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Serving Over 20,000 US Medical Transcriptionists

Bill in Congress re: offshoring/outsourcing of medical records

Posted By: JAS on 2009-05-23
In Reply to:


Just something to think about. 


The link below will take you to a page explaining the House and Senate versions of the bill and a link to send an email to your representatives in Washington indicating that patients have the right to be made aware that their personal information and medical records are being sent overseas for transcription. The letter is already written for you!

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Bill O'Reilly complaining of wanting medical records on net
Bill O'Reilly just stated on his show that Barack Obama wants all medical records put on net and he says that is outrageous and points to camera and says your medical records will be put on computer and someone will hack in, get in, and spread it around, also said more.  It sounds like he has no idea they also are offshored and very vulnerable that way too..  He was really upset.  Hope some of you can see this on his repeat broadcast on DirecTV or other. 
Petition to Congress about outsourcing...sm
medical records.  http://www.rallycongress.com/support-fo ... formation/
Congressional bill re outsourcing
Upset about outsourcing? We can do something about it. Let your voice be heard in Washington. Thanks to post from NM in MME thread below.

I think the solution is to send a standardized letter to every major medical facility, as well as the major medical insurance carriers (Aetna, Health America, BC/BS, Medicare and Medicaid), addressing corporate heads and informing them that their doctors' medical records risk being transcribed overseas in a foreign country where HIPAA regulations do not apply and cannot be enforced. Address the big wigs to get their attention because I truly believe many are not aware of what is happening. There are so many U.S. transcription companies who advertise, snag the client, and provide a contract for the doctor or medical facility in no way indicating that they send their dictation overseas, only to have it available first thing in the morning. So what if the time frame is good. If I were a doctor, I would not even consider the risk of sending my patients' personal information to another county and risking the issue of security to save a few dollars. The insurance companies, who pay the insurance claims on office visits, hospitalizations, surgeries, long term care, should be the first to be made aware of this ridiculous situation. Physician practices, hospitals, hospital administrators, and MTSO's need to put a stop to providing services to offshore companies who work for slave wages, takes jobs away from hard working and experienced U.S. MTs, and jeopardize the security of confidential information regarding our U.S. citizens. Let India transcribe their fingers off for their country's citizens. America, quit trying to save a few dollars by jeopardizing our citizen's most private information. This is such a joke!
Offshoring versus outsourcing

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.

I assume you mean OFFSHORING, not outsourcing? nm
Medical Transcription In The Era Of Electronic Medical Records
EMR has revolutionized the healthcare industry in recent times. Many experts felt that EMR & Voice Recognition would totally replace Medical Transcription - however; the industry soon realized that transcription has certain advantages over point & click charting and many physicians preferred to dictate notes rather than document the data at the point of care themselves.
sorry, meant offshoring isn't working, not outsourcing

I heard back from my senator today about outsourcing bill sm

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.

medical records on the net
I think this drive to put medical records on the net will ultimately put us all out of work.
Citizens against Medical Offshoring
spread the word - become proactive - fight for our jobs I found this website this morning
http://www.ericacodes.com/camio.html Also, check out the discussion list - its a little outdated (couple of months) but everything needs a fresh start, a little boost somtimes
Electronic Medical Records?? What do you think? SM

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.


50, A.S. in Medical Records Technology.
Of course now that course would be called HIM.  Transcription was included.  My first job was in a physician's office and consisted of mostly transcription.  High school courses were heavy in typing. I do not know that I could contribute to a rebuttle.  The company that I just left had mostly older employees.  This company just closed.  Now I am an IC with about the same pay.  I do not believe that there are as many young people entering the profession.  Part of that is because it is hard work, and no longer pays well in proportion to other jobs they can train for.  Also, who wants to spend money and time training for a job that may be outsourced at any time?  The only young people I know going into this profession are doing it because they want to work at home.  This once was a good profession to enter, but now things really seem to be going sour. 
Look up cyberterrorism in medical records.
Was the person in Pakistan who threatened to post VA medical records on the Internet unless they were paid off with thousands of dollars in cash?  Give me an American with a criminal background check any day.
Who would be interested in my medical records?

