BPO INDUSTRY

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Section A:

Part One:

1. Which of the following is not included in Porter’s Five Model for competitiveness?

a. Threat of New Entrants
b. Degree of Rivalry
c. Bargaining Power of Suppliers
d. Government Strategies

2. Which of the following is not a benefit of a BPO?

a. Cost Reduction
b. Cross – pollination of best products
c. Focus on core process
d. Automatic call distributions

3. In -------------------- stage there is orderly transfer of activities to the service provider.

a. Negotiation
b. Ongoing Management
c. Implementation
d. Preparation

4. List the Process of Outsourcing in appropriate order:

i. Listing out available in – house resources
ii. Signing the contract
iii. Negotiations, including a letter of intent and usually a contract with terms & conditions
iv. ‘Steady state’ period, which makes the end of the transitioning phase and the beginning of the cost cutting phase of the company
a. i, iii, ii, iv
b. i, iv, iii, ii
c. i, ii, iii, iv
d. I, iii, iv, ii

5. The BPO that handles almost all the transactional and administrative processes or other several functions are__________

a. Comprehensive BPO
b. Transactional BPO
c. Niche BPO
d. ITO

6. The model which is preferred when the client requires that the job should be done quickly and successfully:

a. Revenue Distance Model
b. Global delivery Model
c. Built – Operate – Transfer Model
d. Blended Offshore Outsourcing Model

7. Which of the following is not a main certifying agency for Indian BPO?

a. IRDA
b. KPMG
c. DNV
d. STQC

8. Challenges related to information infrastructure and branding is a type of a KPO challenge.

a. Internal Challenge
b. Industry Challenge
c. Customer Challenge
d. Competitor Challenge

9. Which of the following is not a dimension of service quality?

a. Empathy
b. Reliability
c. Assurance
d. Responsiveness

10. COPC – 2000 is a____________

a. Quality Certificate
b. Measurement Certificate
c. Performance Certificate
d. Regulatory Certificate

Part Two:

1. Differentiate between BPO and KPO

2. Define the term “COBIT”.

3. Write a short note on “Corporate Governance”.

4. Differentiate between BPO and Call Centers.

5. Define “Outsourcing”.

Section B: Caselets

Caselet 1

Company Background

CBay Systems Ltd. was founded in 1998 by Raman Kumar, Skip Conover and Mahidhar Reddy. The Annapolis based healthcare BPO is a leading provider of medical transcription services to US hospitals. CBay provides transcription and information management services to hospitals, integrated health care facility networks, medical clinics and physicians. CBay’s HIPAA – complaint solutions leverage leading Internet technologies and the world’s most highly credentialed transcriptionists to provide easier, more secure, accurate and cost – effective medical transcription. CBay‟s Development and Process Centre is located in Mumbai and Bangalore, India. Additional offices are located in Taylor, Michigan and Mumbai, Hyderabad, India. The company employs over 1,250 on its own rolls and 2,500 employees on its franchisee rolls. An upwards of 3 million files are processed on an annual basis.

