BUSINESS COMMUNICATION PROJECT

SUBMITTED TO: MISS HUMA WAQAR

SUBMITTED BY:
Aqsa Aziz
Maham Zafar
Sumaira Khalid
DEPARTMENT OF MANAGEMENT SCIENCES
Executive Summary
In this fast moving world, an unexpected unplanned situation can arise at any time. Situation that
suddenly dawns upon from a business out of nowhere, threatens the very stability of a business.
The process by which such events or threats are effectively managed and dealt with is known as
Crisis Management.

In this report we have identified the crisis faced by Medical Transcription and Billing Corporation,
how organization deal with such crisis and what could be other possible ways they can adopt to
avoid such situations.
MTBC
MTBC, Medical Transcription Billing, Corp., is a publicly traded healthcare IT company that
provides electronic health record software and technology-based medical
billing, transcription and practice management services to healthcare providers in the United
States. MTBC is headquartered in Somerset, NJ, USA and runs an operational facility in
Rawalpindi and Bagh, Pakistan through its subsidiary, Medical Transcription Billing Company
(Pvt.) Ltd.

MTBC is a healthcare information technology solution provider that offers physician practices a
comprehensive product portfolio of fully integrated WebEHR, revenue cycle and practice
management solutions and other related business services including transcription and data
management.

Their entire product portfolio-along with native mobile applications-functions as a cohesive,

single-database platform to help healthcare providers, improve their financial performance and
ultimately transform their medical practice into a successful business enterprise. MTBC
technological solutions and related business services can aid physician practices to cost-effectively
and successfully meet regulatory challenges and prosper amidst a rapidly shifting healthcare
industry environment.

MTBC serve an expanding array of diverse healthcare entities and clients are spread across the
healthcare continuum -from single physician, medium sized practices to independent physician
associations-which is a testament to the functionality and flexibility of their core solutions. They
have partnered with a variety of healthcare organizations to extend their reach to 40+ states.

HISTORY
MTBC began operations as a medical billing company specializing in electronic claim services for
healthcare providers primarily located in NJ. The Company attained tremendous growth and on
April 1, 2002, through an affiliate company, started an operational facility in Islamabad, Pakistan
to help manage new business resulting from its rapid growth. The affiliate company, Medical
Transcription Billing Company (Pvt.) Ltd., was later officially incorporated under the laws of
Pakistan on January 16, 2004. Medical Transcription Billing Company (Pvt.) Ltd. is now a fully
owned subsidiary of MTBC.

For four consecutive years, MTBC was recognized as one of the fastest growing companies in the
United States and Deloitte Technology Fast 500. After years of rapid growth, MTBC announced
an initial public offering of its common stock on July 22, 2014.The offering was completed on
July 28, 2014, at an offering price of $5 per share. It now trades on the NASDAQ exchange under
the symbol MTBC.

WHAT IS CRISES?
Crisis refers to sudden unplanned events which cause major disturbances in the organization and
trigger a feeling of fear and threat amongst the employees. There are different types of crisis i.e.
Natural crisis, Technological crisis, Confrontation crisis, Crisis of malevolence, Crisis of
organizational Misdeeds and Crisis due to rumors etc.

The type of crisis that we identified in Medical Transcription and Billing Corporation are the
following:

CRISES OF MALEVOLENCE

 Organizations face crisis of malevolence when some notorious employees take the help of
criminal activities and extreme steps to fulfill their demands.
 Acts like misusing company’s data and officials, all lead to crisis of malevolence.

MTBC is based on HIPPA (Health Insurance Portability and Accountability Act) Privacy and
security rules that dictated all who may come into contact with Protected Health information go
through a training on HIPPA policy, and that there may be a documentation to prove that the
training has been completed. HIPPA Rules actually train employees in regarding the transmission,
privacy and security of healthcare data of patients, insurances and physicians. In MTBC, in mid
2017, it was seen that an employee who was employed since 5 years, he wanted to get promoted
to Team lead or assistant manager position of his practice. But unfortunately he was not getting a
chance of promotion because of his absenteeism rate as leaves are not allowed in MTBC unless
there is some emergency. Also he had clashes with his team members, his practice/department
manager because they were not giving him a chance of promotion to manager level. So he adopted
an unfair mean. As in MTBC maintaining and protecting health information record of patient and
physicians based in US is given a top priority. He tried to manipulate the data of one practice of
physicians based in US, in Rawalpindi office and tried to access the data and transferred some of
it in his USB. That alerted that practice of physician in US and Rawalpindi management. As he
breached the contract of HIPPA privacy and policy rules which he signed in his contract when he
joined MTBC so he got terminated and also case was filed against him for data breach which was
clearly mentioned in his contract and also during their training sessions throughout his career in
MTBC. Because of that incident that physician based in New York left billing services of MTBC
which badly affected organization image. So employees when get frustrated due to such issues,
sometimes try to harm organization so their demands get fulfilled.