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

Electronic Medical Records
Well, get over it. Medical records are one thing...
your boss saying something about you is another. In my opinion, the more the government stays out of it, the better off we are.  Double edged sword, ya know.
electronic medical records
Does anyone have info regarding EMR rules for doctors.   I was told by a physician today that by 2010 that all doctors were supposed to be EMR.  What will this do to our transcription jobs?  Any info appreciated.
electronic medical records

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:)

Electronic medical records. nm
Screwed up Medical Records
My sister went to the hospital after a car accident and was there for about a week. I told her to get her medical records because things had been such a mess while she was there - she had someone else's x-ray reports - reports of things she never had done - part of her H&P and part of someone else's - and just plain sloppiness and incorrect information all through her chart. And then they charge us for our MR. I have in the past gone and paid over $200 for my records and then promptly gone to the bank and stopped payment on the check - it was worth the $15 stop payment fee but not the $200.
Regarding medical records going overseas...

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. 


Electronic Medical Records
Not all EMR systems rely solely on CPOE-type technology. Every acute care account I have worked on in the last 4 or 5 years has an EMR component. The medical records are stored digitally, which allow to any physician with access to the system to pull the patient's record.

The physicians on my current account can input data through point and click (primarily ER notes and radiology which allows immediate access to the information) or they can choose to dictate (H&Ps, consults, ops, and discharges). The dictated reports are still transcribed or edited by MTs.
Probably medical records or unit secretary
In my area the pay is about 50 cents less an hour than MT seems like a gravy job compared to this.
My first boss in medical records (the director)
had a policy that no one could break. When doctors came in, everything else was put aside and they were first to be helped and given whatever they needed, including a cup of coffee, run to coffee shop for lunch or snack if that is what they wanted (they would always pay for theirs and whoever went to get it), and had someone sit with them just in case they had a question or needed help. She, too, said they were tired and "abused".

Oh, but the payoff was wonderful. Christmas was the best with gifts that you could not believe from everyone of them. If any of us went to the doctor's office for treatment we were treated like royalty, never had to wait, and never ever had to pay. She had the bad or difficult doctors teach a class for the transcribers and coders in whatever specialty they were in to "help" us, but it made them so aware of our problems that they soon learned to be good dictators. And when new doctors joined the staff, they were escorted by a senior staff member and told to treat us like we were the most special people in the world because this was the one office that would make their life as easy as possible. Those guys were truly tired and exhausted, but they always had time for us. She never had delinquent charts, flew thru inspections like they were a routine item, and when she retired, we all cried. Sure wish the person who took her place could have taken lessons from her.

Doctors are people, too. You just need to give them the credit they deserve, including the non-American ones. Remember, they not only had to learn English to be a doctor here, they had to learn the medical field in a language that was not their own. How many of us could do that?

Applied to Medical Records Dept ...
... second shift position.
Fun? Working on patient medical records and
drinking. Ah, to have your ISP addy would be PRICELESS.
I started out doing radiology, then went into medical records. SM
It was a hard transition, to go from one speciality to doing them all. ER notes would be a good start, good money. I prefer OP notes myself.
How long do states keep medical records?

Petition to keep medical records from going overseas!
If you have concerns about losing your job to offshore transcription companies, please sign this petition, http://www.ipetitions.com/petition/medrecords.  Ask your friends and family to sign it if they have concerns about their private information being sent overseas.  If they don't want their medical records sent offshore for transcription, ask them to sign it too.  Its going to all of the big-wigs in DC, and the sooner the better.  If we all stand up together, we can fight offshoring in our industry (some?), save our jobs, and protect our private information!  http://www.ipetitions.com/petition/medrecords
The lies from physician put on my medical records
I posted on this before- had plastic surgery done, 2-3 things done at 1 time including tummy tuck, face and ? forgot but anyway, the face not done. Went home, no bruising, no swelling, went and looked at my records, not done, went to the office and told the physician he had not done, he forgot, gave me an IOU on his letter head. Bottom line, I asked for the return of the amount of the facelift only, he refused, was hostile, he was personally calling my house, threatening like, I had to have my job (at same hospital where he practiced)-I just said Karma will take care. Long story short, he did not dictate my operative report until EIGHT (8) months later, then falsified, and put the biggest facelift report in there you could image. My name is French sounding, unusual, and I know that was done intentionally. Big, big lies. I told lady over medical records falsified, she said I could just put an addendum in the chart.
Sometimes you're better off not reading your own medical records..
I read a consultation from a recent hospitalization and this doctor said that I "look slightly older than my stated age"... I am crushed!  It must be my gray hair...I have to start coloring it again.  But  I guess also maybe life is starting to take it's toll on me.  I have had some problems with low blood/iron this past year and I've heard (on a t.v. commercial) that that makes you look older.   That statement made by the doctor could account for the strange looks I've been getting from family members in the last year or so.   They don't say anything, but I can recall some days when they  looked startled or surprised at first glance, like something was wrong.  I've always tended to look younger than my age, so this is an adjustment to me. 
Most medical records contain YOUR phone number,
frequently SS# & other financial information. Plus HMO information as well. For those reasons alone, I don't want MY medical reports typed offshore.

