User:Cal.oasis/sandbox

== Article evaluation ==


 * 1) Regarding the information privacy page:

Content: I thought that the introduction part was fine as it included important definitions about specific terms such as privacy and information privacy; however, I thought that the format of the page could have been better. I think that the list in the introduction is distracting because it is different from the format of the rest of the text. Additionally, I think it would be better if it was a horizontal list rather than a vertical list. Additionally, I think that the authors should introduce the different information types in the introduction part because there the main body of the article is about those. The legality portion is very small and only contains one sentence. More information could be added there. The Safe Harbor program and passenger name record issues is also distracting. I think that it should not have its own section, but can be used as an example of a information privacy problem. Otherwise, if the author would like to keep this section, explain the relevance to information privacy more explicitly.

Tone: I think that the tone is neutral. The viewpoints are neutral as well. There are sections with more information than others, but other than that, I think that the tone is okay.

Citations: In order to check the viability of the sources, I looked at the first 5 citations. Each of the links took me to the original article; however, I had trouble accessing the third citation as there was an original and archived copy. Some of the sources did not look like they were scholarly articles. For example, the fourth and fifth citation took me to websites rather than databases with scholarly articles. The fifth source is from USA Today, and I am not sure if the article is peer reviewed, therefore, it is not a good source.

Talk page: This article is part of the WikiProject Computing, Internet, and Surveillance. This page has high importance. There is discussion over phrasing of the information that makes it seem opinionated. There is also discussion about adding sections regarding different countries and their privacy protection. Additionally, there is a discussion over unavailable sources and moving the article to different pages. At the bottom, there is multiple discussions on citation use.

2. Regarding the computer security page:

Content: I think that the content of this page is very thorough. There is extensive information about the different types of computer risks, actions that can be made if your computer goes through these things, and the response to increase in computer risks. I do not have any issues with the formatting of the page.

Tone: I think that the tone for this article is neutral as well. I do not see any issues with the language used. Additionally, most of the sections are equally explained and have enough information to understand the topic.

Citations: I checked the first 5 sources listed. Each of the links takes me to the correct articles, which are all scholarly articles. I do not see any issues with the information that they have used.

Talk page: This article is part of the WikiProject Computing, networking, software, websites, computer science, hardware, computer security, computing, internet and espionage. There is talk about cleaning up grammar issues, external links, and there was a requested move as of Dec 2017; however, they have decided to not change the page.

Citation Exercise
Although there is a common belief that monitoring can increase productivity, it can also create consequences such as increasing chances of deviant behavior and creating punishments that are not equitable to their actions. Additionally, monitoring can cause resistance and backlash because it insinuates an employer’s suspicion and lack of trust.

Medical Privacy Page
For the Medical Privacy page I hope to give a larger understanding of what medical privacy is and how the concept has changed over time. I would like to give a brief overview of medical privacy prior to the industrial/technological boom and then discuss further the concept after the boom as it is very important modern society. Additionally I would like to discuss more about medical privacy within the United States and talk about different laws that were passed in order to ensure better privacy. I plan to include a list of laws that were proposed. Additionally, I plan to add more information to the state portion. I plan on focusing primarily on the United States rather than other countries.

Additionally, many laws that were proposed not passed because companies feared that they would not be able to make the same profits, so I plan to also address the viewpoint of medical privacy from businesses rather than just the individual.

Annotations:
Alpert, Sheri. 1993. “Smart Cards, Smarter Policy Medical Records, Privacy, and Health Care Reform.” The Hastings Center Report 23(6):13–23.

In Sheri Alpert’s “Smart Cards, Smarter Policy Medical Records, Privacy, and Health Care Reform”, Alpert discusses how today’s current laws do not adequately protect patient’s medical records or privacy. As a result, there has been an effort to establish better privacy mechanisms to protect people’s information. Prior to the technological boom, many people relied on paper medium to file people’s medical data; however, nowadays their information is stored within electronic databases. However, it was more safe to have information with paper as it was harder to physically steal the data, yet now hackers are able to access large amounts of information without the owner’s knowing. Additionally, with the risk of information exposure, the relationship between physician and patient has changed as people are more reluctant to share information that has a chance of being breached. In order to reform the healthcare privacy issues, researchers are looking into the use of credit cards and “smart” cards that will allow people access to their medical information. The new “smart” card allows the storage and processing of information to be stored in singular microchip, yet people are fearful of so much information stored in a single spot that can easily be accessed. This “smart” card would include an individual’s social security number which is important piece of identification that can cause identity theft if the data bases are breached. Additionally, people will target these medical cards as they have information that can be of value to many different third parties including employers, pharmaceutical companies, drug marketers, and insurance reviewers. In response, there has been movement to create better medical privacy protection, but nothing has been officially passed. The Medical Information Bureau was created to to prevent insurance fraud, yet since it is a significant source of medical information for over 750 life insurance companies, it is very dangerous as it is a target of privacy breachers. Although the electronic filing system of medical information has increased proficiency and administration costs have been reduced, there are negative aspects to consider. The electronic filing system allows for individual’s information to be more susceptible to outsiders; even though their information is stored on a singular card, it serves as a false sense of security as it does not protect their information completely. Ultimately, there is still an issue with individual medical privacy as the confidentiality of an individual’s medical information is not guaranteed. I believe that this is a good article as it is not biased, all information is backed up by different studies and sources, and straightforward and a relatively easy read. I think it gives a good overview of the change from paper to electronic filing system of medical information and would recommend it to others. I think that this article is helpful because I can use it to talk about the shift in medical filing and how people’s privacy were changed because of it. I was unaware of how easy it is for outside parties to access my medical information from these large databases.

Etzioni, Amitai. 2000. “The New Enemy of Privacy: Big Bucks.” Challenge 43(3):91–106.

