Outsourcing of Pacemaker Monitoring to Third Parties

I received a letter today informing me that my physican requested some "rhythm management" company "assist with the on-going management of your implanted cardiac device by using remote monitoring. ... If you have an automatic monitor, data received from your implanted cardiac device will automatically be sent to us on a routine basis."   

This is not the pacemaker clinic, nor my EP, nor even the manufacturer of my device and monitor.  Evidently, it is a service in another state that promises to save doctors and their staff time and money.  I was never asked about this. It does not offer an opt-out.  

We have devices with sensitive data that our lives depend on. In the U.S., we have HIPAA laws that supposedly protect our information and data. It concerns me that more and more people I don't know, through my health insurance which outsources a myriad of "services", and the medical system itself don't seem to have a problem getting my information. It's on computer screens everywhere.

For many decades I kept myself mostly out of the healthcare system through smart food, exercise and health choices, until a virus caused me to need a pharmaceutical that ultimately caused heart block. Oh well, stuff happens. People with biological parts are mostly once-and-done other than continued care and drugs.  But our electronic devices that need programming and having parts that expire leave us particularly vulnerable.

Does anyone else have concerns about  this kind of thing?


21 Comments

Wellโ€ฆ

by Lavender - 2024-04-29 22:08:29

I presently am monitored nightly by a company that manufactures my device. They could easily outsource monitoring me.

You said,"some "rhythm management" company "assist with the on-going management of your implanted cardiac device by using remote monitoring. ... If you have an automatic monitor, data received from your implanted cardiac device will automatically be sent to us on a routine basis."   

I guess it's possible that Boston Scientific could choose to subcontract this to another company at some future point(?) Data from my implanted cardiac device is automatically sent to my cardiologist on a routine basis as it is. My cardiologist is still in charge of decision making and my device cannot be adjusted without his presence and permission.  
 

I just received a letter today informing me that my health insurance company had a data breach last year.  Sensitive information may have been hacked. They're offering credit monitoring and help if my identity is stolen. They said it's unlikely anything will happen...but they have to let me know. ๐Ÿ™„
 

We really have so little control over who sees what out there. ๐Ÿ˜ฌ

Same here, so far

by IrishToast - 2024-04-29 22:19:35

Lavender, my situation is the same. I called Abbott and they assured me they have nothign to do with this and that they do receive my data nightly and work with my pacemaker clinic and EP.  So maybe this company is attempting to pick up those patients who don't currently have regular monitoring. The problem is they at least have my name and who knows what else, and I didn't ask for their intervetion. A potential problem I see is, will the health and insurance industry eventually replace our personal clinics with remote systems like this?

Geez!

by Lavender - 2024-04-29 22:24:17

You mean this company contacted you without knowledge or permission of your present monitoring company or doctor?? Ugh!๐Ÿ˜‘ Where do these people get these lists of pacemaker wearers? Someone is selling information, it seems. 

Contact your EP and usual pacemaker clinic to make sure no one is taking over your monitoring. ๐Ÿ˜ต‍๐Ÿ’ซ

Per Their Request

by IrishToast - 2024-04-29 23:24:58

No. The letter began, On behalf of your physicians per their request ...  Which means the physicians sign up with them, I guess.  Maybe someone else here knows more.

HIPPA

by AgentX86 - 2024-04-30 01:06:20

Your medical insurance company knows all about you anyway. Liability insurance, I might worry about.

Medical offices are the least secure places that keep personal records.  They're hacked all the time.  Many advise against giving them your SSN, for this reason.  They may say they need it but really don't.

The credit monitoring is useless.  Be sure to lock your credit!  You should have done this anyway. It's not a perfect solution but it covers 99% of identity theft. Credit monitoring, likely none.  It's a pat on the head, and "now go away."

