HIPAA, unfortunately, did not plan for outsourcing overseas. sm
Posted By: U.S. MT on 2009-01-29
In Reply to:
Unfortunately, when HIPAA was implemented, they did not anticipate the outsourcing of medical records overseas. My question is: With all the controversy regarding HIPPA's regulations in regard to patient confidentiality, and the fact that once the information leaves our country the rules do not apply, why has HIPAA not made changes to specify a ban on U.S. citizens' medical records leaving the country. They know darn well that their rules do not apply and cannot be regulated once that patient's name, SS#, DOB, address, phone number, leave the country. Total lack of competency in my opinion. I guarantee that there are few, if any other countries, who allow their citizens medical records to leave their home country. Our government needs to reflect on the bad choices they have made in regard to patient medical confidentiality. This is the most private aspect of a person and deserves to be respected. I bet 80% (or probably many more) U.S. patients have no idea when their medical records are being transcribed by an overseas transcriptionist. I have been in this profession for many years and can honestly say most doctors have no clue where their dictation is going. Only the hospital administrators, in some cases, can verify who is transcribing their physician reports. Many times, even hospital or clinic administrators are betrayed, as many foreign transcription companies set up base in the U.S. with an address and toll free number, which leads the administrator to believe the MT company is located in the U.S. Laws must become more stringent in this arena before any change is seen. All caring U.S. MTs should write to their congress, senate, and federal government in attempt to have someone make a difference.
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Overseas outsourcing SM
I don't know where you have been for the past several years but a whole bunch of people are screaming bloody murder about this to their congressmen/women. There are plenty of petitions being circulated to put a stop to foreign outsourcing. Most MTs I know have not only sent letters to congress but have called the senators from their states to complain about this. My friends refuse to see a physician who outsources medical records - and they ask up front who does the transcription and make it know that their records are not to be sent to a foreign country.
There's lots of stuff going on. Do a search on the Web and you will more than likely more than you ever imagined.
HIPAA isn't enforcible overseas. MTSOs
Outsourcing doesn't always mean overseas, you
A physician who uses an MTSO for their transcription work, American or otherwise, is outsourcing. That practice has benefitted most of us, so I assume you just mean offshoring.
Don't you think that eventually foreign MTs will up the ante and start asking for more money? I do. Greed usually takes over and I predict it won't be long before they wake up and see that their services are worth more. If that happens, I think we will see less offshoring because the reason most companies offshore is the cost advantage. I've already seen some of the Indian companies requesting more, i.e., it used to be they wanted only 3-4 cpl and now they are saying 5-6 cpl. As an MTSO myself, I get quite a few emails from foreign MTs looking for work so I am just speaking from my personal experience. (I personally do not offshore and never will.)
There are some companies that offshore because they can't find enough MTs that want to work the graveshift and foreign MTs will gladly work it due to the time difference. That practice doesn't bother me as much as the companies just looking for cheap labor despite quality issues.
Overseas outsourcing is here to stay
I've been reading some very interesting posts regarding off-shore outsourcing. I worked as a supervisor in a large MTSO in the 1990s when this subject was being "bantered" around the office, but it was my mistake that I didn't start taking it more seriously at that time.
As I have seen transcription issues evolve over the past 10+ years, I can think back to a time when, in fact, we had lots of "visitors" coming to our office, looking at servers, etc. in what I quite naively thought were server upgrades. Some of these so-called "visitors" were indeed of foreign descent. I lived in the southwest at the time so there was a fair amount of "overseas occupants" and I didn't think much about it. Now, in hindsight, it's plainly and perhaps painfully clear that this was the beginning of outsourcing.
One thing I will say upfront is the fact that overseas outsourcing companies employ smart and very patient people. I don't doubt this very concept of $.03 cpl transcripton is very palatable to foreign entities where there is so much poverty. I also remember reading in some of the transcription magazines around that time that doctors and nurses were quitting their jobs in India to transcribe because they made more money! I laughed outloud when I read that, but I guess the joke was on us.  I also remember reading ads for medical editors in Saudi Arabia for $40-50,000 with a full housing allowance, but the employee had to sign a two-year retainer agreement. One MT I knew took a job in Saudi Arabia. I did hear from another MT who was writing to her that there were huge personal safety issues and she would be glad when her time was up so she could "come home."
