Medical Tourism with Cagri Kanver by Cagri Kanver

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Medical Tourism The Congress Issue Los Angeles 2010

ISSUE 18

Public and Private Sector Collaboration ~ Prevention of Two Tiered Markets

Global

Healthcare &

Wellness~ An Evolving World of Benefits Pg 37

ÂŠ Copyright Medical Tourism Association

Pg 12

Social Media & Marketing ~ Sell More & Reach New Markets

Pg 76

Baby Boomers ~ Unprecedented Global Issue Pg 45

December 2010/January 2011

THESE HOSPITALS ARE AMONG

THE BEST

INTERNATIONAL

ALL HOSPITALS ARE MEMBERS OF THE MTA

HOSPITALS

IN THE WORLD AFRICA

THE NAIROBI HOSPITAL www.nairobihospital.org

BAHAMAS

DOCTORS HOSPITAL www.doctorshosp.com

BRAZIL

HOSPITAL ALEMAO OSWALDO CRUZ www.hospitalalemao.org.br PORTO ALEGRE HEALTHCARE CLUSTER www.portoalegrehealthcare.org

COSTA RICA

HOSPITAL CLINICA BIBLICA www.hcbinternational.com

COLOMBIA

CLUSTER SERVICIOS DE MEDICINA Y ODONTOLOGIA MEDICAL AND DENTAL SERVICES CLUSTER www.comunidadcluster.com

ISRAEL

ASSAF HAROFEH MEDICAL CENTER www.assafh.org

JORDAN

SEOUL WOORIDUL SPINE HOSPITAL www.wooridul.com

THE SPECIALTY HOSPITAL www.specialty-hospital.com

SEVERENCE HOSPITAL YONSEI UNIVERSITY HEALTH SYSTEM www.yuhs.or.kr/en

ISTISHARI HOSPITAL www.istisharihospital.com

MALAYSIA

PRINCE COURT MEDICAL CENTRE SDN. BHD. www.princecourt.com

MEXICO

ALMATER HOSPITAL www.almater.com CHIHUAHUA MEDICAL CITY www.chihuahuamedicalcity.com/

NICARAGUA

HEALTH & WELLNESS TOURISM COMMISSION, AGEXPORT www.healthwellnessguatemala.com

INDIA

MOOLCHAND HEALTHCARE GROUP www.moolchandhealthcare.com MEDANTA- THE MEDICITY www.medanta.org

KOREA INTERNATIONAL MEDICAL ASSOCIATION www.koreahealthtour.co.kr

JORDAN HOSPITAL www.jordan-hospital.com

GERMANY HOSPITAL METROPOLITANO VIVIAN PELLAS DRK KLINIKEN BERLIN www.metropolitanomedicaltourism.com www.drk-kliniken-berlin.de GUATEMALA

SOUTH KOREA

PANAMA

HOSPITAL PUNTA PACIFICA www.hospitalpuntapacifica.com

SPAIN

PLATAFORMA TURISTICA DE MADRID www.madridnetwork.org/red/turismo

THAILAND

BUMRUNGRAD INTERNATIONAL www.bumrungrad.com

UNITED ARAB EMIRATES

AMERICAN HOSPITAL DUBAI www.ahdubai.com

UNITED STATES

BAPTIST HOSPITAL www.baptisthealth.net

VIETNAM

FV HOSPITAL – FAR EAST VIETNAM LIMITED www.fvhospital.com

PERU

PROGRAMA DISFRUTA SALUD PERU www.peruhealth.org

SAUDI ARABIA

GMC HOSPITAL www.gmchospital.com

NARAYANA HRUDAYALAYA www.narayanahospitals.com SEVENHILLS HOSPITAL www.sevenhillshospital.com

December 2010/January 2011

Editorial

A UNITED IMPACT ON

HEALTHCARE

he Medical Tourism Association conceived the World Medical Tourism & Global Healthcare Congress as a call for action; born out of the necessity of a platform for people to learn, share ideas, network, and work together for the greater good of the international healthcare industry. We wanted to bring business leaders together most importantly to dare them to ask difficult questions and to come up with solutions for difficult problems: What do we need to do to improve upon the growth of healthcare worldwide?

