WHAT IT’S ABOUT
Is medicine’s greatest breakthrough also the world’s most efficient killing machine?
After a decade of development, Drexel Hospital’s cutting-edge Electronic Health Records system is about to become the national standard and revolutionize health care. Housing the real-time medical records of every American, the EHR system will enable doctors to access records with a keystroke and issue life-or-death medical orders with a finger swipe.
No one wants the EHR to succeed more than Hugh Torrence, a former NSA honcho who sees the system as a tool for unimaginable and unaccountable power. The only thing standing in his way is a loose-knit group of Drexel employees with conflicting agendas and questionable loyalties—including Dr. Mason Fischer, a physician with a taste for intrigue and a shadowy past; a street-wise techie named RT; and an internal medicine resident, Dr. Carrie Mumsford, the daughter of the hospital’s president.
While they search for answers, the suspicious patient deaths keep mounting as the target on their back grows larger.
- Publisher : Post Hill Press
- Pub Date : June 23, 2023
- Hardcover : 318 pages
Coded to Kill by Marschall Runge M.D. is a techno-medical thriller that explores the idea of a single system housing all Electronic Health Records (EHRs) for every American. While this idea may seem revolutionary and efficient, it begs the question of whether it could lead to abuse and misuse.
The use of technology in healthcare is becoming increasingly prevalent, and it’s important to consider the potential benefits and drawbacks that come with it. On one hand, technology can improve efficiency, accuracy, and access to healthcare services. For example, telemedicine allows patients to receive medical care remotely, which can be especially helpful for those in rural or remote areas. On the other hand, technology can also raise concerns about privacy, security, and the potential for errors or glitches in the system. It is important for healthcare providers to carefully weigh the benefits and risks of implementing new technologies and to ensure that patient safety and privacy are always the top priority.
Dr. Marschall Runge brings a thought-provoking twist to this fictional story. While EHRs could potentially improve healthcare efficiency and accuracy, it also raises red flags for security and ethical concerns. Who would have access to the system, and how would they be monitored to prevent abuse? What happens in the event of a security breach or a glitch in the system?
Suspicious patient deaths add an extra layer of suspense to this thriller.
My Concerns
Some aspects of the book may be distracting. The inner dialogue of each character is written in italics, which may take some getting used to.
Additionally, the dialogue didn’t always feel natural.
Final Thoughts
Despite my concerns, the intriguing plot makes this worth a read for fans of medical thrillers and technology. And though the book didn’t always feel on par with those of other authors, the longer I read, the more it grabbed my attention and pulled me in.
My thanks to the author, publisher, and Books Forward for a gifted copy.
ABOUT THE AUTHOR
Including Author Interview
MARSCHALL RUNGE, MD, PhD, is the executive vice president for Medical Affairs at the University of Michigan, dean of the Medical School, and CEO of Michigan Medicine. He earned his doctorate in molecular biology at Vanderbilt University and his medical degree from Johns Hopkins School of Medicine, where he also completed a residency in internal medicine. He was a cardiology fellow at the Massachusetts General Hospital. He is the author of over 250 publications and holds five patents for novel approaches to health care. As a Texas native who spent fifteen years in North Carolina and an avid thriller reader, Runge has experienced so many you-can’t-make-this-up events that his transition to fiction was inevitable.
INTERVIEW
1. Where did the idea for “Coded to Kill” originate from?
Two words: aggravation and imagination. Like many physicians – I’m a cardiologist – I found the transition to electronic health records (EHRs) to be problematic because they increased our paperwork and diverted attention from patients. As a hospital administrator, I learned more about the power of EHRs – they do improve communication between healthcare providers and make previously illegible notes now legible. But there is little evidence that, overall, EHRs have reduced medical errors, which was their promise. And protected health information (PHI), which previously had to be obtained in written medical records, is now on-line and accessible both to all who have access to these records, as well as to nefarious characters cruising the internet for private information. With these ideas swirling in my mind, and having read too many thrillers, it occurred to me that a novel hinged on the promise and perils of emerging medical technologies would be a fun and effective way to share my concerns with the public.
2. What are your thoughts on recent ransomware attacks on hospitals and how does this phenomenon relate to “Coded to Kill”?
Ransomware attacks – where hackers steal or take control of vital systems and information – are a growing threat to public safety and health. Hospitals are an especially attractive target because we must maintain highly detailed and organized information on those we care far and because our work truly involves life and death stakes. Though the potential risks of online medical records are heightened in “Coded To Kill,” it is important that everyone who uses EHRs and/or have their information contained in them understand their vulnerabilities. In “Coded to Kill,” the action of my “heroes” provide a realistic hope that we can fight back.
3. How should the medical industry approach privacy concerns?
Hospitals have a sacred duty to safeguard Protected Health Information (PHI) even as we face challenges not just from malevolent hackers, but, ironically, from our own decision to improve patient care (and generate revenue). “Data aggregators” like Google offer tens of millions of dollars for access to large medical record databases and high quality information that can be used to devise new diagnostic tools and treatments. “Coded To Kill” illustrates a reality – that some of these arrangements become deals with the devil as “anonymous” patient records can, in some circumstances, be de-anonymized. I am proud to say that Michigan Medicine has become a leader in implementing programs to thoroughly evaluate and vet these requests.
4. In the medical field, do the pros of technological advancements outweigh the cons? Is there a clear path for mitigating the negative effects of progress?
I am convinced that medicine is on the edge of a golden age of innovation that will deliver lifesaving and life-enhancing results to patients around the world. Technological advances are already resulting in amazing therapies and many diseases that were untreatable when I began my career four decades ago can now be cured. A major problem, which “Coded To Kill” illustrates, is that technology can also be hijacked by bad actors. These vast changes also create another problem: the opportunity of fraudsters such as Elizabeth Holmes and Theranos to exploit this hope to peddle high-tech versions of snake oil that hurt those who need help.
5. In your opinion, does the future of medicine involve AI?
Absolutely. Generative AI and deep machine learning are already providing amazing advances in drug discovery, diagnosis and prevention. When I began my career, it took months or even years for advanced medicinal chemists to identify a small number of compounds they could modify and test to inhibit key disease pathways. Just within the last year, AI/ML algorithms have been developed that can generate more than one million new structures a day. But, like the advanced EHR featured in “Coded To Kill,” we never forget that machines are tools that must be used and controlled by human beings, who possess a conscience and morals. We are the secret sauce of innovation.
6. What’s next for you?
My experience writing “Coded To Kill” has convinced me that novels provide a great opportunity to bring important medical issues to life – to start meaningful conversations with the people we care for. I am working on a second novel that revolves around an extraordinary investigator using AI to discover secrets that seem to reverse aging. But shortcuts were taken, data was faked, and terrible outcomes in an illicit clinical trial involving prisoners were suppressed…. you get the picture. As with “Coded to Kill,” I will use real-life examples as a starting place for each of these themes.
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