The trend in corporate America is to offshore manufacturing and services if it is deemed financially prudent. Within the decision-making process, there are also ethical and patriotic considerations as reflected in the recent political conversations about outsourcing and offshoring. There are similar, as well as unique, considerations in relation to offshoring healthcare-related services to overseas operations. For example, possibly the most important consideration pertains to the protection of Personal Health Information (PHI) or sometimes referred to as “Protected Health Information.” PHI is defined under U.S. law as any information about health status, provision of healthcare, or payment for healthcare that is created or collected by a healthcare provider or entity, and can be linked to a specific individual. Let’s take, for example, a large practice of physicians who has contracted their medical transcription service to a company in India. There are many concerns related to PHI and the Health Insurance Portability and Accountability Act of 1996 (HIPPA) to provide data privacy and security provisions for safeguarding medical information. The company in India will need a risk assessment plan and a description of its security measures. Workers will only be allowed to use “dumb” terminals so that no information can be stored on a hard drive. There must be lockers for employees to store their phones so that photos of PHI cannot be taken. Security cameras must be installed and monitored to ensure employees are not clandestinely absconding with PHI. Printers must be in locked offices, printing must be monitored, and printouts accounted for so that they cannot be taken off premises. Audits are conducted on a regular basis to ensure compliance with all of the regulations. Therefore, offshoring healthcare services are not an easy task due to the regulatory concerns of protecting patient information.