Is Offshoring the Future of Medical Record Services?

Growth in offshore medical record management services is gaining traction among Personal Injury attorneys. What’s prompting the shift in business practice?


Is Offshoring The Future of Medical Records Services?
Elliot W. Stone, Esq


Uncertainty about the future of the civil justice system abounds. Coupled with a slow economic recovery, containing case costs and overhead are essential, not just for a firm’s growth, but for its survival. Corporate law firms have been offshoring paralegal and legal work for quite some time. Now plaintiffs firms are slowly accepting the practice of offshoring work to India and other similar economies for a fraction of the costs of doing it stateside.


Can Indian MDs Cure PI firms’ Medical Records Headaches?

Sorting and organizing large medical charts can require hundreds and hundreds of hours of staff time. Significant non-billable attorney and staff time is expended ordering, organizing and summarizing medical charts. If these files are to be reviewed by expert consultants, copying and shipping costs are incurred.

Personal injury firms have been slow to adopt the practice for several reasons. PI firms tend to be very traditional and resistant to innovation and are accustomed to handling records themselves in-house. Several U.S. companies are now offering records services, with offshore partners in India, who organize and review charts.


Receive, Reduce, Review

For the many firms for which piles (and boxes) of records and binders stand like skyscrapers throughout the office, taking the rather large step toward digitizing all records requires a change in business practice and mindset. While many firms claim they want to become paperless, actually taking the steps required can be daunting. Online document transmission can be accomplished easily. First, legal staff scans all records and uploads them via a secure, HIPAA compliant internet portal. Thereafter, organized digital files are downloaded and returned in the identical fashion.

In general, firms who do this work, including ours, receive the medical records, reduce, sort and organize them into a text – based medical file. Any PDF documents are converted into text based files as well. They capture the record dates, procedure(s), treatment/occurrence(s) and other customized data fields. The finished product is a thorough text-based medical record summary that is presented chronologically, enabling the reviewer to better and more quickly understand a sequence of events. The file can be delivered in either WORD or PDF formats. The PDF format option may include two digital navigation tools – Hyperlinks and Bookmarks. Hyperlinks allow for instant navigation from summaries and timelines to corresponding source pages by clicking on the desired corresponding source page. Bookmarks form a digital table of contents allowing for organization of documents by user-defined categories such as provider and date.


Pharmaceutical and Mass(ive) Tort Records

If any type of legal work requires efficiencies that necessitate an outside solution, it would be mass tort litigation. Even with significant capacity within existing staff—sorting and organizing the records of several hundred class members requires serious stamina in terms of labor and hours.  Overseas firms with access to a large pool of medical staff are able to organize quickly to handle large volumes of work. Organizing medical records for mass tort litigation is similar to the general process, except that once medical staff receives the files they review and highlight key class parameters to determine claimant inclusion in the class in a chronology format. For large classes, spreadsheets can be prepared addressing individual parameters with hyperlinks embedded that link to actual chart for ease of confirmation. Plaintiff fact sheets, tedious and time consuming work for firms, can also be prepared by physician reviewers.


Offshoring: Advantages and Disadvantages

Outsourcing medical records services to India has its both advantages and disadvantages. Files that are chronologically sorted into easy-to-read and navigate electronic files, reduce both attorney and expert reviewing time and billing. Cumbersome record preparation and case review can be redirected from lay staff in the office to physicians and other medical professionals, for just $US25-$50 per hr. The charges are a billable expense to the file. While physicians are fluent in English, Hindi pronunciation and diction can make oral communication challenging for American English speakers. Their written English, however, is usually strong and rarely poses a problem. Regardless, this service brings us another step closer to fully leveraging the business potential of the internet.


Elliot Stone, Esq is CEO of medQuest, Ltd, whose division, Record Reform℠ provides medical record outsourcing services to attorneys. , 646-470-8730