If we want to know how persistent outsourcers can be, especially with medical office/hospital administrative staff making critical decisions without actual hands-on experience and think MTs are just "typists," just look at our current situation. We in the USA don't seemingly have the patience to look at the broader picture and the dollars matter more. Don't get me wrong but the spiraling out-of-control cost of healthcare has always been an issue and with more sophisticated scanners, research, etc. being necessary just to compete with the hospital/clinic across the street, dollars have to be taken from somewhere and voila! it's comes from 'discretionary funds' called MT. There is only one very large medical institution still in his country who tried outsourcing in the beginning and when the quality of the work was so poor they wouldn't stand for it anymore, they cancelled the remainder of the "standard" contract and vowed never again to outsource whatever the cost. To this day, they are still one of the most prestigious medical centers in the world and all transcription is being done in-house.
I truly believe there is safety in numbers and hope I live along enough to see a radical change from off-shore outsourcing to bringing MTs "bread-and-butter" home where it belongs!
HIPAA and Outsourcing
How can outsourcing to an offshore company, where a patient's sensitive personal and medical information is concerned, be HIPAA complient? Shouldn't we as patients have the right to know if our medical info and personal data are being sent via the Internet to a foreign country? Shouldn't we as patients be asked to sign a release/agreement to such a practice, notifiying us of this? I have never asked my doctor/hospital if they outsourced to offshore companies...but I will now. Wonder if I'll get a truthful answer.
U.S. Parents Outsourcing Child Care Overseas
http://pop.youtube.com/watch?v=vxj1RDbp_iE&feature=user
Sorry, but with all the serious stuff this morning ,had to send this !!!!
OUTSOURCING PLAN...
Okay, here is the plan. For all of these hospitals with heavy ESL dictation loads, outsource these yourselves to India, Pakistan, Trinidad or where ever they speak that English as an unknown language. It won't matter if it is correct as typing those documents is just a best guess scenario anyway. Leave all of the English as a First Language (EFL) here in the US for those of us to type as we have been working long and hard to gain our experience and deserve to have decent work. If a hospital has a lot of ESLs that they have brought stateside to staff their hospitals as hospitalists as they work cheaper then it should be their responsibility to give them English classes and monitor their progress until they can speak English clearly, concisely, and accurately. The solution to this problem with ESLs is in our HANDS and we know it. The large companies and hospital clients need to take note before it is too late and we are all retired. You need us more than we need you.
OUTSOURCING PLAN...
And it is you and your "oh so thankful to have a job" kind that have gotten those of us that are MTs and will never be MLSs into this ESL cesspool by allowing it to happen. Anything for money, right??
OUTSOURCING PLAN...
Sure, my world is called Affirmative Reaction, taking back what was ours by right of being an MT before the almighty dollar spoke and we allowed our hospitals to actively solicit these ESLs, bring them stateside, pay for their malpractice coverage, and employ them as hospitalists, and now we are stuck with a language barrier that, in all other fields, requires a certified translator but now that we have been awarded the title of MLS we are supposed to type an accurate medical document while listening to an ESL's attempt to speak English?? This is your world now, I have done my time, and you are welcomed to all the ESLs you can handle or rather fool yourself into believing that you can do so very accurately.
OUTSOURCING PLAN...
Okay, this string is not a question of what our ancestors did, it is to get those of you that are new to the MT business to realize that if we don't do something about this outsourcing of medical transcription, your "oh so wonderful jobs" may be forfeit. Look at IBM, laying off over 13K stateside and hiring 14K in India. Any Capitol One sending all of its customer service to Manila--that's right, your credit information. Think money has anything to do with that?? Open your eyes, your job is slipping through your fingers...
OUTSOURCING PLAN...
If these ESL doctors are such wonderful humans, why don't they stay in their homelands and help their own people? There would be no third-world problems if the privileged and educated people stayed in their homeland and actively helped their own, rather than fleeing to the US to live the good life that their own countrymen will never see. Charity starts at home, remember.