In Amitai Etzioni’s “The New Enemy of Privacy: Big Bucks”, Etzioni argues that the main danger to an individual’s privacy are private corporations because of profits from privacy-violating information. Privacy merchants are made up of two categories, one has the goal of collecting people’s personal information while the other focuses on using client’s information to market products. Privacy merchants are also able to purchase information from other companies if there is not sufficient information from their own research. A person’s privacy regarding their medical information is also very common, but people have been responding negatively and have called it “authorized abuse”. Health insurance companies nowadays collect huge amounts of personal information and keep them in large databases by requiring patients to provide more information that is needed for purposes other than that of doctors and other medical workers. Additionally, with the new technological developments, and the development of computerized records, it is easier for people to access information as many databases have been compiled into a singular place. Additionally, people’s information can be linked to other information outside of medical information. Many employers use insurance information and medical records as an indicator of work ability and ethic. Additionally, with the violation of privacy, medical research is difficult to do because people fear losing their confidentiality. The selling of privacy information can also lead employers to receive lots of money; however, this happens to many people without their consent or knowledge. Although there is a large group of people who oppose the selling of individual’s medical information, there are groups such as the Health Benefits Coalition, the Healthcare Leadership Council, and the Health Insurance Association of America that are against the new reforms for data protection as it can ruin their work. Furthermore, it is not the government that is the reason for many issues with medical privacy, but it is the large corporations that are trying to make profits off of our data. I think that this is a good article because all of the information provided is cited by multiple sources, it is not biased, and it is straightforward. I think that this article is targeted towards people who have the mindset that the government is the reason for the issues for privacy violation. It offers a great amount of information that proves that this is not the case and that it is due to corporate greed instead. I think that I will be able to use this information to showcase how and why corporations use people’s data and sell it to other third party companies.

Bradburn, Norman M. 2001. “Medical Privacy and Research.” The Journal of Legal Studies 30(S2):687–701.

In Norman Bradburn’s “Medical Privacy and Research”, Bradburn argues that an individual’s fear of having his or her medical information spread is not a privacy issue, but is a reaction to social norms and relationships between doctors and their patients. He first discusses the benefits of the technological shift of medical filing as the supposed reason for increase in fear of privacy breaching. Online filing is more efficient, accurate, affordable, and can store high volumes of data while not being bulky or hard to transport. Yet, there are negative aspects including easier access to this information. However, he believes that the real reason for the fear of the new medical filing system is due to the social norms of doctor-patient relationships and their uses of the medical information. Although levels of confidentiality are changing, individuals often feel the need to share more information with their doctors in order to get diagnosed well. But, Bradburn argues that there needs to be less of an emphasis on sharing and confidentiality in order to rid patients from their fears of information breaching. There is a common belief that the confidentiality of one’s information also only protects the doctors and not the patients, therefore there is a negative stigma towards revealing too much information. Thus it causes patients to not share vital information relevant to their illnesses. I think that this article was well written, although the concepts were harder to understand. I believe that it was very informative and gave an interesting perspective on the privacy issues within medical data collection. I think that this serves as a good counter argument, instead of technological issues that cause privacy scares, that will help broaden the information within my article. Many articles target the companies as the main reason for lack of privacy, but this offers a new perspective and discusses the relationship between doctor and patient as the main culprit of privacy fears.

Outline
In the introduction I will keep the definitions and explanation of medical and health privacy. In addition to electronic medical records, I will also include PCMS (patient care management systems). There I will give a brief overview of what they are. I will also include background on HIPAA as it is one of the most important medical privacy laws in the United States. I will additionally add a sentence description regarding each country I will discuss in the article - Australia, Canada, Turkey, UK, US, New Zealand, and the Netherlands.

History of Medical Privacy
Change from paper filing systems to electronic system of filing


 * The benefits and problems of such changes

What are the responses from the public from these various changes

Protected Health Information (PHI)


 * Definition
 * Reasons for lack of privacy within this specific field

Patient Care Management Systems (PCMS)
Definition

Benefits of PCMS

Problems with PCMS

Important Laws
HIPAA (link to the HIPAA page)


 * Definition
 * Goals
 * Limitations
 * Katrina
 * Explain what happened in this natural disaster and how it showed how weak medical privacy laws are
 * Effects
 * Public response

Genetic Privacy Act


 * Definition (Oregon)
 * Goals
 * Limitations
 * Property debate
 * Effects
 * Public Response

Australia
I am planning on restructuring this section. In the beginning I will include a brief overview of these eHealth system and then divide the page by laws (governance), safety measures, and certain issues. But in the issues portion, I will format it so that there are no more bullet points and questions, but rather reads more fluidly.

Canada

 * laws within Canada regarding Medical privacy
 * provisions to ensure the security
 * Discussion regarding Medical privacy - opinions from the public and desires for what should be done in order to improve it

Turkey

 * laws within Turkey regarding Medical privacy
 * provisions to ensure the security
 * Discussion regarding Medical privacy - opinions from the public and desires for what should be done in order to improve it

United Kingdom

 * laws within UK regarding Medical privacy
 * provisions to ensure the security
 * Government Gateway - NHS (National Health Service)
 * Discussion regarding Medical privacy - opinions from the public and desires for what should be done in order to improve it

United States

 * Brief overview of medical privacy
 * California Specific Laws
 * Privacy and Electronic Health Records
 * Medical data outside of HIPAA

New Zealand

 * laws within New Zealand regarding Medical privacy
 * provisions to ensure the security
 * Health information Privacy Code
 * Discussion regarding Medical privacy - opinions from the public and desires for what should be done in order to improve it

Netherlands

 * laws within Netherlands regarding Medical privacy
 * provisions to ensure the security
 * Nationwide system for exchange of medical information
 * Discussion regarding Medical privacy - opinions from the public and desires for what should be done in order to improve it

Discussion
Any possible solutions to these issues

Any final thoughts on overall issues with medical privacy

Medical Privacy Draft
Medical privacy or health privacy is the practice of maintaining the security and confidentiality of patient records. It involves both the conversational discretion of health care providers and the security of medical records. The terms can also refer to the physical privacy of patients from other patients and providers while in a medical facility. Modern concerns include the degree of disclosure to insurance companies, employers, and other third parties. The advent of electronic medical records (EMR) and patient care management systems (PCMS) have raised new concerns about privacy, balanced with efforts to reduce duplication of services and medical errors.

Many countries - including Australia, Canada, Turkey, the United Kingdom, the United States, New Zealand, and the Netherlands - have enacted laws that try to protect people's privacy. However, many of these laws have proven to be less effective in practice than in theory. The United States has passed the Health Insurance Portability and Accountability Act (HIPAA) as an attempt to increase privacy precautions within medical institutions.

History of medical privacy
Prior to the technological boom, many people relied on a paper medium to file individual's medical data; however, nowadays their information is stored within electronic databases. Research shows that it is safer to have information stored within a paper medium as it is harder to physically steal data, yet, now, hackers are able to access large amounts of information without the owner’s knowing online.