Our business models need to be sustainable. There needs to be a greater collaboration between government bodies and healthcare providers to deliver a healthcare product which provides value for the increasing number of patients in search thereof. More than 1,200 top healthcare leaders, providers, governments and academics came together in September 2010 and made great progress in their pursuit of knowledge and relationships. The World Medical Tourism and Global Healthcare Congress is gathering each year an increasing number of people from all over the world and 84 countries. Medical tourism is unequivocally more than a trend; it is an entity, a global network and a dynamic of people. Over 200 expert speakers provided testimony that the future of medical travel is in front of us. Our destination as a whole is not only to impact the health care system but to impact the worldwide vision of healthcare. The 3rd World Medical Tourism Congress depicted the importance of multiple aspects and perspectives of the medical tourism industry. First of all, the patient-physician or patientsurgeon relationship became a topic of high interest this year regarding pre and post operative care, exploring the means to articulate the patient trust in a hospital abroad to their needs. In the next few years, this relation will shape itself differently making room for a better personal care monitoring, as telemedicine plays a greater role in medical tourism. Because the population desires are in constant motion through health trends, social influences and political factors, cruise lines and sustainable hospitals are now stepping foot in the medical tourism industry, implementing contrasting services throughout the world. Indeed, new markets are emerging in every continent. From Asia to the Middle East, officials encourage the development and extension of medical tourism. By signing a Memorandum of Understanding during the congress Dubai Health Authority and the Medical Tourism Association agreed to work together to strengthen the medical tourism sector in Dubai. Encouraging the growth and the well-being of untapped markets is a priority for the Medical Tourism Association. On the other hand, if some US businesses are feeling jeopardized by the application of the recent health care reform, it is time to envision medical tourism as a positive alternative and a means of diversification within the healthcare landscape. However, thinking outside the box brings success when projects and concerns are shared.

The Medical Tourism Association is an education management platform open to the entire healthcare industry that will pursue the call for action launched and carried forward during the World Medical Tourism and Global healthcare Congress. We will produce future oriented concepts to the world’s healthcare stakeholders and strive towards the emergence of new business development and sustainable healthcare growth. I know that the challenges that face the medical tourism industry are numerous, but through working together, we can make real progress. Next year, our 4th annual World Medical Tourism and Global Health Congress will take place in Chicago from October 26-28, 2011, featuring worldwide healthcare leader representation and new exciting topics. I’m looking forward to seeing you there.

Renée-Marie Stephano

Renee-Marie Stephano is the President of the Medical Tourism Association™ . Ms. Stephano is also the Editor-in-Chief of the Medical Tourism Magazine, Health Tourism Magazine and Healthcare Development Magazine. Having a background in international marketing and relations, health law and litigation, she provides a valuable service to the Medical Tourism Association™ in these fields. Ms. Stephano speaks regularly at international healthcare conferences on the Legal Issues Surrounding Medical Tourism and in the United States to employer groups, insurance groups and physician associations. Renee-Marie consults international government ministries, private sector organizations and NGO’s about the growth of the global healthcare industry and accreditation, providing marketing assistance to promote their countries high quality of care. Ms. Stephano works with governments and healthcare clusters in the development of their Medical Tourism Initiatives. Ms. Stephano recently is the co-author of three books : “Developing an International Patient Center: A Guide to Creating the Best Patient Experience”, the book “The Medical Tourism Facilitator: A Best Practices Guide to Healthcare Facilitation for International Patients” and the book: “Medical Tourism ~ An International Healthcare Guide For Insurers, Employers and Governments”

December 2010/January 2011

MEDICAL TOURISM

EDITOR-IN-CHIEF & PUBLISHER

Renée-Marie Stephano, Esq.

