Your Privacy and Offshore Outsourcing 236
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.
why do i care (Score:2, Funny)
Rather have it offshore (Score:4, Informative)
Re:Rather have it offshore (Score:4, Insightful)
Well, if this person decided to publish the record on the web and do Google bombing to crank up the search on certain keywords, it would come worse than your gossipy old cow....
Re:Rather have it offshore (Score:2)
This is some guy overseas. No one knows who he is. Not even the hospital hiring him to do the work. That's not exactly what I would call credible.
He could post his data right now, but who is going to believe him? Not me.
Re:Rather have it offshore (Score:5, Insightful)
Re:Rather have it offshore (Score:2)
Do they have oil ?
Re:Rather have it offshore (Score:3, Interesting)
How long before they'd be attacked as a non-taffic barrier under NAFTA or WTO rules?
the point to be made here (Score:5, Interesting)
Does anyone have a free-market solution to this? I would hate to see Democrats legislate this to hell. IMHO overlegislation will solve 1 problem but cause another...
But while the above point is interesting, it's somewhat irrelevant to this case: the breach of contract occured in the US:
Basically, while the article brings up the interesting concept of what offshoring information can do, this particular case of offshoring is really not the greatest example, since the breach of contract occured in the US. And yet we have sensationalist newspapers like the Chronicle and opportunistic politicians who call themselves privacy advocates; the current state of affairs is fucked. The comment leads me to believe that he didn't even RTFA:
Re:the point to be made here (Score:2, Insightful)
Can we bash Pakistan instead?
Re:the point to be made here (Score:3, Funny)
Go a little bit farther north and we can say that the terrorists did it in their Afghan training camps.
No doubt Katz (were he still with us) would tell us about Abdul Komodor who uploads full length movies of patients' records to the internet from his Commodore 64.
Re:the point to be made here (Score:5, Interesting)
Which is the real point of outsourcing I think. The advantage of cheaper labor is something of a smokescreen. I think it's popularity stems from the diffusion of responsability, and the complications of getting information, and enforcing practices in other countries.
She can go in an say, but I didn't know. I was swamped with work, people deserve to have this thing done, Tom was highly recommended and trustworthy, I can't be blamed for holding information hostage! I'm a good person I never have and never would do that. This other sort of innocuous thing is my fault, and I am SOOOO SORRY.
If we put in a type of liability where the ends don't justify the means, but the means are responsible for the whole end, at every point of failure that by passed the normal protections like bankruptcy and incorporation, it would probably stop, with all business in the US.
Re:the point to be made here (Score:3, Interesting)
Re:the point to be made here (Score:5, Interesting)
Yes, simply make the US companies (and government departments) truely responsible (ie their ass is on the line) for protecting this information. If the cost of failure is higher than other savings, then they themselves will implement strict requirements, and will only want to contract out to groups who have proven themselves to be trustworthy.
Re:the point to be made here (Score:2)
I do believe that HIPAA [hhs.gov] is already in place to provide for this "cost of failure." And I do think that UCSF and its immediate contractor handled the situation profe
Re:the point to be made here (Score:5, Informative)
QUESTION: To what extent does the HIPAA Privacy Rule (the "Privacy Rule") govern contracts with foreign contractors and subcontractors?
ANSWER: Contractors and subcontractors, whether foreign or domestic, are generally not directly covered by the Privacy Rule. However, the business associate agreement requirements imposed on covered entities with respect to their business associates will usually apply. The Privacy Rule (as we all know by now) applies to covered entities, i.e., health plans, clearinghouses, and providers who transmit health information in electronic form in connection with a HIPAA covered transaction. A covered entity is permitted to disclose PHI to a business associate if the covered entity obtains satisfactory assurances in the form of a written contract or agreement that the business associate will "appropriately safeguard" the information.
The Privacy Rule describes two different scenarios in which a HIPAA-related business association may arise. First, when the right to use, disclose, create, or obtain PHI is delegated to a third party for use on behalf of the covered entity. Second, where a third party provides certain specified services to a covered entity and the provision of those services involves the disclosure of PHI by the covered entity to such third party. The specified services are legal, actuarial, accounting, consulting, management, administrative, accreditation, data aggregation, and financial services. It is important to note that each and every relationship between a covered entity and a third party does not constitute a business association that gives rise to the requirement for a business associate agreement as set forth under the Privacy Rule.
