Good article--worth thought, rather than just reacting.Thanks, Anony.NM

• ARTICLE RE: EMR AND MEDICAL TRANSCRIPTION - - Anony
  • Good article--worth thought, rather than just reacting.Thanks, Anony.NM - MissIndigo
  • dang, that is the wordiest article I've ever read. nm - Deb
  • EMR Article - Cindy
  • Posted Article - Backwards typist

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First laugh, GREAT side jobs.  Mor sobering:  Avg. 13.78 per hour.  Sad:  Pays less than a dog walker.  Arghhh!

http://hotjobs.yahoo.com/career-articles-7_great_side_jobs_for_extra_cash-842

http://www.azcentral.com/arizonarepublic/local/articles/0402DST0402.html

Arizona's standard issue: We don't change clocks

John Faherty
The Arizona Republic
Apr. 2, 2006 12:00 AM

The rest of the country wakes up this morning asking one simple question: What time is it?

But not here. In Arizona we know exactly time it is. It's standard time, and it never changes.

The fact that we sit in blissful time innocence while the rest of the country tries to figure out how to adjust the clock on their car radio and wonders if TiVo will make the necessary adjustments is not an important thing, but it does say a lot about who we are.

I was reading on the local police web page about starting the neighborhood watch and it basically said the same thing, or to knock on people's doors and ask if they would be willing to come to meetings.  We haven't had a meeting in my neighborhood in over 11 years, so I think it's time now since so many people have come and gone, or rented out their houses.  Other people may have a different list of problems to add to mine. 

Thanks for the response.

I'm 57, learned on the job 28 years ago.  I can out transcribe people half my age.  I have no arthritis, no carpal tunnel syndrome, no fibromyalgia and only occasionally get a crick in my neck from my job.   My QA score is 100%, has been for years, and I type 90 wpm, transcribe 200 lph at least and that's on an account that is almost all ESL.   I could do this job another 20 or 30 years if I wanted to (barring sickness or accident that could happen at any age).

As far as the AAMT rep saying younger people are not lining up for this job - have they done anything to market MT to younger people?  I'm sure a lot of high school kids or even community college people would be interested in this work if they were educated about it. 

One last thought - the people they are offshoring this work to in India, Pakistan, Trinidad, the Philippines, are not spring chickens!!! 

I for one am sick of AAMT trying to justify their greediness by blaming their victims, the US MTs.

My first thoughts were like you, just another way to cheat us.  But then when I considered the possibility (trying to be kind here) that some companies are not giving us full credit for every character typed (as in perhaps counting 3 Keystrokes as 1 as has been mentioned here before), then even if they didn't pay us for spaces, we might make more in such a situation if they had to pay us for every single black character.  They can't hide that from us!  In other words, they would not be able to manipulate the line counting as much as I think they are doing now.  Now how much they would pay us for every black character might differ from company to company, but I think this might work in our favor overall.  If pay based on production is better for us than an hourly wage, we need to find what works most to our advantage.   And with the difference there is out there now in line counts from one company to another, pay by character might help us. 

And yes, even if it is a template, every character should still count as well as spaces, returns, tabs, demographic insertion, and also for our knowledge which comes into play every single time we keep the dictators from sounding like idiots and/or catching their mistakes.  Let's face it -- we do at least basic editing too, folks.  We are NOT just typists!  We should be reimbursed for our knowledge as well as production.   We're not donating our time to a charity here.  This is a way of making a living.  We should be paid for whatever we do for the company we work for, just like in any other job.  This might be a step in the right direction. 

I am cautiously almost hopeful. 

Read this

New Orleans: A Disaster Waiting to Happen
by George E. Curry
NNPA columnist
Originally posted 9/1/2005

I am angry. I am angry at the mayor of New Orleans. I am angry at the governor of Louisiana. I am angry at the Environmental Protection Agency (EPA). I am angry at the Federal Emergency Management Agency (FEMA), now part of the Department of Homeland Security. I am angry at George W. Bush. I am angry because they were warned last November that New Orleans was one of the “Disasters Waiting to Happen” – and did nothing about it. Consequently, hundreds, if not thousands, of people are dead. Needlessly.

In an eerie prediction of what happened as a result of Hurricane Katrina, an article titled, “What if Hurricane Ivan Had Not Missed New Orleans?” was published in the Natural Hazards Observer, a major journal headquartered at the University of Colorado in Boulder. It was written by Shirley Laska of the Center for Hazards Assessment, Response and Technology at the University of New Orleans. In other words, this was an article written by a reputable author in a reputable national publication that should have been read by people involved in disaster relief. If they had taken heed, many of the dead in New Orleans would be alive today.