ASSOCIATE EDITORS

Jonathan S. Edelheit Vivian Ho Gabriella Vicuña Cayla Lambier Anne-Line Crochet

ONLINE MAGAZINE EDITOR

Marines Mazzari

REGULAR AUTHORS

Renée-Marie Stephano, Esq. Jonathan S. Edelheit Bill Cook Dan Cormany Dr. Prem Jagyasi Gabriella Vicuña Michael Bina Vivian Ho Cayla Lambier

CONTRIBUTING AUTHORS

Jean Forbes Antonia Arnaert Anne-Line Crochet Amanda Shaw Emilio Williams David Morgan Brigit Algan

ART DIRECTOR

Renée-Marie Stephano, Esq.

ART DEPARTMENT

Dinier Quirós

MAIN OFFICES

10130 Northlake Blvd. Suite 214-315 West Palm Beach, Florida 33412 USA Tel:561-791-2000 Fax: 866-756-0811 info@MedicalTourismMag.com www.MedicalTourismMag.com

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December 2010/January 2011

Medical Tourism AT A GLANCE

Editorial

A United Impact on Healthcare

Gathering each year an increasing number of people from all over the world, the 3rd World Medical Tourism Congress depicted the importance of multiple aspects and perspectives of the medical tourism industry. The future of medical travel is in front of us, and our destination, as a whole, is not only to impact the health care system but to impact the worldwide vision of healthcare.

Public and Private Sector Collaboration~ Prevention of Two Tiered Markets

BY RENÉE-MARIE STEPHANO

Progress in Motion ~ Medical Tourism Congress Proceedings

Globalization is transforming healthcare rapidly and visibly, ranging from life sciences, research and development, and pharmaceutical networks to the current medical tourism niche industry. Noted by U.S. World & News Report as “one of the top ten trends in 2010,” the medical tourism landscape is a hot area of development in many countries.

BY CAYLA LAMBIER, ANNE-LINE CROCHET & VIVIAN HO

Features

Dubai Diamond Sponsor at The World Medical Tourism Congress

Dubai Health Authority (DHA) led as the Diamond Sponsor at this year’s Congress; the 3rd Annual World Medical Tourism & Global Health Congress (WMT&GHC) in an effort to strengthen its assets in medical tourism and further establish its position in the medical tourism industry. As a leader in medical tourism amongst healthcare clusters around the world, Dubai is continuing to rapidly work towards strengthening its healthcare assets and service capabilities.

BY DAVID MORGAN

Providing Aftercare Services to the Global Patient

Incorporating medical tourism into cruise lines would not be overwhelmingly difficult – with almost entire decks already allocated for the purposes of emergency care and spas, outfitting a cruise ship with additional resources for procedures commonly undergone by medical tourists could just be the next logical step.

BY CAYLA LAMBIER

Since global patients or medical tourists have varying care objectives, the Homewatch CareGivers’ Aftercare Program helps provide clients with the best customized care plan for their specific recovery needs through streamlined communication tools and a quality assurance process.

BY JEAN FORBES

Brand Creation ~ A Roadmap for Medical Tourism

BY ANNE-LINE CROCHET, VIVIAN HO & CAYLA LAMBIER

Smooth Sailing ~ Cruise Lines and Medical Tourism, a Budding Relationship

As the number of people travelling abroad seeking medical treatment continues to grow, many countries around the globe have embarked on building, marketing for and establishing medical tourism options for a regional and global community. But as governments see the benefits of creating their own medical tourism industries, how can they avoid creating the risk of a two-tiered system leading to undesirable and unintended consequences?

BY BRIGIT ALGAN

Caring for Out-of-Town Patients ~ Lessons Learned

Since medical tourism became an industry buzzword, many private hospitals around the globe want to get a piece of the business and start attracting more out-of-town patients. But, as many are learning now, the business of coordinating safe, quality care for patients traveling long distances is not an easy one.

