A community of 30,000 US Transcriptionist serving Medical Transcription Industry

$140 million judgment against Precyse - just me

Posted: Dec 15, 2012

Fatal outsourcing? Thomas Hospital hit with $140 million verdict in death of Daphne woman..

"It began with a mistake made halfway around the world. Juno’s doctor reviewed his patient’s medical chart and certified on a form the medication and dosages that she should take. He then dictated that same information into a phone line.

In the past, a medical transcriptionist at the hospital would have written the information from the dictation onto a discharge summary. But Finkbohner said the average pay for medical transcriptionists in the United States is $19.50 an hour. A U.S company, Precyse Solutions LLC, promised to perform the work cheaper.

That company – the second-largest in the U.S. industry, according to testimony – subcontracted its work to a pair of Indian companies, Medusind Solutions in Mumbai, and Sam Tech Datasys in New Delhi. Testimony indicated that the highest-paid Indian workers make $350 per month.

As a result of the arrangement, information dictated by the doctor went via a computer in Atlanta to India, where the Medusind and Sam Tech employees prepared the discharge summary and sent it back to Thomas Hospital."

This may be old news, but it was news to me... and there is an interesting phrase used a couple times in the article "not up to American standards.."

LINK/URL: Fatal outsourcing?

Thank you for posting this. I hope this verdict makes - other hospitals sit up & take notice. n/m

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X

Don't let the opportunity pass. - just me

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I remember when outsourcing started in earnest several years ago, everyone was trying to find a way to combat it, or at least make it known... but it is always pretty hard to distinguish yourself from all the causes being pushed out there.

I am going to send the article to my congress person, and anyone else I can think of... with your suggested personal note.

I am also going to do some research on the net, ongoing, for committees or subcommittes, or other places to send to in DC. And letters to the editor of local, even national, newspapers.

I think if everybody just sent a copy to the hospitals or practices they work for, that would get things started. Especially reg mail, that gets attention.

There was a time we would have been overjoyed that our concerns and mistreatment were getting such attention nationally. I for one don't plsn to miss the opportunity that is right here... 140 million dollars is a real attention getter, no matter how cost-minded you are.

Please, everyone, think about doing something with this article in the New Year. I will post whatever I come up here, also, as I find things and addresses, if that's okay.

maybe we should send to congress people with - personal note. (thank you too)

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not to mention, few of us make that $19 an hour anymore, but more like just above minimum wage.

great article - and timely!

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and from what I have noticed, even the wages at Precyse are closer to what the Indian transcriptionists are paid....$350 per month. That is what they want us to perform for, but still with U.S. quality standards. I hope the fine is much larger and I hope that the courts will now see that the work needs to be completed within the U.S....but I highly doubt that will happen. No matter what...it's still all about the money, and not to the ones actually doing the work, either. I WISH I could make $19.50 an hour!

thanks for the post! Very enlightening!

Thanks for sharing this... - we can only hope

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that this will mark the beginning of the end of the shameful state MT finds itself in.

Lawsuit! - anon

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This is great,glad it happened, but do you really think it will stop these companies from outsourcing???? Not a chance, they'll find other ways to "save a dollar." Glad I am at the end of my MT career, because I don't see it getting any better.

I doubt it will make any - difference either, and

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there are still many, many reasons why all of us who possibly can should be looking for better jobs. I say let these hospitals and MTSOs lie in the rotten stinking bed of garbage they have made for themselves!

Maybe this time... - just me

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If you read the article, it says the hospital was unaware that the work was being outsourced. Maybe that's just a dodge, but I do believe a lot of hospitals are in the dark about where there work is getting done...most probably don't even realize there is a controversy in the MT field about offshoring...

Just the beginning - MT veteran

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This is just the start of what is going to be a slew of such suits in the future. I'm pretty sure that a lot of these outsourcing companies are lying to their clients about whether or not they oursource overseas, and the clients are not paying close enough attention to the quality of their transcribed documents.

VERY interesting... - MT

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I agree.

Although the fault really lies with the nurse who relied on documentation instead of the doctor's actual medication order form and "signed off" that he confirmed, the issue has been brought to people's attention.

Unfortunately, doctors are doing the dictating but administrators are making the "deals" on who do it. When I worked in-house, we were VERY much appreciated and respected by the dictators. They knew how important our work was and I can't count how many times we were thanked for catching an error or using our common sense and knowledge to correct a document (modern-day MTSO 'QA' grading on minute trivia have no clue).

The lawyer was shrewd in his research and bringing to light the offshore medical documentation issue. At the least, other lawyers will take note of this to use in their malpractice cases, and readers (patients/facilities/doctors) who didn't know this was happening with medical records are now informed.

"Finkbohner said the hospital saved 2 cents per line of text by using the outside firm. But he said it came at a price: Testimony indicated that the Indian firms operate under quality standards that are one half to one twelfth that of the United States in terms of acceptable error rate.

He said Precyse officials claimed that the Indian subcontractors used American standards but that officials from those companies testified that they did not."

What I understood from the article - was that

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it was dictators who did not know the work was being offshored, which I certainly understand. I don't think a lot of them even know or care that it is done by a service or person half way across the country.

I would bet most hospital administrators who contract for transcription know full well where their cheap reports are coming from, and I mean CHEAP. They know what they are paying for, and hoping it doesn't come back to bite them in the @$$ like it did in the above case.

I've seen contracts where a percentage of work - research

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had to be done in the US and the rest could go offshore, proving that, indeed, the adminstrators know the service is being offshored.

