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Nuance

Having a Plan B - alertandoriented

Posted: Aug 6th, 2017 - 8:15 am In Reply to: I find it hard to believe - they did not have a plan B

As a fellow HIS person, I, too was always concerned about this question. When IT came to install computers, take away all of our transcription equipment, I would ask - but what if this central system fails? What is plan B? There is a syndrome that I think needs to be studied. It has two parts. The first part is the one you speak of. Management trusts the person who sells them the transcription system and dumps the responsibility on the person they are paying each month. Once they sign that contract, all their own transcription equipment is dumped (mistake). The transcription provider (in this case Nuance) is then completely responsible for both plan A and plan B (mistake, the hospital should have its own backup, but they never do). The syndrome is they have a responsibility to provide the necessary service to physicians, but they contract that service and the liability of not having it completely to the transcription provider with no back up plan. The transcription provider, in turn, has no catastrophic back up plan. (When my doctors at the hospital were dictating, they were telling me they were unable to access the patient's records. So not only were they not able to dictate, they could not even access previous records which was REALLY A PROBLEM. And there was no "PLAN B". Nobody backed up onto an independent system so if the primary failed they could at least access the records until the day before WHEN A BACK UP WHICH SHOULD HAVE BEEN INSTALLED would have kicked in. But the name of the game is only $$$. Having a back up until the day before or the hour before the disaster or whatever is what should have been in place. Backed up into a separate system. Could have been at the hospital. Could have been in a separate building. Could have been in a separate cloud provider. BUT THEY WOULD NOT SPEND THE MONEY. Thus, all records were lost, all doctors could not dictate, etc. etc. etc. ad nauseum. (NUANCE SYNDROME - WE ARE NOT SPENDING THE MONEY TO CORRECTLY BACK UP OUR SYSTEMS INDEPENDENTLY IN CASE OF A CATASTROPHIC FAILURE)

The second syndrome is "BLIND MAN SYNDROME" -- Because people are alone in their house or their office cubicle and their computer is "theirs" the private information they are typing is private and no one can see it because IT IS IN THEIR COMPUTER". No matter how many times you tell them that what you type into your computer and what you send across the internet is NOT PRIVATE and can be looked at in many different manners, the average person refuses to believe this is possible. The longer they have been using a computer and have never had anyone obviously hack and write them a note about something they wrote thinking it was private, they tend to relax and believe all is well and no one is reading something they don't want looked at. No matter how intelligent the person, no matter how much computer experience, they still keep writing things they would never want anyone other than the intended recipient to read. It can be hijacked at so many points, but they absolutely refuse to believe the warnings.

"INTEGRITY AND PRIVACY IS JUST TOO EXPENSIVE SYNDROME" In this line of thinking medical records should be on a closed system inside the hospital arena or site of production arena and NEVER sent into a system that is connected to the internet. INTRANET? Yes. INTERNET? No. OVERSEAS? Are you kidding? Private confidential medical information sent over the internet and even overseas? Is this even reasonable? NO. It is done solely for the purpose of a cheaper product. We sacrifice the integrity of privacy for cheaper prices.

Moving transcriptionists out of the hospital and into their homes seemed the right move at the time with the invention of the internet. What they failed to forecast was the ability indeed the probability that the records produced and passed back and forth over the internet could be intercepted at various points. It is the wrong decision and it my sincere hope that it will be reconsidered.

I hope this stimulates some thought.

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