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Comment by thinkingtoilet | Hacker News Reader

I work for a medical technology company. How do you propose we service our customers without their medical data?

Does it need to be hosted on your servers? Could you provide something to the customers where they host the data or their local doctors office does it?

Can you delete it after the shortest possible period of using it, potentially? Do you keep data after someone stops being a customer or stops actively using the tech?

Having seen this world up close, the absolute last place you ever want your medical data to be is on the Windows Server in the closet of your local doctors office. The public cloud account of a Silicon Valley type company that hires reasonably competent people is Fort Knox by comparison.

Yeah but the a local private practice is a fairly small target. No one is going to break into my house just to steal my medical records, for example.

This could also be drastically improved by the government spearheading a FOSS project for medical data management (archival, backup, etc). A single offering from the US federal government would have a massive return on investment in terms of impact per dollar spent.

Maybe the DOGE staff could finally be put to good use.

You seem to be confused about how this works. Attackers use automated scripts to locate vulnerable systems. Small local private practices are always targeted because everything is targeted. The notion of the US federal government offering an online data backup service is ludicrous, and wouldn't have even prevented the breach in this article.

> Attackers use automated scripts to locate vulnerable systems.

I'm aware. I thought we were talking about something a bit higher effort than that.

> online data backup service

That isn't what I said. I suggested federally backed FOSS tooling for the specific usecase. If nothing else that would ensure that low effort scanners came up empty by providing purpose built software hardened against the expected attack vectors. Since it seems we're worrying about the potential for broader system misconfiguration they could even provide a blessed OS image.

The breach in the article has nothing to do with what we're talking about. That was a case of shadow IT messing up. There's not much you can do about that.

Professionally, my company builds one of the largest EHR-integrated web apps in the US

Ask me how many medical practices connect every day via IE on Windows 8.

Record retention is covered by a complex set of overlapping regulations and contracts. They are dependent on much more than date of service. M&A activity, interstate operations, subsequent changes in patient mental status, etc can all cause the horizon to change well after the last encounter.

As all the comments in this thread suggest the cost of having an extra record , even an extra breached record is low. The cost of failing to produce a required medical record is high.

Put this together with dropping storage prices, razor then margins, and IT estates made out of thousands of specialized point solutions cobbled together with every integration pattern ever invented and you get a de facto retention of infinity paired with a de jure obligation of could-be-anything-tomorrow.

I'm not trying to be rude, but it's clear you have idea what you're talking about. The medical world is heavily regulated and there are things we must do and thing's we can't do. If you go to your doctor with a problem, would you want your doctor to have the least amount of information possible or your entire medical history? The average person has no business hosting their sensitive data like banking and medical information. If you think fraud and hacks are bad now, what do you think would happen if your parents were forced to store their own data? Or if a doctor who can barely use an EMR was responsible for the security of your medical data? I would learn a lot more about the area before making suggestions.

I just registered CVEs in several platforms in a related industry, the founders of whom likely all asked themselves a similar question. And yet, it's the wrong question. The right one is, "Does this company need to exist?" I don't know you or your company. Maybe it's great. But many startups are born thinking there's a technological answer to a question that requires a social/political one. And instead of fixing the problem, the same founders use their newfound wealth to lobby to entrench the problem that justifies their company's existence, rather than resolves the need for it to exist in the first place. "How do you propose we service our customers without their medical data?" Fix your fucked healthcare system.

Ask for it?

I hope you're joking...

Otherwise it would suggest you think the problem is they didn't ask? When was the last time you saw a customer read a terms of service? Or better yet reject a product because of said terms once they hit that part of the customer journey?

The issue isn't about asking it's that for take your pick of reasons no one ever says no. The asking is thus pro forma and irrelevant.

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