Under the headline, “What if Ivan Had Hit New Orleans?” the author wrote, “New Orleans was spared this time, but had it not been, Hurricane Ivan would have:

- Pushed a 17-foot storm surge into Lake Pontchartrain;

- Caused the levees between the lake and the city to overtop and fill the city ‘bowl’ with water from lake levee to river levee, in some places as deep as 20 feet;

- Flooded the north shore suburbs as much as seven miles inland; and

- Inundated inhabited areas south of the Mississippi River.

“Up to 80 percent of the structures in these flooded areas would have been severely damaged from wind and water. The potential for such extensive flooding and the resulting damage is the result of a levee system that is unable to keep up with the increasing flood threats from a rapidly eroding coastline and thus unable to protect the ever-subsiding landscape.”

Until I read this article, I had said one of the positive things that I hoped would come out of this disaster is that relief experts would realize that they need to make special provisions for the poor, elderly and homeless. In essence, I gave them the benefit of the doubt. Now, however, I realize that there is no benefit in doubt.

The warning was there in black and white:

“For those without means, the medically challenged, residents without personal transportation, and the homeless, evacuation requires significant assistance.”

Laska spelled it out in even more detail.

During Hurricane Ivan in 2004, she continues, ‘Residents who did not have personal transportation were unable to evacuate even if they wanted to.
Approximately 120,000 residents (51,000 housing units x 2.4 persons/unit) do not have cars.

“A proposal made after the evacuation from Hurricane Georges to use public transit buses to assist in their evacuation out of the city was not implemented for Ivan. If Ivan had struck New Orleans directly it is estimated that 40-60,000 residents of the area would have perished.”

The additional problem of people having the means to leave, but refusing to do so was addressed in the article.

“Researchers have estimated that prior to a ‘big one,’ approximately 700,000 residents of the greater New Orleans area (out of 1.2 million) would evacuate,” Laska wrote. “In the case of Hurricane Ivan, officials estimate that up to 600,000 evacuated from metropolitan New Orleans between daybreak on Monday, September 13 and noon on Wednesday, September 13, when the storm turned and major roads started to clear…

“The fact that 600,000 residents evacuated means an equal number did not. Recent evacuation surveys show that two thirds of nonevacuees with the means to evacuate chose not to leave because they felt safe in their homes. Other nonevacuees with means relied on a cultural tradition of not leaving or were discouraged by negative experiences with past evacuations.”

Those that dismiss environmentalists as kooks, should pay special attention to the observations about marshes.

“Loss of the coastal marshes that dampened earlier storm surges puts the city at increasing risk to hurricanes,” the article noted. “Eighty years of substantial river leveeing has prevented spring flood deposition of new layers of sediment into the marshes, and a similarly lengthy period of marsh excavation activities related to oil and gas exploration and transportation canals for the petrochemical industry have threatened marsh integrity.”

Using the Hurricane Ivan model to predict what would happen if a major hurricane struck New Orleans, Laska wrote: “Should this disaster become a reality, it would undoubtedly be one of the greatest disasters, if not the greatest, to hit the United States, with estimated costs exceeding 100 billion dollars. According to the Red Cross, such an event could be even more devastating than a major earthquake in California. Survivors would have to endure conditions never before experienced in a North American disaster.”

It ended, “The hurricane scenario for New Orleans that these conveying risks portend is almost unimaginable. Hurricane Ivan had the potential to make the unthinkable a reality. Next time New Orleans may not be so fortunate.”


George E. Curry is editor-in-chief of the NNPA News Service and BlackPressUSA.com. He appears on National Public Radio (NPR) three times a week as part of “News and Notes with Ed Gordon.” In addition, his radio commentary is syndicated each week by Capitol Radio News Service (301/588-1993). To contact Curry or to book him for a speaking engagement, go to his Web site, www.georgecurry.com.

Please see article below that was published in 2003. Does anybody know if the law it mentions was ever passed in California?

Following news that a Pakistani medical transcriber threatened to post UCSF Medical Center patient records online unless she received more money,

a state senator said she will introduce legislation barring all California hospitals from allowing medical data to leave the country.

Sen. Liz Figueroa, D-Fremont, said she will introduce the bill in January when the state Senate returns for its next regular session. (A special session on financial matters is likely before then.)

"California already has the strongest medical-privacy laws in the nation, " Figueroa told me. "But not strong enough. There's always something you didn't anticipate."

