Home Artikel Kecerdasan Artifisial Biologi:  Masa Depan Sistem Pelayanan Kesehatan Berbasis Teknologi

Kecerdasan Artifisial Biologi:  Masa Depan Sistem Pelayanan Kesehatan Berbasis Teknologi

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Tauhid Nur Azhar
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ChatGPT besutan OpenAI  berhasil membesut perhatian banyak tech enthusiast di berbagai belahan dunia. Beragam tingkah polah para penggunanya. Mulai dari meminta GPT memberikan pernyataan-pernyataan filosofis, memecahkan berbagai rumus sulit, sampai menciptakan lagu dan mengkoding program berbasis phyton, Java, atau mySQL. Unik dan aneh memang, ada potensi kecerdasan yang dapat terus berkembang dan belajar dari berbagai input yang diterima dan dari basis data yang tersedia di dunia maya.

Di sisi lain, Google Research dan DeepMind juga telah mengembangkan MedPalm , model pengolahan bahasa open source yang didedikasikan khusus untuk berbagai keperluan di bidang kedokteran. MedPalm diuji dengan tolok ukur dari MultiMedQA yang menggabungkan HealthSearchQA (data set pertanyaan medis daring) dengan 6 dataset open question yang meliputi pertanyaan dari ujian profesi kedokteran, riset, dan pertanyaan bersumber dari konsumen.

Kapasitas dan kompetensi yang nyaris tanpa batas itu bahkan kini mengarah kepada tercipta dan terwujudnya konsep artificial super intelligence atau ASI. Berbagai kemudahan dalam proses pengelolaan data dan penyelesaian terhadap berbagai masalah di dunia nyata dengan mengedepankan proses analitik sistematik.

Dunia akan menghadapi suatu proses transformasi digital tahap lanjut, dimana sistem akan mengerucut ke arah pendekatan yang bersifat presisi. Termasuk di ranah ilmu hayati dan kedokteran.

Konsep bioinformatika yang mengintegrasikan pendekatan aplikasi teknologi informasi dan komputasi dengan aplikasi biologi seperti pemetaan genom, transkriptomik, proteomik, dan metabolomik serta desain obat dan terapi molekuler, kini telah berkembang pesat sejalan dengan perkembangan infrastruktur dan teknologi penunjangnya seperti whole genome sequencing , small whole genome sequencing, atau next generation sequencing, spektrometri, NMR dan kristalografi, sampai sintesis struktur biologi artifisial seperti gen dan DNA artifisial.

Fitur-fitur dalam Bioinformatika dapat memfasilitasi desain dan perancangan molekul atau struktur biologi artifisial, obat presisi berdasar basis data dari kepustakaan protein ataupun metabolit dari ranah metabolomik, sampai desain vaksin aktif dan pasif yang sangat sesuai dengan target imunoterapi.

Sebagai gambaran, saat inj telah dikembangkan DNA artifisial yang ditujukan untuk meningkatkan efektifitas respon imun, khususnya pada kasus-kasus keganasan (neoplasia).

DNA artifisial adalah untai DNA buatan yang ditujukan untuk berinteraksi atau berikatan dengan struktur mikro RNA (miRNA). Pada penelitian Morihiro K et al ( Morihiro K, et al, Oncolytic Hairpin DNA Pair: Selective Cytotoxic Inducer Through MicroRNA Triggered DNA Self Assembly. Jurnal of the American Chemical Society,2022; DOI: 10.1021/jacs.2c08974) miRNA yang menjadi target adalah miR-21. Dimana fungsi normal dari miR-21 adalah supresor sel neoplasma, dan adanya perikatan dengan DNA artifisial maka kemungkinan sel imunitas seluler untuk mengenali kanker menjadi lebih besar.

Sementara di sisi lain ada kemungkinan perikatan dengan DNA artifisial akan mendorong ekspresi gen tertentu yang memproduksi protein yang dapat direkognisi oleh sel-sel imunitas spesifik.

Pendekatan bioartifisial yang merupakan salah satu fitur dari implementasi bioinformatika juga dapat digunakan untuk mendesain obat serta melakukan simulasi in-silico untuk menilai efektifitas obat atau zat terapeutik yang didesain, baik yang bersumber dari bahan alam, maupun sintetik pada target organ ataupun protein. Sehingga diharapkan hasil desain dapat menghasilkan produk farmakologis yang tepat sasaran.

