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New threat to personal information(22 posts)

New threat to personal informationdr hoo
Oct 23, 2003 5:46 AM
http://www.sfgate.com/cgi-bin/article.cgi?file=/c/a/2003/10/22/MNGCO2FN8G1.DTL

Outsourcing medical records transcription leads to interesting situations, no? With more and more data of all kind being processed overseas, look to more and more stories with this theme.
The amazing thing here,TJeanloz
Oct 23, 2003 6:14 AM
I don't think the threat of personal information being released is all that compelling - the same threat exists even with domestic transcribers (though smaller, because of privacy laws).

What I find amazing is that the transcriber is the FOURTH person down the chain of "sub-contractors" - UCSF needs some transcription work done, so they sub it out to somebody, who subs it out to somebody, who subs it out to somebody, who subs it out to Pakistan. You know each of those people is taking a profit on the transcription - all the while doing nothing but farming the work out down the food chain. When you see statistics like more than 80% of healthcare costs are in paperwork, which seems unbelievable - then you hear about this kind of practice, and it becomes clear. It's really amazing.
that's all supposed to changemohair_chair
Oct 23, 2003 6:28 AM
There is a 1996 law that requires all medical records and insurance information to be computerized and transferred in electronic form. Paper is basically outlawed. I'm not sure when this part goes into effect. A lot of software has to change, so there is decent time period given for conversion.

Part of this law also requires that anyone who holds medical information must control it's visibility and must track who sees it and who changes it. This went into effect earlier this year. You can go down to a hospital or clinic today and demand to see a report of all access to your medical records.

The law is called HIPAA, and it's one undeniably good thing that came out of the Clinton administration.

http://www.hipaa.org
I didn't really realize how bad it was,TJeanloz
Oct 23, 2003 6:37 AM
I sit on the board of a company that offers a HIPAA (HIPPA)-compliance outsourcing solution, so I'm familiar with the concept of the overadministered healthcare morass. But my impression was that hospitals were doing a lot of the data entry themselves - and that outsourcing was going to be a near-term solution. This implies that outsourcing itself has a long way to go before being really as efficient as it should be.
HIPAA. Ugh.jtolleson
Oct 23, 2003 6:52 AM
I felt like privacy rights were pretty well protected by the old fashioned notion of physician-patient privilege, and as a lawyer trying to sort through the HIPAA morass all I can see is twice as much BS trying to get from point A to point B.
HIPAA. Ugh.mohair_chair
Oct 23, 2003 7:06 AM
Your doctor may keep his files under lock and key and armed guard, but if you use insurance, information is flowing out of his office, and that's a big hole in the system.

HIPAA may seem like BS to you, but it does two important things. First, it increases personal privacy by eliminating a lot paperwork, conducting transactions electronically, and tracking who sees and who alters your information (with serious penalties for lapses). People can't just peek through your files anymore. Second, it helps guarantee that everyone gets paid, because paperwork errors and lossage are greatly reduced, and claims and transactions are supposed to go through with lightning speed.

These two things are why there is almost universal support for HIPAA. I guess from your reaction, lawyers don't like it. Big surprise.
HIPAA. Ugh.jtolleson
Oct 23, 2003 3:37 PM
Thanks for the ad hominem anti-lawyer snipe. That was really relevant.

Most of my clients are either health care professionals or health care facilities. They are the keepers of such information, and what you call increased personal privacy is a bureaucratic nightmare, fraught with risk of criminal sanction.

Want your doctor to send your records to the specialist? Not so fast. Is there a release? Is it "HIPAA compliant?" Want your doctor to send a note to your employer regarding your health? All routine exchanges of health care information have been unreasonably burdened by HIPAA.

Want to conduct meaningful research based on medical data? Well, by the time they redact what HIPAA defines as "personally identifiable health information," you won't be able to tell if you are researching on a man or a woman.

It will be dramatically revised within 5 years.

Go to a presentation on HIPAA. You'll be unpleasantly surprised. It is more red tape with no more personal privacy.

PS -- HIPAA does not require personal health information to be maintained in electronic form. Its is just that HIPAA only applies to entities that store or transmit health care information in electronic form. Big difference.
HIPAA. Ugh.mohair_chair
Oct 23, 2003 6:11 PM
Actually, I write software used in the health care industry, so I know quite a bit about HIPAA, what it means and how it is implemented. Believe me, everyone at my work takes it very, very seriously, because none of us wants to go to jail.