What she and other framers of the state's medical-privacy laws, which prohibit the sharing of medical information unless for clear medical purposes, didn't see coming is the explosive growth of the $20 billion medical- transcription industry.

U.S. hospitals have such a huge need for help transcribing doctors' dictated notes into written form that the work is routinely farmed out to private transcribers throughout the country. Those transcribers, in turn, frequently subcontract with other transcribers.

In the case of UCSF Medical Center, three separate subcontractors were involved in handling the facility's records. The last link in the chain was a woman in Karachi, Pakistan, who sent an e-mail to UCSF earlier this month demanding help in resolving a financial dispute with the Texas man who'd hired her.

The Pakistani transcriber said she'd post UCSF's files on the Internet unless the medical center assisted her. She backed up her threat by attaching actual UCSF patient records to her message.

This was the first time an overseas transcriber had used confidential records to threaten a U.S. medical institution. The transcriber withdrew her threat only after receiving hundreds of dollars from another subcontractor in the case.

Figueroa said her bill would prohibit anyone possessing information involving California patients from sending that information abroad.

State hospitals would likely be barred from outsourcing transcription work unless they could guarantee that all related files remain within the country -- a move that would make hospitals accountable for any subcontracting that ensues.

"We're not banning the practice of overseas workers doing transcription," Figueroa said. "But we can regulate the practice of medicine within California. "

The law, at least on the health care front, may be on her side.

In most instances, federal law would trump state law, and the federal Health Insurance Portability and Accountability Act of 1996 outlines rules for safeguarding medical data. Anyone doing transcription work for a U.S. hospital would be required to uphold HIPAA standards, although the law is virtually unenforceable overseas.

A unique aspect of HIPAA, though, is a provision that if a state adopts more stringent restrictions, state law will prevail.

"If there were a statute that no health care information in California could be disclosed outside the country, HIPAA wouldn't have a problem with that," said Paul Smith, a San Francisco attorney specializing in health care issues.

"The state has a clear interest in protecting health information," he added. "This would seem a legitimate exercise of state regulatory authority."

At the same time, though, Matthew Nakachi, a San Francisco lawyer who specializes in trade issues, said it's unclear how the proposed legislation would square with federal laws related to commerce. A hospital might argue, for example, that it has a right to do business with whomever it pleases.

"If California decides to do this," Nakachi said, "it would probably go into the courts and take years to fall out."

For her part, Figueroa expects the health care industry to fight the legislation, just as the banking industry opposed state restrictions on the use of customers' information. But she thinks that in light of the public's increased sensitivity toward privacy matters, her bill would eventually pass.

"The interesting thing will be to see where our new governor stands on privacy issues," Figueroa said. "At this point, we don't know."

Mystery woman: The Pakistani transcriber at the center of the case involving UCSF is still something of a mystery.

In her e-mail to UC officials, she identified herself as Lubna Baloch, "a medical doctor by profession." Beyond that, little is known of her.

In May, however, an interesting little exchange occurred on MT Stars, an online network for medical transcribers. Baloch, using the same e-mail address she used in her threatening message to UCSF, posted her resume at the site in hopes of attracting work as a subcontractor.

Sheri Steadman, who runs MT Stars, of Phoenix, said she's against U.S. transcription work going abroad and routinely deletes postings from overseas transcribers. In Baloch's case, she said she was concerned by the vagueness of Baloch's resume, especially as to her whereabouts.

Steadman wrote to Baloch to say that MT Stars is only for U.S. job seekers.

"I am US based," Baloch replied.

"Not enough info," Steadman responded. "Where?"

"Santa Monica, LA," Baloch wrote back.

For Steadman, this wasn't a very good answer.

"Santa Monica isn't in Los Angeles and it's not in Louisiana," she told me. "It was pretty clear that Baloch wasn't in the country."

Steadman confronted Baloch with her suspicion. Baloch never wrote back.

"She was trying to gain work in any way, shape or form," Steadman said. "She was trying to sucker U.S. medical-transcription services into sending her business."

It didn't work that time. A few months later, though, probably using a different online service, Baloch was more successful in her efforts.

That would turn out to be a very dark day for UCSF.

David Lazarus' column appears Wednesdays, Fridays and Sundays. He also can be seen regularly on KTVU's "Mornings on 2." Send tips or feedback to dlazarus@sfchronicle.com.

EMR might not soon replace us after all....

http://health-information.advanceweb.com/common/Editorial/Editorial.aspx?CC=66392&CP=1