In order to reform the healthcare privacy issues in the early 1990's, researchers looked into the use of credit cards and “smart” cards to allow access to their medical information without fear of stolen information. The “smart” card allowed the storage and processing of information to be stored in a singular microchip, yet people were fearful of having so much information stored in a single spot that could easily be accessed. This “smart” card included an individual’s social security number; this is an important piece of identification that can lead to identity theft if data bases are breached. Additionally, there was a fear that people would target these medical cards because they have information that can be of value to many different third parties including employers, pharmaceutical companies, drug marketers, and insurance reviewers.

In response to the lack of medical privacy, there was a movement to create better medical privacy protection, but nothing has been officially passed. The Medical Information Bureau was thus created to prevent insurance fraud, yet it has since become a significant source of medical information for over 750 life insurance companies; thus, it is very dangerous as it is a target of privacy breachers. Although the electronic filing system of medical information has increased efficiency and administration costs have been reduced, there are negative aspects to consider. The electronic filing system allows for individual’s information to be more susceptible to outsiders; even though their information is stored on a singular card. Therefore, the medical card serves as a false sense of security as it does not protect their information completely.

Emergence of the Insurance System
The emergence of the insurance system was part of the growing democratic movement of the working-class movement. However, the idea of traditional insurance policies was soon overtaken by corporate and social insurance companies who wanted to take advantage of individuals. This ultimately caused many individuals to lose the social assistance they needed from the government. This marginalization of individuals ultimately shaped many of the institutions of many civil insurance practices.

In the nineteenth century, insurance policies were not as formal as they currently are, instead there was an ambivalent relationship between democratic institutions and civil policies. Society was primarily characterized by principles of democracy and elitism which, in theory, should create equality. However, power was concentrated among the elite, causing a feeling of mutuality and exclusivity. Therefore, many of the policies that should have created inclusivity ultimately caused more people to be marginalized. Realizing this was an issue, there was a call for inclusivity and sociability which led to new cautions regarding medical privacy and ability to access individual information.

As a result, during the twentieth century, there was a change within the insurance industry which caused a new development of medical policies on how to handle individual's medical information. There was a shift from being selective to broadening the qualifications of being able to receive insurance help. With the end of exclusiveness within the insurance market, the government started to regulate the market more and thus emerged the fear of lack of privacy. Ideas of transparency caused many people to become wary of privacy violation rights. This led to modern day advocacy groups that argued for larger protections and regulations of insurance companies. As a result, in today's society, the government plays a large role in enforcing these roles within society. Since then, the government has had the role of enforcing these regulations to protect individual’s information and data.

Patient care management systems (PCMS)
With the technological boom, there has been an expansion of the record filing system and many hospitals have therefore adopted new PCMS. PCMS are large medical records that hold many individual's personal data. These have become critical to the efficiency of storing medical information because of high volumes of paperwork, the ability to quickly share information between medical institutions, and the increased mandatory reporting to the government. PCMS have ultimately increased the productivity of data record utilization and have created a large dependence on technology within the medical field.

Yet, it has also led to social and ethical issues because of the basic human rights that can be a casualty for this expansion of knowledge. Hospitals and health information services are now more likely to share information with third party companies. Thus, there needs to be a reform to specify the rules of the hospital personnel who have the access to medical records. This has led to the discussion of privacy rights and created safeguards that will help data keepers understand situations where it is ethical to share an individual’s medical information, provide ways for individuals to gain access to their own records, and determine who has ownership of those records. Additionally, it is used to ensure that a person’s identity is kept confidential in research or statistical purposes and understand the process to make individual’s aware that their health information is being used. Thus, a balance between privacy and confidentiality must occur in order to limit the amount of information disclosed and keep the occupations of physicians in check by constricting the information flow.

Electronic Medical Records (EMR)
Electronic medical records (EMR) are a more efficient way of storing medical information, yet there are many negative aspects of this type of filing system as well. Hospitals are willing to adopt this type of filing system, yet only if they are able to ensure the protection of patient information.

Researchers found that state legislation and regulation of medical privacy laws reduce the amount of hospitals that adopt EMR by more than 24%. This is ultimately due to the decreasing positive network externalities that are created by additional state protections. With increases in restrictions against the diffusion of medical information, hospitals have neglected to adopt the new EMR’s because privacy laws restrict health information exchanges. With decreasing amounts of medical institutions adopting the EMR filing system, the federal government’s plan to have a national health network will be stopped. The national network will ultimately cost the US $156 billion in investments, yet in order for this to happen, the government needs to place higher emphasis on protecting individual medical privacy. Many politicians and business leaders find that EMR’s allow for more efficiency in both time and money, yet they neglect to address the decreasing privacy protections, demonstrating the significant trade off between EMR’s and individual privacy.

Privacy and Electronic Health Records (EHRs) (original page)
The three goals of information security, including electronic information security, are confidentiality, integrity, and availability. Organizations are attempting to meet these goals, referred to as the C.I.A. Triad, which is the "practice of defending information from unauthorized access, use, disclosure, disruption, modification, inspection, recording or destruction."

In a 2004 editorial in the Washington Post, U.S. Senators Bill Frist and Hillary Clinton supported this observation, stating "[patients] need...information, including access to their own health records... At the same time, we must ensure the privacy of the systems, or they will undermine the trust they are designed to create". A 2005 report by the California Health Care Foundation found that "67 percent of national respondents felt 'somewhat' or 'very concerned' about the privacy of their personal medical records".

The importance of privacy in electronic health records became prominent with the passage of the American Recovery and Reinvestment Act (ARRA) in 2009. One of the provisions (known as the Health Information Technology for Economic and Clinical Health [HITECH] Act) of the ARRA mandated incentives to clinicians for the implementation of electronic health records by 2015.Privacy advocates in the United States have raised concerns about unauthorized access to personal data as more medical practices switch from paper to electronic medical records. The Office of the National Coordinator for Health Information Technology (ONC) explained that some of the safety measures that EHR systems can utilize are passwords and pin numbers that control access to such systems, encryption of information, and an audit trail to keep track of the changes made to records.

Providing patient access to EHRs is strictly mandated by HIPAA's Privacy Rule. One study found that each year there are an estimated 25 million compelled authorizations for the release of personal health records. Researchers, however, have found new security threats open up as a result. Some of these security and privacy threats include hackers, viruses, and worms. These privacy threats are made more prominent by the emergence of "cloud computing", which is the use of shared computer processing power. Health care organizations are increasingly using cloud computing as a way to handle large amounts of data. This type of data storage, however, is susceptible to natural disasters, cybercrime and technological terrorism, and hardware failure. Health information breaches accounted for the 39 percent of all breaches in 2015.

