Paid by the pound



  • This is from a friend who currently has a job in the healthcare sector; specifically, a company that handles Medicare/Medicaid patient records. They get these records in PDF format. Friend's company passes on the records to a second company for conversion to EMR format. 

    Now you might -- excusably -- think this could be done by simply emailing the PDF patient records to incoming@megacorp.com. Those of you looking for a WTF will realize immediately that this is far too sensible, and perhaps -- again excusably -- think that there is a WTFish web app running at MegaCorp which can only accept one entry at a time.

    No. Apparently (and I don't know any details, so don't quiz me on this) MegaCorp bills Medicare and gets reimbursed/paid based on how many pounds of printed records have been converted to EMR. So my friend and three co-workers spend a good bit of their time printing the PDF patient records and physically transporting them to MegaCorp.

    This, I suppose, is how the government "creates jobs".


  • Winner of the 2016 Presidential Election

    This is the first thing in a while that has made me tilt my head and say "what?" I had to re-read it to make sure.

    Can't they just multiply the number of converted pages by the average weight of a sheet of US Letter (or A4 or whatever) paper?

    This... makes no sense.





  •  @joe.edwards said:

    This is the first thing in a while that has made me tilt my head and say "what?" I had to re-read it to make sure.

    Can't they just multiply the number of converted pages by the average weight of a sheet of US Letter (or A4 or whatever) paper?

    This... makes no sense.

    These business models are based on keeping inefficiency baked into the workflow.  Ensures job security.  There are some tasks at my job I do inefficiently on purpose.  If I don't, I can run out of things to do.  Then I'm penalized when I'm reviewed and I have unauthorized non-billable time in my time sheets.  The idea is to take the *authorized non-billable* tasks and drag them out as long as possible when billable work is sparse.  Keeps the 8 hours of time sheets filled and me out of trouble.

    Obviously, we can't artificially drag out the billable work because that would be pretty fucked up, if not criminal.  People get fired for it.  Frankly, the fucked up requirements on time utilization here sometimes drive people to do this.

    Think about all the jobs that would be lost and the profits lost if they eliminated the crap with this medical records process...  May even put an entire company out of business.

    I didn't used to be this way, but soul-crushing minute-by-minute tracking of time will do this to an employee.  It's amusing to see the new guys come in here and knock tickets out one after another flying by his more experienced peers.  Then he runs out of shit to do and wonders why he can't just go home and why he's getting in trouble for having nothing to do!

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  • @t_wheeler said:

    MegaCorp bills Medicare and gets reimbursed/paid based on how many pounds of printed records have been converted to EMR.
     

     

    This was probably very efficient at the time the rule was written. All you had to do for accounting purposes was toss it all on a scale and record the weight. 

    The WTF is that MegaCorp is too cheap to take the PDF files electronically and then print and weigh them in house. (We'd have to pay for toner and paper! OMG, think of our profit margin!)

    I've seen similar lines built into contracts for document imaging/workflow projects. They don't pay per hour, nor per page or file, but per standard archival box. It's a large enough unit to be easily tracked, but small enough you can keep tabs on a multi-month/year effort. 

     



  • @t_wheeler said:

    think this could be done by simply emailing the PDF patient records to

    Not really.  These PDF's contain personally identifiable information, including medical histories and probably account numbers or social security numbers.  It could be against the law, and is certainly against company policy, to send these electronically.  Physically printing and delivering the data in this way is certainly more secure than sending by email.


  • Winner of the 2016 Presidential Election

    @DrPepper said:

    It could be against the law, and is certainly against company policy, to send these electronically.

    It's a good thing no one has invented SSL, SSH, FTPS, SFTP, VPN, HTTPS, PGP, ... -snip- ... yet.

    Man, if only someone could come up a secure way of transmitting information over an insecure channel.



  • @joe.edwards said:

    @DrPepper said:

    It could be against the law, and is certainly against company policy, to send these electronically.