OUTSOURCING PLAN...
How could it happen? Very easily. Many of the national companies actually have policies in which they state that, should an MT notify them of a difficult/hard to understand dictator, they will alert that dictator and work with him/her to enhance their dictating skills, along with notifying the client that a particular dictator presents an accuracy problem in that their English is not clearly understandable in order to be transcribed accurately. Unfortunately, most of these companies do not enforce their policies and allow the client to send these dictators as overload work since their own in-house staff doesn't want to type them either. These national companies could address these issues, the dictator would benefit from the help provided, and the MT would be able to produce an accurate product. There are even self-help tools for these ESLs to better their dictating skills. If these clients/hospitals do not choose to help their ESL dictators, then they should either type their dictated product in-house or pay more for the handling of such a poor dictation product. MTs are not the garbage men or clean-up crew. If one wants an accurate medical document, one must provide an accurate and understandable dictated product. We are not magicians, we are MTs.
OUTSOURCING PLAN...
No, not a newbie, more notches on my belt from nursing and working as an MT than you will ever see...
OUTSOURCING PLAN...
Not off base at all. Yes, they are part of the healthcare system, and their documentation is very important. But if the dictation that constitutes their documentation is substandard then the risk of mistakes rises and patient care is at risk. Having worked with these doctors, I know that they generally do take constructive criticism well and do try to make things better once the problem has been pointed out and a solution offered. You can't solve a problem by ignoring it exists.
OUTSOURCING PLAN...
It does exist, won't name the companies without their permission, but even the in-house supervisors will attest to the fact that they do offer suggestions to these difficult dictators in hopes of making the dictated product better. Guess you haven't looked in the right places??
OUTSOURCING PLAN...
Soy intelligente y no necessito trabajar mas! Y tu??
outsourcing plan
I totally agree with you grandma, but please, let us not forget the American Docs who can barely speak English or don't care enough to slow down so that we can understand them. What about that?
ProScript Documentation Services does not send work overseas or employ any overseas MTs. (nm)
You're confusing the new QA plan with the new pay plan. New pay plan is still completely under wr
Shhhhhhhhhhh....
I am talking about the QA plan I dont know what the new pay plan is.
:
Also, they could be done overseas..
I proofed Indian work a few years ago and they sound like similar reports--blanks, everything wrong.
For everyone's info, the clinic in town that outsourced to India still dislikes the quality intensely, after all these years, but still uses them because they are cheaper. Go figure.
overseas
The doc that I work for now used to use a service and paid 9cpl.
re:overseas
We could do this, but then we'd have a small choice of credit cards, cell phone providers, computers, toilet paper, paper towels, food in general, entertainment such as cable and internet providers, clothing, tires, and I could go on and on, but what would be the point? The simple fact of the matter is that this is widespread and there's no turning back on it now. Even in our industry we have plenty of overseas working alongside of us. The way I see it, these people have families to feed as well and want to make a living for them as well. I've worked with U.S. companies that employ both American and Overseas MTs and I have to say that they are more than willing to put in the time and effort to get it right. They are also willing to take English classes to do better. I just think it's time that we end this whole caste system everyone wants to push on the MT world. There is plenty of work to go around, instead of pushing them to the side, why don't we include them and help them become better at this job?
overseas
May I ask what company this is? I would like to work overseas as well.
overseas
Haven't decided yet! Maybe Spain
overseas
haven't decided yet! France maybe?
overseas
The system is not accepting the 3-digit password, after I write out my message, why not?
OUTSOURCE OVERSEAS
and you will be begging for work. get ready to brown-nose to get enough money to live on.
good luck. you could do much better.
They have to be using overseas employees...sm
So remind her that while they claim HIPAA compliance, truth of the matter is that once the records leave the US soil there's really no protection.
They use overseas labor.
.
how did you get an overseas account in the UK?
x
Has anyone ever lived overseas?....sm
A friend of mine is moving to Italy and I am really considering going with her. Just wanting to know if anyone has lived outside of the US (not necessarily in Italy, just anywhere).