Health screening cases
Although privacy issues with the health screening is a great concern among individuals and organizations, there has been little focus on the amount of work being done within the law to maintain the privacy expectation that people desire. Many of these issues lie within the abstractness of the term “privacy” as there are many different interpretations of the term, especially in the context of the law. Prior to 1994, there had been no cases regarding screening practices and the implications towards an individual’s medical privacy, unless it was regarding HIV and drug testing. Within Glover v Eastern Nebraska Community Office of Retardation, an employee sued her employer against violating her 4th amendment rights because of unnecessary HIV testing. The court ruled in favor of the employer and argued that it was unreasonable search to have it tested. However, this was only one of the few precedents that people have to use. With more precedents, the relationships between employees and employers will be better defined. Yet with more requirements, testing among patients will lead to additional standards for meeting health care standards. Screening has become a large indicator for diagnostic tools, yet there are concerns with the information that can be gained and subsequently shared with other people other than the patient and healthcare provider.

Third party issues
One of the main dangers to an individual’s privacy are private corporations because of the profits they can receive from privacy-violating information. Privacy merchants are made up of two groups - one that tries to collect people’s personal information while the other focuses on using client’s information to market company products. Subsequently, privacy merchants purchase information from other companies, such as health insurance companies, if there is not sufficient information from their own research. Privacy merchants target health insurance companies because, nowadays, they collect huge amounts of personal information and keep them in large databases. They often require patients to provide more information that is needed for purposes other than that of doctors and other medical workers.

Additionally, people’s information can be linked to other information outside of the medical field. For example, many employers use insurance information and medical records as an indicator of work ability and ethic. The selling of privacy information can also lead employers to make lots of money; however, this happens to many people without their consent or knowledge.

Within the United States, in order to define clear privacy laws regarding medical privacy, Title 17 thoroughly explains the ownership of one’s data and adjusted the law so that people have more control over their own property. The Privacy Act of 1974 offers more restrictions regarding what corporations can access outside of an individual’s consent.

States have created additional supplements to medical privacy laws. With HIPAA, many individuals were pleased to see the federal government take action in protecting the medical information of individuals. Yet when people looked into it, there was proof that the government was still protecting the rights of corporations. Many rules were seen as more of suggestions and the punishment for compromising the privacy of its patients were minimal. Even if release of medical information requires consent, blank authorizations can be allowed and will not ask for individuals for additional consent later on.

Although there is a large group of people who oppose the selling of individual’s medical information, there are groups such as the Health Benefits Coalition, the Healthcare Leadership Council, and the Health Insurance Association of America that are against the new reforms for data protection as it can ruin their work and profits. Furthermore, it is not the government that is the reason for many issues with medical privacy, but it is the large corporations that are trying to make profits off of our data.

Recent Efforts to Protect Health Information
With the lack of help from the Department of Health and Human Services there is a conflict of interest that has been made clear. Some wish to place individual betterment as more important, while others focus more on external benefits from outside sources. The issues that occur when there are problems between the two groups are also not adequately solved which leads to controversial laws and effects. Individual interests take precedence over the benefits of society as a whole and are often viewed as selfish and for the gain of capital value. If the government does not make any more future changes to the current legislation, countless organizations and people will have access to individual medical information.

In 1999, the Gramm-Leach-Biley Act (GLBA) addressed the insurance privacy debate regarding medical privacy. Yet, there were many issues with the implementation. One issue was that there were inconsistent regulation requirements within the different states due to preexisting laws. Secondly, it was difficult to combine the pre-existing laws with the new framework. And thirdly, in order for the federal government to implement these new rules, the they needed state legislature to pass it.

GLBA aimed to regulate financial institutions so that corporations could not affect people’s insurance. Because of the difficulty of the implementation of the GBLA, state legislatures are able to interpret the laws themselves and create initiatives to protect the medical privacy. When states are creating their own independent legislature, they create standards that understand the impact of the legislation. If they stray from the standard laws, they must be valid and fair. The new legislation must protect the rights of businesses and allow them to continue to function despite federally regulated competition. Patients gain benefits from these new services and standards through the flow of information that is considerate with medical privacy expectations.

These regulations should focus more on the consumer versus the benefits and political exploitation. Many times, regulations are for the personal gain of the corporation, therefore, state legislatures be wary of this and try to prevent it to the best of their abilities. Medical privacy is not a new issue within the insurance industry, yet the problems regarding exploitation continue to reoccur; there is more focus on taking advantage of the business environment for personal gain.

In 2001, President George W. Bush passed additional regulations to HIPAA in order to better protect the privacy of individual medical information. These new regulations were supposed to safeguard health information privacy by creating extensive solutions for the privacy of patients. The new regulation goals included being notified once an individual's information is inspected, amend any medical records, and request communication opportunities to discuss information disclosure.

However, there are exceptions to when the disclosure of PHI can be inspected. This includes specific conditions among law enforcements, judicial and administrative proceedings, parents, significant others, public health, health research, and commercial marketing. These aspects of lack of privacy have caused an alarming amount of gaps within privacy measures.

Ultimately, there is still an issue on how to ensure privacy securities; in response, the government has created new regulations that makes trade offs between an individual's privacy and public benefit. These new regulations, however, still cover individually identifiable health information - any data that contains information unique to an individual. However, non identifiable data is not covered as the government claims it will cause minimal damage to a person’s privacy. In addition, it also covers all health care organizations, covers businesses as well.

Additionally, under new HIPAA additions, the state legislation is more protective than national laws because it created more obligations for organizations to follow. Ultimately, the new rules called for expansive requirements that created better safety measures for individuals. Yet, there are still ways that businesses and healthcare organizations can be exempt from disclosure rules for all individuals. Thus, the HHS needs to find more ways to balance personal and public trade offs within medical laws. This creates a need for extra government intervention to enforce legislation and new standards to decrease the amount of threats against an individual’s privacy of health data.

Physician-Patient Relationships
Patients want to be able to share medical information with their physicians, yet they worry about potential privacy breaches that can occur when they release financial and confidential medical information. In order to ensure better protection, the government has created frameworks for keeping information confidential - this includes being transparent about procedures, disclosure and protection of information, and monitoring of these new rules to ensure that people’s information.

Effects of Technological Advances regarding physician-patient relationships
Recently physicians and patients have started to use email as an additional communication tool for treatment and medical interactions. This way of communication is not “new”, but its effects on doctor patient relationships has created new questions regarding legal, moral, and financial problems.

