Wednesday, March 20, 2013

How Outsourcing Medical Care In Hospitals Is Needlessly Harming Patients

Imagine having a loved one in the hospital who needs to be transferred to a rehab facility. The hospital sends standard discharge paperwork to the rehab facility, which includes necessary life saving medications the patient will need there after being transferred.

Sounds like simple, standard "stuff," right? Think again. Unbeknownst to you, your hospital has outsourced the transcription of the discharge summary to a company in India, where the discharge summary your doctor has dictated is sent electronically, transcribed into written form, and sent back to the hospital.

You might guess what happens from there. In a recent case in Alabama, a 59 year old woman was discharged to the local rehab facility with a discharge summary chock full of critical errors. The most alarming? An order for 80 units of insulin instead of 8 units--10 times the required dose. The rehab facility gave the 80 units of insulin, which caused the patient sustain a massive brain injury, which eventually took her life.

During the case it was discovered that the hospital outsourced transcription of its medical records to a company in New Dehli, India in order to save 2 cents per page on transcription costs. Even worse, the hospital did not use its own internal reviewers to review for possible errors. Apparently, that was outsourced to India as well.

An Alabama jury who heard this evidence was incensed enough to return a $140 million verdict against the hospital.

An integral part of a hospital's responsibility to its patients is to make sure the discharge instructions are correct, whether the patient is going home or transferred to another facility. Patient safety demands it. It's bad enough when there is a colossal mistake like a discharge order that orders a lethal dose of medication.

It's worse when such an important function is outsourced to save pennies per page on transcription costs. Bottom line: when medical providers are outsourcing critical aspects of patient care and safety to increase profits, that is truly a prescription for disaster.

I hope every hospital administrator at the next "administrator's conference" in some warm, sunny location hears about this case, and what a wake up call it sends to hospitals. Let's just hope the wake up call is not outsourced too.