In an age where personal data security is more critical than ever, the handling of health information by healthcare providers and institutions faces unprecedented risks. Every time a person visits a doctor, clinic, or hospital, their private medical and demographic information is entered into electronic medical records (EMRs), creating a permanent and detailed history of their healthcare journey.

While the U.S. has implemented federal HIPAA regulations to protect this sensitive information, outsourcing the handling of these records to foreign countries could dangerously undermine patient privacy.

These risks become even more acute when we consider what might happen under the new U.S. Presidential Administration. On a wide variety of trade, data and intellectual property fronts, it is likely that there will be significant restrictions on the transfer of healthcare records out of the U.S. This looming issue makes the case for fully domestic Medical Coding and HIM even more pressing.

The Hidden Vulnerability in Electronic Medical Records

EMRs include a range of personal data beyond basic health details, such as social security numbers, home addresses, workplace information, prescription histories, and even family demographics like children’s schools. Sensitive mental and physical health information, including potentially stigmatizing diagnoses or explicit medical images, also lives within these records. Given the personal and sensitive nature of this data, any compromise could lead to severe consequences for individuals and their families, from identity theft to exposure of private health issues.

The Outsourcing Dilemma: Sacrificing Security for Savings

Over the past decade, healthcare providers increasingly turned to outsourcing companies based in countries like India, Pakistan, and the Philippines to manage HIM functions, primarily due to the cost savings of cheaper labor. Not only do these foreign resources often produce lower quality results than domestic coding firms, but these cost-saving measures introduce a substantial risk: these foreign workforces are not bound by HIPAA or U.S. privacy laws, leaving a critical gap in accountability and enforcement.

In the U.S., HIPAA regulations require strict controls to protect patient data, and the Department of Health and Human Services (HHS) Office for Civil Rights actively enforces these regulations. Violations can result in significant penalties for U.S.-based providers, coders, and contractors. Overseas entities, however, operate outside the reach of HIPAA and U.S. law. Even if a foreign outsourcing firm claims HIPAA compliance, there is no legal recourse if that compliance is not upheld. This reality leaves patients’ EMRs vulnerable to breaches and misuse without the protective recourse available within the U.S.

The Consequences of Data Exposure in Foreign Hands

Medical records have high black-market value, estimated at $100 to $1,000 per record. Cybersecurity experts warn that any patient information processed overseas faces an increased risk of being sold or leaked, with little accountability for the individuals or organizations that misuse it. If foreign workers mishandle or sell this information, U.S. patients have no legal remedy, and enforcement agencies like the HHS cannot prosecute foreign violations. The risk is magnified as foreign countries may lack the stringent data protection standards the U.S. maintains, making it easier for bad actors to access and exploit sensitive information.

Why U.S.-Based HIM Processing is Essential

The most effective solution to safeguarding patients’ privacy is to keep all HIM processing within the U.S. Here are key reasons why:

1. Legal Protections and Accountability: Processing HIM within U.S. borders ensures that federal privacy laws like HIPAA apply. Domestic coders, record-keepers, and other HIM professionals are legally obligated to follow rigorous data protection standards. If a breach occurs, U.S. agencies can investigate, penalize, and ensure corrective action, holding violators accountable in a way that is impossible with foreign firms.
2. Higher Standards and Compliance Assurance: U.S.-based HIM professionals are trained in HIPAA regulations, and their employers must pass routine audits and uphold security certifications. By contrast, foreign companies may not face the same rigorous standards, creating a lower threshold for compliance and increasing the risk of data compromise.
3. National Security Concerns: The security of U.S. citizens’ personal and medical data is not merely a private concern but a matter of national security. With identity theft and fraud posing substantial risks to individuals and financial systems, any weakness in data security can ripple out into wider social and economic instability. U.S.-based processing helps mitigate these risks by keeping sensitive data within the country’s regulatory and legal reach.
4. Probable Upcoming Legislation: We expect that their will be upcoming scrutiny of offshoring medical coding by the Trump administration, which could produce a seismic shift back towards fully domestic medical coding.
5. Supporting Domestic Workforce and Privacy Protections: Moving HIM functions offshore not only endangers patient data but also erodes the U.S. job market for health information professionals. By keeping these jobs domestic, the U.S. strengthens its workforce in this critical sector, benefiting both privacy standards and the economy.

The Path Forward: Patient Privacy Before Cost Savings

While cost-saving incentives may drive healthcare institutions to consider outsourcing HIM functions, the potential consequences for patient privacy and security are simply too high. Patients trust that their healthcare providers will protect their most sensitive information. This trust can only be preserved by ensuring that data handling stays within the framework of U.S. laws, oversight, and accountability.

To truly protect patient privacy, healthcare institutions must prioritize domestic processing of HIM tasks. When patients can trust that their medical records remain protected by robust U.S. privacy laws, they can focus on their health with confidence and peace of mind.

To get ahead of any changes in government policies regarding the offshoring of HIM and medical coding, you may want to talk to the Team at Coding & Billing Solutions. Are superior results and 100% fully domestic approach are something your organization needs to consider.