Perkembangan di bidang rekayasa genetika, terutama di aspek pemuliaan tanaman, hewan ternak, dan pencegahan penyakit pada manusia, telah menghasilkan berbagai terobosan seperti penemuan dan pemanfaatan “gunting genetika” CRISPR Cas9. Di sisi lain secara in-vitro juga telah dapat dilakukan sintesis gen artifisial yang secara teknis ditujukan untuk mengonstruksi struktur oligonukleotida yang dibangun menggunakan  gugus nukleosida fosforamid.

Pendekatan dan pengembangan biologi artifisial dan bioinformatika dipantik dan diprakarsai antara lain dengan mulai dikenalnya konsep biologi sintetik. Dimana Istilah biologi sintetik sendiri pertama kali diperkenalkan dalam publikasi Stéphane Leduc yang berjudul Théorie physico-chimique de la vie et générations spontanées, 1910 dan La Biologie Synthétique 1912.

Artifisial dan sintetik menjadi dua kata kunci yang saling mengunci. Sistem cerdas yang mampu menghasilkan dan membantu terlahirnya berbagai rancangan gen, DNA, sampai obat dan metabolit terapeutik, berpadu sempurna dengan berbagai pendekatan biologis yang bertujuan untuk mengoptimasi potensi hayati dan fisiologis entitas biologis serta berbagai pendekatan kuratif pada ranah patologis.

Ada satu harapan besar pada konsep yang saat ini tengah diusung oleh Kemenkes RI melalui program Satu Sehat dan inisiatif genom yang bertajuk BGSi.

BGSi adalah akronim dari Biomedical and Genome Science Initiative.  BGSi sendiri adalah inisiatif biomedis terintegrasi nasional pertama di Indonesia yang didirikan untuk membawa Indonesia ke era pengobatan presisi dengan mengintegrasikan kapasitas genomik ke dalam layanan kesehatan. Diluncurkan oleh Menteri Kesehatan Republik Indonesia, HE. Ir. Budi Gunadi Sadikin, CHFC, CLU, pada tanggal 14 Agustus 2022, kantor pusat BGSi bertempat di gedung bersejarah Eijkman yang terletak di halaman kompleks RSUPN Dr. Cipto Mangunkusumo di Jakarta.

Untuk menunjang terlaksananya inisiasi program kedokteran presisi berbasis data genom terintegrasi, maka enam Rumah Sakit Umum Nasional telah ditunjuk sebagai hub perdana yang berfokus pada enam jenis penyakit yang menjadi prioritas pengelolaan pelayanan kesehatan secara nasional.  Kelompok penyakit tersebut antara lain keganasan/kanker,  penyakit infeksi/ menular, penyakit otak & neurodegeneratif, penyakit metabolik, genetik, juga penuaan/geriatri, nutrisi dan kebugaran.

Satu Sehat diharapkan dapat menjadi platform tunggal yang akan dapat mengintegrasikan berbagai data kesehatan yang bersumber dari rekam medis elektronik, hasil laboratorium, hasil pemindaian citra medis, maupun data lainnya seperti data genomik, psikososial, ekonomi, dan aktuaria kesehatan.

Integrasi data khususnya rekam jejak kesehatan dari RME, hasil Lab, dan genom yang direncanakan akan diakomodir di aplikasi super Peduli Lindungi ++ yang akan dilengkapi berbagai fitur terkait seperti evaluasi status gizi, gerak, dan juga data vaksinasi serta tumbuh kembang,  dapat membantu perancangan strategi intervensi personal yang diharapkan presisi dan tepat sasaran. Sementara keberadaan repositori dan kepustakaan data dengan standar keamanan serta aksesibilitas yang mengedepankan privacy dan perlindungan data pribadi, dapat mendorong pergeseran fokus riset ke ranah bioinformatika terpadu.

Terlebih saat ini telah banyak pula dikembangkan berbagai aplikasi tepat guna yang memudahkan riset bioinformatika, sehingga banyak riset dapat dikerjakan dalam konsep on the go dan didominasi penggunaan aplikasi mobile di piranti seluler.

Beberapa aplikasi berbasis Android yang dapat menjadi alat bantu peneliti bioinformatika pernah diulas dan dibahas oleh Aditya Parikesit, 2014, dan telah dipublikasi di Kompas serta situs FKUI.

