. You can also read other stories in the\u003c/em> \u003ca href=\"https://www.propublica.org/series/patient-privacy\" target=\"_blank\">\u003cem>Policing Patient Privacy series\u003c/em>\u003c/a>\u003cem>.\u003c/em>\u003c/p>\n\u003cdiv class=\"fullattribution\">Copyright 2015 ProPublica. To see more, visit npr.org\u003c/div>\n\u003cp>\u003c/p>\u003c/div>","attributes":{"named":{},"numeric":[]}},{"type":"component","content":"","name":"ad","attributes":{"named":{"label":"floatright"},"numeric":["floatright"]}},{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp> \u003c/p>\n\n\u003c/div>\u003c/p>","attributes":{"named":{},"numeric":[]}}],"link":"/stateofhealth/121441/small-violations-of-medical-privacy-can-hurt-patients-and-erode-trust","authors":["byline_stateofhealth_121441"],"categories":["stateofhealth_2407"],"tags":["stateofhealth_2612"],"featImg":"stateofhealth_121443","label":"stateofhealth"}},"programsReducer":{"possible":{"id":"possible","title":"Possible","info":"Possible is hosted by entrepreneur Reid Hoffman and writer Aria Finger. Together in Possible, Hoffman and Finger lead enlightening discussions about building a brighter collective future. The show features interviews with visionary guests like Trevor Noah, Sam Altman and Janette Sadik-Khan. Possible paints an optimistic portrait of the world we can create through science, policy, business, art and our shared humanity. It asks: What if everything goes right for once? How can we get there? Each episode also includes a short fiction story generated by advanced AI GPT-4, serving as a thought-provoking springboard to speculate how humanity could leverage technology for good.","airtime":"SUN 2pm","imageSrc":"https://cdn.kqed.org/wp-content/uploads/2024/04/Possible-Podcast-Tile-360x360-1.jpg","officialWebsiteLink":"https://www.possible.fm/","meta":{"site":"news","source":"Possible"},"link":"/radio/program/possible","subscribe":{"apple":"https://podcasts.apple.com/us/podcast/possible/id1677184070","spotify":"https://open.spotify.com/show/730YpdUSNlMyPQwNnyjp4k"}},"1a":{"id":"1a","title":"1A","info":"1A is home to the national conversation. 1A brings on great guests and frames the best debate in ways that make you think, share and engage.","airtime":"MON-THU 11pm-12am","imageSrc":"https://ww2.kqed.org/radio/wp-content/uploads/sites/50/2018/04/1a.jpg","officialWebsiteLink":"https://the1a.org/","meta":{"site":"news","source":"npr"},"link":"/radio/program/1a","subscribe":{"npr":"https://rpb3r.app.goo.gl/RBrW","apple":"https://itunes.apple.com/WebObjects/MZStore.woa/wa/viewPodcast?s=143441&mt=2&id=1188724250&at=11l79Y&ct=nprdirectory","tuneIn":"https://tunein.com/radio/1A-p947376/","rss":"https://feeds.npr.org/510316/podcast.xml"}},"all-things-considered":{"id":"all-things-considered","title":"All Things Considered","info":"Every weekday, \u003cem>All Things Considered\u003c/em> hosts Robert Siegel, Audie Cornish, Ari Shapiro, and Kelly McEvers present the program's trademark mix of news, interviews, commentaries, reviews, and offbeat features. Michel Martin hosts on the weekends.","airtime":"MON-FRI 1pm-2pm, 4:30pm-6:30pm\u003cbr />SAT-SUN 5pm-6pm","imageSrc":"https://cdn.kqed.org/wp-content/uploads/2024/04/All-Things-Considered-Podcast-Tile-360x360-1.jpg","officialWebsiteLink":"https://www.npr.org/programs/all-things-considered/","meta":{"site":"news","source":"npr"},"link":"/radio/program/all-things-considered"},"american-suburb-podcast":{"id":"american-suburb-podcast","title":"American Suburb: The Podcast","tagline":"The flip side of gentrification, told through one town","info":"Gentrification is changing cities across America, forcing people from neighborhoods they have long called home. Call them the displaced. Now those priced out of the Bay Area are looking for a better life in an unlikely place. American Suburb follows