The avert of government regulations such as the Health Insurance Portability and Accountability Act (HIPAA) coupled with increasingly stringent insurance company requirements today are driving the need for more efficient, accurate and secure medical transcription. Under HIPAA, transcription service providers have to implement technology and business processes to ensure the security and confidentiality of patient information, and establish an audit trail of all those who have accessed this information. This area in the medical transcription space is CBay‟s forte. CBay offers state of art in – house developed software solutions, which enable total control over the entire transcription process – from dictation to transcription to records management. “Our main USP is technology, which differentiates us from others”, agrees Dinesh Kumar, Director of Indian Operations. HIPAA is likely to become a law sometime during fiscal 2005 and conversion entails huge investments between US$ 18 to 23 Billion (greater than Y2K solutions) and expertise in IT systems. It is here that CBay commands a strategic niche as its expertise in technology will enable hospitals and medical practices to not only achieve full HIPAA compliance and streamline transcription processing and management, but also importantly to realize substantial savings. Also because all information can be accessed via standard Internet connections using existing hardware and systems, there is minimum capital investment. CBay has developed its infrastructure, hardware and software architecture with security as the paramount concern. From state – of – the – art encryption technologies, redundant architectures and security monitoring to disaster prevention and recovery measures, CBay has catered to all of the above issues. “The primary challenge facing CBay developers are the automation of logistics”, feels Harsha Kollaramaraju, the Chief Technology Officer of CBay. The amount of data to be handled, the number of transactions that needs tracking is phenomenally high. Since CBay has a global delivery model, it is important to have a system that is totally distributed, with different pieces in different places collaborating to fulfill each transaction, he further adds. The biggest challenge however is to handle the discrete elements such as dictation, demographics data, medical reports, which are all separately created and processed, although they are part of the same transaction. The software makes sure the integrity of data in each transaction and accurately delivers the right data to right people in different places.

Operations Model:

CBay operates through a strong network of 35 franchisee centers that includes Captive centers in Mumbai, Hyderabad and Bangalore. These franchisees are distributed in different parts of the country covering all the metros Delhi, Mumbai, Hyderabad, Kolkata, Chennai, Bangalore and other major cities like Trivandrum, Pune, Chandigarh, Guwahati, Baroda, Nagpur, Pondicherry etc. these centers have either been started by individual entrepreneurs or have been the ventures of large established business houses. All of these units work in close association with CBay, who helps them in training and certification of the MLS, adhering to the quality norms, quality audits, work load balancing and all other operational issues that arise from time to time. The work is routed to these different centers based on several criterions such as amount of work these centers can handle, type of dictators they can handle, their performance in terms of quality and their ability to return work within the predetermined timeframe. The various franchisee centers transcribe the documents, check the quality through the various levels such as proofers and editors and upload the records back to the CBay server in the pre – decided time frame. These files are then randomly checked and only after the quality team is assured about the quality of transcribed records, they are sent to the clients. The production units comply with the quality and time constraints that CBay has promised its clients. Few centers also run multiple shifts and 24/7 operations to cater client specific requirements. “are our partners in progress”, sums up Dinesh Kumar, Head – CBay India Operations, who is also responsible for liaison with these franchisees or production units as they are more fondly called. CBay‟s offices in Mumbai and Bangalore manage the Indian operations. These offices have 24/7 operations to provide support to vendors and service the clients.

Solutions offered by CBay

Different types of healthcare providers characterize the US healthcare industry. There are small 4 – 5 doctor practices, medium sized clinics operating with 20 – 25 doctors and operating out of more than one location and large hospitals where operations and other complex medical procedures are conducted. These entire have different type of work also varies. For example, a large hospital will have more of operative reports while a small clinic will normally have more of operative reports while a small clinic will normally have more of office notes or follow up reports. CBay has solutions of all of these types of possible clients. Very broadly, CBay offers the following four types of solutions:

1. CATTS – CBay‟s automated Transcription Tracking System allows hospitals and clinics on legacy systems to tap CBay‟s networks of 2500 transcriptions in the US and India.

2. CBayScribe: A sophisticated recording, routing and distribution portal that is combined with unrivalled transcription expertise to meet the needs of small and medium sized physician practices.

3. CBay Flo – An advanced solution for recording, routing, transcription and reconciliation, with HL7 integration of large hospitals and clinics.

4. A+ Network – An end to end dictation, transcription and document management platform offered to large integrated healthcare networks.

Each of these solutions has several production units attached to it. There are some production centers that operate on multiple platforms. Each of these has a separate QA center to monitor and control quality. Through a part of the same organization, they operate independently as they cater to completely different profile providers and hence have requirements that are different. As each of these uses a different software platform, the operations guidelines differ.