You are correct. You can't just pass records around with no accountability anymore. You can't throw them over the wall and walk away. You can't get access to information to which you aren't entitled or allowed. To most people, that's a good thing.

Sorry it makes life difficult for a few, but it makes life better for everyone else.
HMO admin cost is about 40%.Very high still but never heard 80%n128
Oct 23, 2003 11:20 AM
Much todo about nothing...........Len J
Oct 23, 2003 6:32 AM
this is the most non-issue I can imagine. Another "Boogie Man" issue whose practical reality is much less than the fear that it generates in people.

An individuals medical history just isn't that important that someone would go to the trouble to make it public. The fears people have about it's misuse to deny them coverage or other personal affront are only issues if they don't truthfully answer questions on insurance applications.

There are enough real issues to worry about without adding something like this.

IMO

Len
Nah, Len, you're WAY too trusting.Silverback
Oct 23, 2003 7:40 AM
No room (or time) for details, but I've been involved in a situation that revolves around the misuse of medical records. It's not a conspiracy or anything--I'm basically pro-medical industry and believe most health care professionals are really dedicated to their jobs. But any time you put this temptation in front of the beancounters who run, say, insurance companies, or even people in the business end of hospitals and clinics, it's going to be misused. The pressures on them ("Our duty to our stockholders" is a dead giveaway) are just so great they're impossible to resist.
I can understand why an insurance company, for instance, would like to see a genetic screening on every applicant so it could weed out those likely to cost it money. But if we allow that, what do we do with the people they don't want to insure, and why should the people they DO want to insure bother with insurance?
Third Party Issuesfiltersweep
Oct 23, 2003 7:05 AM
If you've ever purchased life insurance, you'll be "happy" to know that there exist the equivalent of credit bureaus for your medical conditions... and that the mere act of applying gives them consent to exchange info with 3rd party databases. Aside from the actual blood they draw, they can run a medical background check on you.

This is far more worrisome than medical transcription issues.
Do companies have no shame?Kristin
Oct 23, 2003 8:21 AM
It amazes me that people who call America, "home," so quickly betray the hand that feeds them. These companies exist because of our economy and their CEO's live in big houses inside its (mostly) safe boarders. Yet they ignore the current job market crisis and support other nations just to save a few pennies? Are they so short-sighted that they can't see they are selling out their own well-being?? I just don't get the mentality.
Not a few pennies................Big $$$$$MR_GRUMPY
Oct 23, 2003 8:55 AM
There was an article in the Trib a few days ago. They pay $3000-$4000 a year for what companies here pay $25000-$30000

The trend is to outsource customer service and IT jobs.
profit and pleasing the board of directors comes first (nm)ColnagoFE
Oct 23, 2003 9:02 AM
Do you want to pay even more for health insurance?TJeanloz
Oct 23, 2003 9:13 AM
I'd be happy to see health insurance providers scrimping at every non-care cost.
We could save even more money......MR_GRUMPY
Oct 23, 2003 9:59 AM
if we let people from India who have a law degree, practice here. I would guess that they would charge quite a bit less for their work.
If they're qualified, let them comeTJeanloz
Oct 23, 2003 10:07 AM
If an Indian lawyer can pass the bar in the US, I have no trouble with him (or her) practicing here. If that reduces the costs of legal services without compromising quality, it seems o.k. to me.
It wouldn't supprise me if a law firm..MR_GRUMPY
Oct 23, 2003 10:27 AM
decided to bring over 5 or 6 Lawyers from India, have them cram for the Bar, get them work visa's, and pay them $15000 to $20000 a year for all the scut work.
so what?mohair_chair
Oct 23, 2003 10:37 AM
The free market allows that and people make their choices.

We don't allow slavery in this country, so what's to stop these lawyers, newly minted bar membership in hand, from quitting and setting up their own shop, or joining another firm for decent money?
Suuuure. Why not?Kristin
Oct 23, 2003 10:25 AM
I mean, since all the rich people are moving to the suburbs, we'll have lots of space to expand the ghettos. The city should increase taxes though, so that it can build a large wall around the ghetto. That way the CEO's don't have to look at all the unemployed poor on their way to that teleconference with India.
You completely lost me on that one (nm)TJeanloz
Oct 23, 2003 10:27 AM