Adapun beberapa aplikasi mobile yang telah dibahas dan diulas oleh Aditya Parikesit adalah sebagai berikut,

Aplikasi BAK4BIO (Brazilian Army Knife for Bioinformatics), merupakan suatu front end yang didesain untuk mengakses basis data bioinformatika seperti NCBI, DDBK, KEGG, EBI, dan PDBJ. BAK4BIO dapat digunakan untuk mengintegrasi dan mengelola  data seperti  data genomik, proteomik, dan metabolomik.

Ada juga aplikasi DNA Alignment, yang dapat digunakan untuk melakukan pairwise sequence alignment alias pensejajaran urutan DNA. Namun, karena keterbatasan fitur di gadget, pensejajaran ini hanya dapat dilakukan pada dua sekuens saja.

Aplikasi android lainnya di bidang Bioinformatika adalah; DPSAT. Dimana DPSAT  memiliki berbagai fitur. Salah satunya adalah fitur translate, yang berguna untuk memberikan produk protein dari data nukleotida yang diberikan; fitur nucleotide sequence properties  yang berguna untuk menginformasikan konten GC dan AT, dan juga panjang urutan basa; juga fitur Protein Biophysical Properties yang bermanfaat untuk mengkalkulasi properti urutan protein dengan metode ProtParam.

Aplikasi lain yang tak kalah menarik adalah MENTHA, dimana Mentha dapat digunakan untuk mengkaji interaksi protein-protein pada beberapa organisme.

Berikutnya ada aplikasi SimAlign dan SimGene yang dapat digunakan untuk melakukan pensejajaran sekuens gen dan meramban  gen.

Terlebih jika data antropometri dan status gizi seperti data tumbuh kembang dan BMI (body mass indeks) dari Posyandu dan Posbindu dapat dikumpulkan melalui penerapan aplikasi seperti Monas buatan Telkom University yang menggunakan pemrosesan citra sehingga memudahkan tenaga kesehatan dalam melakukan pendataan, maka kapasitas analitik sistem yang didukung fasilitas high performance computing yang mengagregasi sekumpulan daya komputasi dari sistem komputer yang ada, maka tingkat presisi dari sistem prediksi dan prevensi kesehatan juga akan meningkat tinggi.

Sejalan dengan inisiatif BGSi, maka metoda sampling dan pemeriksaan genomik di area rural juga dapat dilakukan dengan pendekatan baru seperti deteksi dini penyakit berbasis PCR model mobile cartridge dan pemanfataan inovasi seperti test antigen antibodi dengan prinsip assay, surface plasmon resonance, tes berbasis polimer semi konduktif, ataupun pemeriksaan terintegrasi berupa NGS di beberapa sentra pelayanan kesehatan utama yang tersebar di beberapa area.

Perkembangan teknologi IoT (internet of things) seperti biosensor dan NFIR yang bersifat non invasif dapat mempercepat pendataan berbagai kondisi yang berpotensi meningkatkan resiko penyakit di domain degeneratif serta metabolik berdasar data seperti kadar gula darah, profil lemak, dan berbagai parameter serta indikator lainnya.

Sedangkan hub genomik yang saat ini mulai dioperasikan di 6 RSUP yang merepresentasikan cakupan layanan nasional, dapat berfokus pada pemeriksaan bioteknologi yang bersifat lebih kompleks dan sensitif seperti pemeriksaan NGS atau Next Generation Sequencing.

NGS (Next-Generation Sequencing) merupakan teknologi yang digunakan untuk mempelajari sekuen DNA, RNA, dan protein. Teknologi ini memiliki banyak aplikasi di berbagai bidang, termasuk klinik. Beberapa aplikasi klinikal NGS adalah:

Diagnosis penyakit genetik: NGS dapat digunakan untuk menentukan mutasi genetik yang menyebabkan penyakit atau kelainan fenotipe.

Profil genomik: NGS dapat digunakan untuk menentukan profil genomik seseorang, yang dapat digunakan untuk menentukan risiko penyakit tertentu dan menentukan strategi pengobatan yang tepat.

Deteksi patogen: NGS dapat digunakan untuk menentukan jenis patogen yang menyebabkan infeksi dan menentukan resistensi terhadap obat-obatan.

