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29 Feb 2004
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MTIA and AAMT stand on offshore outsourcing...

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Dear Friends,

The following is from a report to the AAMT BOD after initially
being presented to Senator Figueroa by MTIA and AAMT jointly. I am
quoting relevant points, the whole list can be accessed online at
the Hot Zone:

http://www.mtchat.com/cgi-bin/ultimatebb.cgi?ubb=get_topic&f=10&t=0
03049
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Points Presented from MTIA and AAMT:

. MTIA and AAMT will work with Senator Figueroa in developing
rational health policy and to structure legislation that will
ensure privacy of U.S. medical information.
* There is a major shortage of medical transcriptionists in the
United States and even with the use of overseas transcriptionists;
the demand for service outstrips supply. Further, there has been a
decline of US-based MTs year after year for some time.
* If legislation prevents the use of overseas transcriptionists,
the estimated 5%-7% of the work going overseas would come back into
the United States, further exacerbating the shortage and creating
additional backlog of the work.
* Transcription services (40%-50%) have been outsourced from
hospitals to transcription providers and home-based
transcriptionists in an effort to drive down healthcare costs and
to offload the difficult management processes associated with
transcription in hospital departments.
* Of major concern to both associations is the likelihood of an
"unintended consequence" of this legislation causing hospitals to
reabsorb transcription services, thereby driving up the cost of
healthcare and affecting patient care.
* HIPAA regulators were equally concerned about privacy and
security of healthcare documents with U.S. home-based
transcriptionists and overseas transcription services.
* MTIA presented information on the level of privacy enforcement
that exists overseas and promised to provide more details in this
area.
* MTIA stressed the notion that PHI is entering a "black hole" with
respect to enforceability and accountability when leaving the
country is a misperception. In many cases, there are stronger
protections than exist in the United States. Furthermore, India and
Pakistan, as examples, are common law countries, as is the United
States, and contractual, criminal and tort laws operate similarly
to the United States. A breach of confidentiality can certainly be
sued in each of these countries, and damages can be awarded and
collected by an injured party.
* Purchasers of transcription services focus on cost - not
quality - and do not realize that transcriptionists function as
risk managers, averting medical documentation errors and play a
role in patient safety and continuity of care.
* MTIA stressed the realities of what is happening in the State of
California right now relative to the treatment of PHI. Namely, that
a very low percentage of the work is being outsourced offshore, but
a very high percentage is done by at-home transcriptionists
(whether in-sourced or outsourced) whose practices with PHI are
likely to be no better than anyone else's. Moreover, a large
percentage of work is outsourced domestically, but outside state
lines. Hence, any legislative initiative that served to "box in"
PHI within state boundaries could, in effect, eliminate domestic
jobs and increase inefficiencies within the state health care
system.
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To quote Skip Conover, President of CBay Systems: "Let us be clear
that offshore contractors have as much reason as anyone to defend
our confidential healthcare information, to protect their own
businesses - enlightened self interest. Further, each offshore
contractor does have at its disposal very strong criminal and civil
laws to protect the privacy of individuals, even Americans. In
fact, according to the National Association of Software and
Services Companies (NASSCOM), the privacy of every individual and
corporate entity in the World is assured by Article 21 of the
Indian Constitution-not only the privacy of Indians. This is a
stronger protection than even exists in the United States.
Furthermore, India and Pakistan are common law countries, as is the
United States, and contractual, criminal and tort law operate
similarly to the United States. A breach of confidentiality can
certainly be sued in each of these countries, and damages can be
awarded and collected by an injured party."

I think you will all be interested in the article Skip wrote about
offshore transcription, which is to appear in the March 1, 2004
edition of Advance for HIM Professionals, i.e. tomorrow...

In the meantime, let us prepare ourselves - Senator Figueroa's open
forum is scheduled for Tuesday, March 9, 2004 at the State Capitol,
Room 2040 from 9:00 a.m. to 1:00 p.m.

