Bill in Congress re: offshoring/outsourcing of medical records

• Bill in Congress re: offshoring/outsourcing of medical records - JAS
  • Me too...where is the link? (nm) - madmamma
  • I may be missing something, but I'm - not seeing the link. No msg

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Remember this is a difference between offshoring and outsourcing.  Offshoring is sending transcription overseas.  Outsourcing is what hospitals do to give their transcription to us to transcribe.

When you write your senator be sure to make it clear that OFFSHORING is the problem, not outsourcing.

He thanked me for my letter, said that as he understood it, this bill didn't cover anything of what I had mentioned.  However, he said he would be paying more attention to this bill when it comes before the full senate for a vote.  He said he was against outsourcing.  Below is my letter to him:

Dear Senator Barrasso:
 
I am writing to request that you support the above bill. I am a medical Transcriptionist in Wyoming. I moved here 2 years ago from Colorado, bringing my job and income with me. I make an above-average income, which I spend in my community, but my job is at risk because so much of this work is being outsourced, particularly to India. More importantly, the health and privacy of the American public is being put at risk by this practice. First, Indian transcriptionists do their job poorly and inefficiently. The gross errors jeopardize health care. Every error has the potential to injure or poison an American citizen, including many young children for whom accurate diagnoses and medication administration can be a life and death issue. To add insult to injury, Indian transcriptionists are NOT required to honor HIPAA. Once a physician's dictation leaves this country, it is no longer private.
I am a very hard working medical transcriptionist and I am still able to earn a decent living in this industry, but it is certainly not what it used to be. I am paid 9 cents for every 65 Keystrokes I type, whereas an Indian is paid 2 to 3 cents for the same work. This undercutting has hurt this industry and every woman (95% of us are female), many of whom are trying to support families on their own, has been dragged to the poverty line because our wages have not grown with the cost of living. I make 9 cents today and I made 9 cents in 1996, the year my career began.
Please protect the healthcare and privacy of Americans, and help to protect yet another industry from moving to overseas. Support and sign S.810/H.R. 1653.

Ok, so I went to my doctor's office today and noticed that they just installed a computer station for all doctors in the clinic to start doing their own records while they are visiting you!  What do you guys think?? Is this the end of our profession or is our profession going turn it to something else..like editing those reports that the doctors have to type.

Is this a real problem or will it be many years from now before it effects us?  Let me know your thoughts.

Thanks....

I just can't image anyone being all that interested in my medical records, so I really don't worry about anyone seeing them.

Here's the scoop on EMR.... right now not all facilities have everything electronic, but they are working on getting electronic on all records, however, there will still be paperbased files. What MTs need to do is to become familiar in the electronic field and not just limit their skills to transcription, because, lets face it today NO ONE stays at one job for years and years, no matter what the specialty, you need to keep educating yourself, better your skills, and move on to bigger and BETTER things!!! It will eventually change, after all, even AMTA changed their name:)

have you ever asked/educated your friends and family about the fact their medical records may be transcribed overseas and their personal information may be shipped over there, as well?

I was talking with my husband about this issue, and he was oblivious even though I have done transcription for almost 7 years.  (He was also pretty PO'd that with all the money we pay for insurance, our medical records could be coming from third-world ESL transcriptionists).

What if every person who went to their doctor said I want my medical records transcribed in the US by US MTs.  While writing to the president is a good idea, isn't educating each and every healthcare consumer a better idea?  I like the idea of a hospital/clinic having to post a disclaimer that your personal medical information is being transcribed overseas. 

I bet then their pockets would get a little deeper and all these MTSOs that are making money off shipping our work overseas would have a lot less business and a lot less power over us.  If veterans hospitals and Washington DC area hospitals cannot send their records overseas, why don't the rest of us have the same rights?  Are the politicians really going to be responsive to our letters if they know their records are safely done in the US?

I think this movement has to come at least in part from the healthcare consumers, i.e., everyone, as we do not have the money or the mouthpiece that MTSOs do.  It will empower the MTSOs trying to keep jobs here to offer better wages and expand their businesses while keeping American MTs employed. 

Medical Transcriptionists

Well above 90% female with an average age of 49

Most were on-the-job trained for years prior to the development of formal transcription curricula

Majority of new entrants receiving too little education and/or training

Retiring faster than qualified transcriptionists are entering the market

The vast majority resides in the US; however, increasing quantities of entrants are from offshore including

India , Pakistan , Philippines , the Caribbean , etc.

