Outsourced UCSF notes highlight privacy risk (Patient Records Blackmail)

http://www.sfgate.com/cgi-bin/article.cgi?f=/c/a/2004/03/28/OFFSHORE.TMP

Lubna Baloch sat in her office in the sprawling Pakistani commercial center of Karachi and gazed at the e-mail she'd composed. She tried to imagine the reaction half a world away when the people at UC San Francisco Medical Center saw what she'd written.

The famous U.S. hospital would have to take her seriously, Baloch knew, when it realized she was prepared to post its confidential patient records on the Internet. That is, unless UCSF helped her get the money she was owed from the mysterious Tom Spires, her link in a long chain of medical transcription subcontractors.

"Your patient records are out in the open to be exposed," Baloch wrote in her e-mail, "so you better track that person and make him pay my dues or otherwise I will expose all the voice files and patient records of UCSF Parnassus and Mt. Zion campuses on the Internet."

Then the kicker: "Just to make you believe that I am not bluffing I am attaching latest voice file and text of your hospital." Baloch had included private discharge summaries for two UCSF patients.

She clicked the send button on her computer screen.

I'm a medical transcriptionist (MT), one of the many lucky ones who is able to work at home on the computer. Even though my company requires each of us to sign a contract of confidentiality, there are no real means that I'm aware of for guaranteeing that confidentiality.

I've been waiting to hear about something like this happening for quite some time now. Oftentimes, doctors also dictate things into their reports that have no business being there -- dates and destinations for vacations, names and personal information about family members, etc. I can tell you for a fact that this inside knowledge has affected my own relationships with medical professionals. It's not that I don't trust my doctor, but that I don't trust those many scattered individuals handling my medical records.

I was told by a much older, very experienced MT a few years ago that transcription was being outsourced to India and the going rate there was 5 cents per line. What a way to make the shareholders in the information technology (IT) companies very happy! What a way to make doctor-patient confidentiality a thing of the distant past. What a way to destroy patients' confidence in the medical profession altogether.

Some professions should never be "for profit," subject to CEOs' and shareholders' opportunism and greed. Among those professions are any dealing with health care. Even though I'm a wage slave in the transcription industry, I personally am scrupulous about confidentiality issues - but I have little-to-no faith in the scruples of others.

If there were some way I as an individual could compete with corporate technology and sales forces, I'd go independent, but independent transcriptionists are about as scarce as living dinosaurs these days. Small, independent transcription companies have been swallowed up by large, IT corporations. That's the way things are today. I don't know where it will lead, but I'm not hopeful that it will be to the benefit of patients or the once-proud transcription professionals.

On edit: In thinking about how to handle this problem, the thought has crossed my mind that perhaps an anonymous numbering system could be brought into play. It's not necessarily an attractive alternative, but it's a possibility that could protect confidentiality at least to some degree. What a vast web of conflicting needs there is in considering this problem....

Here's link to article on medical transcription:

http://www.post-gazette.com/pg/04083/289929.stm

Here's the series.

Links to each day on the right of first day's story.

http://www.post-gazette.com/pg/04081/288539.stm

Your idea might be an alternative, but how much damage could already be done regarding this? You would think that people would consider that not everyone plays by the same rules especially in other countries!

milk the ultimate profits from and given business endeavor has hurt the American workers in multiple ways, from the loss of jobs to the exposure of personnal information. And like this article says, foreign workers are not subject to our laws in regard to any privacy acts. This outsourcing crap has got to end NOW.