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What is Wrong With Offshoring Transcription?

Posted By: ATA - American Transcription Association on 2010-10-06

Plenty, According to the American Transcription Association (ATA)…

Offshoring in terms of transcription is the act of subcontracting transcription to workers outside of the U.S. As of this writing, most offshored work is sent to India, Pakistan, and the Philippines, though it can happen anywhere in the world.  The American Transcription Association (ATA) is against offshoring for two main reasons: sending personal information outside of the country can lead to unsecured transfer of personal data and even information and identity theft; and offshoring work means U.S.-based transcriptionists are losing jobs.

Information and Identity Theft
Are you comfortable knowing that your own personal medical information and that of your family may be on a computer in Pakistan right now? What about your financial information or your personal legal business? The American Transcription Association (ATA) is not comfortable with it, and we don’t think that many Americans would be. Full confidentiality is required when handling these documents – and the ATA is not convinced that this can be reasonably enforced when the work is offshored.

Here in the U.S., medical transcriptionists are bound by the Health Insurance Portability and Accountability Act (HIPAA), which protects the privacy of your medical records. It sets strict standards for everything including secure handling, transfer and storage of files.

However U.S. law does not apply in foreign countries like India, Pakistan, and the Philippines where many companies offshore their transcription work. Some organizations may not even realize that their clients’ or patients’ records are leaving the country. They may subcontract their work to a U.S. transcription company, assuming that because they’ve hired an American company, all work will be done here. We know that this is not always the case.

Currently, there are no U.S. laws – including HIPAA – that explicitly prevent companies from offshoring personal information, though there has been talk at both the state and federal levels of implementing new Acts or amending current ones.
There are already documented cases of offshore transcriptionists who have threatened to disclose personally identifying information from medical records. Clearly, this would have been a breach of HIPAA, but there is little chance that they would be extradited and brought to justice here in the U.S. For all intents and purposes, these foreign transcriptionists are immune to prosecution.

The problem does not stop here. A medical record often includes not only your name and date of birth, but address, social security number, and even a scan of your driver’s license for photo ID in some cases. It is not too far of a stretch to realize that in the wrong hands, this information could be used to forge passports and other documents that could lead to threats to national security. Some veterans have already voiced concerns that health records for military personnel could be used to target our troops in Iraq, Afghanistan, and other countries.

As touched upon above, the issue for these medical organizations and offshoring transcription companies comes down to money. Offshoring transcription work is cheaper because wages are so much lower than in the U.S.

But some things – like our personal medical records – should not be handled by the lowest bidder. There are some serious issues here about privacy, confidentiality, and security that need to be addressed.

Job Losses
It’s no secret that the domestic transcription industry is smaller than it could be. Many transcription companies, large and small, compete within the U.S. for contracts, only to subcontract or “offshore” that work to transcriptionists overseas. (In many cases, the client isn’t even aware that this is happening – see below.)

These offshore transcriptionists tend to work in countries with weaker economies, which means they can work for pennies on the dollar, compared to what an American transcriptionist must make for a living wage. What makes it really ugly in some cases is that these companies slightly undercut the market here, then grossly underpay their foreign workers there who still make a good wage because of the differences in our economies. The result is that these transcription companies make huge amounts of money while paying relatively little in labor.

We don’t believe this is fair, especially in our current economic climate. We believe that we should keep the jobs here in the U.S. where they belong.

So what can we do?

--  Sign the ATA Petition! (http://www.ataus.org/ata-petition/)

--  Start asking questions of all your medical, legal, and financial providers at your hospitals, clinics, attorney’s offices, financial brokers and let them know you want your records kept in the United States.

--  Write your Senators and Congressmen. Educate them about our industry. Tell them you do not want any of your private, medical, legal, or financial information forwarded via the Internet to any country outside the United States of America. Ask them to ensure that any transcriptionists or companies they work with also do not offshore.

--  Get informed by reading the links below and conducting your own Internet search.

--  You can also find out more at the American Transcription Association (ATA) website http://www.ataus.org

The ATA is dedicated to making this issue public so people understand the risks involved with offshoring of personal and sensitive information. Its goal is to foster a strong domestic – and fully accountable – transcription industry.