Not to mention all the mistakes!
PLEASE mention MT & medical records being offshored
& the privacy issues that go along with that!!! There are tens of thousands of MTs, many in nearly every city. There's no way your employer would know it's you.
I'm sorry, but the physicians are supposed to review the medical records for
accuracy, then sign off on them.  THEY are the people who went to medical school, did their internship, and actually saw the patients.  THEY know what they were trying, often badly, to say.  THEY are the ones making the big bucks.  NOT US.  We go to maybe a year-long correspondence school, make crappy money, and watch our butts spread wider every day while we TYPE, yes, I said TYPE, medical records for them.  Anyone who thinks it's more than that is kidding themselves.  And save your speeches on patient care and work ethics.  I know all about that stuff.  The harsh reality is that this job does not require a college education to get into, and your income is tied to your production level.  The doctors don't care enough about the medical records to speak slowly, enunciate, and double check everything before signing off.  How are we supposed to read their minds?  Anyone in this field who knows more than grammar and medical terminology ought to be working as an RN or MD, because you'd be better at it than half the medical providers we type for.
I am sorry, I meant Electronic Medical Records, not redords.
Facts and statistics from the Medical Records Institute

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.


It was that cute little tush strutting around the Medical Records. nm
It even extends in some hospital medical records depts too
After my first week in the MR department in a state I won't mention, I came home and asked a friend if it was customary in that state for the department manager to call her employees the B word and yell at them like dogs and then (to my shock) watch those employees yell right back, also using the B word.

I didn't last long there.
I guess you never worked in a medical records dept? LOL
Electronic medical records...Is there an option out there for MTSO's SM

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

It's horrifying to think that this company may someday transcribe my medical records. nm
IRS and medical records are other people's business. It's the way of the world, 2006
There is nothing you can hide. Insurance companies have your info and share it with other insurance companies. Medical records are passed from doctor's office to doctor's office, secretary to secretary, MT to MT.
Remember that Pakistan co who threatened to post medical records on the Net?

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


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.

© 1996-2006 Post-Newsweek Media, Inc. All Rights Reserved.

They might if they realized with SS# on medical records, identify theft could happen. nm
Health information personnel, medical records, clerical..sigh...nm
Kaiser switching to EMR and to be offering retrival of your medical records online. sm




OpEd on Medical Records Privacy - Front Page of Yahoo
Thought this was interesting, as it pertains to us. On one hand, it could affect our ability to do our jobs at home. On the other, it could really crack down on medical information being sent to India.



By Sue A. Blevins Tue Aug 26, 4:00 AM ET

Washington - How would you feel about your personal health information flowing freely over the Internet between public health officials, healthcare providers, insurance and data clearinghouse companies, and others – without your permission?

If this doesn't sound like a good idea, it's time to become informed about federal health privacy law.

Today, when Americans visit a healthcare provider for services (including dental and eye exams), they receive a form with a title such as "Notification of Privacy Rights." Many assume that signing the form guarantees that personal information won't be shared with third parties. But the form offers no such guarantees. And neither does federal law.

In fact, the privacy rule established under the Health Insurance Portability and Accountability Act of 1996 (HIPAA) legally permits healthcare providers to share patients' information with more than 600,000 health- and data-related entities – without a patient's consent. Yet the notification form doesn't clearly explain this.

