Review Phreesia Authorization

“Preregistering” for a medical appointment started by clicking a link in an email to reach a website with no obvious relation to the medical office, filling in a selection of my private bits, then being confronted by this wall of text:

———- Wall of text begins ———-

Review Phreesia Authorization
Please review the authorization below. A copy of this authorization form will be available at the front desk.
Authorization for Uses and Disclosures of Protected Health Information
Health-Related Materials

I hereby authorize my healthcare provider to release to Phreesia’s Check-in system my health information entered during the automated Check-in process, or on file with my healthcare provider, to help determine the health-related materials I will receive as part of my use of Phreesia. The health-related materials may include information and advertisements related to treatments and therapies specific to my health status. The materials may be provided by my health insurance plan, a pharmaceutical manufacturer or another healthcare entity. Phreesia may receive a payment for making such information available to me through the Check-in System or Phreesia’s Patient Communication Services including items such as newsletters, patient reminders for visits, medication/treatment adherence and other practice-related services.

If I am presented with an advertisement pursuant to this Authorization and I choose to request certain information and/or samples as described in the advertisement, then I further authorize Phreesia to disclose my protected health information to the advertiser as designated in the advertisement, such as my name, email address, mailing address, or phone number in order to receive such information and/or samples. Phreesia may receive a payment for releasing my personal information. The use and disclosure of my protected health information solely as set forth in this paragraph is valid only for purposes of when I choose to receive the information and/or samples, as described in the advertisement and until I receive such information and/or samples.

My healthcare provider is using Phreesia’s secure platform to enhance the patient-provider experience and eliminate inefficiencies associated with Check-in.

The following is the Authorization to provide me personalized educational health content and to allow Phreesia, on behalf of my healthcare provider, to conduct analytics using some of the information that I provide to gain insight into and support the effectiveness of this educational health content.

Utilizing Federal guidelines and its corporate policy, Phreesia, on behalf of my healthcare provider, ensures that all patient-related health information is protected by administrative, technical, and physical safeguards.

Phreesia will safeguard my personal information and will not use it for any purpose, other than to: provide health-related materials to me; anonymously analyze health outcomes in support of that educational health content, as well as to measure the effect of the health-related materials furnished to me on my communications with me or my family member’s healthcare provider (this analysis is computer-automated and involves no human review of my protected health information); and carry out any use or disclosure otherwise permitted by this Authorization.

Although there is the potential for information disclosed pursuant to this Authorization to be subject to redisclosure by the recipient and no longer be protected by federal privacy rules, Phreesia maintains administrative, technical, and physical safeguards as required by the Federal Government’s Health Information Privacy Rule, or “HIPAA,” to protect each patient’s confidential information. Phreesia does not disclose personally identifiable information to anyone other than each patient’s healthcare provider without this Authorization or as governed, permitted or required by law.

I do not have to grant this Authorization but, if I do not, I will not receive personalized health-related material or, as applicable, receive the materials as described in the advertisement. I understand that my healthcare provider will treat me regardless of whether I grant this Authorization.

I have a right to receive a copy of this Authorization. I may change my mind and revoke (take back) this Authorization at any time, except to the extent that my healthcare provider or Phreesia has already acted based on this Authorization. To revoke this Authorization, I must contact my healthcare provider c/o Phreesia in writing (including my name, date of birth, gender, home address and healthcare provider’s name) at: Privacy Officer, Phreesia, Inc., 434 Fayetteville Street, Suite 1400, Raleigh, NC 27601; or PrivacyOfficer@Phreesia.com. This information will not be used for any purposes other than to verify my identity in order to revoke this Authorization.

This Authorization is valid for the following time periods:

  • One year from the date on which I grant this Authorization – for use in delivering personalized health-related materials from my healthcare provider on the Phreesia platform;
  • When the Patient Communication Services Program concludes – for use in delivering Phreesia’s Patient Communication Services on behalf of my healthcare provider; and
  • When the Analytics conclude – for use in Phreesia’s analytics programs

Phreesia is a business associate of my healthcare provider and is bound by federal law to protect and safeguard my privacy.

Authorization signed by: The patient, [me]

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I assume your eyes glazed over immediately upon seeing the text and it’s entirely reasonable to assume most folks simply select the “Agree” button (which doesn’t appear here), sign the form, and move on.

Having actually read the damn thing, it turns out to be an agreement to let Phreesia (apparently, all the good names were used up) spam me with medical advertising vaguely related to my current malady.

