ATA on Offshoring
Are you comfortable knowing that your own personal medical information and that of your family may be on a computer in Pakistan right now? What about your financial information or your personal legal business? I’m not comfortable with it, and I don’t think that many Americans would be.
Many companies in the medical, legal, and financial industry require transcription services on a regular basis. For example, if your doctor records notes during your appointment, these notes are then sent to a transcriptionist who creates a written document from the audio file. That document is then filed in your chart or attached to your Electronic Medical Record (EMR) and/or forwarded to other medical professionals. It is an extremely convenient, efficient, and accurate way of keeping your medical record up to date.
Of course full confidentiality is required when handling these documents. Here in the U.S., medical transcriptionists are bound by the Health Insurance Portability and Accountability Act (HIPAA), which was passed to protect the privacy of your medical records. It sets out strict standards for everything including secure transfer and storage of files.
However many companies “offshore” their transcription work to companies and transcriptionists in foreign countries like India, Pakistan, and the Philippines where U.S. law does not apply. Some medical organizations may not even realize they are doing it; they may subcontract their work to a U.S. transcription company that offshores the work, paying their transcriptionists less and therefore making more profit.
Currently, there are no U.S. laws – including HIPAA – that explicitly prevent companies from offshoring personal information, though there has been some talk at both the state and federal levels of implementing new Acts or amending current ones (See Link 1, below).
There are already documented cases of offshore transcriptionists who have threatened to disclose personally identifying information from medical records (See Links 2, below). Clearly, this would have been a breach of the HIPAA act, but there is little chance that they would be extradited and brought to justice here in the U.S. For all intents and purposes, these foreign transcriptionists are immune to prosecution. Besides, it’s a little like closing the barn door after the horses bolted.
The problem does not stop here. A medical record often includes not only your name and date of birth, but address, social security number, and even a scan of your driver’s license for photo ID in some cases. It is not too far of a stretch to realize that in the wrong hands, this information could be used to forge passports and other documents that could lead to threats to national security. Some veterans have already voiced concerns that health records for military personnel could be used to target our troops in Iraq, Afghanistan, and other countries (See Link 3, below).
As touched upon above, the issue for these medical organizations and offshoring transcription companies comes down to money. Offshoring transcription work is cheaper because wages are so much lower than in the U.S. (See Link 4, below). Foreign transcriptionists make as little as $4.00 per hour, whereas here in the U.S. a transcriptionist can make $12-$20.
But some things – like our personal medical records – should not be handled by the lowest bidder. There are some serious issues here about privacy, confidentiality, and even national security that need to be addressed.
So what can we do?
- Start asking questions of all your medical, legal, and financial providers at your hospitals, clinics, attorney’s offices, financial brokers and let them know you want your records kept in the United States.
- Write your Senators and Congressmen. Tell them you do not want any of your private, medical, legal, or financial information forwarded via the Internet to any country outside the United States of America.
- Make sure you let your medical, financial, and legal providers know you do not want your records offshored. Ask them to ensure that any transcriptionists or companies they work with also do not offshore.
- Get informed by reading the links below and conducting your own Internet search.
You can also contact the American Transcription Association (ATA). The ATA is dedicated to making this issue public so people understand the risks involved with offshoring of personal and sensitive information. Its goal is to foster a strong domestic – and fully accountable – transcription industry.
Link 3 – Veterans concerned about offshoring