CRISES DUE TO RUMORS

Spreading false rumors about the organization or other employees lead to crisis. Employees must
not spread anything which would tarnish the image of their organization. This can also be
categorized as grapevine communication. In MTBC people are also involved in such activities like
gossips, spreading wrong information about the organization or colleagues.
As we tried to identify, we came to know that

People now a days are spreading rumor that organization is going to layoff many of their old
employees in January and February, who have more salaries and have a chance of getting promoted
to upper level of management. They will hire new employees on less salary package. So such
bogey rumors are when circulating through office, those people start to worry about their jobs,
doubt their future and have concerns they’re being talked about or portrayed in an unflattering
light.

Also new employees who are being hired are told that they should not give suggestions to their
team lead and manager because that is not so welcomed by them. In many practices in MTBC,
employees are being told by other employees who spread such rumors that you cannot share your
views about organization or colleagues because here employees tell those things to their leads for
their benefits so to prove that this employee talk negative about organization and employees. And
if they do so, they will be shifted to other practice and may get poor performance points. Because
of this employees fears sharing even their positive ideas with others. All these rumors which are
not true many times lead to lack of cooperation and coordination among team members, lack of
confidence and more fear which leads to workplace crisis which in result destroy the image of
organization.

OTHER REASONS OF WORKPLACE CRISES

some other problems that we identified there are

 Employees are not appreciated much for their hard work and efforts. Many people are
leaving their job because they do not get much appreciation from their superiors and due
to the strict policies of the company. At times, if they have queries they cannot directly
communicate to their practice manager which also creates problems. So employees look
for other jobs which is also a negative point for a company.

 Those trainers who come from US to train new employees and also for on the job training
sessions in Pakistan in MTBC’s Rawalpindi and Bagh office, they train employees on new
privacy and security rules, new practices of billing and any other specific training. As they
are from US, many people working here face language difficulties in understanding
immediately to what they are saying because of their fluency and some technical terms
used by them. This also effects their communication.
In Crises faced by MTBC, two are mentioned as, malevolence and crises due to rumors.

SOLUTION FOR MALEVOLENCE

MTBC faced crises as one employee breached the data. Number of cyber-crime incidents are the
reminder of the risk associated with the disgruntled or departing employees, who may have
tempted to steal the data.

DATA BREACHED

A data breach can be defined as a security incident where sensitive, confidential and most of the
time valuable information is copied, leaked or even viewed by an unauthorized individual from in
or outside the organizations. These breaches may involve monetary information such as credit
card, bank details, and personal information such as health records, identification information,
property, trade secrets, and even private locations. Data breaches have become very rampant with
numbers escalating as most organizations computerize their systems.

CAUSES OF DATA BREACHED

There is an endless list of possible causes of data breaching. It varies from organization to
organization. Here are the few causes of data breaching faced by organizations;

 Denial of services
Data of organization is accessible to the employees. Mostly data is breached as a purpose
of revenge. Attacker believed that organization have been denied their rights or some sort
of services. As a result, they take revenge. That affect the reputation of organization.

 Physical Theft
Physical theft is usually opportunistic and it is a scenario where a thief lands on valuable
documents by physically taking them from an office or personal property such as cars. It
has been found that physical theft tends to affect the health and public sector more than
other sectors.
  Miscellaneous Errors
Miscellaneous errors occur when sensitive information send to incorrect recipient,
publishing non-public data to public forums and insecure disposal of data.

 web app Attack

Web apps are attacked for the financial gains.

 Cyber Espionage
Cyber espionage is an act also performed to access secrete data held by an organization.

MTBC employee breached data for the purpose of revenge. As he was not getting chance of
promotion because of absenteeism rate and clashes with the other team members.

MAHAMGING CAUSE OF DATA BREACHING

 Good organizations have become paralyzed after data breaching in the past, which lead to
loss data. Now organizations have data recovery system, so incase if data is loss they can
recover it. Securities are increased after such type of incidents.

 Educate your employees how to handle sensitive data. Ignorant employees breach data
without their knowledge or not being very careful for the sensitive confidential data can
cause good percentage of breaching. Educate employees through training to handle
sensitive data with utmost caution. On job trainings can reduce the employee related data
breaching.