By executing a business associate agreement, a business associate contractually obligates itself to protect the PHI and to not use or further disclose the PHI other than as permitted or required under the agreement or as required by law (American). The Privacy Rule includes required components for a business associate agreement. One of these provisions is the requirement that any agents or subcontractors of the business associate must agree to the same restrictions and conditions agreed to by the business associate.
Enforcement of such agreements is a frequently voiced concern when the business associate or subcontractor is in a foreign country. Under the Privacy Rule, the US Department of Health and Human Services only has enforcement authority over covered entities (unless a business associate happens to also be a covered entity). Furthermore, while a business associate or subcontractor must contractually agree to protect PHI and comply with the Privacy Rule to the same extent as the covered entity, the problem with these types of arrangements arises if the foreign business associate breaches the agreement. Depending on the legal system of the foreign country, which may range from comparable to that of the United States to non-existent, the covered entity may well have difficulty enforcing such an agreement in foreign courts. Even if the business associate agreement requires US law to apply and provides that all disputes be settled in US courts, if the contractor is situated in another country and has no property or contacts in the US, such a provision will offer small comfort.
Under the Privacy Rule, covered entities are required to mitigate any harmful effects of a wrongful use or disclosure of PHI by the covered entity or its business associates. And although covered entities must terminate business associate agreements when they "know" of a pattern of activity which is a material violation of the agreement and are unable to cure it, the Privacy Rule does not require covered entities to monitor the activities of their business associates. In spite of this seeming protection, as a practical matter, it is likely that patients who have been damaged by a business associate's breach of an agreement will seek compe
Re:the point to be made here (Score:3, Insightful)
Nor will they be, until you can ante up a few million in bribes. Sorry, donations.
Re:the point to be made here (Score:2)
Sometimes hitting the greedy fuckers where it counts most is the only recourse.
As Long as the system favors the rich so much people will try to get rich any way possible. Just because your on your moral high horse doesnt mean that XYZ person shouldnt be allowed to sue for X million.
What if your father was the only provider in your family, and your mother needs medical atten
The free market solution (Score:5, Interesting)
If people perceive the offshoring to give some privacy risk then they will perhaps be prepared to pay an extra $5 or $10 or whatever each month to a service that guarantees your case will be handled by an American. Alternatively, a company that advertises that they guarantee American processing will get a competitive advantage over their offshoring competition.
It seems hypocracy to me that those that bitch about losing their jobs to India don't seem to mind wearing Nikes made in Philipines and having Korean RAM in their PCs.
Free market means paying for things you value, not just bitching about things.
Re:The free market solution (Score:5, Interesting)
Interesting. I see a business opportunity.
Perhaps the next time you go to UCSF Medical Center, you can fill out a check box saying:
I think that would be kind of cool. simple and elegant.
Re:The free market solution (Score:3, Interesting)
Oh well, I am sure there some people out there that match the stereotype you gave, but I wanted to make sure people knew there were also some who don't.
Re:The free market solution (Score:3, Insightful)
I think the theory says that if there is a perceived profit to be made in providing a service then it will come into existence. A small but telling difference.
Services exist because someone offers them in the hope of making a profit. Advertising exists to ensure people understand they have a need for the service.
If people perceive the offshoring to give some privacy risk then they will perhaps be
Re:the point to be made here (Score:2)
Couldn't agree more. The whole "outsourcing to India" debate is a straw man. Protectionist legislation has a history, and it's not pretty [slashdot.org].
The real issue is that the US economy has been in decline for a number of years, particularly in the overheated IT sector. This seems to be changing now but that does not seem to stop otherwise intelligent
Re:the point to be made here (Score:3, Insightful)
China is, on the other hand, doing very well. However, they've also been moving strongly towards a free market economy. For example, they recently joined the WTO.
Historically, the countries that have embraced free trade (France, Great Britain, Germany, United States) have done better than those who have not. Indeed, if you study economic patterns in western Eu
Re:the point to be made here (Score:5, Interesting)
Most countries go through an extended mercantilist period during their early mass industrialization. During that period, wages in the industrializing country are typically quite low becuase the coutry's currency is artificially depressed. During that period, the country's industrial production skyrockets. Since consumers in the country buy their own products with their own currency, the irrational pricing structure of their industry's exports doesn't affect them, and they act as an internal gate which forces the quality of their exports up.
