A Tough Lesson On Medical Privacy Pakistani transcriber threatens UCSF over back pay

San Francisco Chronicle ^ | 10/22/03 | David Lazarus

[wideminded]

A major university teaching hospital and all its associated regional clinics in my town has gone to automated patient records. When a patient enters the examining room not only the doctor but the nurse enters data about them in the system. This data can then be accessed by virtually anyone working for the hospital, although a record is kept of logins.

When I questioned how patient privacy can be maintained with such a system I was treated like a nutcase. With old fashioned files and paper records one had reasonable assurance that your medical records would not become public property within a few years. With hundreds or thousands of employees having access to medical records at a single hospital now, what will prevent the records from eventually being put on sale either over or under the table?

[TejasRose]

("voice recognition" is the wrong word...I mean the software that types what you dictate. I hear there is a significant learning curve but after that it's pretty slick. Doctors dictating their own charts without having to farm out dictation might help nip this in the bud.)

As a medical transcriptionist for 30+ years, I can tell you that most doctors are not inclined to retrain for anything. Yes, there are some who will, but what do you think the voice recognition software is going to type when the doctor says, "Right leg, no left leg....oh sh*t, just go back and use what I said first....hark, hmmm, kachoo" Oh, and go back up to the first paragraph. She's 41 and not 81, and give her 4000 mg of Coumadin." Yes, I know some companies are selling 95% accuracy for their VR software. If you get 4000 mg of Coumadin, that 95% accuracy is not good enough.

[Samizdat]

A major university teaching hospital and all its associated regional clinics in my town has gone to automated patient records. When a patient enters the examining room not only the doctor but the nurse enters data about them in the system. This data can then be accessed by virtually anyone working for the hospital, although a record is kept of logins.

Okay, if you are saying they are entering data and not dictating, then either this is something new for them (and won't work) or it is just your vital signs and pertinent triage statistics. In either case, I too worry about how many people have access to my medical information. That's why I seldom go see a doctor anymore.

[this_ol_patriot]

Suppose they just changed the records a bit and it resulted in the wrong medicine being given or the wrong procedure being done on patients. Can you imagine the lawsuits this would spawn? Any savings from outsourcing would be eaten up times 1000 or more and even if it never happened smart patients and smart doctors would not take this risk and do business with known outsourcers.

[mo]

You would'nt suppose some "enterprising" plantiff's attorney could'nt "arrange" for that to happen now could you? Naaa they'd never....

[bimbo]

Forward this to your doctor (medical privacy) and your accountant and CEO (financial privacy).

… and if you also forward it to your attorney, the first two will get the message that you are serious about the privacy of your records..

[bimbo]

I don’t know how to fight this. Most people I talk to don’t seem to be alarmed or even care.

You have fingered the foundation upon which many of America’s problems rest. Maybe if Peter, Tom, or Dan got upset over this, many of the sheeple would follow.

[bimbo]

I don’t know how to fight this. Most people I talk to don’t seem to be alarmed or even care.

You have fingered the foundation upon which many of America’s problems rest. Maybe if Peter, Tom, or Dan got upset over this, many of the sheeple would follow.

[Texas_Dawg]

Free Trade Bump

Haha. We're all doomed.

Do you really sit around and fret all day about how free trade is ruining your life? Hilarious.

[harpseal]

Pakistani outsourcing ping

On or off let me know.

Just think besides the immediate threat there is also the fact that Pakistan has the world's highest tariffs and a large number of Al Qaeda sympathizers.

[EagleMamaMT]

I'm a medical transcriptionist, too, with almost 23 years' experience.

I've been wondering how long it would be before something like this happened. Releasing patient records is against U.S. law. We all sign privacy agreements before we go to work for any company. If an American transcriptionist had done this, she/he could be prosecuted under United States law. Foreign transcriptionists can't be prosecuted in American courts. Also, now how long will it be before other foreign transcriptionists pull a similar stunt, basically holding the hospitals/patients/transcription companies hostage for more money?

I worked for a company that began offshoring work. I quit. The company I subcontract from now guarantees in their contracts that none of their work will be offshored.

Just like all other occupations experiencing outsourcing, transcriptionists her in the U.S. are seeing their wages fall as companies threaten us with "we can just send the work offshore". My wages are at what I was paid back in 1991 now, without any benefits (which I did have in 1991).

I agree with you about voice recognition. It might catch on with the future doctors in medical school right now, but doctors who are already trained to dictate will not want to adapt to anything new. Besides, like you said, it types what they say, whatever they say. Also, I'd be real interested to see some voice recognition reports for some of the foreign doctors I've transcribed with really bad accents. Those reports ought to be a real hoot!

[harpseal]

Do you really sit around and fret all day about how free trade is ruining your life?

What business is that of yours?

You post on Free Republic that the current trade rules for the USA are Free Trade and that they are good for the USA and you do this based upon no data.

I have repeatedly asked you for one case where a tariff was harmful to the USA. If the Unfair Trade rules in place were really beneficial to the USA then given the number of economists who stand for this idea we should be swamped with such data.

Instead no "Free Traitor" has been able to come up with even one case from the over two hundred year history of protective tariffs in the USA of one tariff which was harmful to the USA. Yes, there is at least one such study. I found it by searching the abstracts on economic history. Yet there are many case studies of tariffs helping the US economy. Come on Dawg if you have some evidence post it otherwise you are just trying to anger people.

[searchandrecovery]

U.S. laws maintain strict standards to protect patients' medical data. But those laws are virtually unenforceable overseas...

Let's see, medical records, software source code, customer databases all potentially up for grabs if a corporation outsources work overseas. HAHAHAHAHAHAHAHAHAHAHAH. Oops, maybe all those outsourcing corps (oracle, sun, ibm, microsoft, brokerage firms, state gov'ts, etc.) didn't take that into consideration. What a bunch of maroons.

[Centurion2000]

Everything needed to steal identities and open credit card accounts in Europe is in the hands of people making next to nothing.

Worse .... everything needed to create false identities in the United States for terrorists is now in their hands as well.

[Dog Gone]

Oh, that's a wonderful thought I hadn't considered. Fortunately, an al-Qaida type isn't likely to steal my identity, because they aren't going to look anything like someone with my actual name.

That's not the case with at least a few hundred thousand Americans, though.

[DLfromthedesert]

I called the HIPAA enforcement agent at the hospital where I work about this article.

I told them if the hospital ever resorts to outsourcing, they can't honestly tell the patients their records are private.

[EagleMamaMT]

Good for you! If people speak up about this, then the hospitals will begin to require in their contracts with American transcription firms that no medical transcription can be offshored.

I think this case has blown the lid off the potential dangers of offshoring medical records and other sensitive data. For example, suppose a foreign transcriptionist receives a celebrity's or other famous American's medical report to transcribe. There is no law to stop the foreign transcriptionist from auctioning off the celebrity's medical report to a newspaper, magazine, etc., because the foreign transcriptionist is not bound by U.S. law. I, myself, have typed celebrities' medical records in the past, so I do know they can be sent out to American companies to transcribe. If that American company offshores them, the above scenario is entirely possible.

Now that this Pakistani transcriptionist cited in the news story has successfully received money by threatening to release someone's medical records, others will be doing the same stunt, because in this case the transcriptionist received the money she wanted.