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07 Aug 2004

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Security - Red Hat Linux or Microsoft? A case study...

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Dear Friends,

Infoscript required industry standard high security infrastructure to make
certain that there are no lapses in the confidentiality of healthcare
information processed. Internal control and manageability of its network
infrastructure was also crucial to their business. However, Infoscript was
running its Firewall and email servers on Linux that were managed by an
outsourced third-party service provider.

According to Mr. Narayanasamy, Managing Director, Infoscript Services, "We
opted for Linux as we perceived it would be a cost-effective operating
platform. Our in-house IT team however, did not have expertise in Linux and
so we had to take critical third party service support for our Firewall and
Mail."

However, the stringent security standards set by the industry and HIPAA (The
Health Insurance Portability and Accountability Act) to protect confidential
healthcare information, meant that Infoscript had to consider the
implications of a third party external organization having access to its
network, and hence needed to rethink its perimeter infrastructure.

Microsoft partners jointly recommended replacing the Linux mail server and
firewall with Windows 2003 Servers and Microsoft ISA Server 2000. With the
implementation of Microsoft ISA Server 2000, Infoscript's major concern
about outsourcing their Firewall and Email Server management were addressed.
Microsoft ISA Server 2000 provided secure, fast, and manageable Internet
connectivity through an extensible, multilayer enterprise firewall and Web
cache.

"Knowing that control of our information security rests solely in our hands
provides tremendous relief while conducting our business," said Mr.
Narayanasamy. With a combination of Microsoft ISA Server 2000, Windows
Server 2003 and client desktops on Windows 2000 and Windows XP, Infoscript
now possesses a state-of-the- art, secure IT network that can scale easily
as the company grows.

"We have stabilized our operations and there are several possibilities for
the future. With our current infrastructure, we can tackle security and
manageability concerns that may arise from expansion and scale our
operations to service any such increased demands," commented Mr.
Narayanasamy.

See:
http://www.microsoft.com/india/casestudies/infoscript.aspx

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) Outsourcing - The Inside Story

Ferocious debate in the United States notwithstanding, outsourcing is one of
the great sources of hope for poor people in developing countries. Nuimuddin
Chowdhury, a Bangladesh-based economist, interviewed many of those involved
in the industry. Here are two of his stories of what outsourcing has meant
on the ground in India.

The "passage to India" of medical transcription started as a result of
efforts of Indian-born physicians in the United States to provide
opportunities to family left behind.

http://www.theglobalist.com/DBWeb/printStoryId.aspx?StoryId=3847

2) Overseas transcription: Is it safe?

While some US companies advertise that they rely on foreign employees or
subcontractors, others hide this fact or simply don't know where their files
end up. That appears to be the case in the UCSF extortion incident. The
medical center's longtime transcription company in California had
subcontracted work to a Florida company, which subcontracted with a Texas
company, which subcontracted with the Pakistani woman.

Healthcare Information leaders say the key to security is using the right
technology and business practices, not imposing legislation they consider
draconian. Steven Mandell, Heartland's president, told a California state
Senate subcommittee in March that Heartland's computers prevent employees
from downloading, transmitting, or printing patient information.
Furthermore, they're not allowed to bring patient information into or out of
the building.

If you want to take advantage of offshore transcription, it's imperative to
HIPAA-proof yourself as much as possible. For starters, ask the
transcription company to document its security precautions both here and
abroad, says Sue Miller, a healthcare attorney in Concord, MA. Does it
encrypt digitized dictation transmitted over the Internet? Is data stored in
secure, firewall-protected servers, and are user IDs and passwords required
to access it? Have transcriptionists signed confidentiality agreements? Are
they prevented from downloading, printing, faxing, or otherwise capturing
patient files for possible misuse?

Experts also recommend that you tighten the business-associate contract that
a transcription company must sign under HIPAA. To put teeth in the contract,
include a damages clause that makes the transcription company financially
responsible for HIPAA violations committed by employees or subcontractors,
says healthcare attorney Robyn Meinhardt in Denver.

http://www.memag.com/be_core/content/journals/m/data/2004/0618/transcribe.html

3) Medical Transcription: Its Past, Present, and Future

Yet, there is no need for immediate concern among its practitioners, just as
there has not been such a need for transcriptionists at any time over the
past 20 to 30 years - and that, of course, is part of why the profession and
industry are being left behind. Transcription, as we know it now, will
continue for many years to come; those currently practicing it need not
begin the search for a new career. They, like so many before them, can
rightly conclude that there's enough transcription to keep them busy through
their professional lifetime. But it is time to advise those entering the
profession in the next several years to think of it as a transitional career
step or to enter it with the strength of knowledge, skills, drive, and
stamina that will enable them to change in step with the healthcare
industry.

http://www.medrecinst.com/pages/libArticle.asp?id=28

4) Philippines: Promoting medical transcription services

"The Center for International Trade Expositions and Missions (CITEM) of the
Department of Trade and Industry (DTI) is pushing for a stronger presence in
the United States outsourcing services market."

"Filipinos should take advantage of the opportunities in the US medical
transcription market," said Angelita A. Madulid, CITEM caretaker.

She notes that subcontracting transcription work overseas has become popular
among US companies and medical institutions.

"Our high literacy levels, excellent business and information technology
infrastructure and availability of manpower with either medical or computer
training or both, are definite plus factors," she said.

http://www.asianlabour.org/archives/001286.php

5) Broadlane launches program to lower costs of transcription services

In addition to U.S.-based vendors, Broadlane also has developed
industry-leading contracts with India-based medical transcription service
providers. Rigorous health information security, quality and pricing
standards were applied to these offshore vendors, including site visits to
their production facilities. Many of the transcriptionists with the
India-based companies are physicians. This solution directly addresses the
growing shortage of American medical transcriptionists, as well as concerns
over quality and security of offshore vendors.

http://www.broadlane.com/new/new_1_1_070604.html

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All original content of this newsletter is © Copyright 1998-2004
Mediweb Infotech Pvt. Ltd. All cited articles are copyright of
their authors and/or respective publications. Please feel free to
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as long as it is left intact with all links unchanged and this
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Thank you for your interest in MT India!

The MTIndia Team
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