Penelitian klinis: NGS dapat digunakan dalam penelitian klinis untuk memahami mekanisme penyakit dan mengembangkan terapi baru.

Skrining prenatal: NGS dapat digunakan untuk menentukan mutasi genetik pada janin selama kehamilan, yang dapat digunakan untuk memprediksi risiko penyakit atau kelainan fenotipe pada bayi setelah lahir.

Jadi di masa depan dapat kita bayangkan bahwa akan ada pos kesehatan cerdas mandiri (PKCM) di daerah-daerah yang berada di lokus permukiman ataupun pusat kegiatan sosial ekonomi, dimana PKCM dilengkapi dengan sistem akusisi data biologi dan antropometri serta sampling mandiri spesimen kesehatan yang akan dianalisis lebih lanjut, dimana sebagian besar sensor dan aplikasi IoT yang digunakan bersifat non invasif serta terkoneksi dengan jaringan 5G yang memungkinkan transfer data lancar dan aman. Jika terintegrasi dengan sistem pemeriksaan genomik di hub, maka data kesehatan akan menjadi sangat komprehensif serta dapat memfasilitasi rencana pengembangan pelayanan dan juga berbagai riset terkait seperti riset epidemiologi, farmakologi, dan tentu saja kedokteran presisi dengan mengedepankan pendekatan berbasis bioteknologi dan bioinformasi.

Pada akhirnya, di masa depan dapat diharapkan bahwa sistem cerdas pelayanan kesehatan berbasis bioteknoinformasi akan dapat berkontribusi optimal dalam meningkatkan kualitas hidup manusia dan memajukan peradaban secara berkesinambungan. 🙏🏾

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  19. Top 10 Customer Support Outsourcing Companies in 2023 | Helpware
    Outsourcing customer support is a great way to provide affordable but reliable service to your
    clients. Whether for voice or non-voice applications,
    there are plenty of excellent customer support…
    Written by Dana Mahoney
    Sunday, Jan 22
    Table of Contents
    Outsourcing customer support is a great way to provide affordable but reliable service to your clients.
    Whether for voice or non-voice applications, there are plenty of excellent customer support outsourcing
    companies that fit every requirement.
    But then again, why even think about outsourcing?

    Isn’t local talent good enough to provide the service needed by a company’s customers?
    Plus, wouldn’t it be a disservice to customers if a
    company farms out its frontline operations to contractors?

    What Is Customer Support Outsourcing?

    By now, the best customer service companies should know the value of customer support
    and why it’s an essential cog in an organization. Like
    sales and marketing, customer service should already be in play
    during a company’s first day, as they are the group that comes into direct contact
    with clients.
    The main goal of customer support is to keep customers happy by attending to their needs and responding to their questions.
    However, it’s also a way to instill loyalty and generate additional
    sales. To do so, an outsourcing company must have its
    support team available whenever the customer needs it. Outsourcing customer
    support allows companies to maintain an around-the-clock service team
    managed by industry veterans and experts.
    Advantages of Customer Support Outsourcing
    Admittedly, not all company startups have leaders who
    are experts in every facet of their operations.
    Given their many responsibilities, many startup founders accept that they can’t do everything themselves.
    Non-core competencies such as customer service can benefit from outsourcing.

    Turning the service over to competent experts lets companies benefit
    from a bigger source of talent from all over the world.

    At the same time, companies that outsource customer support enjoy reduced
    payroll without sacrificing service quality. Other benefits of outsourcing include:

    More Opportunities to Grow the Business
    By assigning customer support to expert outsourcing service providers, leaders can instead turn to scaling the
    business. Overseeing the day-to-day operations
    can already take much of management’s time, and customer support is equally demanding.
    To help executives focus on the big picture, they’ll
    need to partner with the best service companies that know
    what they’re doing.
    Enhance Customer Experience
    Given the opportunity to communicate and interact with customer service, many customers
    will express their satisfaction in getting their voices heard.

    If customer service companies and their team address customers’ issues in a
    satisfactory way, they’re more than likely to remain customers.