CATTS

CBay‟s Automated Transcription Tracking System (CATTS), allows the doctors, administrators etc. to view the status of a record from the moment it enters the system until the final transcribed version is sent back to the hospital/clinic. This software allows the users to know the status of their dictated record all the time, every time till they get the transcribed record back. By means of a simple query into the CATTS database, the system can provide the status of every dictated voice file. CATTS is a manually operated platform, which is being slowly transitioned to other more automated platforms.

CBayScribe

CBayScribe is the first end – to –end service that gives medical practices the speed and efficiency once reserved for large hospitals. Physicians dictate on digital recorders, over the phone, or on a PDA (Personal Digital Assistant). Transcriptions are guaranteed next day, with 98 – point accuracy. And detailed reports can be accessed over the Internet, any time, from any place. CBayScribe aims to fulfil the transcription needs of a physician practices, medium sized and smaller clinics etc. with the level of security and audit trail to meet HIPAA standards. CBayScribe provides the dictators with Olympus Dictaphone, which has the capacity to store upto two and half hours of dictation. They can dictate the patient records and details at their leisure and upload either all at once or in batches as per their convenience. Report Pro allows the doctors to upload the dictation to the CBay server or CBayScribe web services as it is called. The webserver routes these files based on how these dictators have been allocated to the production units, their capacity and some other criterion to the production centers. It also automatically sends the accessory documents such as demographic information (about the patient whose medical record is to be transcribed), templates related information and any other instructions given by the doctors to the respective franchisee/captive units.

CBay Flo

CBay Flo is the latest transcription platform devised by CBay‟s software development team in Bangalore. It enhances the ease with which transcription jobs are managed easily. CBay Flo facilities ease of operation at every step of the transcription process right from capturing the dictators from a legacy server or from its dictation server to allocation of dictations to stipulated transcriptionists automatically, reducing the time needed for the transcriptionist to access the dictation. CBay Flo uses a Six Sigma process for quality management. This process ensures the accuracy of the document in meeting customer requirements with regards to consistent quality and turnaround time. CBay Flo has various delivery mechanisms for the delivery of transcription reports. The reports can be printed or faxed or can be directly delivered to an HIS (Health Information System). This allows the reports to be generated using RTF, PDF and Plaintext formats. CBay Flo facilitates a free archival of all the transcribed reports on its servers. CBay clients can use this facility to obtain an older transcribed report. CBay Flo is a completely HIPAA complaint solution for managing transcriptions. It uses 128 – bit encrypted channels for the transfer of jobs and a complete audit trail for each job. There is also a physical security provided to servers, which host the dictators and transcription reports. The Electronic signature E – sign feature provides a mechanism of remote Internet signing with automatic tracking of records on every edit for compliance auditing purposes.

A+ Network

A+ Network is the winning combination of leading edge HIM software and unrivaled transcription expertise. A+ Network tracks when and where each report is accessed and by whom. Every activity such as dictating, transcribing, viewing, printing, faxing, QA editing, and physician – signing occurrence is audited with HIPAA – complaint audit reports. In order to provide a fully outsourced, exceptionally flexible turnkey transcription service combining unrivaled transcription expertise and leading HIM software, CBay has tied up with Arrendale Associates. The A+ Network handles everything from integrating the existing, dictation process, full transcription, comprehensive document management and achieving. All of this is done on CBay‟s secure servers. 7x24x365 access over the Internet is protected by complete audit trails and high – level security to meet and surpass strict HIPAA requirements.