The American Medical Informatics Association has characterized medical emails as way to communicate “medical advice, treatment, and information exchanged professionally”; yet, the “spontaneity, permanence, and information power characterizing” role is significant because of its unknown affects. However, the use of emails allows for increased access, immediate aid, and increased interactions between patients and doctors. There are many benefits and negative aspects of using emails; doctors feel a new sense of negative responsibility to respond to emails outside of the office, but also find benefits with facilitating rapid responses to patient’s questions.

Additionally, the use of email between physicians and their patients will continue to grow because of the increasing use of the Internet. With the Internet, patients are able to ask for medical advice and treatment, yet issues regarding confidentiality and legal issues come up. Ultimately, emails between a physician and patient are supposed to be used as a supplement for face to face interactions, not for casual messages. If used properly, physicians could use emails as a way to supplement interactions and provide more medical aid to those who need it immediately.

Traditional beliefs on doctor-patient relationship that spur fear
Although many people believe that the technological changes are the reason for fear of sharing medical privacy, there is a theory that states that institutional ideals between doctors and their patients have created the fear of sharing medical privacy information. Although levels of confidentiality are changing, individuals often feel the need to share more information with their doctors in order to get diagnosed correctly. Because of this, people are concerned with how much information their physicians have. This information could be transferred to other third party companies. However, there is a call for smaller emphasis on sharing and confidentiality in order to rid patients from their fears of information breaching. There is a common belief that the confidentiality of one’s information also only protects the doctors and not the patients, therefore there is a negative stigma towards revealing too much information. Thus it causes patients to not share vital information relevant to their illnesses.

United States
See: Health Insurance Portability and Accountability Act of 1996

Since 1974, numerous federal laws have been passed in the United States to specify the privacy rights and protections of patients, physicians, and other covered entities to medical data. Many states have passed its own laws to try and better protect the medical privacy of their citizens.

An important national law regarding medical privacy is the Health Insurance Portability and Accountability Act of 1996 (HIPAA), yet there are many controversies regarding the protection rights of the law.

Oregon Legislation
The Oregon Genetic Privacy Act (GPA) states that “an individual’s genetic information is the property of the individual”. The idea of an individual’s DNA being compared to property occurred when research caused an individual’s privacy to be threatened. Many individuals believed that their genetic information was “more sensitive, personal, and potentially damaging than other types of medical information.” Thus, people started calling for more protections. People started to question the how their DNA would be able to stay anonymous within research studies and argued that the identity of an individual could be exposed if the research was later shared. As a result, there was a call for individuals to treat their DNA as property and protect it through property rights. Therefore, individuals can control the disclosure of their information without extra questioning and research. Many people believed that comparing one’s DNA to property was inappropriate, yet individuals argued that property and privacy are interconnected because they both want to protect the right to control one’s body.

Many research and pharmaceutical companies showed opposition because they were worried about conflicts that might arise regarding privacy issues within their work. Individuals, on the other hand, continued to support the act because they wanted protection over their own DNA. As a result, lawmakers created a compromise that included a property clause, that would give individuals protection rights, but also included provisions that would allow research to be done without much consent, limiting the benefits of the provisions. Afterwards, a committee was created to study the effects of the act and how it affected the way it was analyzed and stored. They found that the act benefited many individuals who did not want their privacy being shared with others and therefore the law was officially implemented in 2001.

Connecticut Legislation
In order to solve HIPAA issues within Connecticut, state legislatures tried to create better provisions to protect the people living within the state. One of the issues that Connecticut tried to solve were issues with consent. Within the consent clause, health plans and health care clearinghouses do not need to receive consent from individuals because of a general provider consent form with gives healthcare providers permission to disclose all medical information. The patient thus does not get notification when their information is being shared afterwards.

Connecticut, like many other states, tried to protect individual’s information from disclosure of information through additional clauses that would protect them from businesses initiatives. In order to do so, Connecticut legislature passed the Connecticut Insurance Information and Privacy Protect Act, which provides additional protections of individual medical information. If third parties neglect to follow this law, they will be fined, may face jail time, and may have their licenses suspended. Yet, even in these additional provisions, there were many holes within this legislation that allowed for businesses agreements to be denied and subsequently, information was compromised. Connecticut is still working to shift its divergent purposes to creating more stringent requirements that create better protections through clear provisions of certain policies.

California-Specific Laws (original page)
In California, the Confidentiality of Medical Information Act (CMIA), provides more stringent protections than the federal statutes. HIPAA expressly provides that more stringent state laws like CMIA, will override HIPAA's requirements and penalties. More specifically, CMIA prohibits providers, contractors and health care service plans from disclosing PHI without prior authorization.

These medical privacy laws also set a higher standard for health IT vendors or vendors of an individual's personal health record (PHR) by applying such statutes to vendors, even if they are not business associates of a covered entity. CMIA also outlines penalties for violating the law. These penalties range from liability to the patient (compensatory damages, punitive damages, attorneys’ fees, costs of litigation) to civil and even criminal liability.

Likewise, California's Insurance Information and Privacy Protection Act (IIPPA) protects against unauthorized disclosure of PHI by prohibiting unapproved information sharing for information collected from insurance applications and claims resolution.

Health Insurance Portability and Accountability Act of 1996 (HIPAA)
The most comprehensive law passed is the Health Insurance Portability and Accountability Act of 1996 (HIPAA), which was later revised after the Final Omnibus Rule in 2013. HIPAA provides a federal minimum standard for medical privacy, sets standards for uses and disclosures of protected health information (PHI), and provides civil and criminal penalties for violations.

Prior to HIPAA, only certain groups of people were protected under medical laws such as individuals with HIV or those who received Medicare aid. HIPAA provides protection of health information and supplements additional state and federal laws; yet it should be understood that the law’s goal is to balance public health benefits, safety, and research while protecting the medical information of individuals. Yet many times, privacy is compromised for the benefits of the research and public health.

According to HIPAA, the covered entities that must follow the law's set mandates are health plans, health care clearinghouses, and health care providers that electronically transmit PHI. Business associates of these covered entities are also subject to HIPAA's rules and regulations.

In 2008, Congress passed the Genetic Information Nondiscrimination Act of 2008 (GINA), which aimed to prohibit genetic discrimination for individuals seeking health insurance and employment. The law also included a provision which mandated that genetic information held by employers be maintained in a separate file and prohibited disclosure of genetic information except in limited circumstances.