 Sometimes organizations have mobile workers. Mobile workers work outside the building
of organization. In that case there is a great risk of data lost. In this case, intentionally or
 unintentionally data can be breached. The best to avoid such a catastrophe is to train them
on data handling and maintaining security.

 Do not over-rely on encryptions as the only form of defense. Most of the organizations
think they are super protected by having encryption on their systems. Organizations should
have hire more expertise and invest more in data security rather than rely merely on
encryption.

MTBC APPROCH ON MANAGING CRISES OF DATA BREACH

After this serious incident MTBC took serious steps to avoid such serious in future. These steps
were taken;

 No employee is allowed to use office website other than official work.

 Employees are not allowed to bring cell phones in the premises of MTBC.
 Personal laptops and USBs are also strictly prohibited in MTBC.
 Employees are not allowed to use their personal email systems on office computers.

SOLUTIONS FOR WORKPLACE CRISES

For the success and growth of organization communication is very important. It can make or break
the organization. Communication should be clear and effective. One common practice that hinder
the efficiency of the company is the grapevine communication.

GRAPEVINE COMMUNICATION

It is unofficial, informal and personal communication system or channel that take place in an
organization as a result of gossip and rumor. As grapevine communication can distort facts and
create conflict, it is important that this type of communication should be avoided.
MANAGING WORKPLACE CRISES

MTBC is facing another problem currently. There is rumor spread in organization that company
is going to lay-off employees in next two months and hire new employees on less salary package.
To deal with this kind of crisis MTBC have following ways;

 Rumors spread when the situation is not clear. When the things are not explained clearly,
other people may tend to explain it incorrectly. MTBC should open all channels of
communication, present the facts positively and fight the negative message positively.
 Periodic meetings are very important in every organization. As this is the venue where
team is made aware of what happened in organization. MTBC can also arrange periodic
meetings to inform employees about current issues occurring is organization.

 Question answer sessions are important and great medium to air out questions and
concerns. This way can clear all the misunderstandings. MTBC can arrange effective
question answers sessions so that employees can clear their ambiguities. As this
organization have very strict rules so this way can help in a better way to reduce the rumors.

 Mostly rumors flourished when management don’t inform employees about policies,
objectives and work procedures of organization. This cause feeling of insecurity which
cause rumors in organization. MTBC should communicate with employees timely. Inform
workers about the information that is necessary for them so they feel relax and satisfied.

 It is up to the management if they want they can use grapevine as a barometer of the public
opinion in the organization or to feel the pulse of the employee in the particular situation.
If MTBC also practice this they can revise policies which make their employees happier
and satisfied. And this will also cut the negative rumors as well.

 Negative grapevine occurs when management is failed to maintain trust relationship with
employees. As employees are not appreciated much for their work and sharing any ideas
 in MTBC. This result in great dissatisfaction. Mostly workers left the job just because of
this reason of not being appreciated. MTBC should appreciate employees as this is the right
of the employee. Other than that, this little appreciation motivate employee to stay in long
run and work more sincerely with organization.

CASE ANALYSIS AND FINDINGS

The case analysis of MTBC reveals some very serious challenges and issues being faced by the
organization which needs serious attention in order to resolve them in a timely manner. Any delay
in the crisis management will take organization towards a disastrous situation as per the nature of
current issues and challenges.

MTBC is presently confronting with following major issues and challenges;

 Lack of data security and privacy

 Rumors about company and possible downsizing
 Communication gap between management and employees
 Lack of effective H.R structure

LACK OF DATA SECURITY AND PRIVACY

Client data security and privacy is an important area especially for organizations providing services
like MTBC and dealing with client’s confidential data including personal and financial
information.

Any deficiency or negligence in the services especially like data breech may lead to severe
consequences for the organization especially for an organization working in a global marketplace
since certain countries have very strict policies and legal framework to ensure secure and reliable
business practices.
In this manner, any breech or deficiency with reference to data privacy and security can take the
organization towards strict legal actions which may include heavy penalties and/ or cancel of
organization’s registration or operations until certain safety and security measures are not
employed and concerned department is not taken into confidence that such incidents will be strictly
controlled in future.

The data breech issue can severely damage the organizational reputation and client base which is
the most important asset for any organization. Due to this, the clients may not trust MTBC anymore
and most of them will even cancel their contracts with MTBC after knowing the weak client data
security and privacy measures (as already discussed in case of the US based doctor).

The data breech being a serious issue can badly harm the organizational financial stability by
cutting down organizational present revenues (with leaving clients) plus have a strong effect on
organizational future business since clients on knowing organizational bad reputation for weak
data management and privacy will not be willing to work with any such organization.

