Is Offshore an Option?

Few subjects are more relevant in the medical transcription world than this one. Many physicians and medical records specialists are concerned about this topic. What is the issue and what are their concerns? The issue is offshore outsourcing and the concerns are these:

1) There are difficulties in simply understanding those that live in other countries because of language and dialect differences, hence the title of this paper.
2) Even if they do speak English, American colloquial and idiomatic speech is not apart of their culture, as a result they will have no idea how to handle it.
3) There is often geographic and regional information needed to do acceptable transcription that is not a part of that culture either.
4) What about the security of the dictation itself? If it is being zipped around the world, who has access to it?
5) And my all time favorite; “Isn’t this un-American?”

How should the physician or medical records specialist view or deal with these issues? Let’s go over them again one at a time:

1) There are difficulties in simply understanding those that live in other countries because of language and dialect differences.

Almost certainly the end client will not communicate directly with the offshore typists so, understanding verbal speech will not be an issue for them. It will, however, be a big issue for the medical transcription service. If the service can’t communicate well with the off shore provider, then how is it possible to obtain quality transcription? Well, in fact, under this scenario quality transcription will not take place. However, many local and overseas companies do communicate well with each other. If quality communication is not possible, however, off shore associates should not be pursued. And in fact, there are some offshore business people that cannot communicate with Americans, no matter how they try.

2) American colloquial and idiomatic speech is not a part of their culture; as a result they will have no idea how to handle it.

In essence, it is the job of the American firm to make sure colloquial and idiomatic speech is correctly understood and typed. This boils down to having the off shore client’s work carefully reviewed until it is obvious they are “getting it.” In time much of this can be learned by the off shore typist. In addition, it is important to have the offshore client (or local typists for that matter), double slash (//) the work at points of confusion. With the “find” option, the proofer can zip to the points in question, edit as needed and move on quickly.

3) There is often geographic and regional information needed to do acceptable transcription that is not a part of that culture either.

Again, if the same typist is used by the client firm for your work every day, geographic and regional information will be learned. But again, the local medical transcription service is ultimately responsible for making sure this is addressed.

4) What about the security of the dictation itself?

Security, this is a hard one. Most client firms assume they have a trustworthy relationship with their offshore partners—and they may. But there are no guarantees. There are good security programs that can and must be used to move the files through the Internet. This is a given. Any firm that sends medical records “in the open” is both breaking the law and is downright foolish.

5) “Isn’t this un-American?”

One can appreciate the desire to “buy American” and thereby protect American jobs. Economically, however, this is actually flawed logic. The standard of living of any country that buys from others what these countries can produce cheaper is thereby improved by the transaction. In other words, the economy of the US is much improved by buying bananas from other countries than in incurring the additional cost of growing them in the US instead. True, there would be many new US jobs associated with this banana business, but the cost to the consumer would be so great as to actually lower the standard of living of the US as a whole. This applies to all products, medical transcription included. However, notwithstanding the economic soundness of this statement, many simply don’t believe it. So, it is the perception that must be lived with and dealt with—not the facts.

Like most firms, we export some of our work to an offshore staff and thereby take responsibility to deal with each of these problems.

However, the “buy American” issue takes a little special handling. Let’s face it “everybody is doing it” is pretty much a fact. The only difference is that we actually tell our clients this if they ask. A firm of any size that says they don’t use offshore typists would cause me to question their veracity. A lie is a poor foundation for a trusting relationship. We address this issue this way: if asked we respond that we do send some work offshore but if they prefer to have their work done here by Americans only, we will honor their request and make sure it is done only in the US.

Digital Transcription Inc
Ralph & Carol Bass
ralphebass@digitran.net
caroljbass@digitran.net
864-292-8487
www.digitran.net