Eventually, however, growth leads to major industries being unable to provide for their own production with local acquired raw materials. At that point, prices of locally produced products start to reflect the relative level of the currency: foreign raw materials must be bought in foreign currency, which raises the prices of the finished goods into which they are made. That triggers a sharp round of inflation, which leads to a more restrictive currency policy. The price difference between finished good produced in country and those produced abroad gradually shrinks, due to this pressure.
To see this pattern in action, you can go back to Japan in the fifties through the eighties, S. Korea since the eighties, and India now. Alternatively, you can go back to the United State in the late nineteenth century, or to the great European powers in the early nineteenth century.
Europe and the United States managed to extend the period during which they could pursue a mercantilist policy somewhat longer by maintaining a captive market to which finished goods could be exported and from which raw materials could be imported in the local currency. The European powers did this by maintaining colonial markets in Asia, Africa, and, to a lesser extent, the Americas. The Americans settled our West, which became a huge source of raw materials for our East coast industries. The captive markets allowed the industrial base to continue to acquire raw materials at a disproportionately low price.
Schumpeterian equilibrium may well apply to an economy which is dependent on a influx of externally produced raw materials balanced by an egress of internally produced finished goods. That's not the case for economies in their earlier stages of industrialization and development. I don't know how long it will take for India to reach that state, but given the combination of destitution and size of her population, I wouldn't be inclined to expect her government to adopt less mercantilist policies any time soon. It's not rational to do so.
Re:the point to be made here (Score:2)
I don't know, but "China doing very well" might be 'rushing' to conclusions - or a matter of perspective. Saw this article [bbc.co.uk] recently.
Rural China - i.e. the bulk of it - is (at some places literally) dirt-poor.
Agreed, trade begets economic power and, as stated in the article, the Chinese people are surely much better off than during the "Cultural revolution". I'm just saying it (like India) is a very large country. A Free market economy will very likely continue to strenghten China, but perhaps more clear
Re:the point to be made here (Score:2)
Of course, you might have to read a bit more widely to reach that understanding
Re:the point to be made here (Score:2)
It must be noted, however, that one of the prime reasons Britain was able to establish such an empire in the first place was that it embraced elements of a modern, free-market economy sooner than the other countries in Europe.
Re:the point to be made here (Score:2)
Finally I would dispute "MUCH" and
Re:the point to be made here (Score:2)
Now, there is a very good free-market solution to this: Do nothing. If people care about their privacy, they will make sure to deal only with companies that put measures in place to protect it. If people do not care about their privacy (and it appears to be the case that they do n
Re:the point to be made here (Score:2)
Unfortunately, people can not be trusted to always look out for their privacy, just like an AOL use
Re:the point to be made here (Score:3, Interesting)
There are situations where the government should intervene to protect the population. The vast majority of these cases are:
- Where one person's failure affects everyone. For example, automotive regulations exist because if you crash your car, you could hurt other people. Laws against smoking in c
Re:the point to be made here (Score:2)
Exactly. In fact India does have a well developed legal system. I am sure that, like all legal systems, it has its flaws, corruption, etc. but it does exist and can be used.
So perhaps if the outsourcing had been done properly, with the appropriate contracts and to someone in India (where, as a long-standing democracy I would put more faith in the judicial system than in Pakistan), th
Re:the point to be made here (Score:3, Insightful)
No news (Score:5, Interesting)
You speak. Human transcribes. Computer learns. Human error checks... eventually the computer is good enough that the human is not needed at all.
We are using this system now. It, of course, sucks compared to a real transciptionist... but it is 10 times cheaper.
Davak
Re:No news (Score:2)
Are you sure it's cheaper than a real, trained transcriptionist--in California or India?
Consider the cost of labor to get the doctor to look over all of his transcriptions. Si
Re:No news (Score:2)
A special purpose dictation system can do as well as a human who has no direct interest in the result, overlooked by someone who has a direct interest in correct results is going to do a lot better. The inmediate availability and very little administration efford often outweight the little extra time spent on reading and correcting on the fly.
Re:No news (Score:3, Informative)
We ended up getting the portable digital transcription system (4 recorders, foot pedal, and software) from the same company. It was cheaper to pay the transcriptionist than the software, and we now have a
HIPPA Violation ? (Score:2)
HIPPA [hhs.gov] carries some hefty fines is this was in fact a violation.