 Question:

1. Discuss in detail about the solutions offered by CBay to the healthcare providers.

Caselet 2

Company Background

Suyash software Private limited started as a franchisee of CBayScribe in the month of May 2002 in Nagpur, Central India. The year 2003 was very difficult for healthcare BPO franchisees as a number of companies had shut shop due to quality issues and several people had become unemployed. All of this had made people skeptical about the profession and its long – term potential. “Since Suyash began as a franchisee of CBay, getting business was never any issue with us and hence we could concentrate on quality and employee development,” says G. R. Thengdi, chairman of Suyash Software. “Nagpur has a good educational base with thousands of graduates being churned out every year. Unfortunately employment opportunities are not commensurate with the supply of graduates. This means that a large chunk of the population is perennially in search of jobs. Our company targets this very group, grooms them in the nuances of the healthcare BPO job and provides them a career which is life- long, solid, progressive and satisfying,” he adds.

“As a franchisee of CBay we got a tremendous head start, right from the recruitment of transcription staff to orienting them in the rigorous quality requirements and standards of CBay in particular and HIPPA in general, to advise on technological setup. CBay helped us thoroughly at every stage,” says Samit Admane, Production Head at Suyash Software. CBay has pooled its capsule and every franchise or production unit has access to this.

“Currently the company is fully involved in offering only transcription services to the clients of CBay. But we might plan to move up the value chain in the near future. This would mean offering other related services such as medical coding, billing etc,” says Thengdi.

Career Opportunities

Training is the first and only entry point into the profession. Graduates of any discipline are taken. However science graduates learn faster as they are already familiar with the human body, anatomy etc (as these are part of the biology course at the final school-leaving exam syllabus). The training programme is divided into various modules include courses on medicine, anatomy, pharmacology, English grammar, transcription style and method, accent training (to understand, not to speak), typing skills, training in using Internet search engines, basic computer and keyboard skills etc.”Quality consciousness, time virtues that need to be ingrained at this stage itself,” feels Shirish Baptiwale, head of training at Suyash. “Once these virtues become virtues become a habit, you have long-term good employs with you,” he adds. Suyash has a full-fledged training centre and conducts training programmes throughout the year. Topics like medicine and pharmacology are quite daunting for students coming in from non – science backgrounds and they also need to be constantly motivated and encouraged. “The first one month is difficult, after which they get into the groove,” says Dr Swapan Dutta, who teaches medical subjects at the Suyash Academy of Medical Transcription. New recruits at Suyash are selected from among the trainees or hired directly as an MLS if they have already undergone a training programme elsewhere and pass the entry – level transcription test. Growth is completely performance – based. “Of course, other things like attitude to work, attendance and sincerity are also rewarded,” says Thengdi. Suyash has had instances of MLS becoming editors in matter of months simply because they demonstrated the necessary qualities mentioned above. The owners are directly involved in all aspects of the business, even day – to – day operations. The company follows open – door policy and anybody can at any point of time talk to anybody in the company, including the top management. This gives everybody the confidence that they will be listened to and get the same opportunities as anybody else. In addition to the salary there is an incentive scheme that automatically rewards hard work and sincerity. “Suyash aims to be one o the best employers, and provide its employees more than just a job. The company also regularly organizes programmes to distress its staff members. The first of May every year is celebrated as Suyash Day, when all members participate actively to make it memorable. In winter, a picnic is organized for everybody. All birthdays are celebrated, and a Diwali party is a regular affair. We have several plans in the pipeline to make working with Suyash a happy and growth – oriented journey,” adds Thengdi.

Future

This future is here to stay; no backslash or any other problem can stop the outsourcing of jobs in the healthcare sector. This is because here there are no job losses. No American loses his/her job because of outsourcing; it is used to bridge the severe demand – supply imbalance in the US. “This is a sound long – term career with growth opportunities not only within the company but even outside it, i.e., entrepreneurial opportunities are plenty. India has already established its track record of providing quality service in the tightest of time schedules. We must take advantage of this opportunity and become a part of the profession,” feels Thengdi.

Question:

1. Discuss in detail about the career opportunities with Suyash software.

Section C: Applied Theory

1. Explain porter‟s Five Forces Model of Competition with reference to the BPO Industry in India.

2. Discuss in detail the main challenges of BPO Industry.

3. What are the different models of Business Process Outsourcing?