Individuals control their information when they give consent; they don't with notification. When you sign a notification form, all you are doing is acknowledging its receipt. The HIPAA notification form offers no control over who sees your information and instead just tells you about some of the entities that can access your information, rather than asking for your permission.

Consequently, many physicians and other healthcare providers are urging Congress to strengthen privacy rights. They know firsthand that the HIPAA rule fails to ensure true confidentiality.

"...[T]he regulations under [HIPAA], which were intended to extend patient privacy as we moved from a paper-based system of medical records to a digital system, are a sham. HIPAA allows the routine release of personal health information without patient consent or knowledge, and even over a patient's objection…" stresses Dr. Janis G. Chester, president of the American Association of Practicing Psychiatrists.

As the ACLU put it, "HIPAA has so many medical privacy loopholes, it makes Swiss cheese look solid." The organization also points out that under existing federal regulations, the term "privacy" hasn't been well defined. The ACLU is urging Congress to define medical privacy as "patient control of electronic medical records."

Moreover, these organizations and others are lobbying for privacy amendments to key health Internet-technology (HIT) bills currently being considered in Congress.

Lack of privacy has serious consequences. It fosters making personal health information a commodity that businesses sell and trade in the marketplace, notes ACLU. Weak privacy rights also interfere with doctor-patient relationships. When drafting the HIPAA privacy rule, the US Department of Health and Human Services (HHS) noted that "Privacy violations reduce consumers' trust in the healthcare system and institutions that serve them." The ACLU noted recently that at least one third of Americans are not sharing their complete personal medical histories because they feel their privacy will be weakened in the name of efficiency. Additionally, without strong privacy rights, individuals can't take steps to adequately protect themselves from bad, lost, stolen, or misused data.

Meanwhile, more and more personal data is being collected during routine healthcare visits, including information about marital and sexual matters. A married woman (wedded for over 30 years) and mother of two adult children, said she was appalled when asked during a routine visit if she preferred men or women. She stressed that while she "has nothing to hide," she doesn't think it's anyone's business what her sexual preference is or when her first sexual encounter was (which is often asked during exams).

What's more, it is becoming easier to share healthcare information with just a click of a mouse. As HHS has noted, "Until recently, health information was recorded and maintained on paper and stored in the offices of community-based physicians, nurses, hospitals, and other healthcare professionals and institutions.... Today, however, more and more health care providers, plans, and others are utilizing electronic means of storing and transmitting health information…. In a matter of seconds, a person's most profoundly private information can be shared with hundreds, thousands, even millions of individuals and organizations at a time."

Do Americans really want the intimate details of their lives and families shared so easily without their consent? If not, they need to urge Congress to establish stronger privacy rights. Tinkering with HIPAA won't do it. That would just keep a lot of people busy rewriting regulations that don't guarantee privacy. Rather, Congress needs to pass a new law that defines "privacy" and upholds the precious ethic of consent. The new law should guarantee individuals' freedom to decide whether to be part of electronic medical-record and genetic databases for years to come.

• Sue A. Blevins is president of the Institute for Health Freedom in Washington.
Started in-house at a hospital, medical records department, on a typewriter in
1983, earning $6.00/hour, eventually moving up after 7 years to $10.00/hour. All hospital work was then outsourced to a national service in 1986 (beginning of our downfall), went to work for the service and made $2.10/page. Service was bought out by another service, rate changed to $1.90/page. Rates changed again to $0.08/cpl. After many years of experience in all services, found my first account in 1992, charged $.09/cpl/gross lines but blank lines not counted. Business has grown steadily through the years through word of mouth. Now charging $.16/cpl or $25.00/hour or $6.00/page, and having to turn down work at this point. If you have the experience and are detail-oriented, you can find your own accounts eventually like I did. But you have to pay your dues first and be able to transcribe all ESLs accurately. If you learn how to transcribe ESLs well, those doctors are the ones to target for work. I do work an ungodly number of hours, only because I am trying to save at a faster pace for retirement because of all the uncertainty in this line of work.
I think it's unprofessional not to pay..I simply state, if you don't bill, I bill directly...

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. 

Medical records are data driven. Numerals are data.