Re:HIPPA Violation ? (Score:2, Informative)
Re:HIPPA Violation ? (Score:2)
Re:HIPPA Violation ? (Score:3, Interesting)
The question is not if this is a HIPPA violation... which it clearly is. But is it a violation of US law at all?
If the presidental candidates want to win over the working class, make companies that send jobs overseas follow the same rules we do. Pay taxes, not pollute, no child labor, and even HIPPA -- why should they get to drop the US rules just because they cross the border?
If I get a ticket in Texas, points s
Re:HIPPA Violation ? (Score:3, Interesting)
Re:HIPPA Violation ? (Score:2)
Re:HIPPA Violation ? (Score:5, Informative)
Re:HIPPA Violation ? (Score:2)
IANAL, but surely the hospital is responsible for the privacy of patients regardless of which party leaked the information?
this lawyer [slashdot.org] seems to have it down in plain English:
Re:HIPPA Violation ? (Score:2)
Yes it is.. (Score:3, Informative)
Weaker standards? (Score:4, Insightful)
I don't actually need privacy.... (Score:3, Funny)
And no I was never a football tight end.
Blackmail (Score:5, Funny)
"You've got (black)mail!"
*sigh* (Score:5, Insightful)
"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.
Re:*sigh* (Score:3, Insightful)
Interesting. Looks like we just found the free market solution
Why? (Score:5, Insightful)
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.
Those are the risks of outsourcing... (Score:3, Insightful)
Re:*sigh* (Score:2)
Re:*sigh* (Score:2)
Re:*sigh* (Score:2)
The real lesson here is that maybe she shouldn't outsource at all. They lost control of the data and it came back to bite her on the ass.
She is lying. (Score:5, Insightful)
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?
contactors must be held responsible (Score:5, Insightful)
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:contactors must be held responsible (Score:3, Informative)
HIPAA (Score:5, Informative)
QUESTION: To what extent does the HIPAA Privacy Rule (the "Privacy Rule") govern contracts with foreign contractors and subcontractors?
ANSWER: Contractors and subcontractors, whether foreign or domestic, are generally not directly covered by the Privacy Rule. However, the business associate agreement requirements imposed on covered entities with respect to their business associates will usually apply. The Privacy Rule (as we all know by now) applies to covered entities, i.e., health plans, clearinghouses, and providers who transmit health information in electronic form in connection with a HIPAA covered transaction. A covered entity is permitted to disclose PHI to a business associate if the covered entity obtains satisfactory assurances in the form of a written contract or agreement that the business associate will "appropriately safeguard" the information.
The Privacy Rule describes two different scenarios in which a HIPAA-related business association may arise. First, when the right to use, disclose, create, or obtain PHI is delegated to a third party for use on behalf of the covered entity. Second, where a third party provides certain specified services to a covered entity and the provision of those services involves the disclosure of PHI by the covered entity to such third party. The specified services are legal, actuarial, accounting, consulting, management, administrative, accreditation, data aggregation, and financial services. It is important to note that each and every relationship between a covered entity and a third party does not constitute a business association that gives rise to the requirement for a business associate agreement as set forth under the Privacy Rule.
By executing a business associate agreement, a business associate contractually obligates itself to protect the PHI and to not use or further disclose the PHI other than as permitted or required under the agreement or as required by law (American). The Privacy Rule includes required components for a business associate agreement. One of these provisions is the requirement that any agents or subcontractors of the business associate must agree to the same restrictions and conditions agreed to by the business associate.
Enforcement of such agreements is a frequently voiced concern when the business associate or subcontractor is in a foreign country. Under the Privacy Rule, the US Department of Health and Human Services only has enforcement authority over covered entities (unless a business associate happens to also be a covered entity). Furthermore, while a business associate or subcontractor must contractually agree to protect PHI and comply with the Privacy Rule to the same extent as the covered entity, the problem with these types of arrangements arises if the foreign business associate breaches the agreement. Depending on the legal system of the foreign country, which may range from comparable to that of the United States to non-existent, the covered entity may well have difficulty enforcing such an agreement in foreign courts. Even if the business associate agreement requires US law to apply and provides that all disputes be settled in US courts, if the contractor is situated in another country and has no property or contacts in the US, such a provision will offer small comfort.
