Wednesday, September 1, 2010

Random Musings on Identity

“|You have as many identities as you have friends.  -- Unknown

This particular post is one in which something I learn via one persona crosses over to the other, and of course, because this is a different persona, gets warped and rewritten.

My online identities are quite convoluted. I reported in a post titled Tweet a little bit more than a year ago that I have at least 16 different ways that I communicate electronically.  Associated with each one is a slightly different identity.  Some identities (e.g., @motorcycle_guy on Twitter and this blog ) cross over to the point of being virtually indistinguishable.

Others are very closely held, not quite secrets (you can find me on the interweb), that I try to keep separate. These are not identities I share with many, some only to close friends and colleagues, and others only to people that have known me in college (or through that tribe).  One thing that I have learned through all my friends and close colleagues is that no matter what issues I have with identity, they have even more.  I know of one person who is male in one place, female in another, and in yet a third, both.

I have a Facebook account, mostly so that I can peruse pictures from my family members, but I rarely ever post there.

I have a LinkedIn account that I started when I was first hunting (for this job), and now use it to stay connected with former colleagues and to connect to others in this industry. That is pretty well hooked into my twitter identity.

I have a Blog internal to GE that I haven't posted to in quite a while because I do so much more writing here.

I'm on at least 50 different mailing lists, some using my personal e-mail and others with my work e-mail address.  The rule is, if I'm officially representing my employer it get's my work e-mail, but otherwise, it goes to the personal one.  I don't post my e-mail address because frankly, it's too easy to scrape and I've burned at least three personal e-mail addresses due to junk mail.  My e-mail address is on the web, and if you know what I do and for who, you can find it easily enough (big hint, I cochair committees for HL7 and IHE).  And if not, you can always hit the Contact Me link on this blog (and if you know how that works, you can e-mail me directly).

One useful rule I've figured out is that if it's coming with me should I leave my current employer, the identity is tied to my personal e-mail address.

I have a personal journal, and if you are among the about 10 people I share it with, you are pretty lucky, and also pretty cool.  Most of my friends have already agreed that what I post there to "friends only" will not make it back into the wider twitterverse.  I need a place to moan and gripe where I don't have to worry about what [redacted] thinks.  I once recieved a job offer from someone who found me there and though it would be neat to let me know he discovered my "alternate self".  That wasn't a complete and total turn-off, but it definately had a negative impact.

I have a Skype account, you can find me there using "Keith W. Boone".

So, with all of these different musings on identity, what are you to do?  Don't worry, I'll figure it out for you.  If you contact me through one identity and I think another is more appropriate, I'll let you know.  If you want to tweet, share, or otherwise link to this content feel free to do so, in whatever venue you like (In fact, I just made it easier to do that).  That of course doesn't give you free reign to exceed your rights or mine under copyright (see the Policies Page),

With all of these identities, my mind next wonders (or is it wanders) to how that relates to the online relationships I want to have with my healthcare providers.  I don't think I want healthcare information in my "gmail" inbox.  For one, its not something I can reliably secure.  I want an e-mail inbox that requires encryption on the way in via TLS.  No, that's not the NHIN Direct way (they have specified an S/MIME solution).  But I worry that someone will try to e-mail me healthcare data without knowing what they are doing, and I want to make sure that A) it is secure and B) I can tell my mother how to do it.

I think I'll be happy to have one or two direct electronic relationships with my providers.  When that becomes three our four, then I'll start looking for better solutions.  But I can take this identity thing one step at a time.

My last musing on Identity?  It seems that while the American populace (or at least it's Congress) is not ready for a National Patient Identity, the VA and DOD are ready for a national solidier healthcare identifier.  Maybe that's another step at a time approach.  Of course the VA and DOD have a pretty well documented reason to want it that the rest of the citizenry may just be waiting to have.  Frankly, I could skip that step if you don't mind.

     Keith W. Boone
     "That Motorcycle Guy"
     Standards Geek
     Co-chair HL7 Structured Documents Workgroup
     Co-chair IHE Patient Care Coordination Planning Committee
     Co-chair EHRA Quality and Clinical Decision Support Special Interest Group
     A few unmentionables and some private ones

P.S.  If you know the source or original for the quote above, please let me know. 


  1. As I work on the VLER project, specifically supporting identity management issues, I find it very interesting about the VA and DOD's struggle for a nationwide identifier. Whenever disparate identity stores are linked up there has to be some kind of way to identify the unique correlation between them. The VA and DOD have realized that probabilistic matching of patients is very very hard to do and they see a nationwide unique id as an easy way out. What happens though when you introduce numerous HIEs or the millions of providers that don't use these IDs? Gets a little tougher. What about dependents? Do they get a different EDIPI? They use their sponsor's so what then?

  2. I have many identities. Some of them arise from what I do for a living, others from my hobbies and personal communication.

    However, I find one trick very useful. When I'm asked to supply an e-mail address to an on-line business or service, I create a unique e-mail address that I only use for that one place. Each of such address is an alias for my primary personal account, so I don't need a complex e-mail receiver. But this allows me to quickly identify the source of any e-mail they send.

  3. Gmail supports creating multiple e-mail addresses. Anything after the + sign and before the @ sign in a gmail address is ignored. So, if your google email address is, you can tell someone to send you messages at and it will reach you. Google even lets you use the address to categorize your e-mail, and auto-circular-file. I don't use that feature as much as I should, mostly because then I have to remember what I used for each different site. That could be really annoying when your e-mail address is your login name.