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Language Barriers Affect Health Care Data Quality
According to a front page article in the November 23rd issue of The New York Times, as the United States becomes more diverse, and the number of spoken languages multiplies, language barriers are both isolating patients and affecting the quality of medical data obtained from and about patients. And nowhere is the diversity of nationalities and languages greater than in the New York City area.
Written by Times staff journalist Ester Fein, the report concludes that the consequences of medical miscommunication can be severe. Patients become sicker because they fail to stick to treatment regimens they don't understand. They pass on infectious diseases (like tuberculosis) because they don't know when to take their medication or return for follow-up care. Doctors miss diagnoses, order too many tests, or get patients to agree to procedures the patients don't fully understand - all because of language barriers.
Adding to the confusion, there is a serious shortage of trained medical interpreters in the New York City area. The Federal Government and New York State mandate that hospitals provide interpreters, but the laws are vague and enforcement is difficult. Hospitals largely rely on a hit-or-miss system of volunteer interpreters recruited on an ad hoc basis from hospital staff, or the patient's family members or friends. Often children must interpret for their immigrant parents. Often these relatives and friends keep critical but embarrassing information from doctors and other health care professionals. The article doesn't mention the data quality problems that result when health care professionals who speak English as a second language make diagnoses based on translations by ad hoc interpreters with poor English communications skills.
White House May Tighten Data Encryption Exports
On November 24th, The New York Times reported that the Clinton Administration is debating whether to further tighten export controls on electronic data scrambling systems. The controls have so far allowed financial institutions to export strong encryption technology. If the policy is changed, it could reduce the number of financial institutions that are allowed to use the most powerful encryption equipment overseas. The debate over the Administration's proposal comes at a time of significant change in electronic commerce. Federal regulations are changing, and Internet commerce is blurring the lines around institutions. Federal regulators have allowed financial institutions like banks and security firms to export equipment based on the U.S. data encryption standard, while other American companies are restricted to less powerful data scrambling techniques.
Now, according the Times, law enforcement officials want to remove the exemption from securities firms, limiting the export of DES equipment to banks. The U.S. Commerce Department, on the other hand, wants to permit companies developing certain financial applications to be able to use strong encryption without any provision for eavesdropping. These companies include credit card firms like Visa and Mastercard, which want to insure that electronic transactions are secure worldwide. Other companies that sell products over the Internet want similar protection - including Microsoft Corporation, which is moving into a variety of commerce-related areas.
The Clinton Administration wants companies to develop so-called "recoverable key" systems. These are encryption systems that would allow third parties (like Federal law enforcement agencies) to decode scrambled electronic communications. Most software firms, Internet commerce start-ups, and securities firms oppose any reduction in the quality of data-scrambling software. The article was written by Saul Hansell and appears on page D1.
Stock Price Data Confuse Money Managers
According to a report in the November 24th issue of The Wall Street Journal, recent stock market volatility is making strategic planning increasingly difficult for money managers. Many portfolio managers use valuation as an important tool for portfolio management, and stock price gyrations over the past month have caused substantial confusion. The primary value indicator has been the price-to-earnings ratio (P/E). But turbulence in the prices of high technology stocks (especially computer companies) has both confused portfolio managers and forced them to look to other indicators, such as price-to-sales ratios and more esoteric valuation indicators.
The Journal article fails to mention underlying processes that may be driving stock market prices for high tech issues. The article was written by Suzanne McGee and appears on page C1.