In 2013, after GINA was passed, the HIPAA Omnibus Rule amended HIPAA regulations to include genetic information in the definition of Protected Health Information (PHI). This rule also expanded HIPAA by broadening the definition of business associates to include any entity that sends or accesses PHI such as health IT vendors.

Controversies regarding HIPAA
Contrary to the popular belief, the Health Insurance Portability and Accountability Act (HIPAA) does not provide strong medical privacy protections as it only provides regulations that disclose certain information.

The government authorizes the access of an individual’s health information for “treatment, payment, and health care options without patient consent”. Additionally, HIPAA rules are very broad and do not protect an individual from unknown privacy threats. Additionally, a patient would not be able to identify the reason for breach due to inconsistent requirements. Because of limited confidentiality, HIPAA facilitates the sharing of medical information as there is little limitation from different organizations. Information can easily be exchanged between medical institutions and other non-medical institutions because of the little regulation of HIPAA - some effects include job loss due to credit score sharing or loss of insurance.

Additionally, doctors are not required to keep patients information confidential because in many cases patient consent is now optional. Patients are often unaware of the lack of privacy they have as medical processes and forms do not explicitly state the extent of how protected they are. Physicians believe that overall, HIPAA will cause unethical and non-professional mandates that can affect a person’s privacy and therefore, they in response have to provide warnings about their privacy concerns. Because physicians are not able to ensure a person’s privacy, there is a higher chance that patients will be less likely to get treatment and share what their medical concerns are. Individuals have asked for better consent requirements by asking if physicians can warn them prior to the sharing of any personal information. Patients want to be able to share medical information with their physicians, yet they worry about potential breaches that can release financial information and other confidential information and with that fear, they are wary of who may have access.

In order to ensure better protection, the government has created frameworks for keeping information confidential - some of which include being transparent about procedures, disclosure and protection of information, and monitoring of these new rules to ensure that people’s information is not affected by breaches. Although there are many frameworks to ensure the protection of basic medical data, many organizations do not have these provisions in check. HIPAA gives a false hope to patients and physicians as they are unable to protect their own information. Patients have little rights regarding their medical privacy rights and physicians cannot guarantee those.

HIPAA and Hurricane Katrina
HIPAA does not protect the information of individuals as the government is able to publish certain information when they find it necessary. The government is exempted from privacy rules regarding national security. HIPAA additionally allows the authorization of protected health information (PHI) in order to aid in threats to public health and safety as long as it follows the good faith requirement - the idea that disclosing of information is necessary to the benefit of the public. The Model State Emergency Powers Act (MSEHPA) gives the government the power to “suspend regulations, seize property, quarantine individuals and enforce vaccinations” and requires that healthcare providers give information regarding potential health emergencies".

In regards to Hurricane Katrina, many people in Louisiana relied on Medicaid and their PHI was subsequently affected. People’s medical privacy rights were soon waived in order for patient’s to get the treatment they needed. Yet, many patients were unaware that their rights had been waived. In order to prevent the sharing of personal information in future natural disasters, a website was created in order to protect people’s medical data. Ultimately, Katrina showed that the government was unprepared to face a national health scare.

Medical data outside of HIPAA (original page)
Many patients mistakenly believe that HIPAA protects all health information. HIPAA does not usually cover fitness trackers, social media sites and other health data created by the patient. Health information can be disclosed by patients in emails, blogs, chat groups, or social media sites including those dedicated to specific illnesses, "liking" web pages about diseases, completing online health and symptom checkers, and donating to health causes. In addition, credit card payments for physician visit co-pays, purchase of over the counter (OTC) medications, home testing products, tobacco products, and visits to alternative practitioners are also not covered by HIPAA.

A 2015 study reported over 165,000 health apps available to consumers. Disease treatment and management account for nearly a quarter of consumer apps. Two-thirds of the apps target fitness and wellness, and ten percent of these apps can collect data from a device or sensor. Since the Food and Drug Administration (FDA) only regulates medical devices and most of these applications are not medical devices, they do not require FDA approval. The data from most apps are outside HIPAA regulations because they do not share data with healthcare providers. "Patients may mistakenly assume that mobile apps are under the scope of HIPAA since the same data, such as heart rate, may be collected by an application that is accessible to their physician and covered by HIPAA, or on a mobile app that is not accessible to the physician and not covered by HIPAA.

Recent Attempts to improve HIPAA
In 2000, there was a new surge to add new regulations to HIPAA.

It included the following goals: to protect individual medical information by providing secure access and control of their own information, improving healthcare quality by creating a more trust between consumers and their healthcare providers and third party organizations, and improve the efficiency of the medical system through new rules and regulations put forth by the local governments, individuals, and organizations.

The implementation of these new goals was complicated by the change in administrations (Clinton to Bush), so it was difficult for the changes to be successfully implemented. HIPAA, in theory, should apply to all insurance companies, services, and organizations, yet there are exceptions to who actually qualifies under these categories.

Yet, within each category, there are specific restrictions that are different in every category. There are no universal laws that can be easily applied that are easy for organizations can follow. Thus, many states have neglected to implement these new policies. Additionally, there are new patient rights that call for better protection and disclosure of health information. However, like the new rules regarding insurance companies, the enforcement of the legislation is limited and not effective as they are too broad and complex. Therefore, it is difficult for many organizations to ensure the privacy of these people. Enforcing these new requirements also causes companies to spend many resources that they are not willing to use and enforce, which ultimately leads to further problems regarding the invasion of an individual's medical privacy.

Peer-review
PandaFantasy: Regarding the lead, I think the first section gives a great overview of the rest sections of this article. Although in terms of content, the lead clearly states the structure, which is really straightforward and comfortable to follow, the problem is that the style of the language is not the same as what I read in most wikipedia pages. What I find really amazing is that this article is rich in content for each section, even though it is supposed to be the first draft! Regarding the tone, most of the sentences are based on some reliable sources, and the balance of each part is good. As for the shortcoming of this article, personally speaking, the content should be condensed slightly, or be divided into different parts with corresponding subheadings. Another way to make it more convenient to go through is dividing the whole part of the section into three or four paragraphs logically, making it easier for readers to find the main idea of the section quickly. For example, take the "controversies of HIPAA" part, the content is unbiased and reliable, combining different opinions of different kinds of people, but I think it would be better if it contains three parts: one about the lack of strong medical protections in the law and the reasons; another one about the possible effects of this: the last is what the government has done and what should be improved. All in all, though not perfect, this article is abundant in content and has lots of advantages.