BY EMILIO WILLIAMS

December 2010/January 2011

Medical Tourism AT A GLANCE

Cross Border Health Care ~ A European Union Phenomenon

Medical Tourism is not only a US phenomenon, but some Europeans are also looking for better, cheaper and more accessible treatments abroad while staying within the EU borders. Commonly referred to as cross border healthcare, European residents are travelling from Finland to Spain specifically for healthcare services while their national governments reimburse the procedures.

BY ANNE-LINE CROCHET

Columns Economics

Healthcare Reform ~ Think Medical Tourism

What if, employers could provide coverage to their employees and reduce their cost? Alternatives exist and medical tourism is one of them. Traveling abroad to undergo surgery is an ancient, yet becoming an altogether new trend in the corporate world and destinations are numerous.

Sustainability

Sustainable Hospitals ~ Consider Going Green?

BY ANNE-LINE CROCHET

Global Healthcare and Wellness ~ An Evolving World of Benefits

In a global market environment experiencing exponential growth, corporations with employees all around the globe, corporate executives have the task of researching, evaluating and implementing a Global Healthcare and Wellness Strategy that will cover the lives of their workers wherever they may be situated in the world.

BY ANNE-LINE CROCHET

Sustainability Infusion as Architectural Life Force

BY RENÉE-MARIE STEPHANO AND GABRIELLA VICUÑA

Choosing the Right Hospital ~ Interview with Armando Polanco

Self-insured employers are typically choosing their insurance plans through the advice of a broker or third party administrator. To facilitate the understanding and comprehensive reviews of medical tourism plans, Armando Polanco created a guide for buyers and sellers to evaluate foreign hospitals’ assets and procedures.

BY ANNE-LINE CROCHET & VIVIAN HO

Branding Wellness ~ Increasing Business Opportunities Through Natural Resources

Wellness quest started centuries ago when Romans and Greeks were nourishing the vivid tradition of thermal spa and traditional medicine the unique way to heal. Nowadays, wellness is becoming a state-of-mind and a quality of life; however, competition is tough and branding its services becomes a requirement in the health tourism industry.

BY ANNE-LINE CROCHET

December 2010/January 2011

In 1987, the United-Nations was defining sustainable development as meeting the needs of the present without compromising the ability of future generations to meet their own needs. Nowadays, in the healthcare industry, landscaped green hospitals are flourishing offering patients a better, and cleaner healthcare environment.

As medical tourism continues to expand, healthcare facilities around the world are more determined to renovate and build hospitals to meet the expectations of good quality care. They are combining design and new initiatives in management to create a greater experience for patients. The awareness of sustainability and “going green” is flourishing and it only makes sense for healthcare facilities to implement this trend.

BY AMANDA SHAW & ANNE-LINE CROCHET

News & Insights

University of Richmond Partners With MTA~ Earning A Medical Tourism Certification

Baby Boomers ~ Unprecedented Global Issue

At this year’s World Medical Tourism and Global Health Congress, keynote speaker Dr. Jeanette Takamura, Dean of the School of Social Work at Columbia University, cast Baby Boomers in a global light while discussing what role medical tourism might play as the world’s population of Baby Boomers begins to hit the age of 60.

BY VIVIAN HO & CAYLA LAMBIER

December 2010/January 2011

Medical Tourism AT A GLANCE

Hospitality ~ Creating Alliances and Developing Services

From travel agencies handling inbound and outbound flights and local on the ground transport, to hotel stays before and after procedures and companion tourist attraction services, the need to pair up service providers into a ‘seamless continuum’ is becoming crucial and integral to a country’s development of a growing medical tourism niche market.

BY VIVIAN HO, ANNE-LINE CROCHET & CAYLA LAMBIER

Social Media & Marketing ~ Sell More & Reach New Markets

Navigating the Worst Case Scenario

For the past few years, social networking as a whole has been transforming personal and professional relationships and these networks have, in turn, been effective tools in targeting potential customers, defining parameters for optimal social networking brand strategies and essentially useful in building better products, reaching new market sectors and selling more services.