this migration to one California town along the Delta, 45 miles from San Francisco. But is this once sleepy suburb ready for them?","imageSrc":"https://cdn.kqed.org/wp-content/uploads/2024/04/American-Suburb-Podcast-Tile-703x703-1.jpg","officialWebsiteLink":"/news/series/american-suburb-podcast","meta":{"site":"news","source":"kqed","order":"13"},"link":"/news/series/american-suburb-podcast/","subscribe":{"npr":"https://rpb3r.app.goo.gl/RBrW","apple":"https://itunes.apple.com/WebObjects/MZStore.woa/wa/viewPodcast?mt=2&id=1287748328","tuneIn":"https://tunein.com/radio/American-Suburb-p1086805/","rss":"https://ww2.kqed.org/news/series/american-suburb-podcast/feed/podcast","google":"https://podcasts.google.com/feed/aHR0cHM6Ly9mZWVkcy5tZWdhcGhvbmUuZm0vS1FJTkMzMDExODgxNjA5"}},"baycurious":{"id":"baycurious","title":"Bay Curious","tagline":"Exploring the Bay Area, one question at a time","info":"KQED’s new podcast, Bay Curious, gets to the bottom of the mysteries — both profound and peculiar — that give the Bay Area its unique identity. And we’ll do it with your help! You ask the questions. You decide what Bay Curious investigates. And you join us on the journey to find the answers.","imageSrc":"https://cdn.kqed.org/wp-content/uploads/2024/04/Bay-Curious-Podcast-Tile-703x703-1.jpg","imageAlt":"\"KQED Bay Curious","officialWebsiteLink":"/news/series/baycurious","meta":{"site":"news","source":"kqed","order":"4"},"link":"/podcasts/baycurious","subscribe":{"apple":"https://podcasts.apple.com/us/podcast/bay-curious/id1172473406","npr":"https://www.npr.org/podcasts/500557090/bay-curious","rss":"https://ww2.kqed.org/news/category/bay-curious-podcast/feed/podcast","google":"https://podcasts.google.com/feed/aHR0cHM6Ly93dzIua3FlZC5vcmcvbmV3cy9jYXRlZ29yeS9iYXktY3VyaW91cy1wb2RjYXN0L2ZlZWQvcG9kY2FzdA","stitcher":"https://www.stitcher.com/podcast/kqed/bay-curious","spotify":"https://open.spotify.com/show/6O76IdmhixfijmhTZLIJ8k"}},"bbc-world-service":{"id":"bbc-world-service","title":"BBC World Service","info":"The day's top stories from BBC News compiled twice daily in the week, once at weekends.","airtime":"MON-FRI 9pm-10pm, TUE-FRI 1am-2am","imageSrc":"https://cdn.kqed.org/wp-content/uploads/2024/04/BBC-World-Service-Podcast-Tile-360x360-1.jpg","officialWebsiteLink":"https://www.bbc.co.uk/sounds/play/live:bbc_world_service","meta":{"site":"news","source":"BBC World Service"},"link":"/radio/program/bbc-world-service","subscribe":{"apple":"https://itunes.apple.com/us/podcast/global-news-podcast/id135067274?mt=2","tuneIn":"https://tunein.com/radio/BBC-World-Service-p455581/","rss":"https://podcasts.files.bbci.co.uk/p02nq0gn.rss"}},"code-switch-life-kit":{"id":"code-switch-life-kit","title":"Code Switch / Life Kit","info":"\u003cem>Code Switch\u003c/em>, which listeners will hear in the first part of the hour, has fearless and much-needed conversations about race. Hosted by journalists of color, the show tackles the subject of race head-on, exploring how it impacts every part of society — from politics and pop culture to history, sports and more.\u003cbr />\u003cbr />\u003cem>Life Kit\u003c/em>, which will be in the second part of the hour, guides you through spaces and feelings no one prepares you for — from finances to mental health, from workplace microaggressions to imposter syndrome, from relationships to parenting. The show features experts with real world experience and shares their knowledge. Because everyone needs a little help being human.