    A pleasant customer experience will almost always lead to longer retention and a significantly higher
    customer lifetime value (CLV). This isn’t to say a stellar customer experience
    is only possible through outsourcing. Rather, the chances of improving
    customer satisfaction come with a continuous and consistent level of service.
    Providing a highly specialized, dedicated team of professionals from day one is a great way to
    achieve this quickly.
    Top 10 Customer Support Outsourcing Companies

    We’ve narrowed down the list of companies with great customer service to the top 10 most prominent ones in 2022.
    We’ll also provide a brief description and highlight the
    main strong points of each outsourcing company.
    1. Helpware

    Helpware started in 2015 with the initial goal of providing support to startup companies.
    Over the years, the company has grown big and is confident enough to provide
    both enterprise and small business customer service outsourcing
    solutions.
    Providing back office, technical, and customer support, Helpware specializes in assisting companies
    in various support areas. This includes Omnichannel Customer Support,
    Technical & IT Support, Content Moderation, CX Consulting Services, Back Office Support, Data
    Labeling, Digital Marketing Solutions, and Cyber Security.
    The company provides only dedicated agents, in-house training, and equipment to help its clients boost
    their productivity from day one. Now it’s one of the top customer service companies in the
    US and European markets with numerous awards and positive reviews from satisfied clients on Clutch and other reputable
    platforms. Helpware’s people-focused culture seems very attractive to businesses sharing the same
    philosophy.
    Pros:
    Shows outstanding flexibility when providing for clients’ specific needs.

    This means its support can scale along with your company’s growth.

    Offers turn-key solutions, so you don’t have to look for either option separately.

    Helpware’s focused on developing its people and their skills and it pays off
    handsomely, especially in customer support outsourcing contracts.
    Some global brands are happy to have their customer support outsourced
    to Helpware.
    2. Sykes

    U.S.-based Sykes is one of the pioneers of the BPO industry.
    Established in 1995, the company trailblazed its
    way to the top and was one of the first BPOs to open multiple
    locations. In 2021, the Sitel Group acquired Sykes
    to widen its reach and increase its capacity.
    Sykes is one of the top 10 service companies and leading service providers of demand generation and customer engagement
    services, with clients included in the top 2000 companies worldwide.
    At the core of Sykes’ business are its staple services:
    outsourcing, customer experience, service to sales, digital
    transformation, and brand extension.
    Pros:
    Sykes maintains a pool of service agents from its clients’ home countries.

    The company is well-versed in matters concerning data
    privacy. Specifically, Sykes follows various privacy guidelines, including HIPAA compliance and Payment Card Industry (PCI)
    data security certification.

    3. Ascensos

    Founded in 2013 in the UK, Ascensos is one of those outsourced
    customer service companies that wanted to change the customer experience by applying a personal touch to customer care.
    The company is now Europe’s number-one customer support outsourcing
    company, providing bespoke customer experience solutions to clients around
    the world. In addition, its contact center operation locations include the UK,
    Romania, Turkey, and South Africa.
    Pros:
    Ascensos is more nearshore than an offshore support center,
    so location and time zone differences aren’t as pronounced as operations in Asia
    and South America.
    Companies that outsource customer service to Ascensos value
    the fact that it supports diversity and inclusivity among staff while focusing
    on promoting happiness as a key asset among its workforce.

    Although there aren’t any published pricing rates, instead, Ascensos will individually respond to requests for quotes,
    the prices of this outsourcing customer service company are more than affordable.

    4. Teleperformance

    With more than 40 years of experience in the BPO industry,
    Teleperformance is an established leader in solution design, business optimization strategies,
    and front-office customer support. It also offers back-office services such as finance and accounting,
    collections, and technical support.
    Pros:
    Teleperformance is a truly global service provider. It operates in 80 countries and employs more than 330,
    000 agents speaking over 265 languages and deservedly
    belongs to a league of good customer service companies.
    You won’t find it difficult to get support in the language and location you require.

    Clients also appreciate the company’s expertise in providing omnichannel solutions.

    5. VXI

    VXI Global Solutions is one of those outsourcing agencies that
    offer customer care and customer experience (CX) solutions to some of today’s major
    global brands. In addition, the company offers contact center and BPO services, omnichannel
    and multilingual support, software development, CX
    innovation, quality assurance (QA), and infrastructure outsourcing.
    VXI employs more than 35,000 workers in 43 countries throughout
    North America, Asia, Europe, and the Caribbean.
    The company also prides itself on its ability to help clients resolve major CX and employee experience (EX) pain points and take their customer service systems
    to the next level. Like any modern BPO, VXI employs omnichannel support services to
    enhance communication coverage for clients.
    Also, VXI provides additional analytics and insights generation services so clients can learn as they go.