Look at that first paragraph again:

I hereby authorize my healthcare provider to release to Phreesia’s Check-in system my health information entered during the automated Check-in process, or on file with my healthcare provider, to help determine the health-related materials I will receive as part of my use of Phreesia. The health-related materials may include information and advertisements related to treatments and therapies specific to my health status. The materials may be provided by my health insurance plan, a pharmaceutical manufacturer or another healthcare entity. Phreesia may receive a payment for making such information available to me through the Check-in System or Phreesia’s Patient Communication Services including items such as newsletters, patient reminders for visits, medication/treatment adherence and other practice-related services.

“May receive a payment” indeed. I declined and haven’t died yet.

This could happen:

… there is the potential for information disclosed pursuant to this Authorization to be subject to redisclosure by the recipient and no longer be protected by federal privacy rules …

Scum, the lot of them.

Sharing the Lane in Red Oaks Mill

We’re in the middle of three southbound lanes on Rt 376 in Red Oaks Mill, turning left into the rightmost lane going down the hill across the bridge, when a car approaches from behind:

Red Oaks Mill Intersection - close pass - approach - 2020-12-24
Red Oaks Mill Intersection – close pass – approach – 2020-12-24

Most drivers seem content to wait behind us until we get into the huge intersection where there’s plenty of room (comparatively speaking) to pass, but not this one:

Red Oaks Mill Intersection - close pass - waiting - 2020-12-24
Red Oaks Mill Intersection – close pass – waiting – 2020-12-24

I warned Mary (one the reasons we have radios on our bikes) about the mirror just behind her shoulder and she verified the minimal clearance:

Red Oaks Mill Intersection - close pass - arms length - 2020-12-24
Red Oaks Mill Intersection – close pass – arms length – 2020-12-24

Prudence dictated we wait until he was clear before moving:

Red Oaks Mill Intersection - close pass - rolling - 2020-12-24
Red Oaks Mill Intersection – close pass – rolling – 2020-12-24

Of course, the signal timing doesn’t let us get all the way through the intersection under the best of conditions, but we make an impressive enough parade to keep oncoming cars from moving before we’re out of their way.

This section of NY Rt 376 is also NY Bike Route 9, which doesn’t explain why NYS DOT pays so little attention to bicycle safety.

Turkey Baster FAIL

We bought a generic Walmart-grade baster perhaps two years ago to replace a much older one with a failed rubber bulb. We use it intermittently throughout the year and had a turkey in the oven when we discovered this:

Cracked Baster - overview
Cracked Baster – overview

A closer look at the business end:

Cracked Baster - tip detail
Cracked Baster – tip detail

Yes, those cracks go all the way through, there’s a loose spear running the length of the thing, and it definitely doesn’t work as a baster.

Contrary to what you might think from the general fogging and stress cracking, I haven’t used it for gasoline or brake fluid, nor do we put it away without washing it.

The rubber bulb still works fine, though, so there’s that.

We’ll up our spend for an OXO baster and see what happens.

Jonas Peeler: Reshaping and Origin Mystery

This past summer we replaced a worn-out vegetable peeler with what was allegedly a high-quality Linden Jonas peeler. It worked quite well, which it should have, given that it cost nigh onto seven bucks, until I recently backed over it with my wheelchair (about which, more later) and smashed it flat.

World+dog having recently discovered the virtues of home-cooked meals, the replacement cost nigh onto ten bucks and, through the wonders of Amazon, came from a different seller, albeit with a letter-for-letter identical description:

Linden Jonas peeler orders
Linden Jonas peeler orders

With a spare in the kitchen, I applied some shop-fu to unbend the first peeler:

Jonas peeler - reshaping tools
Jonas peeler – reshaping tools

Tapping the handle against the bandsawed dowel sufficed to remove the sharpest bends. The final trick involved clamping one edge of the handle to the section cut from a thread spool, resting the Vise-Grip on the bench vise, and whacking the other edge with the rubber mallet to restore the smooth curve around the main axis, repeating the process along the other side, then hand-forming the gentle curve closer to the blade. It ain’t perfect and never will be, but it’s once again comfortable in the hand.

During that process I had plenty of time to admire the identification stamped into the handle:

Jonas peeler - weak emboss
Jonas peeler – weak emboss

Which, frankly, looks rather gritty on an allegedly high-quality product from a Swedish factory.

Compare it with the new peeler:

Jonas peeler - good emboss
Jonas peeler – good emboss

Now, that’s more like it.