BY CAYLA LAMBIER & VIVIAN HO

When traveling internationally, one should not only expect the unexpected but be prepared for it. When a medical procedure is thrown into the mix, the typical hazards of international travel take on a new level of concern and entirely new dangers arise. However, with proper education and planning, the dangers of international medical travel can be minimized to make for a successful, healthy and fun journey. BY CAYLA LAMBIER

Untapped and Undeveloped Markets ~ Dubai and Saudi Arabia

2025 has been declared a “goal year” by the government and a progressive list of healthcare-focused objectives has been undertaken. The objectives include reducing the burden of injuries and infectious diseases, as well as improving the health status of UAE nationals, and, in order to be accomplished, will require the implementation of educational programs, policy revisions, health screenings and national surveys.

BY CAYLA LAMBIER

Saving Lives

Corporate Wellness ~ Healthier Employees, Better Performances

The Japanese call it Karōshi, meaning death by overwork; mostly caused by heart attacks or strokes due to stress. In Japan, this phenomenon was discovered more than 50 years ago, and here in the U.S, a few cases have been noted already.

BY ANNE-LINE CROCHET

Telehealth in Medical Tourism ~ Personalizing Health Care

Extending the reach of medical tourism into pre and post surgical care for clients is now possible. Indeed, the new information and communication technology on the market added to the desire of clients to have a more personalized service in the field of global health services make it attainable using telehealth.

BY DR. ANTONIA ARNAERT

E-Health and Telemedicine ~ A Matter of Buying Solutions

Nowadays, patients have come to expect technology to be everywhere. From a hospital provider perspective, competitors are using state-of-the art and advanced technology to their market advantages. However, one must keep in mind it is not an inexpensive investment to make.

BY VIVIAN HO

December 2010/January 2011

ÂŠ Copyright Medical Tourism Association

MEDICAL TOURISM

Progress in Motion ~

Medical Tourism

Congress Proceedings

By ANNE LINE CROCHET, VIVIAN HO and CAYLA LAMBIER

In early 2000, Thomas Friedman, the Pulitzer Prize winning foreign affairs columnist for The New York Times in his book, “The Lexus and the Olive Tree” articulated for us that globalization had replaced the cold war system. He further elaborated that “globalization was here to stay and the world-at-large could look forward to an increasing level of ‘integration of capital, technology, and information across national border.”

oday, ten plus years later, we have all seen, experienced and been impacted by convergences and intersections of globalization and life as a single community. We are a global village, with widespread implications as to what that means and how to live within it. We are also a world comprised of different cultures, geographies and traditions which we somehow balance as a single community. Globalization is transforming healthcare rapidly and visibly, ranging from life sciences, research and development, and pharmaceutical networks to the current medical tourism niche industry. Noted by U.S. World & News Report as “one of the top ten trends in 2010,” the medical tourism landscape is a hot area of development in many countries. Globalization was a common point of discussion at the 2010 World Medical Tourism and Global Healthcare

Congress as physicians, healthcare professionals and business executives from all over the world gathered to share ideas and perspectives. The number of attendees focused on setting healthcare development goals and progressing forward within the medical tourism industry was inspiring.

Knowledge and expertise laid the foundation for the keynote speakers of this year’s Congress, featuring brilliant perspectives from all around the globe and all facets of the industry. December 2010/January 2011

MEDICAL TOURISM “Not only hospitals and other medical institutions see the opportunities of medical tourism,” said Dr. Mathias Goyen, CEO of UKE Consult & Management. “The tourism industry is picking up, too. Airlines and hotels are starting to realize that this is a growing business that is worth consideration.” Due to the string of natural disasters and illnesses that have occurred abroad recently, threats to the success of medical tourism were another popular topic. From the logistics of a volcanic eruption to the avoidance of drug-resistant strains of TB, several sessions at this year’s Congress went into great detail on how international threats to travelers should be addressed and handled.

