Outsourcing to India: Considerations for the Future -
Wwe cannot overlook trends in other industries
By Larry Dunham, RHIA, CHP

In a recent Business Week journal article, I was quite surprised to read and learn more about what may lie ahead of us in the need to meet the needs of an ever-changing health care industry not to mention other industries workforce that we interact with daily. More on this later.

Most recently the possible problems with outsourcing came to the headlines with a transcriptionist freelancer from oversees threatened to expose protected health information in an attempt to force the primary contracting agency to pay for work performed. This triggered a frenzy of review of current contracts with transcription agencies who without notice had been using secondary freelancing transcriptionists to perform work on their behalf within leading healthcare facilities across the United States.

AHIMA rushed to the press and offered up these top ten questions every healthcare organization should ask when outsourcing medical transcription services:

While there is always risk for misuse and abuse when someone has access to another individual's personal health information, the concern is far greater when that someone is based outside the US. The more degrees of separation that exist between the provider and the transcriptionist-whether foreign or domestic-the more difficult it is to manage all of the technical, procedural, and personal factors that go into keeping the information secure.

Beyond this issue of "newsworthy" highlight, I would like to share the insights from the Business Week Journal. The article presented the facts of India being a fast growing country of highly educated individuals with also a legacy of youth who also are in-line to be highly educated and impacting a depleted American workforce.

Many other industries are already turning to India not to augment their workforce but to outsource and utilize the experience of many. It was noted that a top engineer in India earns about $10,000 per year-roughly one-eighth of U.S. starting pay. This has allowed many companies hire several top engineers in addressing innovation versus single engineers in American firms. "Corporate American no longer feels it can afford to ignore India. There's just no place left to squeeze costs in the U.S. states Chris Disher, a Booz Allen Hamilton Inc. outsourcing specialist." Again, this has involved all industries including Healthcare. If India can turn into a fast-growth economy, it will be the first developing nation that used its brainpower, not natural resources or the raw muscle of factory labor, as the catalyst to step into leading the US in support. The strength is intellectual services where the US economy is made up of 60% of services that can benefit from India's work force….and we are seeing most companies move jobs in their direction. Some have cut jobs in America and moved jobs oversees to realize a 40-60% benefit to their bottom lines. This factor in our globalized healthcare system can not be ignored. We can not simply place our heads in the sand and not explore the possibilities. I am not saying we should outsource for only the sake of dollars, but I am saying we need to really understand "the shift" in outsourcing and to also challenge the ethical and personal conflicts we are having.

I do not propose that I understand economic strategies and workforce management projections, but I do wonder how we can continue to cut healthcare costs when most of the costs that we are up against are "fixed" based off of overhead management of the regulations we must have in place (ie..CMS, JCAHO, etc…). This added information is food for thought for me in understanding more that my "gut" was telling me……These factors truly open our US economy to a more "global" picture….We just need to continue to learn from each other and to uphold a standard of practice…regardless of country. I have challenged myself to be more open for the possibilities….with utilization of knowledge and insight from articles such as this….It feeds my "out of the box" thinking!

Reference:
The Rise of India, BusinessWeek, by Manjeet Kripalani and Pete Engardio