London: Outsourcing of medical notes to Indian call centres to save money and speed up work at the National Health Service (NHS) in Britain is leading to cases of confusion, a London daily claimed on Thursday (Aug 19, 2004).

While some "lost in translation" mistakes are hilarious, trained medical secretaries warn that the consequences could be serious if drug quantities go wrong, 'The Daily Telegraph' reported.

A drug for stomach ulcers called Lansoprazole was transcribed as the much more familiar holiday destination of Lanzarote.

Information about a patient's "phlebitis" (vein inflammation) left leg" was typed out as "flea bite his left leg".

A "below knee amputation" was transcribed as "baloney amputation" and "Eustachian tube (in the ear) malfunction" was given as "Euston station tube malfunction".

Eight London hospitals are using or negotiating to use the services of Omni-medical, which employs a pool of secretaries in India to transcribe letters from tapes dictated by consultants. It is estimated that about 7,000 letters a month, often between consultants and GPs, are dealt with in this way.

The Association of Medical Secretaries has been keeping a log of some of the most glaring mistakes.

"Some of these are funny and we cannot say the mistakes have caused problems yet but there are real concerns about drug quantities being misheard, 15mg for 50mg, for example," said Michael Fiennes, of the Association of Medical Secretaries.

"I have no doubt that the secretaries in India type very good letters but they are not trained medical secretaries familiar with medical terms," the daily quoted him as saying.

The report quoted Gorav Datta, Omni-medical's marketing director, saying it was only one of several companies providing transcribing services and the quality of its work was superior to that provided by temporary staffs employed in the NHS.

"All the letters are signed and checked by doctors before they are sent to GPs. Some are checked by the medical secretaries," Datta said.