Tuesday, April 2, 2013

EMR and Troubles with Identity Privacy



So recently I received a bill from an out of the state medical clinic. The bill charges me with treatment that were obviously not rendered unto me. The bill contained my name and physical address.

I called them and they very quickly rescinded the bill.

However, there is one remaining issue, which is that the US has promoted Electronic Medical Records (EMR) system. In fact, it appears that there might even be a mandatory EMR system in the near future. Consider for a minute that such a thing happened when mandatory EMR system is in force. What would happen?
I may be rejected for health insurance on the basis of pre-existing condition based on treatment a hospital claim to have rendered. Is this possible? Well, I have a bill here from an out-of-state clinic that says YES they can make mistake like that and can affect my permanent medical record.

Mandatory EMR/EHR is a godsend for insurance companies. It means they can receive the full history of a person's past and perform sophisticated risk analysis that produce premium rates according to the person's risk for illness or injury.

One would react to a  $25 insurance premium by not buying insurance and react to a $5,000,000 premium by committing suicide. Because if it is entirely based on risk and incidence prediction a $25 bill means that insurance company expects to pay that or less for your treatment, and similarly a five million dollar bill would mean there are significant evidence that I will need to pay that much to live.

I had written a bit about how this company found my address and put me down for the bill, but I realize that by talking about it, I am letting the world know how that company found my personal address, and I don't want that, so let us not talk about the privacy problems here and move on to a larger issue:

The problem it could cause for us when an error is made is that our permanent record will be marred forever. I hate telling horror stories but let me tell this one:

4 months ago I leased my new 2013 Chevy Volt. California has a law that allows drivers of these environmentally friendly cars to drive in HOV lane using a "GREEN STICKER" which the DMV must issue. This is one of the main incentives that moved me to lease this car.

Needless to say it has been 4 months and I have not received the sticker to drive in the HOV lane. After two(3) series of phone calls and four(4) form submissions, I found out finally that my registration address had a problem from the start when I leased it from Boardwalk Chevy. I had a horrible experience leasing this car from them, being forced to sit through negotiation on a national wide promotional program with my eight-month(8) pregnant wife; being forced to sign contract three(3) times with numerous line items changing without due notice to me; the contract requiring me to pay upfront for 9 oil changes that must be used in 3 years(ON A FUCKING PLUGIN HYBRID that will not be burning gas most of the time); and then, after all that, having the wrong address entered into the computer so I cannot receive my green sticker.

But that is besides my current point, which is that there is a lot of racism and hatred and unkindness and merciless greed in this world added on top of legitimate human error and the Devil Satan. I do not believe we, as a species, have overcome these hurdles sufficiently to instrument an EMR system that will be central to our medical treatment.

If the address is wrong in my EMR, and I don't receive prescription or communication from the doctor, it could be a matter of life or death. I mean, having to sit in traffic for an extra 60 minutes every day is a matter of wasted life, but at least it is not something that caused the complete cessation of life as an EMR error of this sorts could cause.

I am against universal mandatory EMR in the United States any time this decade.

The Problem with Transitivity



Transitive Action Space is fairly concise space containing all those actions that are divalent. These actions are the first class of actions that we consider because it occurs most frequent in interpersonal relationships. Also because the Golden Rule and Silver Rule of ethics both syntactically refer to precisely this class of actions.

Linguists have long thought of this issue and discuss the concept of valency of verbs. monovalent verbs are intransitive, transitive verbs are divalent… Other verbs are more expressive and some has multiple valencies: do and have both can be monovalent, divalent and trivalent.

The example given in wikipedia is the following American southerner statement:

I am having myself some dinner.

"I", "myself" and "dinner" are the parameters of "have", which in this case is trivalent.

The interesting fact about this is that the first two np's associated with this verb are covariant (vaguely speaking). And by this I mean

He is having himself some dinner.

She is having herself some dinner.

They are having themselves some dinner.

and so on and so forth. The first two vary together. I can never have, for example

I am having themselves some dinner…

it just wouldn't make any sense.

