Your Privacy and Offshore Outsourcing

An anonymous reader sends in a link to this story about medical transcription work and patient privacy. You probably recall the original story (from around October 2003), but the Chronicle here does a great job of tracing the entire chain of sub-sub-sub-sub-sub-contracting.

Comments

Re:Transcriptionist

[Ateryx]

All docters should have their computers transcribe their dictations like my father does.

From your comment, I hope your father does as well... a few letters can make a huge difference in what drug is given/how much drug is given. Especially if the pharmacist just blindly fills the perscription. (For more info please see: "High Malpractice Insurance")

*sigh*

[TheCabal]

I work in a similar industry, handling patient claims information. This story has been circulating around for a while. What really grabbed my attention from this article was the statement of Transcribe Stat's owner.

"After 23 years in business, it took just one little e-mail to ruin me."

And there it is. These are the things that keep me up at night, watching firewalls logs and everything else that keeps me from getting a good night's sleep.

contactors must be held responsible

[fermion]

The problem really is that subcontracting is meant to pass responsibility to another party. The person who contracts the work, as is the case woth, for example, Walmart or Nike, is allowed to feign ignorance and tends to be resolved of all responsibility. This situation, of course, gets worse as you move down the chain of subcontractors. It is a situation in which contractors are taking money for doing little more than taking a cut for mailing some paper.

The truly scary part is that the US government is trying to outsource everything as well. This includes the IRS, which means that your personal tax information is going to be in hands of some work-at-home person making $1 per transaction filed, stored on the computers on some half-assed system administrator. The original contractors will have no responsibility as the contracts will be written to require minimal due diligence and almost no penalties for infractions.

This of course has been defended as completely consistent with all current privacy laws. In addition, the somewhat friendly people at the IRS, a result of new regulations that resulted from the friends-or-Reagan audits, will be replace with the same people who call during diner asking you to buy their product, or yelling at your children because their parents did not pay a bill.

Re:Transcriptionist

[thedillybar]

Seriously, I haven't seen any natural-language software reach the point where I would trust it with medical information.

Would you rather have it outsourced to someone overseas who your doctor met on the Internet? That more-or-less happened here. The person can't be held responsible.

US authorities would have a hell of a time finding them, and, if they did, there's not much they could do anyway. Do you still think this person is more reliabile than computer software? I don't think either is reliable enough.

Re:Rather have it offshore

[rodgerd]

And you could then have her dealt with under US law. What's the US going to do to get the Indian? Invade? Shit, most of your Army's tied up in a country with 20 million people and no WMDs; the Pentagon isn't going to go after a nuclear power for the sake of your medical records.

Separate medical data from patients?

[fembots]

Wouldn't it make sense to separate data from patients? This is like Database Design 101.

So patient medical records can be transcribed by anyone without leaking the identities, and the patient details are held in another database.

So if someone wants to post a medical record, it can only go as far as "Patient DFA12435 has xxx, HA! HA!".

She is lying.

[SmallFurryCreature]

What it took to ruin her was her own greed. She was hired to do the transcribing. But instead of hiring her own people, checking those people, checking their work she outsourced it to a lower bidder.

This has nothing to do with countries and law this has to do with your privacy being handled by the lowest bidder.

Each step in the chain shows someone wanting lots of money for not doing anything. If hospitals and others were serious they would do the transcribing in house. But of course that is no longer allowed. Focus on your core capabilities has become the watch word. So that a place like a hospital is now really a meeting hall for outsourcing companies. From temp nurses to cleaners, from caterers to office staff. No one works for the hospital, they all work for the lowest bidder.

Neat eh? And the funny thing is? Medical bills only seem to go up. Why am I paying more insurance when all this cost saving is going on?

Why?

[SmallFurryCreature]

She was payed to transcribe. Instead she outsourced. She got paid to keep records confidential, she didn't instead going with the lowest bidder to maximize her profits. No doubt offering the lowest bid herself making other respectable companies loose out on the contract.

No this whole story is one of greed and it starts right at the patients. After all they want low low insurance and medical bills. So the hospital saves by outsourcing instead of doing it in house. The outsourced company outsources again instead of doing it in house and so on.

Feeling sympathy here is misplaced. Each and everyone involved, including the patients, is a victim of their greed.

Maybe I am just a cynical bastard.

This is insightfull?

[SmallFurryCreature]

This story is about doctors SPOKEN notes being put in writing. The doctor is supposed to do database abstraction while doing surgery? I know doctors are not the dumbest people, although their blunder kill thousands each year, but that might just be a little bit diffiult.

Seperarting database records like you suggest is indeed possible. You could easily seperate a patients credit history from their medical history. Doctor don't need to know payment details and the collectors don't need to know medical details.

But in this case that is impossible. Medical details do belong with the name.