Ori Karev, CEO of UnitedHealth International “This is a room of people that are looking to the future,” said Dr. Kevin Fickenscher, Chief Strategy and Development Officer for Dell Services, during his keynote presentation on healthcare reform. All the most pressing issues pertinent to medical tourism and its future – from the expansive organization of regional healthcare clusters to the specific set of standards that international hospitals must strive to meet – were tackled headon at this year’s Congress. Some of the major topics of interest, conversation and industry development at this year’s Congress included healthcare clusters, branding, social media and online marketing, global benefits and the future of healthcare. Though the overall adoption of medical tourism by insurance companies and corporate benefits plans is still fairly low, many industry players who presented at the Congress maintain optimistic outlooks. Entrepreneurs, insurance companies, brokers and employers are determined to look outside the box and step in the multi-billion dollars industry medical tourism industry portrays. “Medical Tourism, if it can continue to provide access to significant pricing discounts and comparable quality to American medical providers, is going to be a part of every insurance carrier’s provider model going forward,” predicted Michael Bertaut, Senior Healthcare Intelligence Analyst for Blue Cross and Blue Shield. Other opportunities for healthcare sector growth and development within the medical tourism industry were discussed, including regional collaboration and the increasing involvement of the travel industry in establishing linkages to the medical tourism sector.

Stirred by the global trend of aging populations, Baby Boomers were a popular speaking point as well. In the U.S., the Baby Boomers will soon add 76 million older persons to the over 65 years old population. Medicare is providing health coverage for persons over 65 and health care reform is enabling more people to get coverage. However, what about elective surgery, cosmetic surgery or wellness? Medical tourism is definitely a new market opportunity where affordable prices and high quality meet the need of the elderly. To support and promote medical tourism, social media is becoming a new trend. Marketing to expand and grow a business via the means of a social media is even more interesting on a medical tourism point of view. From any part of the world, a patient can find information on a hospital, an expatriate can ask for solutions immediately and buyers and sellers can get in contact. Telemedicine also is becoming popular. In order to provide efficient after care, telemedicine is a way to incorporate health management into medical tourism. In that way, patients and medical staff can exchange information and concerns prior and after surgery. The dialogue of ethics in medical tourism also remains important. Since every country approaches patients differently, standards must be set for governmental safeguards, preprocedure information and patient follow-up care. Around the world, ethics are beginning to incorporate sustainability. Sustainable hospitals are thriving from Europe to America, with green architecture and engineering fueling the new trends. Sustainability brings a healthier environment for patients and staff, permitting among others, natural ventilation, natural light and healthy food; in a word, a nonhospital atmosphere. Another topic prevalent on the minds and agendas of the congress attendees was the U.S healthcare reform that passed into law in March 2010. Healthcare has been reformed in the U.S. in an attempt to make health care coverage accessible to everybody. Nevertheless, the bill implementation will take several years to be put into practice and corporations are now looking to reduce expenses. Medical tourism appears as an attractive market with high quality and cost effective surgery, and some self-funded companies and voluntary employee benefits programs already stepped foot in the medical tourism industry while some employers are investing in maintaining the health of their employees, promoting corporate wellness and health tourism.

Pete Thomas - Winner of “The Biggest Loser” Season II

December 2010/January 2011

Knowledge and expertise laid the foundation for the keynote speakers of this year’s Congress, featuring brilliant perspectives from all around the globe and all facets of the industry.

Dr. Max Sawaf ~ CEO of Emirates Hospital, Dr. Prem Jagyasi, MD & CEO of ExHealth, Dubai Healthcare City ~ UAE, Jonathan Edelheit, CEO of MTA, His Excellency Qadhi Saeed Al Murooshid ~ Director General of the Dubai Health Authority, Renée-Marie Stephano ~ President of the MTA, Laila Al Jassmi - CEO Health Policy and Strategy Sector, Tony Elzoghbi ~ Dubai Health Authority Director - Audit

Around the world, ethics are beginning to incorporate sustainability. Sustainable hospitals are thriving from Europe to America, with green architecture and engineering fueling the new trends.