The genuine Linden website doesn’t provide much detail, so I can’t be absolutely sure which peeler is a counterfeit, but it sure looks like at least one fails the sniff test. Linden’s site redirects to Amazon through a Google search link (!) that, given the way Amazon works, could result in anything appearing as a valid result:

https://www.google.com/search?q=amazon.com+linden+sweden

As one should expect by now, Amazon’s commingled inventory produces a fair percentage of reviews complaining about craptastic peelers stamped “Made in China” from any of the sellers unearthed by that search.

Privacy Preferences: Broken As Intended

The Chase website seems to be fine, except:

Chase Privacy Settings - not working
Chase Privacy Settings – not working

Huh.

Follow the money: being a bank / credit card / fintech company, it’s safe to assume they sell your sensitive bits and have zero incentive to let you limit their actions in any way.

A week later, that part of their site remains broken, presumably as intended.

Raspberry Pi Camera vs. RTSP Streaming

It Would Be Nice to turn the various Raspberry Pi camera boxen around here into more-or-less full-automatic IP streaming cameras, perhaps using RTSP, so as to avoid having to start everything manually, then restart the machinery after a trivial interruption. I naively thought video streaming was a solved problem, especially on an RPi, particularly with an Official RPi Camera, given the number of solutions found by casual searching with the obvious keywords.

As far as I can tell, however, all of the recommended setups fail in glorious / amusing / tragic ways. Some failures may be due to old configurations no longer applicable to new software, but I’m nowhere near expert experienced enough to figure out what’s broken and how to fix anything in particular.

Doing RTSP evidently requires the live555.com Streaming Media libraries & test suite. Compiling requires adding -DNO_SSL=1 to the COMPILE_OPTS line in the Makefile, then letting it bake it for a while.

The v4l2rtspserver code fetches & cleanly compiles its version of the live555 code, then emits various buffer overflow errors while streaming; the partial buffers clearly show how the compression works on small blocks in successive lines. Increasing various buffer sizes from 60 kB to 100 kB to 300 kB had little effect. This may have to do with the stream’s encoding / compression methods / bit rates, none of which seem amenable to random futzing.

Another straightforward configuration compiled fine, but VLC failed to actually show the stream, perhaps due to differences between the old version of Raspbian (“Stretch”) and the new version of Raspberry Pi OS (“Buster”).

Running the RPi camera through the Video4Linux2 interface to create a /dev/video0 device seems to work, but controlling the camera’s exposure (and suchlike) with v4l2_ctl behaves erratically. Obvious effects, like rotation & flipping, work fine, but not the fine details along the lines of auto exposure and color modes.

Attempting to fire raspivid through cvlc to produce an RTSP stream required installing VLC on a headless Raspberry Pi, plus enough co-requisite packages to outfit world+dog+kitchenSink. After all the huffing & puffing wound down, the recommended VLC parameters failed to produce an output stream. The VLC doc regarding streaming is, to me, impenetrable, so I have no idea how to improve the situation; I assume RTSP streaming is possible, just not by me.

Whenever any of those lashups produced any video whatsoever, the images suffered from tens-of-seconds latency, dropped frames, out-of-order video updates, and generally poor behavior. Some maladies certainly came from the aforementioned inappropriate encoding / compression methods / bit rates.

The least horrible alternative seems to be some variation on the original theme of using raspivid to directly create a tcp stream or firing raspivid into netcat to the same effect, then re-encoding it on a beefier PC as needed. I’m sure systemd can automagically restart raspivid (or, surely, a script with all the parameters) after it shuts down.

So far, this has been an … unsatisfactory … experience, but now I can close a dozen browser tabs.

Monthly Science: Burnett Signal Timing

The NYS DOT has been improving the pedestrian crossings at the Burnett – Rt 55 intersection. I expect this will be a bullet item in their Complete Streets compliance document, with favorable job reviews for all parties. The situation for bicyclists using the intersection, which provides the only access from Poughkeepsie to the Dutchess Rail Trail, hasn’t changed in the slightest. No signal timing adjustments, no bike-capable sensor loops, no lane markings, no shoulders, no nothing.

Here’s what NYS DOT’s Complete Streets program looks like from our perspective, with the four-digit frame numbers ticking along at 60 frame/sec.

We’re waiting on Overocker Rd for Burnett traffic to clear enough to cross three lanes from a cold start:

Burnett Signal - 2020-09-25 - front 0006
Burnett Signal – 2020-09-25 – front 0006

That building over there across Burnett is the NYS DOT Region 8 Headquarters, so we’re not in the hinterlands where nobody ever goes.

