When Indian transcriptions head awry

Below knee amputations becoming 'baloney' should provoke more concern than laughter
Written by Fran Foo on
India's image as a paragon of outsourcing took a severe beating last week after revelations of offshoring tasks gone awry shook the entire medical fraternity in the United Kingdom.

Facing an acute shortage of medical transcribers, eight hospitals in London decided to outsource transcription services. Instructions and letters were dictated into digital voice recorders and the files forwarded to a company called Omnimedical, which would then send the recordings to a team of transcribers in India.

In theory, it's a straightforward process but reality proved otherwise. The mistakes in the transcriptions were so serious, they prompted the Association of Medical Secretaries to go public, with spokesman Michael Fiennes citing several horrific examples in the Daily Mail : below knee amputation became "baloney amputation" and phlebitis (vein inflammation) left leg was changed to "flea bite his left leg".

Hilarious? Not if such blunders cost lives.

This episode evoked memories of the venerable Ian Rush, one of Liverpool's greatest strikers. Rush's post-match TV interviews always proved tricky... due to his Welsh accent, "goal" was the only word I could usually decipher.

Football, or soccer as some call it, transcends linguistic and cultural barriers simply because all over the world, players apply the same set of rules. The motley mix of accents and colloquialism, however, means that the English language is open to local interpretation and can sometimes be incomprehensible.

On the surface, it may seem like the onus for patient safety lies in Omnimedical's hands but it is the hospitals that should be held accountable.

They say the prime motivation behind outsourcing the workload is to provide better service to patients but they fail to address the ramifications of such a move.

The root cause behind the dearth of medical secretaries -- a combination of low wages and dim career growth -- has been skirted in favour of offshoring, the magic short-term solution.

The monthly wage of medical secretaries in India is reportedly one-third that of their British counterparts. The hospitals will argue that cost wasn't the only factor in deciding to outsource. In fact, any suggestion that hospitals wilfully put patients' lives at risk would surely be met with furious rebuttals.

This is the peril of outsourcing to India, some camps might say. What if the destination was Australia, Scotland or the United States? Would that have made any difference?

The outsourcing of transcription services can be juxtaposed against the offshoring of call centres -- the perennial favourite among many large enterprises. Some companies implement a "follow-the-sun" approach which seeks to ensure that customers from all continents are serviced 24 hours, seven days a week. Noble idea but frustrating when the operator can't tell the difference between "today" and "to die" or when Toorak becomes "Two Rack". Organisations that compromise on language and local knowledge will eventually pay the price. The question is, at whose expense?

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