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Wednesday, 10 February 2016
The Medical Transcription Industry: Challenges ahead
  • The Medical Transcription Industry Association of the Philippines Inc. (MTIAPI), which comprises of 80 medical transcriptionists/MT firms, plans to provide training in various functions and aims to triple the industry workforce to 32,000 by 2010.
  • Comat Technologies, an India-based player in e-governance and ICT development projects has launched a training program in medical transcription aimed at the rural youth. The 4-6 months program will cover subjects like Science, US accent training, English typing and grammar.

The above recent instances demonstrate that offshore Medical transcription (MT) industry is sprucing up its act to tackle a major impediment to the growth of medical transcription offshoring - adequately trained manpower.

The US Medical Transcription industry

The size of the US medical transcription industry is estimated to be in the range of $12 b and is expected to reach $16.8 b by 2010.

The US healthcare industry went through a major change in the 1990s, when the need to standardize transcription style in order to clarify medical terminology was recognized. Further, the American Association of Medical Transcription (AAMT) Book of Style for Medical transcription was published in 1995. This led to an increased emphasis on standardized documentation and accuracy.

The US medical transcription industry is highly fragmented. Hospitals and clinics usually transcribe notes in-house or outsource the work to medical transcription service organizations (MTSOs) or home-based US medical transcriptionists. These MTSOs either get the work done in their own centers or sub-contract the work to smaller medical transcription companies within the US.

While 40% of the transcription work is outsourced in the US to MTSOs, only 5% is currently being offshored to low cost destinations such as India, Philippines and other Asian countries. MTSOs either do the work at their own transcription centers in the US or subcontract to home workers in the US or vendors in offshore destinations. It is rare for hospitals or clinics to directly offshore the work.

The Offshore Supply - India Story

There are numerous large and small vendors offering medical transcription services. On one hand, there are large players such as CBay with the India headcount of over 3,500 and aggressive growth plans. On the other hand, there are numerous players with less than 50 employees. The large players, mostly US MTSOs with offshore centers in India, account for almost 70% of the revenues in the industry. While the remaining, mid-sized and smaller players manage a relatively smaller portion of the market.

Although offshoring is not new for the US medical transcription industry, it is still not well accepted by the US buyers. Not surprisingly, several hospitals and physician groups in the US are not in favor of offshoring their medical records. This explains why the offshoring space is dominated by the American MTSOs who sub-contract the work to their offshore units.

Technological advancements: Boon for some, bane for some!

Smaller offshore vendors are dependent on MTSOs for subcontracted work, and find it difficult to change buyer perception. The apparent opportunity in MT offshoring does not easily translate into offshore revenues for these players.

Apart from stable and trained manpower, access to large independent business contracts and internal competition; advancements in speech recognition and Electronic Health Records (EHR) technology is adding to their challenges. The technology is gaining popularity and is expected to be increasingly adopted by clinics in the US. This is likely to eat into the possible clientele of the smaller offshore vendors.

Nuance is a key player that dominates the speech-to-text market for health care professionals, closely followed by speech recognition division of Royal Philips Electronics Inc. According to Nuance, around 6,000 professionals use the company's software across all branches of the military. The company says that adoption of this technology grew by 100% over the last year for the US military's health system.

Offshoring in MT now has another competition in the form of technology. The speech recognition software is said to get 98% accuracy in results. Technological advancements in this area will continue to improve in tandem with recruitment, quality, training and other efforts on the offshore front. The technology can be a great ally for the large players in India that can afford the acquisition of technology and leverage it to tackle training and employee attrition/retention issues. However, it can prove to be a threat for small India-based MT companies, as lesser work flows to them either directly or via sub-contracting with greater technology adoption in the market.

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