Doctor-Patient Confidentiality and Medical Transcription

In the last couple of years, medical transcription companies have been sprouting around the country like mushrooms after a rain.

It's been such a boom that several friends, all with MDs, have joined the bandwagon and have become editors or encoders for the booming industry.

But something has been bothering me with all this hoopla about the phenomenon of medical transcription.

It appears that there has been little talk about the issue of doctor-patient confidentiality. Of people from another continent having access to medical information of people half way around the world. Now undoubtably this seems trivial seeing that there is little chance that they would ever meet but with the increasing connectivity of our world and the increasing sophistication of our society, it is becoming more and more apparent that physical meeting is no longer such a big issue.

What is becoming a graver concern is the possibility of using the information to initiate and perpetuate social security scams as well as HMO claims scams..... all from a distance...

Of course, there are obvious safeguards currently in place. Using secure websites and ensuring that the names of the patients as well as their social security numbers are edited out before the entries are sent to the third party transcriptionist probably being the most obvious. But being from a medical background, I know that you don't really need those in order to commit fraud. After all, what are the phishing websites and identity theft rings there for but a good source of those edited out portions of the transcrition. Meanwhile, the medical history, laboratory tests, course in the ward and outcome are ripe for the picking and later mixing and matching to the proper name and social security or HMO number.

Furthermore, an inadvertent slip or error in removing the said identification would open up a patient to potentially damaging or embarassing information being made available over the net. Afterall, who doesn't have a facebook, friendster, or multiply account nowadays. And finding out who someone is is a matter of a few keystrokes in the search function of our favorite social networking site. Imagine the embarassment of having someone post on your wall that you had been treated for STDs. (Then again Philippine celebrities sometimes admit to this in live TV so maybe it's not such a big deal after all...)

But eventually, it all boils down to trust. Is your doctor betraying your trust by using a medical transcription company? Legally... probably not, because I'm sure that in the spirit of defensive medicine, he has made sure that a clause has been inserted in the consent for treatment that allows him to utilize the said service.

But fundamentally, I'm not quite so sure anymore.