Mrzy732993: Nice Job! It's so impressive to see that you've already got so much work done in the first draft! I read through the draft very carefully, and it's hard for me to find out spelling or grammar mistakes (I helped corrected 3-4 small mistakes). Also, the language is neutral and easy to understand, so you did really well on interpreting the technical terms to the general readers. I particularly like your lead sections because it precisely covers everything in your outline and there is no redundant sentence. The references also look pretty good now. Try to start adding some hyperlinks next week! Although you haven't started working on all the sections, the balance of section length looks good for now. The sources all come from academic journals so I feel they're very reliable when I look through them!

One advice would that since the headings look a little confusing now, you can do some small adjustments. Like in your first draft, there are only the lead section and the "history of medical privacy" selection, but you actually have covered many other things, such as laws or relevant controversial, but now they are all under the "history of medical privacy" section. I think it's just a small problem with the use of headings and sub-headings, and it's very easy to fix that!

One thing I really want to learn from you is how you break a big topic into small sections. For example, in the law section, you created smaller sections regarding its definition, goals, effects, and limitations. This is a very good way to structure the article since the readers can easily follow. In general, very good job and keep going!

Angryflyingdolphins: The information provided is very informative and well elaborated on. The lead section is perfect as it gives a concise overview of what your article is about and will be very helpful in guiding readers through your article. The problems you article face is mostly formatting. I assume (maybe incorrectly) that you plan to add more to your section on recent efforts which. If you do end up adding more, I believe that it would warrant its own main section. HIPPAA is also a seemingly huge part of your article so I think that having an entire section dedicated to it would be helpful as well. In your Emergence of the Insurance System, you have a line that says "take advantage of individuals." That part may come off as slightly biased because it seems like you are passing judgement. You also need to clarify who a person is and what authority they have when you suddenly include a name in your article. It was a bit confusing when I came across names I never saw in any previous section. Without clarifying, readers may wonder who they are and why they should care about what they have to say if they don't hold a title that signifies that they can serve as a reliable source of information. There are also some wording issues throughout the article and they are most obvious in the first section regarding the history of medical privacy.

Overall, the article was very well put together. Despite some minor formatting issues, there was a nice flow throughout the article. Aside from that one line, the tone is unbiased and consistent and each topic as well as subtopic is fleshed out very well. Amazing work so far!

Rainbowdolph Peer Review: You're going to here this so many times but the lead section looks really good! I know you mentioned that you were already working off a page that exists so that might help but there is no bias here and the hyperlinks fit well. Is there a difference as to why under the Physician-Patient Relationships that you have HIPPAA and the US under it? I think it should be separate because they're not small enough to be together. Maybe if you have a section for HIPPAA and then a section for states in the US that are unique because those might be better separate and cleaner. I'm not sure about some diction like in the Connecticut Legislation I cannot tell if some of the words come off with a slightly more negative connotation or if I just read it and think that because it has a negative argument. Flow is well. I think maybe going back to the lead maybe mention a little small something about HIPPAA since it was really big maybe because it's the best example that the US has. Looking at your draft too, if it's big enough, I would say that the Discussion on Solutions should be an entirely new section because it's completely changing directions unlike the other sections and it is pretty large in itself. Overall, this looks really great!

Funfettiqueen Peer Review: The lead section perfectly sets the scene for the article while providing a clear definition, which is very helpful to the rest of the piece as a whole. However, I noticed right off the bat that the lead section is void of any citations. I know you are adding to an existing article, so I'm not quite sure if that was done by you or a previous writer. Regardless, I think it might be helpful to add in some citations. Additionally, I noticed that the sentence "Prior to the technological boom, many people relied on a paper medium to file their medical data; however, nowadays their information is stored within electronic databases" uses the indirect noun "their", which reads a bit off to me. It might be useful to use "individuals'" or "patients'" throughout the article to create a nice flow, since I know a lot of your sentences have to refer to general individuals. I also got a bit stumped while reading this sentence in regards to the verb tense: “would allow people to access to their medical information without fear of stolen information” because in subsequent sentences, you go back to past tense. I would probably just stick with the same tense and, if it already happened, change the sentence to "it allowed people to access...". In the History of Medical Privacy section, you start another paragraph in the section with "In response, there was a movement to create better medical privacy protection, but nothing has been officially passed." I think it might be more clear for readings if you clarify more specifically what it was in response to. Also, in the "Emergence of the Insurance System", it might be helpful to hyperlink insurance so that readers have a better idea of what insurance is and its implication on medical privacy. In that same section, one of your sentences reads, "In the nineteenth century, insurance policies were not as formal as they currently are, instead there was an ambivalent relationship between democratic institutions and civil policies." I think it might be more understandable to split this up into two sections, such as "In the nineteenth century, insurance policies were not as formal as they currently are. During that time period, there was an...". The sentences following also don't have a ton of citations, so that might be useful to add in. Additionally, when reading the PCMS section, I was a tad confused since I am not sure what PCMS is and there was not a definition, so it could be helpful to readers to include that! For the EMR part as well, it could be nice to hyperlink EMR as well and provide a quick definition at the beginning of the paragraph so that the rest of the section has more context. While reading your Third Party Issues, I think it would be helpful to check out my article, since third party issues in regards to health records are a big use case regarding blockchain! In the section "Recent efforts to protect health information, the sentence "These exceptions have caused an alarming amount of gaps within privacy measures" is a bit out of context; it would be beneficial to maybe have an explanation and citation about this. The sentence “Ultimately, there is still an issue on how to ensure privacy securities; so, the government has created new regulations that makes trade offs between an individual's privacy and public benefit" reads a bit casually. Maybe swap out "so" for something like "in response", or something like that. I was also pretty confused while reading the sentence "any information that contain information that is unique to the individual". I think its just a redundancy issue, so maybe reword it to fit more so with what you were hoping to get across. Lastly, for the "Traditional beliefs" section, maybe extrapolate on what people are scared of. Are they scared that doctors will share information that patient's discuss with them? Share it with who? Has this happened in the past? Lastly, I know someone else commented on this, but it could be nice to give HIPAA its own section, since it seems like a whole discussion separate from effects changing medical laws. Your content is so good and clear, so that's why I focused more on grammatical structure! Great work.

