quality medical care depends on quality medical transcriptions and its importance has been recognised by the us government which has set aside over $100m for the creation of an electronic medical records system with the aim of producing more immediately available medical records as part of its ‘21st century health initiative’.<">
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Medical Transcription – The Controversy Over Outsourcing to Developing Countries

Posted on:3/25/2010
Written By: Justin Butcher
The role that medical transcription plays in the healthcare process is often an overlooked and rarely debated topic. It involves receiving a medical dictation by tape, or digital voice file from a healthcare professional and using ear phones, a foot pedal for start-stop control and a word processing program to produce medical documents.


Medical transcription requires good listening and language skills, computer skills and knowledge of medical terms and the importance of accuracy of the documents produced cannot be underestimated. In short,  quality medical care depends on quality medical transcriptions and its importance has been recognised by the US government which has set aside over $100m for the creation of an electronic medical records system with the aim of producing more immediately available medical records as part of its ‘21st Century Health Initiative’.

In the past, most healthcare institutions had in-house staff plus a supply of part-time and freelance workers who helped get the transcription done. Over recent years a trend has developed toward the outsourcing of medical transcription which became attractive to healthcare institutions due to the fixed costs involved, the lack of ongoing technical investments required and the reduction of day-to-day management responsibility required.

Until recent years the outsourcing would remain in the host country – however countries such as the US, UK and Australia are increasingly outsourcing their medical transcription due to technological advances which allow digitally dictated voice files to be sent quickly over the internet and of course the availability of far cheaper labour in developing countries such as India and the Philippines.

The continued outsourcing of these services has caused major controversy.  As in all industries where outsourcing to developing countries is commonplace, one of the main arguments is over the effect of the outsourcing on the medical transcription industry in the home country.   Transcriptionists in the developed world are either in danger of losing their jobs or are being forced to accept lower line rates.

However the main controversy which is specific to the medical transcription industry in particular concerns the quality and accuracy of the work being produced by the transcriptionists in these developing countries.  It is feared that the quality of the transcriptions being produced in these countries may not be as high, due to the transcriptionists not being native English speakers and possible lack of knowledge of language usage, accents and idioms. The fear is that a lack of accuracy in transcription could lead to errors in patient diagnosis and the potentially disastrous results that that would entail.

There are also legal, security and privacy issues of outsourcing to developing countries. For example a disgruntled transcriptionist in Pakistan recently threatened to post medical charts of a patient on the internet. This would obviously be a major concern to any institution thinking of outsourcing their medical transcription.

“Outsourcing is always a politically contentious issue, and recent media coverage of confidential medical records being sold illegally overseas has only raised concerns about what happens to data that is allowed to leave the EU.  Offshoring may initially appear to be a cheaper option, but to us, the risk is just not worth taking” says Helen Healiss of Accuro – a medical transcription company which provides an onshore medical transcription service to health professionals across the UK.

As medical transcription volume grows, providers need to decide whether to outsource the work, and if so, whether to retain offshore or onshore firms. There are clearly benefits and drawbacks to both, but with the potential problems being so serious institutions need to think very carefully before outsourcing their medical transcription abroad.


  
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