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30 Oct 2004

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Outsourcing - Contractual Considerations from a Privacy Perspective

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Dear Friends,

I felt this article to be written with a view to contractual considerations
from a privacy/security perspective.

Companies may want to consider the following issues during the drafting and
negotiation of every hosting or data processing contract. The facts and
circumstances of each transaction will dictate the appropriate level of
concern, but one should at least consider these issues. So often, raising
these issues and negotiating them with the service provider will assure a
much better understanding of the provider's capabilities and procedures, and
afford the provider with a clearer set of expectations.

To read the entire article, go to:
http://www.tmcnet.com/usubmit/2004/Oct/1083418.htm

Regards,

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 of jobs overseas raises security concerns

In this age when your phone company's customer service center might be in
India and your taxes might be prepared in China, it shouldn't be surprising
that your personal medical information may travel electronically to the
other side of the world before it ends up in your medical file.

For more than five years, growing numbers of hospitals and medical practices
nationwide have opted to have notes dictated by their medical staffs sent
overseas to be transcribed rather than having the work done by U.S.
transcriptionists.

"Offshoring" medical transcription has become a booming business for
countries, such as India, Pakistan and the Philippines, which usually
undercut the prices charged by U.S. transcriptionists because of cheaper
labor pools.

Some of Tulare County's largest health-care providers are among those
offshoring their transcription work, including Family HealthCare Network,
Sierra View District Hospital in Porterville and United Health Centers of
the San Joaquin Valley, which operates a clinic in Earlimart.

As offshoring medical transcription and other services to foreign lands has
grown, so have concerns about how safe it is to put all that personal and
financial data in the hands of overseas workers who often can't be touched
by U.S. laws.

"I am gravely concerned that consumer data is being sent overseas without
proper safeguards," Sen. Diane Feinstein, D-Calif., wrote in a February
letter sent to the heads of several corporations offshoring work, Citigroup
and Bank of America among them.

Those concerns have prompted some legislation, including California Senate
Bill 1492, which would have prohibited hospitals and medical practices from
sending patient information overseas without patients' consent. But Gov.
Arnold Schwarzenegger vetoed it Sept. 29, calling the bill "unnecessary."

Dr. Srinivas Vuthoori, founder and CEO of Scryptions International in
Nevada, which subcontracts work to India for United Health Centers, said,
"Right now, we do have different vendors to whom we subcontract the work."

He said his company maintains U.S. standards for patient privacy by hiring
consultants in India and having a company vice president there "to
periodically check the work being done."

"We have been very happy with [Scryptions]," said Wunna Mine, information
technology manger for United Health Centers.

Vuthoori dismissed those concerns, saying in India, medical transcription
service is "as technologically advanced as it is over here."

Patients have mixed reactions to the possibility of their personal
information traveling around the globe. "I am surprised because that's quite
a long way to send something like that," said Christine Babler, a secretary
at Kaweah Delta. Still, she said, "If it saves them money, I totally
understand."

Steven Jensen, a Tulare chef, said, "It doesn't bother me as long as
everything's done like it's supposed to be. Why should I care?"

Gary Scherer, a spokesman for HIPAA.com, an online service that answers
questions about HIPAA law, said patients should realize that by law,
providers don't have to disclose who does their transcription work.

http://www.visaliatimesdelta.com/news/stories/20041027/localnews/1490153.html

2) After BPO, India looks to cash in on medical transcription boom

Following the revival in the medical transcription (MT) business activities
in the US, Hyderabad based Worldtech, one of the organised player in the MT
industry, has decided to more than double its manpower in Hyderabad. In
order to capitalise on the growing demand, the company is also looking at
possible acquisition of smaller companies in the US to scale up its
operations. "We are looking at smaller companies in the range of $one
million and above to increase both clients list as well as manpower," he
said.

"The demand for quality manpower in this industry will outpace the demand
that of Business Process Outsourcing (BPO)/ Information Technology enabled
services (ITES) and IT services sector in the next few years," he said.

"Currently 20% of our total strength of 320 are from different cities such
as Warangal, Guntur, Coimbatore, Chennai, Kochi and Mumbai," he said.

The company continues to encourage outsourcing from other cities for in
order to further its future growth," Mr Tummala added.

http://www.financialexpress.com/fe_full_story.php?content_id=72392

3) Medical records taken from trash

Personal medical information of at least 500 people was taken from a
Dumpster where several private practices threw away documents without
shredding them, according to authorities.

The documents were discovered when police searched a motel room occupied by
two people suspected of using methamphetamine.

Police arrested the couple Tuesday. The two used patient information to buy
prescription medications and then sell the drugs, said Phoenix Sgt. Jason
Davis, a document crimes investigator who is heading the case. advertisement

By not shredding the documents, the medical practices may have violated new
health privacy regulations, Davis said.

http://www.azcentral.com/arizonarepublic/local/articles/1028idtheft28.html

4) Medical offices can cut transcription costs in half

It certainly was tempting, Dr. Jatinder Chopra said. He could have cut his
medical transcription costs by at least half if he were willing to have the
medical notes he dictates transcribed by workers in India.

"Overhead is actually going up every year," and the amounts insurance
companies pay doctors is dropping, putting growing pressure on medical
providers to cut costs, Chopra said. "So do the math."

By some estimates, medical transcription done in Third World countries can
save medical practices and hospitals 20 percent to 50 percent or more
compared with work done by transcriptionists in the United States.

Harry Foster, president and chief executive of Family HealthCare Network in
Tulare County, said his company pays only a half-cent less than the 11 cents
a line it paid to local contract transcriptionists before switching to a
company employing transcriptionists in the United States and the
Philippines. That doesn't sound like much of a savings, but Foster said
initial estimates are that the half-cent savings will save more than
$316,000 a year.

Stephanie Cooley of Porterville was let go in December from her job as a
staff transcriptionist but switched to another transcription firm. She said
cutting costs is bad news for U.S.-based transcriptionists. "It's not tough
to find a new job. The problem being they don't want to pay you," said
Cooley, who landed a job that pays her 7.25 cents per line. Some U.S.
transcription firms are offering less.

http://www.visaliatimesdelta.com/news/stories/20041027/localnews/1490154.html

5) The New AAMT Quality Standards

http://www.aamt.org/ScriptContent/Downloads/ace/hinicklebuchanan.pdf

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The MTIndia Team
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