Ori Karev, CEO of UnitedHealth International spoke on the future of healthcare insurance, sharing new ideas and posing interesting predictions. Chief Strategy and Development Officer for Dell Services, Dr. Kevin Fickenscher gave an informed and thorough presentation about healthcare reform at the corporate level, and Rob Davenport, Wellness Program Manager for NASA, spoke regarding the approach to corporate wellness NASA has pursued. From Brazil, Mário Augusto Lopes Moysés, Vice Minister of Tourism, introduced Brazil as an emerging player in the medical tourism industry. Dr. Jung, CEO of KIMA, brought his experience with public private partnerships to the table and discussed what role they might play in the future. Pete Thomas, the motivational speaker and Winner of “The Biggest Loser,” Season II, gave an energetic talk on setting goals in the workplace and accomplishing them efficiently and positively. n

Kevin Fickenscher - Chief Strategy & Development Officer, Dell Services

December 2010/January 2011

MEDICAL TOURISM

Public and

Private Sector

Collaboration ~ Prevention of Two Tiered Markets By DAVID MORGAN

nyone can tell you that travelling abroad for health care is nothing new. Since early times people have travelled far and wide in search of cures and treatments for various ailments. The nineteenth century was perhaps the heyday for spa towns and health resorts to flourish throughout Europe. In recent times, wealthy patients from around the globe have traditionally sought the latest technology and highest quality service in exclusive private clinics in Switzerland or world-renowned American hospitals, generally travelling wherever they felt they could get the best care. Nowadays, medical tourism is the most visible part of a generalised growth in the globalisation of health encompassing not just patient movement but also crossborder supply. Fuelled by technological progress, e-health and tele-medicine are increasingly breaking down national frontiers as a delivery mechanism for health information and services. Improved communications and transportation facilitate the movement of people, both as patients and healthcare providers. In most developed countries, people generally still prefer to receive health care close to home. However, under certain circumstances it may be more preferable for a patient to seek care abroad.

December 2010/January 2011

In some cases, the nearest health facility may in fact be just across a border. In others, certain specialists or state of the art treatments are simply not available at home or are subject to long waiting lists. Besides, cost plays a key role: Rising health care costs at home and lack of insurance coverage are among the more often quoted reasons for patients to be treated abroad. Indeed, some countries are able to provide the same procedures and treatments at a fraction of the cost incurred at home. Legal and ethical obstacles, such as stem cell therapy or some fertility treatments have also been cited as forces behind the increase in health tourism. But in recent years there has been a growing body of evidence that the number of patients travelling across international borders specifically for the purpose of receiving health care has become increasingly important in many countries. Hard statistics on the value of health-related travel remain patchy but certainly underestimate activity. The Thai Investment Board reports Thailand treated over one million foreign patients in 2006. More than just holidaymakers, these patients were part of an expanding global trade in medical tourism which the board then valued at $40 billion worldwide and with growth potential of some 20 percent per year worldwide.

ÂŠ Copyright Medical Tourism Association

Some estimates go higher still. A 2008 report by the Deloitte Center for Health Solutions estimated the value of the world medical tourism market in 2008 was around $60 billion and expected double digit growth rates in the years ahead. A follow up report in 2009 suggested the recession would slow this growth–a trend which recent reports from Thailand appear to echo– but it still estimated tthe number of U.S. outbound medical tourists would reach 1.6 million by 2012. The health sector has not been slow to respond to this phenomenon. An increasing number of countries have been actively promoting their comparative advantage as medical travel destinations. Promising high quality, technologically advanced and competitively priced health services lead their hope to attract patients from all over the world. Substantial visitor numbers floated around with significant growth estimated in India, Singapore and Malaysia as well as South Korea, Costa Rica, Jordan and many more. Individual hospitals and clinics or clusters of health care providers also have sought international accreditation in order to win recognition on the international health insurance and purchaser networks.

