Offshore Outsourcing for Medical-Related Call Centers

By John Chess

August/September 2005

Resistance to offshore outsourcing medical-related call centers is waning.  One reason is the success other companies that handle sensitive information, such as banks and government entities, have experienced when outsourcing offshore and still keeping their data secure.  A number of factors have combined to spark this shift: offshoring's ability to dramatically cut costs, a shortage of healthcare professionals in the United States, the availability of large pools of English-speaking healthcare professionals outside the United States, and a convergence of technology.  

The ability to offshore outsource medical communications has the potential to change the face of the healthcare industry, which today is bogged down by time-consuming processes and sky-rocketing costs.  This model enables entities such as health plans, managed care organizations, medical-device companies, and integrated healthcare delivery systems to offload a number of staff-intensive, costly programs, ranging from educational and training programs to clinical trials and case and disease management support.  

Offshore medical-related call centers are beginning to provide a wide range of industry-specific services.  Some of the largest are located in the Philippines, which has a large pool of well-trained English-speaking healthcare professionals. Canadian centers have made inroads in recent years and East Indian call centers are also entering the market.

A Case in Point: Disease Management: A growing trend in healthcare is disease management.  Today, most health insurers outsource some or all of their disease management programs.  The foundation of disease management programs is the call center, which is often staffed by registered nurses who monitor patients' health by phone and the Internet. 

For example, a company that offers a variety of services to diabetics can use an offshore medical-related call center outsourcer.  The offshore call center might be staffed with nurses in the Philippines who have specialized training in diabetes who can educate callers about the disease, deliver supplies, handle insurance claims, and support existing nurse staff by doing the data gathering, data entry, follow up, and contact.  This frees up the U.S. based RN staff to truly manage the patients more effectively, offering higher levels of service at lower average costs. 

American nurses can earn over $30 per hour plus benefits, while foreign nurses earn considerably less, making offshore call centers an attractive alternative for plans and vendors.  Even with overhead (salaries, benefits, space rental, utilities, connectivity, and telecom charges) a call center in the Philippines can offer significant savings compared to a nurse call center in the U.S. Offshore call centers can provide tremendous healthcare support services.  They may extend the services of highly educated, trained, and experienced staff to existing centers based in the U.S.  This helps meet two primary goals: improving the quality of healthcare while reducing its cost.

Convergence of Technologies: A convergence of technologies makes it possible to provide access to healthcare professionals outside the United States without compromising quality of care or data security. These technologies include:

• CRM (Customer Relationship Management) software for prioritizing and routing calls and electronic contacts while maintaining high levels of customer service

• VoIP (Voice over Internet Protocol) to use the Internet to transmit phone calls, greatly reducing costs

• "Thin clients," which are network computers that don't have hard drives and, thereby, don't put sensitive information at risk

• Hosted, pre-integrated call center services that simplify and reduce the costs of outsourcing call centers because the vendors host the entire hardware, software, and networking infrastructure

Keep Data in the U.S.: A high level of security is essential to outsourcing medical-related services.  When you deploy call center services that are hosted in the U.S. with thin-client network computers at the offshore call center, customer service representatives are unable to download, print out, or copy information to a CD or floppy disk because the data resides in U.S.-based servers.  Hosted services also keep start-up costs to a minimum as customer service representatives need only a PC on a LAN or a DSL connection if they work at home. 

Here's how it works.  Your toll-free numbers, web links, and email addresses are pointed to the hosting vendor's communications center.  All contacts are queued and routed to nurse customer service representatives in the offshore call center based on your routing rules via a data network. Voice calls are delivered via VoIP.  Web chat, web callback, email, and faxback services broaden the range of communication options for both the consumer and the medical provider. 

For clarity, let's consider a medical records transcription application. Inputting information into an electronic medical records system is a time-consuming task.  Patient records must be located, written notes reviewed, and all the pertinent information must be typed into the system and reviewed. 

Using an outsource EMR transcription service as an example, doctors and nurses may dial a toll-free number when they finish with a patient, input their ID code and the patient name, and begin their dictation.  Patient records are updated on a near real-time basis.  The payoff is big in an industry that places a premium on time, decreasing the amount of time spent by doctors and nurses on this task by up to 70 percent.

Tapping Into Global Resources: Outsourcing allows the healthcare industry to tap into healthcare expertise available in other countries.  The Philippines is particularly well-suited for outsourcing medical-related call centers because it has a large pool of highly skilled, well-educated, English-speaking healthcare professionals.  To become a nurse in the Philippines, a four year college education is required, prior to taking the certification exam.  The country boasts 214 nursing schools at present with many graduates emigrating to the U.S. and eventually becoming RNs.

Training is Key: The key to making this model work is rigorous training programs that prepare offshore healthcare professionals to meet the needs of specific U.S. clients.  The right kind of training enables services as complicated as providing a support infrastructure for compliance and retention programs and patient discharge follow up, or as simple as satisfaction and risk assessment surveys. 

The real value of outsourcing medical-related call centers lies in their ability to provide services that meet the highest standards, 24/7, at a cost structure not available domestically. Offshore outsourcing of healthcare services should not be viewed as not a replacement for U.S. call centers.  Instead, they should be used to assist domestic centers through good coordination and management efforts.  Today, we are only seeing the tip of the iceberg in terms of outsourcing medical-related services.  The offshore call center, as a silent partner trained in your protocols, may rise in value as the benefits are better understood.

John Chess, President and CEO of MediCall, is a pioneer in the field of outsourcing. He has founded or co-founded three companies involved in outsourcing and held key leadership positions at several others.