[link|http://www.sfgate.com/cgi-bin/article.cgi?file=/c/a/2003/10/22/MNGCO2FN8G1.DTL|A tough lesson on medical privacy: Pakistani transcriber threatens UCSF over back pay], David Lazarus, [link|http://www.sfgate.com/|SF Gate], Wednesday, October 22, 2003

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"Your patient records are out in the open... so you better track that person and make him pay my dues."

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A woman in Pakistan doing cut-rate clerical work for UCSF Medical Center threatened to post patients' confidential files on the Internet unless she was paid more money.To show she was serious, the woman sent UCSF an e-mail earlier this month with actual patients' records attached.

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The violation of medical privacy - apparently the first of its kind - highlights the danger of "offshoring" work that involves sensitive materials, an increasing trend among budget-conscious U.S. companies and institutions.

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U.S. laws maintain strict standards to protect patients' medical data. But those laws are virtually unenforceable overseas, where much of the labor- intensive transcribing of dictated medical notes to written form is being exported.

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Nearly all Bay Area hospitals contract with outside firms to handle at least a portion of their voluminous medical-transcription workload. Those firms in turn frequently subcontract with other companies.

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In the case of the threat to release UCSF patient records online, a chain of three different subcontractors was used. UCSF and its original contractor, Sausalito's Transcription Stat, say they had no knowledge that the work eventually would find its way abroad.

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Lazarus, I'll add, is one of the very, very, very few reasons for reading the Chronicle (a/k/a SF Gate) any more.

It's not like this can't (and doesn't) happen onshore. But when I go wild with data from Kaiser, Visa, Schwab, or Roche, I'm subject to US jurisdiction and law enforcement.

Heh. As I type this, offshoring will be the topic of this morning's KQED Forum program, per blurb.

Live stream is on [link|http://www.kqed.org/radio/index.jsp|this page] (Javascript link, idiots). Program is scheduled for 9am, PDT (noon Eastern, 11am Central, 10am Mountain), and will include the article's author, David Lazarus, as well as Larry Magid (hrm...). Archives are generally posted after a couple of days [link|http://www.kqed.org/programs/program-archive.jsp?progID=RD19&ResultStart=1&ResultCount=10&type=radio|here].

Forum is generally a pretty good show, roughly peers ToTN if you listen to that. Krasny (host) has guest-hosted ToTN, we thought he might have been in the running for permanent host after the Juan Williams fiasco. Personally, I was rooting for Melinda Penkava, though it looks as if she's now landed at [link|http://www.unc.edu/news/newsserv/archives/aug03/wunc080503.html|WUNC].