Who controls our care

by IrishToast - 2024-04-30 01:26:06

I agree, AgentX. It's not the financial so much as who controls the care we are dependant on. The PM companies have a history of being reliable and trustworthy. So too with most of our own medical contacts. But once this very personal information is handled by entities in another state who make recommendations and promise to capture more revenue for doctors, what control do we have? I know the education and experience my EP has, and I know a lot about Abbott, and my hospital. But I know nothing of these people. 

Phishing...

by Andiek11 - 2024-04-30 09:28:14

Especially since your manfacturer knows nothing about this and the letter is written so generally, this is a pure fishing expedition.  They may or may not know you have a pacemaker - that's almost inmatierial. I get emails from large banks about problems with my account when I've never even done business with those banks.  It is just a huge, massive eblast list that they buy via the dark web. Do not respond or provide them with any info.  If you respond or unsubscribe they know they have a live email.  Phishing emails are getting very sophisticated and difficult to identify.  It's not you.   

Rule of thumb, if  you get any emails like this for health or financial or claims supposedly from your grandkids, etc, DO NOT RESPOND without initially reaching out to the source directly i.e. your medical team.  These days it is not called paranoia, it is called being a safe consumer.  We live in "interesting" times. 

Oh and I agree with what others have stated above.  As much as we may not like it, the web probably knows more about us that we do ourselves. Do lock your credit reports.  Huge, easy step to take that makes a tremendous difference.  I kinda think about that old political joke... If you even want to know about your family history, just run for an elected office. 

Not Phishing This Time

by IrishToast - 2024-04-30 09:59:14

It is an actual letter that names my EP and the company is legit. Abbott rep said she has heard of them. I should hear back from my PM clinic today so I can find out more.

Outsourcing

by Good Dog - 2024-04-30 10:20:53

I don’t think that this outsourcing will end and frankly, I think it may become more widespread. I think that some enterprising individuals likely see ways to hire people at a lower cost, find ways to get more productivity, and maximize the reduction of overhead. While cheaper may not be better for us, let us not forget that the U.S. is a capitalist market economy. It is all about the money!

The quality of our care in the U.S. is changing. And not for the better. It has been all about the need for efficiency to contain costs in recent years. Those efforts include containing the wages of healthcare workers while attempting to increase their productivity. We are also seeing a consolidation of hospital systems as another means to rein-in costs and improve efficiency. At the same time; the businesses and public companies supporting healthcare have to maintain and/or increase their margins and their profits. Since it is difficult if not impossible to contain costs outside of the system, there remains a continuing effort to find ways to cut costs within it.

We are now experiencing shortages of doctors and healthcare workers as a result of all of this. My neighbor is a young girl that was just entering college a couple years ago. She told me that she was enrolled in pre-med classes. She has a couple of doctors in her family, so I assumed that she was inspired by them. About a year later I asked her how her medical classes were going? Her response was that she changed her major. I asked why? She said that everyone was telling her that there is no longer any money to be made in healthcare, so now she is studying marketing.

I suppose that we could change our priorities in thoughtful and considerate ways to improve the system, but I fear that as the result of too much greed it may get much worse before it gets better. That is; if it does get better at all!

out sourcing

by new to pace.... - 2024-04-30 12:22:24

I too would be supsicious if i received a letter telling me i was being monitored by a different company.  First i would check with my pacemaker clinic to find out if this was true.   If not  then i would notify Fraud prevention an let them know this was happening.  of course if it came via email can notify spam on line.

new to pace

Credit lock ๐Ÿ”’

by Lavender - 2024-04-30 15:17:49

I locked my credit and also put a freeze on through equifax. Putting on fraud alert lets all three credit monitoring companies know at once. 

Please let us know what your EP says!

Good Dog Called It

by IrishToast - 2024-04-30 16:29:10

You got it absolutely right, Good Dog. Here's what I found out. My big health care organization acquired the out-of-state rhythm management group. The PM clinic will stay in place with our usual personal contact (at least for now, I anticipate), but the remote group will be involved in monitoring and also billing, so I and my insurance will get statements from both my own health care organization and this group. It's supposed to result in insurance paying out better for remote care. Since I always ask the next question, I anticipate my premiums will increase. More money for another layer has to come from somewhere. 