We should let this sink in a second. First of all there are multivalent verbs beyond transitive verbs. Second of all, some verbs may have restriction on them regarding some or all of their np's when used in an actual sentence.
do is the other multivalent verb.

I am doing myself a favor.

Again trivalent, however in this case covariant np's are not required.

I am doing him a favor.

I am doing her a favor.

I am doing them a favor.

etc.

In fact, not to be vulgar but these are the things that came to mind as I think about this:
I am shitting myself a bucket of golden coins.
I am making myself a bucket of golden coins.
I am shaking myself a headache.
I am driving him nuts.
I am driving him home.

ahha, so we have a pattern. These are still transitive verbs, but their third np parameterizes the content of the action or indicate a byproduct of the action.

I can shit you a bucket of gold.

To me, you the object of the action, the receiver and gold is the content of the action. I am straining but not seeing my doing anything to gold using you. similar pattern apply to the other of the previous sentences.

I'd like to include these trivalent verbs in the transitive action space by adding the additional noun phrase into the verb forming verb-np super-verbs that can be applied to the parameters of previously defined Transitive Action Space (i.e. you and me).

(shitting gold)
(making gold coin)
(shaking (out) a headache)
(driving nuts)
(driving home)

are included as trivalent transitive actions.

IG AND THE QUANTIFICATION OF PRIVACY


A while back, I talked about computing IG–information gain–by clandestine methods via an otherwise secret(personal) email. I will point to some other prior blogs entries about what can we reasonably consider private and some reasons why I think it’s bad (Because it removes competition….
The basic challenge is this: If your competitor can spy on what you do (unilaterally) then they will never be motivated to innovate. Their key strength will be their ability to hack your secrets and they will work hard on that, but not on how to build a better product or cure a disease or solve a new problem. If you can both spy on each other with perfect information then there is no need to innovate, just calculate the equilibrium and aim for that. If you can disinform your opponent then all your effort will go into disinformation instead of innovation. Basically it is much easier to do something sneaky and cheat than to do the right thing and innovate. This is why the government, a non-competing body whose interest is to make sure everyone compete (at least in America government this is the case), should provide for information security.
)
I realize in retrospect that IG may not make sense to most people based on the formulation I laid out. Let’s review. IG is the change in entropy from a state without additional knowledge to a state with knowledge
IG = H(secret) – H(secret | private email)
This measurement seem to be of a quite abstract concept of entropy–a unitless measurement. Why would I think this useful for any reason other than that it is called “Information Gain?” Well truth be told, what I had in mind was more of the IG from machine learning literature: Class purity after conditioning on some private information. It is actually used more as a measurement of correctness of predicting discrete output than abstract change in entropy of distribution after conditioning. I will refer reader to these excellent introductory books regarding “classification” algorithms.
… Some days passes and the books will hopefully have arrived on your desks…
So the example is if my secret is the probability that I will have Chinese food tonight. Let’s throw in several more classes, say Italian, Mexican cover 99.9% of all possibilities. This probability may be internal to me. Or it may be an externalizable model like I will toss a three-sided die and figure out what I will eat tonight.
Actually, this system forces us to think of a new class. I will call this new class the innovation class. It covers all cases where something new might happen, such as tonight when I went off on a tangent and forgot to eat dinner completely. Or I might be abducted by Aliens for demandingprivacy, Japanese paramilitary for blogging, or God for thinking all these awful things. The fact is, I do not know what will happen, but what I do know is that things I don’t know will happen. So the class is called IC, Innovation Class–now we have a 4 sided die: Chinese, Mexican, Italian, IC; Let’s write naively that the probability for each class is:
ChineseMexicanItalianIC
33%33%33%1%
The formula for the entropy of these classes is written as:
-H(Dinner)= p(Chinese) * log(p(Chinese)) + p(Mexican) * log(p(Mexican)) + p(Italian) * log(p(Italian)) + p(IC)*log(p(IC))
the above evaluates to almost the maximum possible entropy in three-class situation: H(Dinner)= 1.6499060116098556
that’s it. that’s the formula for calculating entropy that we will use repeatedly. Now, suppose that you have read my email to my wife saying “oh man, look at this great deal on groupon, 50% off on Indian food right near our home” What is the right thing to think about the distribution of my dinner?
P(IC)=99%
Indian food is not Chinese or Mexican or Italian, but we have thought of that and put in IC to account for it.
ChineseMexicanItalianIC
10%10%10%70%
-H(Dinner|private email to wife) = p(Chinese|private email to wife) * log(p(Chinese|private email to wife)) + p(Mexican|private email to wife) * log(p(Mexican|private email to wife)) + p(Italian|private email to wife) * log(p(Italian|private email to wife)) + p(IC|private email to wife)*log(p(IC|private email to wife))
gives us the conditional entropy of probability of dinner after reading my private email. This entropy H(Dinner|private email to wife)=0.09596342477405478
IG(Dinner; private email to wife) = H(Dinner) – H(Dinner|private email to wife) = 1.6499060116098556-0.09596342477405478=1.5539425868358008. This corresponds to an IGR of 1619.31%, that is, 15X more information after you saw the email than before.