RUMORS ABOUT COMPANY AND POSSIBLE DOWNSIZING

The second serious issue being faced by MTBC operations in Pakistan is the rumors and negative
propaganda being spread within and outside the organization with reference to employees and the
great possibility of laying-off some employees within the next two months.

Employees are an important asset for any organization, especially senior employees working on
key positions and handling major operations. The rumors circulating are specifically targeted to
the senior employees with the logical reasoning that senior employees will be replaced with new
employees with comparatively less salary package to save organizational revenues since
organization is under financial crisis.

The impact of this rumor is very devastating since it is effecting organizational operations badly
due to the reason that employees are concerned for their job security which is diverting their
attention from their job and ultimately their performance graph is going down.

In a situation when the employees are concerned about their job security, it is really hard to expect
optimum performance outputs since with their jobs at stake the prime objective of any average is
to find alternative job to secure their monthly income to ensure bread and butter for their families.
At this stage their reaction to the rumor is very natural and logical and it is at the organizational
part to deploy effective mechanism to eliminate any possible rumors or in the alternate case to
address the issue and clear the situation to ensure satisfied and motivated employees with their full
potential.

COMMUNICATION GAP BETWEEN MANAGEMENT AND EMPLOYEES

Another reason that is strengthening the rumors factory and creating many other issues and
challenges for the organization is the gap between organizational management and the
employees. Since the organizational management is based in the United States therefore there is
a communication gap between employees and management.

Due to the communication gap, mostly the actual information is not communicated to the
management or sometimes delivered with such a delay when it is already too late to control the
situation or adopt any alternate course of action to make things right.

This is because there is no proper check and balance mechanism or reporting procedure with
regular intervals to keep the management updated and well informed to make timely and right
decisions which itself is a big drawback and is continuously affecting the organizational
performance.

Communication is one of the basic organizational requirements within and outside the
organization for smooth organizational operations. Timely and right information about the
organization, employees and market enables management to take timely and right decisions
which can ensure smooth operations and growth of all stakeholders including employees.

In case of MTBC, effective communication can enable the management to handle the rumors
right from the beginning and at the same time effective communication can keep the employees
satisfied and motivated.
LACK OF EFFECTIVE HUMAN RESOURCE DEPARTMENT

The Human Resource Department is responsible for hiring the right candidate for the right job
and at the right time. In addition providing necessary training on business practices, ethical
standards and then ensuring compliance is also the job of HR Department. At the same time, it is
on HR part to maintain strict monitoring of the employees, their performance and other activities
at workplace.

Keeping employees motivated and focused towards their job with full dedication and concern is
a major challenge for HR professionals because a less or not motivated employees can’t produce
good results and at the same time a demotivated or unhappy employee can even cause problems
for the organization. The case of data breech is an example of this kind. HR department should
time to time discuss with employees for their issues and concerns and they should be resolved or
satisfied in a timely manner to ensure they are not piling up in the employees mind against his
job or organizations.

Designing and employing a strict monitoring mechanism is also at an important task of HR

department. This enables the HR professionals to remain updated about employee performance,
intentions and activities at workplace which can not only enable the organization to deal with
any propaganda or rumor against the organization but can also figure out the problem creator
which can be dealt accordingly.

The HR part professionals should take the employees in confidence to share their problems and
concerns which should be satisfied timely. In this manner, the HR professionals should have
dealt the angry employee by satisfying him for not getting a promotion and also his performance
and activities should be monitored in order to know his intentions before committing something
bad for the organization.

At the same time, its HR job to ensure hiring of employees with strong moral and ethical values
and in addition employees should be provided counselling with regular intervals on ethical
business practices with sincerity and integrity besides convincing employees to report about
employees who they feel are indulged in malpractices or are trying to commit something against
the organization.
SUGGESTIONS

Crisis at workplace can occur in many forms. It may also possible that this can cause decrease in
revenue which can lead to cut down the cost and downsizing. Here are the few suggestions for
MTBC to avoid workplace crisis or if they face any they can handle it in a better way.

 Make transparent communication with employees about the crisis facing by the
organization. So, the know well about it and help as well. Conduct brain storming.
 Gather all the facts about the crisis.
 Whenever company face some crisis establish crisis management team. Make a leader of
a team who possess ability to lead and tackle the difficult situations.
 Identify the other employee who can support the team leader in handling the situation.

LIMITATIONS

Getting Information from an organization like MTBC was not an easy task as employees are not
allowed there to share any type of information so employees were hesitating in giving information
about the company.