Under the Privacy Rule, covered entities are required to mitigate any harmful effects of a wrongful use or disclosure of PHI by the covered entity or its business associates. And although covered entities must terminate business associate agreements when they "know" of a pattern of activity which is a material violation of the agreement and are unable to cure it, the Privacy Rule does not require covered entities to monitor the activities of their business associates. In spite of this seeming protection, as a practical matter, it is likely that patients who have been damaged by a business associate's breach of an agreement will seek compensation fr
Bottom Line ... Americans Don't Care (Score:5, Interesting)
As for the story, I work as a consultant in the Health IT arena, and have all too often seen private data mishandled. However standards are greatly improving in the US, but this is only due to the threat imposed by legislation and civil lawsuits. Will 3rd party companies overseas have the same incentive if they are outside of US jurisdiction? Probably not
In Europe... (Score:5, Informative)
In Europe this would have never ever happened: our laws are very strong regarding to personal data and privacy.
For instance, if a company here in Spain keeps customers data in a database, and the company wants to have that database hosted abroad (for example, for its website), in the USA, France, or any other country in the world, one person -with a name and a surname- of that company has to ask the Director of the Data Protection Agency [www.agpd.es] for a written permission to do so.
Break Privacy Laws and you'll face a monetary penalty from $600 to $600000
Re:In Europe... (Score:3, Interesting)
Because, of course, there aren't any greedy, immoral people in Europe.
This information didn't go out in boxes that customs can search, it was sent down a wire at the speed of light. It went off-shore against the law because someone decided to charge local rates then pay for some under-protected borderline-slave labour person to do it at a fraction of the cost.
The companies involved are dead, destroyed by this act of stupidity. Short of jail time (costly to s
Re:In Europe... (Score:3, Interesting)
I work for a German company where the personal data of German customers is 100% available to the customer support center in Singapore. There's nothing stopping a similar privacy leak happening to this European company.
Re:In Europe... (Score:2)
All that's good to hear, but it's the enforcement that counts.
$600? That's a common speeding ticket in the U.S. and would deter no one from doing anything here. Heck, it's almost like granting permission.
--Richard
An example (Score:2)
An example of the amounts:
An ISP (I won't say the name, this is an actual case) kept backup tapes in a cabinet. A good practice, isnt it?
One day, an employee forgot to keep some tapes inside the cabinet. Tapes were available to the employees, nobody else. Bad luck, that day was the inspection day (not announced, of course). Their punishment was $1000 per tape
Interesting update to the original story (Score:4, Insightful)
I'm trying to decide if Ms. Newburn is an out-and-out hypocrite, or just spectacularly inept at fraud. She apparently sends the work to Pakistan, ignoring any concerns about professional ethics, and creates "Tom Spires" to cover her posterior; then cries about how awful it is that American jobs are going overseas, once her house of cards comes crashing down. This situation really calls for the old question: "What the hell were you thinking?!"
Re:Interesting update to the original story (Score:3, Insightful)
She new that what she was doing was wrong. But greed pretty much overrided that.
I really think that a prosecutor somewhere needs to make an example of her.
Tape Storage (Score:3, Informative)
Granted yes, it takes efforts to dig it up. But still, the data is theorectically outsourced.
I warned people about this last year (Score:4, Insightful)
Let's see them prosecute identity theft in Bangladore. It's only a matter of time before people who make 3 dollars an hour start figuring out how to turn your financial data and credit card numbers into $$$$$.
Re:I warned people about this last year (Score:2, Insightful)
Pakistanis are known as backstabbers everywhere and if they don't change their habbits, that doesn't mean that all civilized nations India, Canada, Philippines, Mexico are like that.
From experience, Indian and Canadian governments, in particular, have very strict laws to protect any kind of security leaks.
Condoms for Data. (Score:5, Informative)
-You have the right to access any personal data any company/organisation holds on you, including the police (the police can be exempt in certain situations), government agencies, your school, shops etc and this can include video and internal memos about you and non-electronically stored data AFAIK
-You have the right to know who is holding what and what they intend to do with it
-It cant be taken outside the European Economic Area without your consent
-Security measures must be taken to ensure its safe
uhuh uhuh you know you want it yeah! come on! pah in-your-face like a can-of-mace!
