And in news from San Francisco, UCSF the biggest teaching hospital in the Bay Area was threatened with release of some of its patients’ data on to the Internet.  The wrinkle is that the threat came from a transcriptionist who is a sub-contractor to a sub-contractor to a  sub-contractor to a sub-contractor…… and the individual lives in Pakistan. The transcriptionist in Pakistan had been stiffed on her bill by the subcontractor she was working for to the tune of $500.  That’s a huge sum–above the average annual income in Pakistan, so you can understand that the transcriptionist was pretty desperate, given that her employer had disappeared and that she had nowhere to turn other than UCSF (as she didn’t know who had hired the person she was working for). In the end no patient data was release, and the threat was rescinded apologetically.

How this works out under HIPAA’s privacy standards is anyone’s guest, but it could lead to a major revisiting of the whole concept of outsourcing transcription.

Update: There was a NPR talk-show on this in San Francisco yesterday, (audio available about halfway down this page).  The journalist who wrote the original story claimed that as many as 50% of all transcriptions are being typed up abroad.