YOUR recent article on outsourced transcription of digital voice dictation may have been based on a misunderstanding.

The paper medical records are not sent anywhere outside the hospital confines and this needs to be emphasised. Past, present and future patients can be reassured that there is no breach of patient confidentiality.

It is an electronic dictation file that is typed abroad; the files sent are anonymised as they are identifiable only by a number; not a name, let alone an address.

I do not wish to bore your readers with the technical mumbo jumbo except to say that we are BS7799 compliant, which in plain English means that our processes follow extremely stringent UK standards on data security, and your readers (my patients) can be assured their confidentiality is fully respected and uncompromised by outsourced transcription.

The lack of medical secretaries has long been an NHS wide problem! and a six week delay between the patient's appointment and the GP receiving the hospital doctor's letter is not uncommon.

The key advantage of outsourced transcription is the affordable guarantee that the transcribed file can be returned within 48 hours, irrespective of holidays and sickness and other unexpected absences.

The only delay now is the doctor signing off his/her letters, and even though some are tardier than others, the letters can usually be guaranteed to be with the GP within three to four working days.

In the US, more than 60 per cent of medical transcription is now outsourced to other countries (compared to less than one per cent in the UK) and again it is the guaranteed turnaround time and not just cost savings that has driven the changes.

Such outsourced transcription is already common in other areas such as legal practices. Quality of transcription is perhaps not quite as good as can be achieved by a locally based secretary; familiar with local accents, the quirks of her doctor and having the advantage of the medical records to refer to, but if that means the doctors are now forced to proof-read their letters more diligently, well, that is probably no bad thing!

Dr Sheru George, Clinical director for dermatology, Amersham Hospital