How technology enabled and destroyed a sunrise industry

Medical transcription saw significant growth in India at the cusp of the millenium

As the world contemplates the dizzying ascent of Artificial Intelligence and what it will mean for workers everywhere, here’s a cautionary tale of how technology enabled and destroyed a sunrise industry in the 21st century. Medical transcription, the process of converting dictated medical reports into written format, witnessed significant growth in India at the cusp of the millennium. With the fibre-optic cables laid across the globe in the 1990s, a new business became possible. American doctors had to dictate their notes to a secretary, pay her overtime, put up with mistakes, and cope with absences for leave and illness. Dictating to transcribers overseas over the internet was both cheaper and more efficient in generating timely medical documentation.

India boasted a vast pool of educated individuals proficient in English and possessing strong typing skills, as well as a willingness to adapt to technology. Indian transcription companies offered competitive pricing without compromising on quality, making India an attractive option for offshore outsourcing. The cost advantage was linked to Indians’ command of the English language, including medical terminologies, ensuring largely error-free transcription. The time zone difference meant notes could be typed up in India while Americans were asleep. Overnight turnaround times ensured US health care providers received transcribed reports promptly, improving their efficiency and patient care.

Indian transcriptionists possessed more skills than American secretaries, did not disappear on holidays, and did not charge overtime. Seamless IT connectivity facilitated real-time communication between health care providers and transcription companies, ensuring quick feedback and prompt resolution of any clarifications. Indian transcription companies invested in rigorous training programmes to educate their workforce on medical terminologies, American regulations, and data security protocols. All this made India an ideal destination for medical transcription services. Indian companies’ commitment to quality and compliance, and the growth of a skilled workforce to meet the industry’s demands, earned the trust of international clients, further boosting the industry. Both sides thought they had a long-term winner on their hands.

They were wrong. They had not anticipated the advent of AI and voice recognition software, which led to the collapse of the medical transcription business. AI technology, particularly in natural language processing and speech recognition, rapidly advanced, leading to the development of sophisticated voice recognition software. These systems were capable of accurately transcribing spoken words into written text. For the price of one-time purchase of AI-driven voice recognition software, health care providers could reduce expenses by adopting automated transcription systems. The software enabled doctors to speak into their computers and see their words appear on the screen in real-time, eliminating the need for outsourcing to human transcriptionists. Why pay Indian companies for documentation that could be generated almost free in the doctor’s office?

While early iterations of voice recognition software had limitations, subsequent advancements in AI technology led to improved accuracy. Machine-learning algorithms trained themselves on the voice of the doctor, continuously analysing and learning from vast amounts of medical data, reducing errors and enhancing transcription quality. The integration of AI transcription software with electronic health records systems further streamlined operations. Automated transfer of transcribed reports into patient records improved data accessibility and efficiency.

There is a sobering lesson in all this. Those who thought the medical transcription business would play a vital role in the health care industry for several decades underestimated how rapidly technology would render their business model obsolete. The evolution of AI will continue to shape the health care industry. Indian radiologists who used to read MRIs for American hospitals (another seemingly sunrise industry, given the shortage of radiologists in the USA and their high wages) have already been displaced by AI systems.The Oxford Martin School estimates that 30 per cent of the jobs in the world in 2030 will be jobs that don’t exist today. Equally, at least 30 per cent of the jobs today will cease to be necessary or viable by then. We have entered a world in which our businesses will have to constantly focus on adaptation and upskilling if they hope to survive.