    It's a good thing no one has invented SSL, SSH, FTPS, SFTP, VPN, HTTPS, PGP, ... -snip- ... yet.

    Man, if only someone could come up a secure way of transmitting information over an insecure channel.

    Ok smartypants, how exactly would you charge by-the-pound for that? Oh, wait...


  • Speaking of jobs that shouldn't exist, I've been trying to find an old DWTF about a guy whose entire job consisted of literally cutting up directory listings with scissors and pasting them into a log book, or something like that.



  • @DrPepper said:

    @t_wheeler said:

    think this could be done by simply emailing the PDF patient records to

    Not really.  These PDF's contain personally identifiable information, including medical histories and probably account numbers or social security numbers.  It could be against the law, and is certainly against company policy, to send these electronically.  Physically printing and delivering the data in this way is certainly more secure than sending by email.

    Because we all know that a mail carrier would never look at someone's mail, and that it is impossible to open someone else's mailbox.

    On a related note, I bought a house a month ago, with my parents on the loan.  They sent my dad a packet for his records (containing his tax documents, SSN, etc.) in the mail, in an unsealed envelope.



  • @joe.edwards said:

    It's a good thing no one has invented SSL, SSH, FTPS, SFTP, VPN, HTTPS, PGP, ... -snip- ... yet.

    Man, if only someone could come up a secure way of transmitting information over an insecure channel.

     

    And yet companies like BT and Virgin think nothing of sending personal customer details as an unencrypted excel attachment to a plain-text email...

     



  • @Cassidy said:

    @joe.edwards said:

    It's a good thing no one has invented SSL, SSH, FTPS, SFTP, VPN, HTTPS, PGP, ... -snip- ... yet.

    Man, if only someone could come up a secure way of transmitting information over an insecure channel.

     

    And yet companies like BT and Virgin think nothing of sending personal customer details as an unencrypted excel attachment to a plain-text email...

     

    Judging by that URL... they do now.


  • @Zylon said:

    Speaking of jobs that shouldn't exist, I've been trying to find an old DWTF about a guy whose entire job consisted of literally cutting up directory listings with scissors and pasting them into a log book, or something like that.

    The Indexer?



  • @Zylon said:

    Speaking of jobs that shouldn't exist

    For years I've been completely baffled (and still am) by the existence of a job it defies my mind to define. The guy who sits on the elevators and press the buttons for destinations floors, all day long. Are there similar jobs on other countries?



  • @atipico said:

    For years I've been completely baffled (and still am) by the existence of a job it defies my mind to define. The guy who sits on the elevators and press the buttons for destinations floors, all day long. Are there similar jobs on other countries?

    There's exactly one building in Seattle with this. It was completed in 1914. And it's because the cage-style elevators don't have buttons; you have to manually stop them.

    But then I don't live in a dystopic country taken-over my union thugs as you apparently do...



  • @blakeyrat said:

    a dystopic country taken-over my union thugs

    No, you misidentified the cause. It's a colonial mentality. Most buildings have a 2nd elevator exclusively for staff peaople performing services, ranging from the cable guy to cooks / housemaids / cleaning staff. And cooks and cleaning staff have a very small room destined for them to sleep on the workplace, hidden away from their non-lowclass bosses. I am not making this up (I'm trying to search for articles confirming my claim but I can't find any in English).



  • @Sutherlands said:

    Because we all know that a mail carrier would never look at someone's mail, and that it is impossible to open someone else's mailbox.

    The important difference is, before computers, that was the only way, and hence its inherent lack of security was acceptable. Now, in the age of computers and lawsuits, people are reluctant to change to anything that potentially introduces a risk they didn't already have. And if the people signing off on it don't understand how it works, that's usually the same thing as an unacceptable risk.

    Normal mail may have its flaws, but "all those flaws were there before I arrived, and therefore, should those flaws manifest themselves into an actual problem, it's not my fault"



  • I love the semi-random directions these threads go in. Some of the discussion on this site reminds me a bit of the old alt.sysadmin.recovery newsgroup I used to lurk in.