    Pros:
    High CX expertise leads to enhanced customer and employee
    experience.
    VXI displays an uncanny ability to scale up or down to fit its client’s capabilities.

    6. InfluX

    In its quest to build the world’s first remote-only CX team, InfluX managed to recruit employees from more than 120 cities
    worldwide. This strategy also lets them provide 24-hour customer support outsourcing solutions within the client’s time zone.
    In addition, InfluX creates specialized customer experiences that reflect the client’s vision, voice, and values.

    Pros:
    Less dependence on automation and more on human interaction make for a better customer
    experience.
    Having employees in every time zone solves the common offshore problem of mismatched time schedules between clients and
    outsourcing companies.
    Pay-as-go pricing may be attractive to some clients who
    prefer flexible packages.
    7. Skycom

    Skycom is also on the list of nearshore outsourcing companies that specialize
    in multi-continent support services. The company employs native English contact center agents with experience in multiple
    industries. Skycom also offers a full range of services,
    including business process outsourcing, telemarketing and sales, customer support, and healthcare.
    With more than 15 years of experience, Skycom also employs
    over 2,000 workers assigned to 35 clients in five countries.

    Pros:
    Nearshore operations mean fewer problems dealing with time zone and
    distance differences.
    Skycom covers a wide range of industries, including healthcare, travel, utilities,
    IT, finance, retail, and telecommunications.
    8. Integra

    Integra’s differentiator is its focus on training its workforce in customer psychology.
    This means company-provided support agents are more sensitive in detecting changes in the customer’s
    voice or tone. As a result, they can respond to these changes to defuse any tension and lead the customer into a more positive mindset.
    Starting with four employees in 2004, Integra currently employs
    more than 1,400 workers stationed across four countries. It handles customer service duties over the phone, email, live chat,
    or social media.
    Pros:
    Integra offers some of the most cost-effective solutions in the
    industry.
    Sales psychology is also an incredible asset to have if you work in a customer support outsourcing company.

    9. Telus

    Telus International is one of the world’s leading digital CX innovators.

    In particular, it designs and produces next-generation digital solutions for brands all over the world.
    This is one of the Canadian top IT outsourcing companies
    that provide IT services and multilingual customer service to industries such as technology, media,
    communications, eCommerce, financial technology, travel, hospitality, automotive, healthcare,
    and games.
    Pros:
    Telus International is a premium multilingual contact center.
    It is one of those IT support outsourcing companies that offer top-tier customer support
    services in various countries and more than 50 languages.

    Telus is famous among IT services outsourcing companies for organizing an annual charitable
    initiative called “Telus Days of Giving.” In particular, the company taps
    225,000 volunteers from its offices to complete various service projects across its
    many host countries.
    10. Arise

    Arise is a 25-year-old United States-based company that specializes in providing support outsourcing services across the USA.
    It employs more than 60,000 remote agents in the U.S.,
    Canada, and the United Kingdom. Unlike a traditional BPO, Arise utilizes a network of service partners to provide the needed customer service experiences.
    In addition, the Arise Platform helps companies lower expenses.
    As a result, Arise clients report an average 25% reduction in contact
    center service total costs, which is why clients want to outsource customer service small
    business really needs.
    Pros:
    Arise deploys a tiered security approach in its communications with clients.
    This ensures they preserve the confidentiality of
    documents or files sent over. It also means Arise conforms to widely accepted data privacy regulations
    such as HIPAA, CCPA, and others.
    Arise also focuses its employment on local talent, hiring residents of
    the U.S., UK, and Canada. This means stable employment for the company and an easier method of hiring or replacing staff members.

    Choose the Best Outsourcing Companies That Fit Your Needs
    Deciding which outsourcing providers to contact
    for your customer support outsourcing needs?
    Perform the necessary research before settling on your choice.
    For instance, some customer service outsource companies on our list might command a pricing structure higher than what your budget holds.

    In addition, consider your company’s specific requirements and areas
    for improvement. Do you need a customer support team focused on CX?
    Or, do you prefer having sales psychology-trained outbound callers who can close deals?
    Finally, does the appeal of higher-cost nearshoring
    resonate better than offshore talents a few time zones away?

    No one-size-fits-all solution exists when it comes to customer support outsourcing.
    However, if you want a highly flexible and secure customer service solution that
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