Unfortunately... (Score:4, Informative)
Personal data may be taken out of the EU/EEA only if without prejudice to compliance with the national provisions adopted pursuant to the other provisions of this Directive, the third country in question ensures an adequate level of protection. (EU Personal Data Directive 95/46/EC, Article 25). See here [dataprivacy.ie] for whole Directive.
The United States is not a third country that the EU has determined to provide an adequate level of protection of personal data. However, if the individual companies or organizations in the US adhere to the Safe Harbor [export.gov] agreement, personal data may be transferred.
Unfortunately, it can ultimately be difficult to control that data once it gets to the US. A in Europe may determine that B in the US provides adequate protection via Safe Harbor. All is well, right? Not necessarily. What happens when B subcontracts to C, who subcontracts to D, who subcontracts to E, who subcontracts to F in country G where privacy laws don't exist? Yeah sure, there are rules, but if something were to happen, there would be more finger-pointing and "you weren't supposed to..." and the such, as opposed to taking on responsibility. But nonetheless, your personal data has been compromised. All the bickering in the world won't resolve that matter.
Separate medical data from patients? (Score:5, Insightful)
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!".
This is insightfull? (Score:5, Insightful)
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.
Re:Separate medical data from patients? (Score:2, Interesting)
Even without the patient identities, there are multiple ways to abuse such information, including selling it to drug companies as demographic data
The problem, as the article pointed out, is that the US laws cannot be used in most cases to control what people abroad do with the data. The solution there is to send out sensitive data only to established corporations, and not cheapen out to such an extent. Wipro or Infosys (two largest ours
Re:Separate medical data from patients? (Score:4, Interesting)
Where I work, we've looked at outsourcing our pathology transcription business. We decided against it, because we want to keep control of the entire process.
We keep our costs manageable by a fanatic concentration on efficiency and productivity. The process is as streamlined as it can be, and are constantly vigilant on how we can keep the process running smoothly.
We manage to stay profitable in a business that's as cutthroat as it gets. And we pay a decent salary (even by San Diego standards!) for good transcriptionists who can meet their accuracy and productivity standards.
insurance information (Score:4, Informative)
I know many of you work in the heatlh care business, and take HIPPA pretty seriously. I work in it myself, although in a tangential relationship and don't have to abide by HIPPA due to the nature of my facility.
However, my wife works in the insurance business; specifically, she evaluates claims made against her company for legitimacy. She has the ability to draw upon resources that will tell her any individual's medical history, public and private; she can relatively easily flaunt the protections of HIPPA, although she can't reveal that she knows more about your medical condition than you do. She's not clear on how her resources can determine the things that they do, but it just shows the lie that to how much these protetctions provide.
Capital one (Score:5, Informative)
This isn't new, just new for you Americans... (Score:5, Interesting)
For several years now, some larger German companies used to offshore their customer data processing to the USA. Some claim this is also done because of the USA's less strict privacy laws that allow for far more data profiling than allowed in Germany. There is also growing concern in German media that it will be impossible to control such outsourced data and that there is no way to ensure that customer data will not be used by the American procesing company for other purposes or sold to third parties.
One such example was the Bahncard, a price rebate system for the national railway. For a few years, it came combined with a creditcard option and its data would be shared with an external partner of CitiBank US [tuwien.ac.at] for customer profiling, including a photograph, a full credit history and all payment data of the user.
Privacy Laws in the works in India.. (Score:3, Informative)
http://www.computerworld.com/managementtopics/out
http://www.computerweekly.com/articles/article.as
http://216.239.51.104/custom?q=cache:aGXMuwaC72YJ
Poorly hidden protectionism (Score:3, Insightful)
From the article:
Nonsense. Plenty of countries have perfectly good laws on privacy -- especially, the privacy of medical records. This is just an attempt to score some points with outsorcing-scared electorate without upsetting the pro-business part of it too much.
Even if so, as long as the original customer (the hospital in this case) is in US, the victims have someone to sue. It should be left up to the hospital to decide, not mandated by law. Sooner or later WTO will demand, California drops this law... And I'll support them.
Plenty of vitally important stuff is being made abroad -- medical equipment, cars, food. By this Senator's logic, we should not be importing any of it because "there is no remedy" in case the manufacturer screws up.
Re:Transcriptionist (Score:2)
Now, if your father has an automated computer system where he can just use checkboxes for the majority of his work -- then maybe.