    @NoOneImportant said:

    This was probably very efficient at the time the rule was written. All you had to do for accounting purposes was toss it all on a scale and record the weight. 

    The WTF is that MegaCorp is too cheap to take the PDF files electronically and then print and weigh them in house. (We'd have to pay for toner and paper! OMG, think of our profit margin!)

    I've seen similar lines built into contracts for document imaging/workflow projects. They don't pay per hour, nor per page or file, but per standard archival box. It's a large enough unit to be easily tracked, but small enough you can keep tabs on a multi-month/year effort.

     

    Ah, this makes sense. And MegaCorp's refusal to accept PDFs is a WTF, but IMO the real WTF is a contract/regulation that is about 15 years out of date.


     



  • @t_wheeler said:

    alt.sysadmin.recovery
     

    The monastery still going?

    Their insanity kept me sane in difficult times. I loved those scary devils.



  • @justanotheradmin said:

    @Sutherlands said:
    Because we all know that a mail carrier would never look at someone's mail, and that it is impossible to open someone else's mailbox.

    The important difference is, before computers, that was the only way, and hence its inherent lack of security was acceptable. Now, in the age of computers and lawsuits, people are reluctant to change to anything that potentially introduces a risk they didn't already have. And if the people signing off on it don't understand how it works, that's usually the same thing as an unacceptable risk.

    Normal mail may have its flaws, but "all those flaws were there before I arrived, and therefore, should those flaws manifest themselves into an actual problem, it's not my fault"

    True, but also only a partial explaination. In most cases of mail interception, it is only a small amount that can be compromised at any one time. With electronic interceptions, the ability to get either a larger ammount in one shot, or to establish a repeatable theft pattern is much greater.


  • Discourse touched me in a no-no place

    @TheCPUWizard said:

    True, but also only a partial explaination. In most cases of mail interception, it is only a small amount that can be compromised at any one time. With electronic interceptions, the ability to get either a larger ammount in one shot, or to establish a repeatable theft pattern is much greater.
    Once mail is in the postal stream, sure. But I work in the print industry and handle financial/medical data almost exclusively. Here's a high level overview of how that mail gets made:

    1) The customer transmits the data necessary to generate the letters/packages/whatever.
    2) Some software ingests and preprocesses that data, shoving it all in a SQL database where it will remain for one of two durations: Until we run out of space on the SQL server (typically years) or until we're contractually obliged to remove it (I'm only aware of one client with such a requirement).
    3) Some more software takes that data and crunches it into PostScript or PDFs, and sticks those somewhere. Postal regulations require anything that gets mailed at automation rates to be archived electronically for two years. Only a few clients do this themselves - and in those cases it has to be transmitted back across the internet anyway.
    4) Production printers ingest the PostScript or PDF and spit out paper.
    5) Someone QC's the print
    6) That paper is taken to be assembled into complete letters - typically folding is done by machines, but the actual envelope stuffing is more often than not human. Large-volume stuff (statements, etc.) will get auto-stuffed, but anything with enclosures, or a non-windowed envelope, etc. is definitely hand-packed.
    7) A human being QC's the product
    8) A human being splits the product up into postal trays, palletizes them, and they get shoved on the truck.

     

    At step #1, the stuff is getting transmitted across the internet anyway, so it's open to interception there. Password-protected (not keyed) SFTP is the most typical mechanism. The passwords are usually what I'd call "strong" but wouldn't last very long. They are only changed when contractually required (I've never seen one change).
    Step #2, programmers, support personnel, datacenter monkeys, etc. have access to the data nearly indefinitely.
    #3, again, programmers, support personnel, etc. have access to the finished product for 2+ years.
    #4, Print operators, material handlers, etc.
    #5, this person's job is actually to look at the thing.
    #6, equipment operators, temps, etc. etc. etc.
    #7, one more employee whose job is to actually look at it.
    #8, one more human being.