We’re rolling:

Burnett Signal - 2020-09-25 - front 0258
Burnett Signal – 2020-09-25 – front 0258

The Burnett signals just turned green, although the cars haven’t started moving yet, and we’re accelerating out of Overocker:

Burnett Signal - 2020-09-25 - front 0463
Burnett Signal – 2020-09-25 – front 0463

About 1.5 seconds later, the vehicles have started moving and we’re lining up for the left side of the right-hand lane:

Burnett Signal - 2020-09-25 - front 0752
Burnett Signal – 2020-09-25 – front 0752

There’s no traffic behind us, so we can ride a little more to the right than we usually do, in the hopes of triggering the signal’s unmarked sensor loop:

Burnett Signal - 2020-09-25 - front 1178
Burnett Signal – 2020-09-25 – front 1178

We didn’t expect anything different:

Burnett Signal - 2020-09-25 - front 1333
Burnett Signal – 2020-09-25 – front 1333

We’re rolling at about 12 mph and it’s unreasonable to expect us to jam to a stop whenever the signal turns yellow. Oh, did you notice the truck parked in the sidewalk over on the left?

As usual, 4.3 seconds later, the Burnett signals turn red, so we’re now riding in the “intersection clearing” delay:

Burnett Signal - 2020-09-25 - front 1593
Burnett Signal – 2020-09-25 – front 1593

Two seconds later, the Rt 55 signals turn green:

Burnett Signal - 2020-09-25 - front 1711
Burnett Signal – 2020-09-25 – front 1711

Did you notice all three eastbound lanes of Rt 55 (on our right) were occupied? That means a driver can’t come zipping through without stopping at the green light in their direction.

One second later, we’re still proceeding through the intersection, clearing the lethally smooth manhole cover by a few inches, and approaching the far side:

Burnett Signal - 2020-09-25 - front 1771
Burnett Signal – 2020-09-25 – front 1771

Here’s what the intersection looks like behind me:

Burnett Signal - 2020-09-25 - rear 1
Burnett Signal – 2020-09-25 – rear 1

Another second goes by and we’re pretty much into the far right lane , with the westbound traffic beginning to move:

Burnett Signal - 2020-09-25 - front 1831
Burnett Signal – 2020-09-25 – front 1831

The pedestrian crossing ladder has fresh new paint. They milled off the old paint while reconstructing the crossing, so the scarred asphalt will deteriorate into potholes after a few freeze-thaw cycles. Not their problem, it seems.

Although it’s been three seconds since Rt 55 got a green signal, the eastbound drivers remain stunned by our presence:

Burnett Signal - 2020-09-25 - rear 2
Burnett Signal – 2020-09-25 – rear 2

After another second, we’re almost where we need to be:

Burnett Signal - 2020-09-25 - front 1891
Burnett Signal – 2020-09-25 – front 1891

There’s a new concrete sidewalk on the right, with a wheelchair-accessible signal button I can now hit with my elbow when we’re headed in the other direction. It’s worth noting there is no way to reach Overocker by bicycle, other than riding the sidewalk; there’s only one “complete” direction for vehicular cyclists.

One second later puts us as far to the right as we can get, given all the gravel / debris / deteriorated asphalt along the fog line near the curb:

Burnett Signal - 2020-09-25 - front 1957
Burnett Signal – 2020-09-25 – front 1957

Which is good, because four seconds after the green signal for Rt 55, the pack has overtaken us:

Burnett Signal - 2020-09-25 - rear 3
Burnett Signal – 2020-09-25 – rear 3

If you were the driver of the grayish car in the middle lane, directly behind the black one giving us plenty of room, you might be surprised at the abrupt lane change in front of you. Maybe not, because you had a front-row seat while we went through the intersection.

Elapsed time from the green signal on Burnett: 25 seconds. My point is that another few seconds of all-red intersection clearing time wouldn’t materially affect anybody’s day and would go a long way toward improving bicycle safety.

Unlike the pedestrian crossing upgrade, NYS DOT could fix this with zero capital expenditure: one engineer with keys to the control box, a screwdriver or keyboard (depending on the age of the controls), and the ability to do the right thing could fix it before lunch tomorrow.

But it’s just a typical bike ride on NYS DOT’s Complete Streets, where their planners & designers claim to “promote pedestrian and bicycle travel for all persons.” Maybe that’s true somewhere in NYS DOT’s fantasies, but you’ll find far more evidence from our rides, with plenty of numbers, showing that’s not the case around here.