MediCall Inc., a Pleasanton, Calif.-based company that supports the health care industry, has a call center in Makati City with 230 agents, primarily nurses, said Jeff Williams, vice president of operations. The company offers a variety of services to its clients, mostly insurance companies, including calling people after a hospital discharge to make sure they're taking their medications and following other regimens. Such measures significantly decrease the likelihood that they'll have to be readmitted to the hospital, according to Williams. MediCall also provides information on whether a particular medication is covered under Medicare, he said.

CEO John Chess, who, like Williams, had extensive outsourcing experience, said he chose the Philippines for several reasons. First, the country has 214 nursing schools, and next to the U.S., it produces more nurses than any country in the world, he said. Second, people in the Philippines tend to have less of a recognizable accent than do people from India, and they felt the U.S. market might not accept the language barriers of placing the company in India, he said.

Typhoons are fairly commonplace -- Typhoon Milenyo, a Category 5 storm that struck on Sept. 28, was the tenth one that season -- but they typically are less likely to go inland and do damage in comparison with hurricanes, Williams said. That's what caught everyone off-guard -- people tend to be more complacent about warnings because the storm typically changes course and ends up not going onshore. "This one didn't change course," he said. "It went right through the middle of the island."

Williams had kept this in mind when locating the company's two facilities. He made sure they were not in the parts of the island of Luzon below sea level and had equipped both facilities with backup generators and uninterruptible power supply systems. The battery backup systems cover the entire floor for two hours, and there is enough diesel to run the generators for 36 hours.

And it turned out that another decision MediCall's founders had made when they started the company three years before helped them better ride out the typhoon, even though business continuity had not been the primary motivation for that decision at the time. Instead of setting up a standard call center, MediCall had worked with Echopass Corp., a Pleasanton, Calif.-based provider of call center services.