Does anyone else have concerns about this kind of thing?

by docklock - 2024-04-30 16:47:17

Not trying to start anything.  This is just my personal thought. 
What website/forum has the most, fairly detailed information on pacer people??  
I read on another post about someone who thought their account was hacked. 
I'm certainly not a computer nerd, but even I could track down a person given that I have: name, address, birthdate, device and perhaps the clinic to which it's attached to electronically. 
not being paranoid, but caution is advisable. 

Outsourcing

by AgentX86 - 2024-04-30 17:02:04

Outsourcing of medical procedures has been happening for decades. Medical immaging is very often outsourced, commonly to India. With the Internet and digital immaging, the costs can be reduced.  As pointed out here, it's all about costs.

OTOH, hospitals are not consolodating to reduce costs, rather the opposite.  Hospitals are buying up other hospitals and every doctor's office they can get their hands on.  It's called "monopoly".  They want control over the medical care in a community.  In large metropolitan areas (like here) there may be multiple such conglomerates, working towards the same goals.  That doesn't mean they're necessarily competing. BTW, this was all forced by Obama-care.  The medical care industry, primarily large hospital "chains" and insurance companies, wrote it.  Surprise! It makes them billion$.

People don't ask how much a procedure is going to cost, usually because "insurance is covering it" (see below) so there is no competition. It's about market share.  Each one of the doctor's office feeds customers, err patients, deeper, and deeper into their networks. 

The patient is referred to that particular hospital for imaging, for example.  It's not unusual for the hospital to charge 10x what the private imaging place a mile down the road would charge. It wouldn't be unusual for the imaging center to charge less than the insurance deductible. Again, people don't shop, "because insurance is paying for it".

The same goes for drugs.  Everyone should shop for drugs (doesn't apply to those panted drugs). Often they're cheaper paying cash than using insurance. Very often. Use something like GoodRX.com to search prices in your area. The differences are amazing.  Wholesale clubs also have good prices but don't advertise the member's price (much better) because they are required to sell to everyone, but not at the same price. Mark Cuban (billionaire owner of the Dallas Mavericks) started a company that manufactures generic drugs and sells them at a fixed markup.  See: costplusdrugs.com. He thought drug prices were ridiculous, so is trying to do something about it.

Then there are the drugs, where the patent(s) haven't expired.  I'm sure we all know about Eliquis ($600/mo).  My wife is on a drug that's also $600/mo, and was just put on another that's $1000/mo., retail prices. The other drugs are cheap, by comparison, but I always check the local pharmacies (through GoodRX).

Doctors and hospitals are required, by law, to publish good-faith estimates for all common procedures.  They are also required to give an estimate for any procure, in advance.  The don't like it, and don't advertise it, but it is the law (only for about two years).

There are ways to force competition but people are too lazy, evidently. "Insurance will pay for it" or "medical care is just too expensive", yet don't want to fight it. I'm not guilt-free.

It' not a capitalist system. The customer is the inurance company. They negotiate prices with the medical care facilities.  We are not part of that transaction, so have no incentive to save money. Insurance company may force us to save by being the gate-keeper between us and the doctors.

I never received a letter or notification..

by USMC-Pacer - 2024-04-30 17:08:38

I simply got several phone calls from the "rhythm management"  company from DC telling me my 90 day check is tomorrow. I checked with my clinic and sure enough it was sourced to them. Shortly after my 90 day upload, they sent me an $80 bill!  Hahaha, nope, not paying you a red cent. My insurance always covered it. I told them if they don't fix the billing, I won't send another transmission. Several phone calls back and forth with customer service telling me I had to send them transmissions and pay for the service.... I said try me! I called my clinic and told them the issue and that I would be coming to the clinic for my uploads and not paying this company. It was rectified faily quickly after that. Now, as far as connection issues.. that was a mess in the beginning. The company would keep blaiming my cell phone on 3 different occasions when it was always connection issues on their end. On one occasion, this went on for 3 weeks without connection before they got back to me! Now, all seems okay. I think like mentioned above that I should have been notified and not blindsided by the whole thing.

