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> For about ten years, I've theorized that we will see the rise of 'boutique' doctor, dentist, and law offices that keep only paper records for the sake of the

by sofixa 2y ago

> For about ten years, I've theorized that we will see the rise of 'boutique' doctor, dentist, and law offices that keep only paper records for the sake of the privacy of their clients. "Privacy" until a disgruntled staffer copies or takes a picture or just takes the pieces of paper and publishes them. With digital systems, this can be mitigated (rate limiting, encryption and least privilege information sharing, audit logs etc.) to an extent. With paper, you're screwed. I still remember a few years ago walking on a street in a city in Easter Europe, behind a bank office for a bank which no longer exists. There were dumpsters nearby that were overflowing with garbage, and the wind was carrying some of it around, like sheets of paper with bank loan applications, ID card scans, etc etc etc. Paper is not easier to secure than digital systems if the people supposed to secure it don't care.

pjmorris 2y ago
> With digital systems, this can be mitigated (rate limiting, encryption and least privilege information sharing, audit logs etc.) to an extent. None of those measures do anything to prevent someone from taking a picture of the screen, which is the same sinking boat you describe. I think you are insightful in identifying care as the key principle. My argument would be that care is more easily achieved by smaller groups working on smaller populations using fewer components.
- sofixa 2y ago
  > None of those measures do anything to prevent someone from taking a picture of the screen, which is the same sinking boat you describe. But it's relatively easy to only have the people that need specific information to have it. Receptionist only has your names and contact information; doctor only has your relevant medical information; etc etc. With paper, either everything will be together in a big file, or it would be very impractical to manage. > My argument would be that care is more easily achieved by smaller groups working on smaller populations using fewer components. Potentially. Or they'll improvise because they're a small operation and there's trust. Many a small company has been caught with terrible physical or digital security, because nobody cares and at their scale dedicated people to care don't make sense.
  - pjmorris 2y ago
    > But it's relatively easy to only have the people that need specific information to have it. Which brings us back to... > "Privacy" until a disgruntled staffer copies or takes a picture or just takes the pieces of paper and publishes them. With paper, it's primarily about the trust you place in people. With digital it is not only the trust you place in people, you add the trust required for the systems you use; not only the ones you select, but the ones they depend on. Across a range of systems, we are seeing that we haven't yet mastered complexity. > Many a small company has been caught with terrible physical or digital security, because nobody cares and at their scale dedicated people to care don't make sense. Which brings me back to those boutique firms... with paper-only you reduce the problems to one that have been well-understood for hundreds of years. Air-gapped systems seem like an attractive option, but even then, you're depending on both the trust you place in the hardware, OS, and package vendors and in the practice of the new field of digital hygiene by the staff. My prediction is that some clientele somewhere - actors, politicians, billionaires - will decide that their private data should be as private as they can possibly make it, and that it will be the old-fashioned way.

by sofixa 2y ago

pjmorris 2y ago

> With digital systems, this can be mitigated (rate limiting, encryption and least privilege information sharing, audit logs etc.) to an extent. None of those measures do anything to prevent someone from taking a picture of the screen, which is the same sinking boat you describe. I think you are insightful in identifying care as the key principle. My argument would be that care is more easily achieved by smaller groups working on smaller populations using fewer components.

sofixa 2y ago
> None of those measures do anything to prevent someone from taking a picture of the screen, which is the same sinking boat you describe. But it's relatively easy to only have the people that need specific information to have it. Receptionist only has your names and contact information; doctor only has your relevant medical information; etc etc. With paper, either everything will be together in a big file, or it would be very impractical to manage. > My argument would be that care is more easily achieved by smaller groups working on smaller populations using fewer components. Potentially. Or they'll improvise because they're a small operation and there's trust. Many a small company has been caught with terrible physical or digital security, because nobody cares and at their scale dedicated people to care don't make sense.
- pjmorris 2y ago
  > But it's relatively easy to only have the people that need specific information to have it. Which brings us back to... > "Privacy" until a disgruntled staffer copies or takes a picture or just takes the pieces of paper and publishes them. With paper, it's primarily about the trust you place in people. With digital it is not only the trust you place in people, you add the trust required for the systems you use; not only the ones you select, but the ones they depend on. Across a range of systems, we are seeing that we haven't yet mastered complexity. > Many a small company has been caught with terrible physical or digital security, because nobody cares and at their scale dedicated people to care don't make sense. Which brings me back to those boutique firms... with paper-only you reduce the problems to one that have been well-understood for hundreds of years. Air-gapped systems seem like an attractive option, but even then, you're depending on both the trust you place in the hardware, OS, and package vendors and in the practice of the new field of digital hygiene by the staff. My prediction is that some clientele somewhere - actors, politicians, billionaires - will decide that their private data should be as private as they can possibly make it, and that it will be the old-fashioned way.