Great! so now we know how much information is gained by reading that one private email of mine. This number, I think quantifies my loss of privacy.

Btw, this innocent example contain some hand waving. H(Dinner) for example is something that we may or may not know. Most people have trouble writing down a distribution for dinner choices. also, P(Dinner|private email to wife) here written as a table contain assumed values. What if after reading my private email you feel that P(IC)=85%? Who is to say what the reality of this probability is? This is why I felt that this model will not make to main stream legal system because the link between private email and the actual secret itself is not so obvious. You might use naive Bayes as the definitive of reality (refer to chapter in books or wiki), logistic regression, decision trees, or you might use something else… You may even use a distributions system like SVM or god forbid rule based systems…
If you understand this computation above, then it will be easy for you to understand the continuous version. Let dinner be a continuous variable, we can still write the same expression
IG(Dinner; private email to wife) = H(Dinner) – H(Dinner|private email to wife)
and it would have the same meaning. How far are we from the truth. This idea, btw, is indeed partially inspired by the name Information Gain, which also goes by Kullback-Leibler divergence when computed over distributions. The above formation exactly with the exception that “private email to wife” is a distribution, say, perhaps, my emails are generated randomly.
KL( Dinner|private email || Dinner )
But KL divergence does point us to some other interesting characterizations. Divergence–distance without some properties of distance. Namely that it is not a metric distance:
* Nonnegative dl(x,y)>=0:  yes
* Indiscernability: dl(x,y)=0 iff x==y: yes
* Symmetric dl(x,y)==dl(y,x): NO
* Triangle inequality dl(x,y)+dl(y,z) >= dl(x,z): NO
This has some serious implications regarding this formulation of privacy. Somethings that we naturally think should make sense do not.
Let’s say I have two emails, e1 and e2, and let’s say dinner is still the subject of intense TLA investigation:
KL(d;e1) + KL(d;e2) != KL(d;e1,e2)
All private information must be considered together, because considering them separately would yield inconsistent measurement of privacy loss
Let’s say there’re two secrets, d1 is my dinner choose and d2 is my wife’s dinner choose
KL(d1;e1,e2) + KL(d2;e1,e2) != KL(d1,d2; e1,e2)
All secrets must be computed together, because computing IG separately and adding is not equal to the total information gain.
Let’s say we have an intermediate decision called Mode of Transportation (mt), and it is a secret just like my dinner choice.
KL(mt;e1,e2) + KL(d ; mt) != KL(d; e1,e 2)
The intermediate secret can be calculated, but again, it must be calculated carefully and not by additive increase of IG.
Bummer, but fascinating!! But we we must make some choice about how to proceed. Knowledge about the nature of information (and especially electronic information), I believe, informs us about how we make choice in our privacy laws:

  • Should the whole data be analyzed all at once?
  • or should we only allow each individual’s data be processed all at once?
  • or should we only allow daily data of everyone to be processed together?
  • or should we only allow daily data  of each individual to be processed separately?
Each of these choice (and many other) impact the private information loss due to clandestine activities.