Thanks
Overseas posters?
I can't find anywhere on the site that prohibts off shore MTs from posting.
jobs overseas
Personally, I do not worry about this. There are plenty of companies who hire MTs purely in the US. For other jobs, just you wait, there is going to be relocalization of jobs/services, etc in the coming years. I already see/read about towns relocalizing. I would never consider going abroad for any major medical procedures. I proudly support my local medical team. There is probably a reason that medical care is cheaper abroad.
With the comment made in this article about importing physicians, does anyone wonder why medical costs have skyrocketed? I am sure a good portion of these physicians have come over here to make all sorts of money versus what they could make in their country of origin. I am sure they would not have left their country of origin if they were doing well for themselves.
Military Overseas
When companies state no overseas applications or solicitations does that include Overseas Military?? I have DSL and we have a US Post office here on base. Curious cause i'm about to start school and want to know it wont be wasted while we are stationed overseas.
Thanks!
Don't kid yourself. The overseas companies are going in at 0.13 and 0.14 now. nm
nm
Overseas jobs?
Does anyone have any sources for info on overseas MT jobs?! I have been Googling but haven't come up with a single MT position in Australia, New Zealand, Japan, or Costa Rica -- only Saudi Arabia, the UAE, and Dubai.
Thanks.
never worked overseas....
If I could get up the courage to fly over the ocean I may have been able to answer this one for ya... :)
But I dont know why you wouldn't be able to take your work with you... you just have to have access to everything you use on a daily basis... Right now I'm away from my home away from home, visiting my sister (and new niece!!!) for Christmas and here I am working away... :)
Good luck!!! and how awesome for your son
Working overseas
If you worked for an American company say in Scotland all well and good, transcribing for U.S hospitals and the work contained in the U.S., BUT if you transcribe for British or European hospitals/doctors, the work contained in those countries, it is VERY difficult. The spelling is very different. I was born and raised in Britain x25 years and when I started working here in the U.S. I found the American spelling very difficult - although less characters per word. British spelling adds a lot. Just a thought! Plus the accents are hard too. They don't say period, they say full stop which sometimes sounds like part of the text, but you have probably already experienced that. Good luck, it sounds wonderful.
They did not contract an overseas
company. The company they contracted with was sending it overseas.
Just because the records go overseas
does not mean the laws are being broken. Granted, they cannot be enforced, however, if the company doing the overseas transcription does not follow the guidelines, then something might be done. However, unless there are specific cases, you cannot say laws are being broken. I am sure their contracts state they have to abide by our laws.
It is more of a risk overseas. SM
If some company operating from an offshore country with a "store front" in the U.S., decides to retaliate against Dr. John Doe, and spreads 50 of his patient's medical records over the internet, how easy do you think it would be to track down the so-called contact (whose name cannot even be pronounced) for the transcription company who is nowhere to be found? HIPAA has now power to fine, penalize, or imprison any overseas operation because the HIPAA laws only apply here in the United States. IMO, there is a substantial safety risk in having medical records leave the country.
working overseas
Can a U.S. citizen travel while working for an American transcription company, as long as they have a legal U.S. residence? Is there any legal reason not to hire someone who likes to travel and visit foreign countries while they work? I'm not talking about off-shoring.
Can anyone confirm that JLG outsources overseas?
y
I find it hard to believe that the MTs overseas
experienced at MT, but that's just me. These companies are just trying to save money, plain and simple because people in those countries can and will work for peanuts.
Does Transcend outsource overseas?
Thinking of applying with them as an IC. Anybody with any input?
We had an account that went overseas that when we lost it
one of hte people said they'd be back. Hasn't happened yet and it's been over a year. I always wished they would.
Good accounts are going overseas
How ironic!
Regarding US companies using overseas labor
Maybe we can start by not utilizing their services and getting the word out.
http://www.cnn.com/CNN/Programs/lou.dobbs.tonight/popups/exporting.america/content.html
No, it does not. The call center is probably overseas
k
To me too. When did CS start training overseas?
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