But you can't tell me that a doctor spending hours each day listening to his own voice is more cost effective than just seeing a couple more patients and hiring somebody to do the transcription.
Davak
Re:Transcriptionist (Score:2)
One of the doctors in my family was using such a "checkbox" system but the clinic system (the largest processor of VA claims in the US) abandoned the pilot program, citing that well...it sucked.
Perhaps you have a suggestion for a better one? Or just a better system in general? Agreed, the human transcription system seems relatively inefficient.
Re:Transcriptionist (Score:2, Funny)
A medical wiki
Allowing diagnosis treatment charts to be followed, and a place to enter new symptoms and conditions effecting the decision.
Get the doctors insterested in a scheme and build up a huge medical database.
Peer review then sorts out the crappy answers from the useful.
Re:Transcriptionist (Score:3, Funny)
AskSlashdot / Your Health Online (http://medical.slashdot.org/)
Re:Transcriptionist (Score:5, Interesting)
Well, hope God helps you when you get "an a cute case of men in vaginas".
Seriously, I haven't seen any natural-language software reach the point where I would trust it with medical information. I would rather get the right treatment than someone fucking up my patient records...
Not to mention the cost of a doctor having to sit down and error-check afterwards, etc. If you look at a doctor making $100/hr (hey, they went to 7+ years of school, residency, internship, etc) that would add even more to the current cost of health care.
On an unrelated note, my uncle (who is a doctor), works in the ER. He says that because persons on Medicare don't pay for amublance rides, he sees people in the ER who have cuts on their fingers, minor abrasions, etc, who have their ambulance rides paid for by us, the public. And considering one of my friends got billed $1000+ for a recent ambulance ride, I think we're getting screwed.
Re:Transcriptionist (Score:5, Funny)
If I had such an affliction, I would argue that god had helped me.
Re:Transcriptionist (Score:5, Informative)
Re:Transcriptionist (Score:2, Informative)
local transcriptionists are not safe (Score:2)
So i would suggest you check your "local" transcription service to see who they are subcontracting to etc etc. that may just save your gluteus maximus
Suchetha
Re:Transcriptionist (Score:5, Interesting)
Actually, I used to write medical software that had an autotranscription component using Dragon's software, and given a medical dictionary to select from and a proper training cycle, it was incredibly effective. The physician or a designated individual still had to approve the report, but very rarely were there any problems with transcription (we tracked corrections through the system so we'd know how effective it was, and after a proper training cycle it was better than 96% effective.)
on the subject of the cost of healthcare, doctors using our system loved it specifically because it allowed them to accomplish more work (for a lot of reasons, not just the Dragon software) in the same period of time, which helped the hospital keep costs down. Did that drive down medical costs for everyone? of course not--but not because things were more expensive. Face it, people are greedy. Insurance companies never cut rates, nor do doctors start working for less money. hospitals won't start charging appropriate costs back to the patients until they're forced to through legislation (which should be accompanied by a national healthcare system or a system to provide insurance coverage to the 40 million of us without it, to keep hospitals in business.)
Re:Transcriptionist (Score:5, Insightful)
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:Transcriptionist (Score:3, Interesting)
Are you saying doctors don't proofread their dictation? I agree leaving it to computers is bad, but a low-paid transcriptionist (who might not even speak english) doesn't sound real great either.
The Doctors' Union (AMA) restricting medical school availability and enrollment doesn't hurt either.
Re:Transcriptionist (Score:5, Insightful)
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")
Re:Transcriptionist (Score:3, Insightful)
I'm a little incredulous. Yes, voice transcription software is becoming impressively accurate. In a scenario where just one discrepancy can potentially endanger a patient, however, should physicians be applying the current technology?
On the other hand, one could argue that a traditional transcriptionist is also capable of committing mistakes, and that argument is completely valid. However, there exists one difference:
Re:Transcriptionist (Score:5, Interesting)
Things like medical transcriptions are a lot easier then general purpose transcriptions for a computer and can be a lot more accurate due to more specialized and limited dictionaries.
Meditalk (Score:3, Informative)
Re:US Privacy laws are a joke (Score:3, Interesting)
A little l liberarian (such as myself) realizes that the average joe can't afford to go up against a major corporation. Less government is good, no government is bad.