FOR RICHER AND FOR POORER


The title makes no reference to marriage, per say. Bear with me here for a sec…
A certain strange set of circumstances inspires this thought. Some time ago, some entrepreneurial friends recommends a series of books to me, How to Win Friends and Influence people and Rich Dad, Poor Dad. Saying that these are must read for a young person planning to have a good life.

And I’ve never read either, btw, I’m guessing it really shows, huh?

Okay, okay, please stay calm when I say this, and hopefully you find it funny and non-offensive, as I don’t want my tires punctured again by a nail gun.

Has anybody thought about the psychology of Rich Dad and Poor Dad? I mean com’on, isn’t it obvious that the Japanese author wrote this subconsciously thinking of two real entities?

well? do you see it? The Japanese American author, what did he think while he wrote this? What is the driving thought?

Okay, okay, here it is. America is the Rich dad to Japan and China is the Poor dad.

oh fuck, I can hear all four tires exploding on my car…

okay, yes, yes, I am of Chinese lineage, it’s probably not PC for me to think like this, but if I were Japanese, or had Japanese wife, or if I was dating a Japanese women, it would make it all better, right?. ugh, I promise, when I am rich enough I will adopt a Japanese child, to try to make up for this trespass.

ehem, okay, so I am Chinese ethnically. And I am taught and think that Japan’s language, religion, gene pool, etc, that they in noticeable part come from China some time long long ago. I hope most reasonable people with a bit of rational unbiased inquiry will not object to my thinking this: that China can be considered a dad.

America the rich dad. Right, what makes it the rich daddy?

Here is the reasoning: I see two very large Japanese companies, Toyota, Honda,Mazda, Nissan, dominates the US automobile industry by selling to US consumers more than 50% of cars that they buy. So, that number, fifty-some percent, is more than US and European makers’ sales added up together. Certainly I will not be the first to say that “Japanese cars last longer than American cars” is common wisdom among value car shoppers.

Now, I’d like to consider myself a hard-working American. I am American, born in China but naturalized. I feel that my upbringing, growing up in the China of 1980s, and America of 1990′s that I deeply believe in the values that America was built upon. I feel that it is right that I should support this country by working hard, contributing to its production. I recently begun to drive to work everyday and have begun to appreciate the importance of a reliable car when work demands that I get there everyday.

As a hard-working American needing a reliable car, I can tell you that in large investments such as a car for a hard-working American, reliability is important. And if it is Japanese car company that we need to go to find reliability, then we will do that, because we want to work and getting to work is important.

BUT, would you not agree that you’d rather be driving an American car to work than a Japanese car? As a person working and producing in America, would you not feel happier if you heard somebody say: “American cars are Better than Japanese cars” ? More reliable, better fuel mileage, higher safety standards. Would that not bring a grin to your face like it would to mine? I will not belabor this point, but I fear that many Americans have not had a chance to stop and think this thought… no no, feel that thought:

“American cars are better than Japanese cars.”

Do not let the media brain wash you into thinking that Japanese cars is always better than American cars, or that it is necessary for another reason. You, American, you can dance, you can sing, you can build a better car than the Japanese.

Why is this so important? Because I feel that sometimes, people here do not get the freedom of mind to think these thoughts. It is not racist to want to build a better American car. It is not politically incorrect. In fact, it really should be less politically incorrect than for the mass media to try to steal the shirts off of those poor Chinese children’s back as they try to make wage to feed themselves and perhaps their family.

Let me repeat! This is not racist! This is national competition. When an honest working American hands out the cash that he honestly made to a Toyota dealer for a car, and I don’t care of the sleazy sales guy is American and his boss is American and his boss is American and the whole company falls under an American registered corporation. The owner of that company (stock owners, board, etc.) are Japanese people. Check on Google or Yahoo or Bing finance, the board of these American companies are completely occupied by people with Japanese names. Yes, some of them may be American citizens, but they all have Japanese names, they are all Japanese people. I don’t need to perform a statistical test to say that that’s not a representative sample of American business man. The companies are completely controlled by Japan.