 

I'm wondering if there is a program out there that allows a small MTSO to provide EMR to a clinic of three physicians.

I'm looking for a web-based transcription program that allows me to send/receive dictation on the web and that allows them to access the finished records via the web.

Any ideas?  TIA

REMEMBER WHEN THIS STORY BROKE? Finally, somebody is dealing with the issue. Check this out!

http://www.gcn.com/online/vol1_no1/41035-1.html

VA IT security gaps extend to contractors
06/14/06 -- 04:15 PM
By Mary Mosquera,

Rep. Buyer: Department CIO needs IT security enforcement authority
 
[b]The Veterans Affairs Department said today that it has been investigating allegations that an offshore medical transcription subcontractor last year threatened to expose 30,000 veterans’ electronic health records on the Internet in a payment dispute with a VA contractor. [/b]
The VA assistant inspector general referred to the investigation during questioning in a congressional hearing on VA’s data security environment in the wake of the theft of sensitive data of 26.5 million veterans, active duty military and reserves officers.

The medical transcription incident highlights how gaps in information security also extend to contractors, said Michael Staley, VA’s assistant inspector general for auditing. Some VA medical transcription contractors have used offshore subcontractors in India and Pakistan without VA’s approval and without adequate controls to ensure veterans’ health information was secure under the Health Insurance Portability and Accountability Act, according to an audit released today.

“Contracts do not specify criteria for how to protect information,” Staley told the House Veterans Affairs Committee.

Staley enumerated audits of information management security under the Federal Information Security Management Act, the Consolidated Financial Statement and Combined Assessment Program that revealed significant vulnerabilities. These include VA not controlling and monitoring employee access, not restricting users to only the data they need and not terminating accounts of departing employees in a timely manner.

In last year’s FISMA review, the IG provided 16 recommendations, including addressing security vulnerabilities of unauthorized access and misuse of sensitive information and data throughout VA demonstrated during its field testing. All 16 recommendations remain open, he said.

Audits also found instances where out-based employees send veterans’ medical information to the VA regional office through unencrypted e-mail; monitoring remote network access and usage does not routinely occur; and off-duty users’ access to VA computer systems and sensitive information is not restricted.

“VA has implemented some recommendations for specific locations identified but has not made corrections VA-wide,” he said.

From fiscal years 2000 to 2005, the IG identified IT and security deficiencies in 141, or 78 percent, of 181 Veterans Health Administration facilities reviewed, and 37, or 67 percent, of the 55 Veterans Benefits Administration facilities reviewed.

“We recommended that VA pursue a more centralized approach, apply appropriate resources and establish a clear chain of command and accountability structure to implement and enforce IT internal controls,” Staley said.

The underlying situation is the VA’s department CIO does not have authority to enforce compliance with data security and information management and recommendations from GAO, said Veterans Affairs Committee chairman Steve Buyer (R-Ind.).

Buyer traced problems in security enforcement to a memo dated April 2004 from the general counsel that said the department CIO did not have enforcement authority.

The CIO, undersecretaries who lead VA’s benefits, health and burial administrations, and the VA secretary share responsibility for enforcement, said Gregory Wilshusen, director of information security issues for the Government Accountability Office.

“Information security is a governmentwide problem, and we have talked with OMB about that,” said Linda Koontz, director of GAO’s information management issues.

Buyer expressed frustration that there are no consequences for “recalcitrant” agencies that do not correct problems that GAO has repeatedly highlighted. He cited the Privacy Act, which has been strengthened with consequences.

“If you have a bureaucracy so strong in the department that the secretary or political bodies are unable to act, don’t you think the president or vice president or OMB needs to know that because there are monetary consequences behind that inaction? I’m bothered that GAO doesn’t have the higher authority to which they can turn,” Buyer said after the hearing.

After several more hearings this month, Buyer and his committee will make recommendations or craft legislation. He suggested that Congress consider looking at strengthening FISMA.

“We can even come up with that in our language, but we’re not going to have jurisdiction over that. We’ll have to work with Mr. Davis [House Government Reform Committee chairman Tom Davis (R-Va.)] and his committee. I’d be more than happy to do that,” he said.

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http://www.amazon.com/gp/product/B0008DHVJ2/ref=nosim/104-6407180-5455101?n=551440

This has only happened once, and I had my check cut same day.  This is business and I will not beg someone to give me my money.  I simply stated it as a fact.