Credit Freeze

by AgentX86 - 2024-04-30 17:21:34

You have to put a freeze on all three credit bureaus. One is not enough.  Lender do not go to all three to get report.  They only use one, and that need to be the one that' frozen.  All three need to be frozen.  It's simple to do, and simple to do a temporary thaw to apply for credit.  You can specify that it's to be unfrozen today only, then frozen again at midnight, automatically.

Credit monitoing really does nothing.  Even if it did, by the time they see something fishy, the money/credit is gone. Credit freezes block even an inquiry.

You're not responsible, legally, for identity fraud but it will take a significant portion of your life to clean up the mess. It' easier to protect yourself, up-front.

I don't even want to get into title fraud. Yikes!

Yes, It's That Same One

by IrishToast - 2024-04-30 20:11:50

USMC-Pacer, yes, that is it; they are in DC. I did some extensive internet searching on the company name. There is a lot out there. However, I don't see much that indicates actual pacemaker expertise. Mostly marketing, corporate buzzwords, promoting and financial. That is why I am concerned.  Has anyone had any actual benefit from this?

Nothing new

by piglet22 - 2024-05-01 06:45:15

The UK is awash with outsourcing and not just the NHS.

The councils who look after roads and highways hardly ever do the work themselves.

Transport, water gas electricity all use contractors.

Still scandals over politicians awarding PPE  (gowns, masks) supply contracts to their chums.

A company rep goes to the hospital management and only has to say they'll do something cheaper like monitoring and that's it.

Sometimes the outsourcing is to companies associated with consultants.

The bottom line is that outsourcing gets in-house staff off the books, all that tedious admin payroll and HR stuff goes as well.

The NHS regularly uses private hospitals with consultants from the NHS.

Just what happens when you reach the bottom of the barrel, I've no idea 

Outsourcing Nothing New - Piglet

by Good Dog - 2024-05-01 07:50:15

The U.S. is also awash in outsourcing. It has been happening for years. In my experience it began here mostly in the government sector Dept. of Defense (where I worked) in some areas of very essential responsibilities. As Piglet mentioned, it has been going-on for years traditionally in areas where specific expertise was needed and did not exist in-house and/or it was not practical nor cost-effective to hire additional personnel. However, I am referring here specifically to outsourcing of work that has generally always been performed by staff personnel. That work has often been contracted to achieve some very significant savings. However, the end result was often that those savings resulted in a significant degradation of services as well as equipment and infrastructure. Despite the draw-backs, it continues today albeit on a slightly smaller scale. Following that, I had held a director’s position in a large organization and prior to that a Plant Manager position with a staff of over a couple hundred people. I tried to rein-in outsourcing whenever possible. However, it is sometimes difficult to justify due to budget constraints. I tell you that only to highlight the fact that I have experience in dealing directly with the many considerations involving outsourcing. While I will acknowledge that it can certainly reduce costs, sometimes very significantly, it rarely ends well. I think the reason is that when it becomes "all about the money", quality suffers! The quality of the lives of people working for lower wages with less, if any benefits. Additionally, the quality of the service suffers as a result of the change in priorities. Most often when it comes to service; faster and cheaper replaces the priority of having a vested interest in insuring quality and customer satisfaction. Of course there are exceptions, but they are few and far between. That is just my experience.

Fast, Cheap, Good

by IrishToast - 2024-05-01 09:45:32

My son had a little triangle symbol that he sometimes showed customers.

Fast - Cheap - Good ... Pick Two

Our PM lives depend on Good.

Fast, Cheap, Good

by AgentX86 - 2024-05-01 16:23:27

What's your other choice? Cheap or fast?

My choice is Goldilocks.๐Ÿ˜

You know you're wired when...

You have a high-tech ticker.

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Pacemakers are very reliable devices.