The basic process of Medical Transcription flows as follows: Transcribe and Edit - Delivery (Hospital Specific Format) within a contracted turnaround cycle - Bill Customer.

A successful medical transcription unit is characterized by the following strategies:

- Continuous watch and reduction of variable costs: This is effected through accessing offshore manpower, new technology and improved processes. These costs typically consist of staff costs (transcriptionists), telecommunications and operating various offices.

- High Margins: Better cost management, outsourcing, large volumes and continuous investments in more productive technologies.

- Internal Strategies: Enhanced value additions and maximizing productivity through internal assets.

- Business Differentiation: Ensure constant uptime, minimum turnaround time, quality and cost advantage through efficiency and cost management.

- Internal training programs: It is important to have in-house training programs to train MTs for new skills and medical terms, checking and ensuring the level of their output and for internal growth.

- Business propositions for customers should be to offer cost advantage, improved productivity and quick response.

- The industry has the potential to spin off a complete healthcare information industry. It may be worthwhile to note that low quality manpower supply base, modest levels of customer satisfaction, and a potential trend to concentrate on insourcing presently affect this industry. Customer support has been found a more wanting factor than availability of services. Thus, ensuring 24-hour support with expert help desks should help to improve customer satisfaction levels.

- The outsourcing to India process will work only if the customer feels comfortable and does not have to put in precious management time to make it work. This means credibility in terms of delivery time and quality. For this, it is essential to have a service centre in the USA. This service centre has to be fitted with adequate hardware, software networking and 800 lines so that it acts as a clearing station between the outsourcing company in the US and the service provider in India.

- The customer will deal with this centre and so will the service provider. Outsourcing needs a reliable third party provider. Even though the market size is large, it calls for top level contact and coverage to get agreements to transfer these jobs offshore. An aggressive marketing and sales team is a must. Basic raw material is easily available and the technology is relatively stable. However, training is to be imparted to create both the skills required for the particular job as well as cultural issues like language, following rules, delivery on time and quality. Since communication is the key, there has to be a network with adequate bandwidth and back-ups.