    And that's without even getting into comminglers and such.

     

    Employees are supposedly carefully vetted to minimize this (I didn't notice anything above and beyond the normal pre-employment screening), but it's not the postal service introducing the risks, it's the production process. And there are all the opportunities to do small-quantity manual interceptions PLUS highly-repeatable electronic interceptions.



  • Weng - you are correct, but my intended point was in the "pre-computer" days where copies where made on Xerox (or equiv) machines, etc.



  • @atipico said:

    @blakeyrat said:
    a dystopic country taken-over my union thugs

    No, you misidentified the cause. It's a colonial mentality. Most buildings have a 2nd elevator exclusively for staff peaople performing services, ranging from the cable guy to cooks / housemaids / cleaning staff. And cooks and cleaning staff have a very small room destined for them to sleep on the workplace, hidden away from their non-lowclass bosses. I am not making this up (I'm trying to search for articles confirming my claim but I can't find any in English).


    Conrade?



  • @serguey123 said:

    @atipico said:
    @blakeyrat said:
    a dystopic country taken-over my union thugs

     

    No, you misidentified the cause. It's a colonial mentality. Most buildings have a 2nd elevator exclusively for staff peaople performing services, ranging from the cable guy to cooks / housemaids / cleaning staff. And cooks and cleaning staff housemaids have a very small room destined for them to sleep on the workplace, hidden away from their non-lowclass bosses. I am not making this up (I'm trying to search for articles confirming my claim but I can't find any in English).


    Conrade?
     

    I realized what I said could give the impression that the staff of some offices will sleep on their workplace, and that is not what I meant. The fact is in my country, contrary to the US, the suburbs are the poor neighborhood - the more distant from the big centers, worst is the life quality.

    It's quite common for people who live on those poor suburbs to have jobs on the central part of the cities and endure hours of traffic (oh, the joys of traffic jams). And it is quite common for middle-class citizens to have weekly or daily cooks and housemaids on their homes. If itś daily, they usually sleep on the houses of their bosses, and many buildings have this taken into account and part of the architecture, and also a 2nd elevator destined to this kind of workers, or the occasional cable guy, etc.

     



  • @Weng said:

    At step #1, the stuff is getting transmitted across the internet anyway, so it's open to interception there. Password-protected (not keyed) SFTP is the most typical mechanism. The passwords are usually what I'd call "strong" but wouldn't last very long. They are only changed when contractually required (I've never seen one change).
    Step #2, programmers, support personnel, datacenter monkeys, etc. have access to the data nearly indefinitely.
    #3, again, programmers, support personnel, etc. have access to the finished product for 2+ years.
    #4, Print operators, material handlers, etc.
    #5, this person's job is actually to look at the thing.
    #6, equipment operators, temps, etc. etc. etc.
    #7, one more employee whose job is to actually look at it.
    #8, one more human being.

    SSHHHHHH! You'll scare the boss! If you scare the boss he might hire an extra auditor. And then I'd have to find a way to justify all those non billable tickets that took 6 times longer than the billable tickets of the same type.



  • @Sutherlands said:

    Because we all know that a mail carrier would never look at someone's mail, and that it is impossible to open someone else's mailbox.

    Obviously, the mail isn't terribly physically secure. Nevertheless, when you mail something, it's being handled by the government, which has all sorts of legal ramifications. Of course, any tampering / stealing / etc is a federal crime. Also, of course, you get into sovereign immunity issues, and so the liability for disclosure gets nicely laundered evaded.



  • @fatbull said:

    @Zylon said:

    Speaking of jobs that shouldn't exist, I've been trying to find an old DWTF about a guy whose entire job consisted of literally cutting up directory listings with scissors and pasting them into a log book, or something like that.

    The Indexer?

    That's it. Good comments on that story too. Kind of depressing to be reminded how nice the comment threads used to be before the trolls took over.

     


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