Ciao!

Maj (Dr.) Amit Chatterjee, SM
Strategist / Founder ~ mailto:amit@...
MT India ~ www.mtindia.org
"The Community of MT Professionals"

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NEWS AND VIEWS :
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1) Medical transcription may have to take a bitter pill

Suresh Nair, COO of Health-Scribe, a leading healthcare call centre
in India , says the IT Act of 2000 has provision of prosecuting
individuals for leaking out information. The Indian government is
also planning to introduce a legislation for providing legal
safeguards to ensure data privacy protection in India . "The
chances of this bill becoming a law are nil. The US firms are
sending healthcare work here due to quality of work done here,'' he
added.

http://economictimes.indiatimes.com/articleshow/msid-469338,curpg-2
.cms

2) Highflier settles down in new firm

New-economy mantras such as "get big fast" and "seize first-mover
advantage" seem like tarnished relics of a defunct era, but not
long ago they worked well enough to make John Weiss a millionaire.

Weiss, a Kenosha entrepreneur, joined three co-founders in 1995 at
an Internet start-up that eventually became yesmail.com. Before
selling the Chicago-area company for more than $700 million in
March 2000, they ran the business with a go-for-broke style that
brought rapid change, massive growth and eventual success.

The company has blended its Web-based technology with a global
network of medical transcription teams in places such as India and
the Philippines, allowing for some dictated records to be
transcribed overnight.

Scribe is drawing on numerous lessons taught by the yesmail.com
experience.

http://www.jsonline.com/bym/news/feb04/210967.asp

3) Hewitt to expand India operations

Even as the backlash against Indian BPO activities continues in the
West, the outsourcing buzz is adding sound wattage. After IT,
medical transcription, equity and legal research, it is the human
resource function which is adding colours to the Indian BPO flag.

Global HR consultancy and outsourcing firm Hewitt Associates is
doubling the headcount of its Indian operations engaged in
international outsourcing services for its global clients.

http://economictimes.indiatimes.com/articleshow/491259.cms

4) Staging the great rebalancing act

By the end of this year, 10 per cent of jobs in America's computer
and software services industries will have gone overseas, mainly to
India, China, Pakistan, Jamaica, Argentina and the Philippines.

American tax returns, complete with the sacred social security
number that is the key to official proof of identity, will be
completed offshore. So will the transcription of medical records,
the processing of insurance claims, and the answering of hundreds
of thousands of queries for every conceivable type of service, from
local government welfare in New Jersey, to Dell upgrades, to Yahoo
technical support.

On its own, offshore outsourcing would have been only a detail in
the much larger US unemployment picture, with 2.9 million jobs lost
in the past three years. But that was before Gregory Mankiw,
chairman of the White House Council of Economic Advisers, offered
this explanation: "Outsourcing is just a new way of doing
international trade. More things are tradeable than were tradeable
in the past and this a good thing." This implicit support of
outsourcing came in the council's annual report.

http://www.smh.com.au/articles/2004/02/20/1077072841572.html

5) Medical Transcription Funnies

A self-proclaimed junkie when it comes to being plugged into his
transcription equipment - the keyboard, headset and foot pedals -
Dillon has created a cottage industry out of the humor to be found
on his transcription tapes.

His book, "Just What the Doctor . Dictated!: Ten Years of Medical
Transcription Funnies" details some of the funnier moments in his
10 years as a transcriptionist.

"Some doctors forget to tell you the patient's name," Dillon said.
"Sometimes, they lean away to reach something and forget that they
have leaned away from the microphone, too."

There are times, he added, that the physician may "goof up or the
patient has a freakish complaint or accident and you get a great
big chuckle out of it. That breaks the monotony, and, sometimes, it
even helps you write a book."

http://www.timesdaily.com/apps/pbcs.dll/article?AID=/20040202/NEWS/
402020333/1011

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The MTIndia Team
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