\u003cbr />\u003cbr />\u003ca href=\"https://www.npr.org/podcasts/510312/codeswitch\">\u003cem>Code Switch\u003c/em> offical site and podcast\u003c/a>\u003cbr />\u003ca href=\"https://www.npr.org/lifekit\">\u003cem>Life Kit\u003c/em> offical site and podcast\u003c/a>\u003cbr />","airtime":"SUN 9pm-10pm","imageSrc":"https://cdn.kqed.org/wp-content/uploads/2024/04/Code-Switch-Life-Kit-Podcast-Tile-360x360-1.jpg","meta":{"site":"radio","source":"npr"},"link":"/radio/program/code-switch-life-kit","subscribe":{"apple":"https://podcasts.apple.com/podcast/1112190608?mt=2&at=11l79Y&ct=nprdirectory","google":"https://podcasts.google.com/feed/aHR0cHM6Ly93d3cubnByLm9yZy9yc3MvcG9kY2FzdC5waHA_aWQ9NTEwMzEy","spotify":"https://open.spotify.com/show/3bExJ9JQpkwNhoHvaIIuyV","rss":"https://feeds.npr.org/510312/podcast.xml"}},"commonwealth-club":{"id":"commonwealth-club","title":"Commonwealth Club of California Podcast","info":"The Commonwealth Club of California is the nation's oldest and largest public affairs forum. As a non-partisan forum, The Club brings to the public airwaves diverse viewpoints on important topics. The Club's weekly radio broadcast - the oldest in the U.S., dating back to 1924 - is carried across the nation on public radio stations and is now podcasting. Our website archive features audio of our recent programs, as well as selected speeches from our long and distinguished history. This podcast feed is usually updated twice a week and is always un-edited.","airtime":"THU 10pm, FRI 1am","imageSrc":"https://cdn.kqed.org/wp-content/uploads/2024/04/Commonwealth-Club-Podcast-Tile-360x360-1.jpg","officialWebsiteLink":"https://www.commonwealthclub.org/podcasts","meta":{"site":"news","source":"Commonwealth Club of California"},"link":"/radio/program/commonwealth-club","subscribe":{"apple":"https://itunes.apple.com/us/podcast/commonwealth-club-of-california-podcast/id976334034?mt=2","google":"https://podcasts.google.com/feed/aHR0cDovL3d3dy5jb21tb253ZWFsdGhjbHViLm9yZy9hdWRpby9wb2RjYXN0L3dlZWtseS54bWw","tuneIn":"https://tunein.com/radio/Commonwealth-Club-of-California-p1060/"}},"considerthis":{"id":"considerthis","title":"Consider This","tagline":"Make sense of the day","info":"Make sense of the day. Every weekday afternoon, Consider This helps you consider the major stories of the day in less than 15 minutes, featuring the reporting and storytelling resources of NPR. Plus, KQED’s Bianca Taylor brings you the local KQED news you need to know.","imageSrc":"https://cdn.kqed.org/wp-content/uploads/2024/04/Consider-This-Podcast-Tile-703x703-1.jpg","imageAlt":"Consider This from NPR and KQED","officialWebsiteLink":"/podcasts/considerthis","meta":{"site":"news","source":"kqed","order":"7"},"link":"/podcasts/considerthis","subscribe":{"apple":"https://podcasts.apple.com/podcast/id1503226625?mt=2&at=11l79Y&ct=nprdirectory","npr":"https://rpb3r.app.goo.gl/coronavirusdaily","google":"https://podcasts.google.com/feed/aHR0cHM6Ly9mZWVkcy5ucHIub3JnLzUxMDM1NS9wb2RjYXN0LnhtbA","spotify":"https://open.spotify.com/show/3Z6JdCS2d0eFEpXHKI6WqH"}},"forum":{"id":"forum","title":"Forum","tagline":"The conversation starts here","info":"KQED’s live call-in program discussing local, state, national and international issues, as well as in-depth interviews.","airtime":"MON-FRI 9am-11am, 10pm-11pm","imageSrc":"https://cdn.kqed.org/wp-content/uploads/2024/04/Forum-Podcast-Tile-703x703-1.jpg","imageAlt":"KQED Forum with Mina Kim and Alexis Madrigal","officialWebsiteLink":"/forum","meta":{"site":"news","source":"kqed","order":"8"},"link":"/forum","subscribe":{"apple":"https://podcasts.apple.com/us/podcast/kqeds-forum/id73329719","google":"https://podcasts.google.com/feed/aHR0cHM6Ly9mZWVkcy5tZWdhcGhvbmUuZm0vS1FJTkM5NTU3MzgxNjMz","npr":"https://www.npr.org/podcasts/432307980/forum","stitcher":"https://www.stitcher.com/podcast/kqedfm-kqeds-forum-podcast","rss":"https://feeds.megaphone.fm/KQINC9557381633"}},"freakonomics-radio":{"id":"freakonomics-radio","title":"Freakonomics Radio","info":"Freakonomics Radio is a one-hour award-winning podcast and public-radio project hosted by Stephen Dubner, with co-author Steve Levitt as a regular guest. 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