Angryflyingdolphins Peer Review (Week 10):

Lead section: Your lead section serves as a great start to your article. You do a wonderful job with defining important terms in a concise manner and you give readers a great overview of what you plan to discuss in your article. However, the last sentence seems out of place. It may be better if you move it up towards the beginning of the second paragraph when you are listing countries.

History of medical privacy: You should remove the "however" in the second sentence since you're trying to show chronological development instead of a comparison. Also, "data bases" should be put together as one word: "databases." As a suggestion, the sentence " The Medical Information Bureau was thus created to prevent insurance fraud, yet it has since become a significant source of medical information..." could be reworded as "Although the Medical Information Bureau was created to prevent insurance fraud as a result of lacking privacy protection, it has since become a significant source of medical information..." because it seem that you're trying to build off the previous sentence but it seems disconnected. The last two sentence in the Emergence of the Insurance System subsection seem a bit redundant so they could be combined to say: "Since then, the government has had the role of enforcing these roles within society through regulations that protect individual information and data." In the second paragraph of your PCMS, subsection, your start off with the word "yet." It may just be me being nit-picky but it seems a bitt odd to start a paragraph that way. You could maybe reword it as: "PCMS has also led to social and ethical..." In the EMR subsection, you should delete "yet" in the " Hospitals are willing to adopt this type of filing system, yet only if they are able to..." sentence. With the Third Party Issues subsection, you could reword the sentence: "Within the United States, in order to define clear privacy laws regarding medical privacy, Title 17 thoroughly explains..." to say: "In order to define clear privacy laws regarding medical privacy, Title 17 of the United States code thoroughly explains..." Also, the word "our" in the last sentence of the same sentence should be changed to something like "people's" because "our" seems a bit too close to your point of view.

Effects of changing medical privacy laws: In the first sentence of the Physician-Patient subsection, the word "confidential" could be moved up before the word "financial" so it doesn't seem like financial information is public information. The word "yet" can also exchanged with "when" in the sentence: "With the Internet, patients are able to ask for medical advice and treatment, yet issues regarding confidentiality and legal issues come up." I feel like you should also delete the "see: HIPAA" template under your United States title since you go on to discuss state level laws after a short intro to HIPAA. If you move up the entire section you have on HIPAA before the state laws then the template may still be fitting. This may again be nit-picky, but the titles you have for the state laws are not uniform. This is a possibility that that would confuse readers. You could chance the titles so say "legislation" or "-specific laws." Also, as Tommytheprius pointed out to me, the titles in Wikipedia should only have the first letter capitalized unless it's the name of something. In your HIPAA and Hurricane Katrina subsection, the paragraphs should be reordered to primarily reflect Hurricane Katrina first. You discuss information protection of the HIPAA immediately after the title which may confuse some readers as they might wonder if the section actually deals with the topic of the hurricane.

Overall, your article is very well developed. You did a great job of putting together an abundance of information and made it interesting throughout. The only problems found throughout your article are minor wording and formatting issues. Aside from all that, this is a great article! Great work!

PandaFantasy Peer Review (WEEK 9):
It is really amazing that you have written a lot so far! And I think it is almost done, since there are many advantages in the Medical Privacy Draft. Still, I think you can make small improvements in some sections:

The lead section:
The lead section is brief and provides a good definition of "Medical privacy", and the following sentences briefly explain the main idea of the article, which helps the audiences learn about the structure of it. Personally speaking,


 * Since HIPAA is a major part of this article, I think you can add a sentence to introduce this in the end of the lead section following the last sentence of the second paragraph.
 * After reading the sentence of "However, many of these laws have proven to be less effective in practice than in theory", I felt quite disappointed at the laws before I read more detained information about these laws. It seems to be biased or illogical to me; therefore, I think it would be wise if the evaluation of these laws is neutral. Or maybe you can just cite some scholars' words directly to show the unbiased image of laws in the following sections at the beginning of this article (Just like this article Internet privacy).

The history section:
I think the history of medical privacy is absolutely informative and well divided into several smaller parts. The contents is evenly balanced in each small parts, and I can barely find any grammatical errors. Besides, it is really comfortable to read the evolution of technologies related with medical privacy, such as paper medium, insurance system, PCMS and EMR. The small problems I found are as follows:


 * The evolution of different technologies are listed independently, even though I assume that they are in chronological order. I would suggest in the part before "Emergence of Insurance System", one more paragraph be added to emphasis the evolution history and the relationship between each new technology.
 * I see the "original page" as a copy from other articles, so I suggest that to introduce EHRs, it is not necessary to write down all the information that already exists in other articles. Instead, it is better to just provide a link (For example: see also xxxxxx).
 * It seems that there are only two main sections in this article, and the contents in this section looks lengthy, so I think you can just put "Third party issues" & "Recent Efforts to protect health information" aside to form another section called "Related issues and Efforts". Maybe this new section should be put after the laws section because HIPAA is mentioned before you introduce it in the "Health Insurance Portability and Accountability Act of 1996".

The laws section:
This section is also quite informative and well organized. Firstly, it talks about the relationships between physicians and patients, then look for the deeper reasons. Later it mainly focus on the laws and corresponding effects. From where I stand, the shortcomings can be:


 * Even though many sentences are based on citations, some I found is a bit groundless ,like "Many research and pharmaceutical companies showed opposition because they were worried about conflicts that might arise regarding privacy issues within their work". Maybe more citations are needed.
 * For some sentences that are not followed with citation, I suggest that remove the logical relation and just list the apparent facts. For example, in this sentence "Additionally, the use of email between physicians and their patients will continue to grow because of the increasing use of the Internet.", the casual relationship between the growth use of email and the increasing use of Internet is apparent. But I think it can be changed into "Additionally, the use of email between physicians and their patients continues to grow with increasing use of the Internet", which is unbiased and straightforward.
 * To be more accurate, it is wise to revise some sentence with extreme opinions such as "The most comprehensive law passed is the Health Insurance Portability and Accountability Act of 1996 (HIPAA)". Instead, I would say "One of the most comprehensive law", making the sentence more precise and not that extreme.

Other aspect:
I think there are many hyperlinks and citations already, so good job! What I find to improve is to add the so called "See Also" section to your article. Besides, I find that despite the amazing length of this article, few sentences are biased. All the problems are detected through a magnifying glass (just joking). In addition, although I am not sure about how, but I suggest the sub-headings be even more brief. In fact, this is one of the problems in my own article, so I just mention it here.

Overall, the draft is absolutely wonderful. Looking forward to look through your article in the main pages of wikipedia！