When you hand over your hard-earned greenbacks to Toyota or Honda, or Nissan or Mazda for a “higher quality car” you are putting that money in the hands of a Japanese person. He is not an American Citizen, he is not concerned about the perpetuation and propagation of the American way. He is a Japanese person who has his own national and racial interests and agendas that differ, perhaps greatly, from those of American interest and values. When you hand your money to him, he has free will to use that money in ways that do not align with American values.

God!! Japan couldn’t send a single radio-activity resistant robot into their power plant to fix the leaks and had to wait for American robots to check out the power plant? I do not believe this, and you shouldn’t either. For all we know, (and we do know at least Honda is doing significant research in non-automotive robotics) that the robot that kills you in World War III is being designed right now! Using your hard-earned money! right now! in Japan! Right at this moment!

This really needn’t be said, but for some reason I feel this needed to be pointed out: when you buy a Japanese car, you implicitly support Japanese value system and if their values are racist or imperialistic, you have no say over if he can spend money-making weapons or take over the world. You have no say in their attempt to sabotage a great American company like Boeing with their defective batteries. (And making it look like America cannot engineer a good plane.)

When you hand the money over, it is theirs and they can spend it how they want.

True, when you buy from England, Germany, France, Russia, Brazil, India or Chinese, you hand them money so they can spend it the way they want, but I find it very hard to believe that we find Japanese culture and policies, in the long-term, to be more American than all of America, German, Europa, Asia, etc, combined.

In Capitalist world, money speaks, and the money is speaking Japanese right now.

America, the rich sugar daddy, and China the poor chopstick daddy.

America, the rich sugar daddy at cost to it’s lower/middle class people who have to have dependable cars to go to work. They are being forced to hand money to Japanese company due to the lack of dependable American cars.

I might sound like a protectionist here, but realistically speaking, all this hollering about Chinese stealing American jobs not only echos the same from more than two centuries ago in the 1800′s:
chinese must go ce_witness_2_lg
The Japanese doesn’t even bother stealing American’s Jobs, they just put a plant in America, make Americans work to build the cars and then take the money. I mean, Capitalist or not, as a sane person, that economical enslavement and thorough humiliation hurts more than a fucking Chinese kid working for a mouthful of food. Those fat Japanese (economic) imperialists pigs haven’t changed a bit in their ways since the last time they tried to take over the world through racial and ethnic cleansing of Asia. AND they are doing it from right under our eyes under the guise of being a better race: The advertised facts seem to say that only under Japanese management can cars be made with high quality in America. Are you going to take this crap sitting down?

Somewhat racist comments aside. I will bet you one thousand 2013 dollars that America will be richer and will have higher quality of life if we made our own cars and keep the money instead of giving it to a Japanese.
America will be richer and have better quality of life if all of China was to sink into the ocean, but the improvement will not be any where nearly as drastic as having one–just one–god damned car maker do a good job. Think of the morale boost it will give us. Who cares about the stinking iPad when I can drive, without polluting the environment, and safely and have the money go to a fellow American’s hand.

And the hidden agenda here, btw, if you are wondering about this rambling Chinese American, is to perpetuate the American way of life–life, liberty and the pursuit of happiness.

Why don’t we build a better car! Build a better car and show the world that we can do it. All of that negativity: corruption in government, large corporations, wall street… All those foreclosures, broken credit reports and all those mass killings… We will have lifted ourselves out of this freaking rut and resume our dreams of prosperity marching towards the great manifest destiny of the American way.

That would be so great!

Disclaimers: I work for a Japanese owned company. My statements here do not reflect my company’s policies. I suspect but do not know for a fact that Japan is building military robots using your hard-earned cash. I am not saying that America treat Chinese people the way they treat us in the 1800′s. I do not know the author of either books and have never read them.