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With the occasion of International Overdose Awareness Day, people close to us with substance abuse issues are in our thoughts. America’s ongoing addiction crisis is a problem that is close to the hearts of the Team at Coding & Billing Solutions. In fact, our annual Golf Classic is dedicated to helping children who have been impacted by addiction.

Do you have an adult family member or friend struggling with drug or alcohol abuse? You’re likely wondering how to help. The following are some questions to ask and some tips on how to help.

Am I Overreacting to a Substance Use Problem?

If you’re noticing issues in your loved one’s work, health, relationships, finances, or social life, you’re not overreacting. Continuing to use substances despite these problems is a clear sign that substance use has become a significant issue. When someone is unwilling to discuss their behavior or consider that there might be a problem, it’s a strong indicator that a problem exists.

What You Can Do:

1. Educate Yourself: Learn about the signs and symptoms of substance use.
2. Observe Behavior: Monitor the person’s actions over days or weeks to gather information. This can be helpful if you decide to talk to other family members, seek professional advice, or address the person directly.
3. Share Concerns: Discuss your observations with other family members and friends to gauge their perspective. If they agree, decide who will talk to the person about seeking help.
4. Seek Professional Advice: Contact a substance use professional, mental health professional, or other trusted experts to describe the situation and get their assessment.
5. Ensure Safety: If there’s any risk of physical or emotional harm, develop a safety plan.

The Benefits of Taking Action Early

The idea that someone must “hit bottom” before they can be helped is a myth. Research shows that early identification of substance use problems is far more effective. Catching the issue early—before significant damage occurs—leads to better outcomes. Early intervention might involve a health screening or a conversation with a professional. Treatment is often less intense and disruptive when the problem is addressed early.

Don’t wait for a crisis to take action. Without intervention, you may face severe consequences like arrests, medical emergencies, job loss, and even death. Moreover, untreated substance use can lead to additional problems for family members, such as health issues, depression, anxiety, and even substance use problems in children.

How to Raise the Subject

You might worry that bringing up the issue will lead to drastic reactions. However, the conversation could be productive. The person might not realize the extent of their problem or its impact on others. Without change, the situation could worsen, leading to the very outcomes you fear.

Tips for a Successful Conversation:

1. Choose the Right Time: Don’t bring up the subject when either of you is under the influence of substances.
2. Plan Ahead: Find a time when you can talk privately and without interruptions. Aim for a dialogue where both of you can express your thoughts.
3. Express Concern: Start by showing that you care for the person and are concerned for their well-being.
4. Be Specific: List the behaviors that worry you and explain how they’ve impacted you and others.
5. Encourage Dialogue: Ask open-ended questions and listen to their perspective without judgment.
6. Follow Up: If the person denies there’s a problem, suggest revisiting the conversation later. Your goal is to express your concerns, not to force an immediate change.

What If They Can’t Cut Back?

If the person has only recently developed a problem, they might be able to cut back on their own. However, many people who try to reduce their use find that they can’t sustain it for long. This realization may help them understand that the problem is more serious than they thought. If the person is willing to consider that there’s a problem, suggest getting an evaluation from a professional.

How to Help a Friend Understand They Need Help

If you’ve tried expressing your concerns repeatedly without seeing any change, focus on delivering a consistent, positive message: “We care about you and want you to get help.” Avoid blaming or arguing, as these can lead to denial and defensiveness.

Consider involving other trusted individuals—such as a friend, doctor, or clergy member—who might be able to reach the person in ways you haven’t been able to.

DOs and DON’Ts

• Don’t try to talk when either of you is under the influence.
• Do protect yourself and others from physical harm.
• Do call the police if there is violence.
• Do set and stick to limits that protect your home, finances, and relationships.

If you’re at your wits’ end, a formal intervention might be necessary.

How to Help a Loved One Get the Care They Need

When people think of treatment for substance use, they often imagine long-term residential facilities or detox. However, treatment options vary widely and are tailored to the individual’s needs. Treatment addresses physical, psychological, emotional, and social aspects of the person’s life.

Treatment Steps:

1. Screening: This involves questions about substance use and its impact. It can be done by various professionals, including doctors and counselors.
2. Brief Intervention: If a problem is identified, the person may receive feedback and be asked to cut back or stop their use. If they’re willing to make changes, a health professional can help set goals and offer support.
3. Ongoing Support: If necessary, the person may be referred for more intensive treatment. Any number of programs can be effective if the person is willing to engage.

To find a treatment program, visit SAMHSA’s Behavioral Health Treatment Services Locator.

What to Do in an Emergency

If your loved one shows any of the following symptoms, call 911 or emergency services immediately:

• Loss of consciousness after taking drugs or alcohol.
• Seizures.
• Suicidal thoughts after drinking or drug use.
• Severe withdrawal symptoms, such as confusion or tremors.

Getting help for someone struggling with substance use is never easy, but taking action is crucial for their well-being and the well-being of those around them.

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