Outsourcing markets in everything

If you live in India, you can now get a job staring at a monitor that displays images of American doctors entering hospital rooms thousands of miles away. Your task is to sound an alarm if the doctor fails to wash his hands.

This may sound disturbingly similar to being an auditor for the telephone handset sanitizers guild, but in practice it turns out to be very effective. It also turns out that this Big Brotherish technology has gotten a big boost from the passage of Obamacare.

That is from Kevin Drum.


Sound an alarm or administer an electric shock? the latter would be far more entertaining.

I think they should just hire celebrities to provide PSA's at the ICU entrance:

"Hello, this is Hugh Laurie, and from all of us at North Shore, we thank you for washing your hands"

something to that effect.

could be cheaper... and as effective if they can get a handful of celebs, and rotate the greetings so you don't get too bored of them...

I think that idea (not the electric shock, the other one) is about the worst method possible! It would be so annoying that even the patient would plead with the doctor "Please don't wash your hands again! I'd rather die of infection!".

Yeah but now turn that around. Play something like that, maybe really annoying Muzak in the room for the next half hour, every time a doc. forgets to wash.

Now you'll have the patients begging them to wash with a hawks eye.

Apart from the setup, it should be dead-cheap anyway. Doctors don't spend all day washing hands, and there's no need to check *every* time, being actually checked 10% of the time is more than sufficient to keep people in line if the penalty for non-compliance is suitable. If the software knows the identity of the doctor entering, then you can get away with even less checking, all you need to do is start of at random auditing 10% of the time, but -lower- this graudally for doctors who consistently comply.

If Doc A was supposed to wash his hands 120 times this week, was checked 12 times, and washed his hands every one of those, I'd say it's justified checking on him more seldom, say 1% of the time randomly or something of that nature.

Right. Then someone from Bangladesh ought to watch the Indian workers to make sure they're not fooling around on the job.

But who watches the watcher's watchers, a Parthan?

...and then the gorillas freeze to death. Or something.

Yeah so given his proclivities, I can't decide whether our mariner friend sees that anecdote as pro or anti immigration

It wouldn't be a problem if the incentives are aligned. Do they get paid but each person they catch, or do they have a quota?

If instead of Bangladesh you chose Pakistan you might get another interesting dynamic.

In Neal Stephenson's REAMDE, they outsourced a similar task to... Azeroth.

Entering hospital rooms? Not ERs or surgeries. Hmmm.

That makes it sound more like this is just a band-aid for the iatrogenic staph epidemic.

The hand washing protocol in ER/surgery rooms is probably tighter. Yglesias had a post the other day on how this seems to actually be cutting down secondary infections.

How many patients does a resident talk to a day? This is a lot of hand washing. That might end up causing hand skin problems if not infections.

Anywhere from 10 to 50 individuals, and more than that # of encounters. Yes we all have skin peeling off from the hand foam, but we've learned to suck it up.

Should have had these guys on the case watching Obama on the evening of September 11, 2012.

You're worried that Obama din't wash his hands?

I think the problem is that he did.

No offense, but conservatives make terrible conspiracy theorists.

I miss the days when it was the left who were continually making non sequitur comments about the establishment, while the right was hippie punching anyone who dared to question the people in power. The universe is upside down.

Those days were probably just a product of the fact that Republicans held the Presidency almost continuously between 1969 and 1992 with the exception of Carter. Before this era, you had Eugene McCarthy and the John Birch Society arguing that George C. Marshall, certain high-ranking military commanders and even Harry Truman were Communist sympathizers or dupes. I'd say the universe is returning to its normal state.

The Justice Department would never never ever read journalist's emails, nor pursue the family of a journalist who was asking (and getting answers to ) uncomfortable questions.

You should be ashamed to find equivalence in the weird birthers, truthers or birchers, and the rather disgusting abuse of power we are seeing evidence of.

Sounds really inefficient. There must be all kinds of other faux-pas these monitors can also be asked to monitor while no opportunity for hand washing (or not) arises. The propect of making any job a long list of questionable do nots is frightening. But it would increase the producticity of tort lawyers..

I've seen this story bounce for a couple days now. Is there a google-like engine that will try to track it to the first report? Maybe the news-breaker should get the hat-tip.

There's an opportunity for handwashing recognition software. Put it in a device next to the sink and controlling the door lock, so the doctor can't enter the room without first washing hands.

You could pretty easily create an interlock between the door lock and the hand soap lever / sensor. Of course it wouldn't work unless the door was always closed and had a magnetic lock on it. And it would be expensive. You know, the kind of thing that creates the most expensive medical system in the world.

Doctors would just make the soap dispenser work but let the soap drop onto the floor (counter, whatever) so that they don't have to wash their hands.

Indeed, the recognition software is likely required. Then again, could the doc get a stand in? Yep, well, we need facial and hand recognition now. Then again...

What about a Sticker a la Taco Bell:

"If We Don't Wash Our Hands, Your Order's Free"

Obviously we need to lower the minimum wage and pass immigration reform so that we can keep these jobs in America.

I've heard that there is an Indian owned bar in town where the bartenders are monitored from India, mainly to make sure that they card everyone they should.

Could Bangdaleshis be retained to make sure the Indians are actually watching.

If the doctor fails to wash “his” hands… aren’t we in 2013?

"...if the doctor fails to wash its hands."

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