A similar situation with Johns Hopkins in the early 90s - research

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When I went to work for Signal, they distributed an article about a death occuring from a mis-trascription for a chemotherapy drug. That was a US MT as that was the days before offshoring. It happened with the MTSO that had the account before Signal had it (Signal was pre-MDI-MD MTSO). The patient was given a lethal dose of a chemo drug when it was mis-trascribed and no one double checked it. To me, bottom line is that it is the responsibility of everyone person encountering patient care to check and double check before a mistake like this happens.

HIM Department... - MT

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The Health Information Management people at the hospital are playing a big role in work being outsourced and offshored. If you are a member of AHIMA, you will see through various discussions that it's seen as no big deal to offshore work. Transcriptionists are basically seen as a joke in that circle. We are "uneducated" and most are not certified. Many of these HIM managers are people with not much experience in healthcare and have degrees from strictly online schools (think: University of Phoenix... you know the ones that advertise on commercials). It's not surprising that not many seem to care where the work goes. They probably get bonuses when they cut expenses.

The problem isn't just off shore (sm) - Morgan

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I don't think most doctors have any idea how MT has changed and that they now have people all over the nation/world transcribing their reports. We are silenced by the MTSOs not being allowed to communicate problems to the doctors. Docs have no idea that we are not paid for half the work we do. Researching online or in the demographics for confirmation on a medication dose is a FREE SERVICE that we are not paid for. How many really take the time to check a doctor's sloppy dictation that doesn't specify mL vs mg on an uncommon med? Do the doctors know that a person making minimum wage, if that, is trusted to volunteer their time to verify data for every questionable dictation because that is the way it has always been, from the days we were paid a fair wage? Do they have any inkling that those who are conscientious enough to always verify data are terminated for low line counts?

In an industry governed by lawsuits, how many more patients will have to die before they finally get the picture?

OMG look what I just found! - This is from the Medusind website!

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I see mistakes in there, and just look at some of the comments! Medical Transcription

Background:

MMA is a leading nationwide provider of quality medical transcription work to hospitals and clinics all over the US. It offers a full range of medical transcription services that can reduce costs and improve throughput in their clients' healthcare environment. The company ensures the following for their clients:

Scalable transcription system.
Dependable turnaround time.
Domain expertise.
Dependable solutions via technology.
A large workforce of transcriptionists.
Supports clients in meeting HIPAA standards.
Encrypted and secure internet-based technology.

Key Challenges:

Increasing number of errors in transcripts produced by US staff. (WHAT????)

Shorter TAT demand from new and existing clients.

Dwindling resource of experienced staff in the US.

Lack of interest in medical transcription as a profession in the US. (again...WHAT???)

Operational Costs on medical transcription as high as $5.00 a report irrespective of length of report.

Inability to deliver on ramp-up
schedules and projections or to sign on new clients due to the points mentioned above.

The Medusind Approach & Solution:

Process Study of MMA transcription workflow to assess the reason for quality not being delivered.

Rigorous testing was conducted on both productivity and quality fronts to shortlist vendor companies.

At the initial stage the Medusind vendor companies were required to deliver the workflow until the first stage of QA at above 96% quality.

A three-stage QA process was put in place as against the single stage QA process at MMA at a lower cost to ensure output of above industry standard quality.

The third-stage US QA was put in, with the intention of being an optional stage once Medusind could deliver from stage 2 QA directly.

A team of highly experienced QA2s was hired at Medusind to manage the second stage of QA - all with above 5 years of experience as QAs in medical transcription.

Medusind focused on operational efficiencies to minimize wasteful processes.

Each account that was transitioned to Medusind took less than a fortnight to go off third-stage US QA requirement thus bringing down US QA labor costs much earlier than predicted.

Costs were cut down by bringing the third stage of QA taking place in the US from 100% to 10% of the total volume processed at Medusind for every account transitioned.

Consistent delivery of above industry standards at the stage 2 QA level on a 24 x 7 basis by Medusind.

All vendors are capable of ramping up to over 50,000 lines/day to ensure that MMA delivers its ramp-up schedules projected to the end clients.

Regular reporting to MMA on both quality and productivity fronts with value added statistical analysis.

Benefits to Client:

Availability of trained resources in medical transcription in India enables recruitment of higher quality team members.

Reduced QA cost by 30%.

Succeeded in transitioning 4,50,000 lines of work per month to India at a lower cost within the first nine months of our working relationship with MMA
The US and India time difference & high quality work resulted in shorter TAT, thereby leading to work being delivered to end clients at least 6 hours before TAT on all work types assigned to Medusind.

Medusind has helped MMA become identify weak links in quality and productivity processes and thereby made MMA more quality efficient.

Medusind services help test the global scaling of the MMA online tech platform to ensure a robust delivery system to end clients.

Medusind's consistently delivered above industry Quality standards leading to MMA shifting QA of their US work to Medusind thereby controlling recruitment requirements and costs at their end.

Medusind - just me

[ In Reply To ..]
I guess this is the heart of the matter, right here:

"Costs were cut down by bringing the third stage of QA taking place in the US from 100% to 10% of the total volume processed at Medusind for every account transitioned."

This is extraordinary. I find it very upsetting, and again, it's the almighty dollar that fuels everything...

I for one think this is a golden opportunity, and 140 million, is no small sum... not for any hospital or MT company anywhere..

You didn't post a link to the website, or maybe I just didn't see it.

Thanks for the research...

Just google Medusind. - *

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Nm

Here is the link: - original poster

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http://www.medusind.com/ss-medical-transcription.asp

Sorry...... - I did not mean to say...

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....that I was the original poster, I am not the original poster.

I gave a deposition in this case, had worked for Precyse - laughing out loud

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Hehttp://blog.al.com/live/2012/12/fatal_outsourcing_thomas_hospi.htmlre's an article I found:

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