A 2008 report by the Deloitte Center for Health Solutions estimated the value of the world medical tourism market in 2008 was around $60 billion and expected double digit growth rates in the years ahead. Medical tourism concerns are often termed the NorthSouth flow. Predominantly travellers from North America and Europe travel to destinations in Latin America, Asia and Africa. However, other flows can also be important, particularly regionally. First, flows within Europe or between the U.S. and Canada called North-North; second, flows between countries in the Middle East or Asia called South-South, where one country acts as a hub for medical care for neighboring countries – such is often cited for Jordan. While medical tourism remains marginal, it is growing and can have proportionally larger effects on states, regions and specialist areas of care. Such globalisation of health services offers new opportunities for countries but also creates new risks. In examining the potential benefits, governments of developing countries have sought to promote the growth of medical tourism in their economic growth policy as a way to introduce new technologically advanced and quality health services to their own citizens. However, the danger is when an increased demand from foreign patients provides important revenues, it may draw away critical resources from the local population.

MEDICAL TOURISM ~ RISKS AND ADVANTAGES For countries promoting themselves as medical travel destinations, the risk of a two-tier health system developing arises. In a two-tier health system, offering high quality richly resourced healthcare for foreign patients results in the provision of low quality, low resourced care for the resident population. Alternatively, scarce public funds would be given away in the form of tax breaks, incentives and subsidies to help develop the private health care provider industry, and diverted away from the core task of delivering much needed primary care. Indeed there is a danger of a ‘crowding out’ of the local population by investing in health providers dealing with quite different population needs

– tertiary technology intensive care services unadapted to the basic care needs delivered in a primary care setting. Another concern can lead to a possible brain drain. Trained health professionals would prefer private providers servicing foreigners to domestic public health systems, and urban to rural areas. In many countries the cost of training of doctors and nurses is provided or underwritten by the state which then sees this investment lost. In summary, the accusation goes that medical tourism will only result in aggravating the poor performance of the local health system and help to widen further observed health inequalities. But, while much of the focus rests on possible effects of medical tourism on the destination country there may be undesirable and unwanted effects on the patient’s country of origin. In addition to a possible inadequate domestic health system unable to meet the needs of its population, there are questions over equality. Indeed, wealthy patients are able to access certain services abroad or jump waiting lists, and as such it may be seen as a substitute for much needed health care reforms or investment in resources in the domestic health system. Other public health issues have also been well documented and found their way recently into the headlines. such as complications from treatment abroad or the introduction of drug-resistant superbugs back into the home country. More generally there may also be concerns and questions over the lack of control and the by-passing of legal hurdles for certain treatments only available abroad. But consider the positive effects of achieving a win-win situation: there are a number of potential benefits of medical tourism to be gained from both inbound and outbound medical tourism. For the country promoting medical tourism there

December 2010/January 2011

MEDICAL TOURISM are the obvious foreign earnings from both increased health and tourist flows. While acknowledging the medical tourism industry plays for now only a marginal economic role, improved health outcomes and rising income are shown to be closely linked, especially in developing countries. And, as a secondary effect, there should be increased employment opportunities for the local population and improved infrastructure and business opportunities servicing the needs of the new health providers. Importantly, a desirable ‘trickle down’ effect can be envisaged. Indeed, the more rapid diffusion of new health care technologies and treatments coming from the presence of internationally recognized and accredited health care providers would help raising the health care standards for local populations. The problem of health care professional flows within developing countries from the public sector to private medical tourism providers is dwarfed compared to the migration from developing to developed countries. In fact there has been some anecdotal evidence pointing to a small scale ‘reverse brain drain.’ For instance, in countries such as Trinidad and Tobago or even India, whereby health professionals are being enticed to return to work in the health system of their country of origin.

Strong public-private partnerships and a clear and consistent medical tourism strategy appear key to success. For the importing country, there may be important economics of scale and cost savings to be made by patients going or being sent abroad for specialist and costly treatment. Rather than a substitute for reform, it may also be seen as a catalyst for change or a necessary introduction of badly needed external price competition into a malfunctioning domestic market. Often, the potential loss of revenue can have a sobering effect on an industry. So, how do governments develop effective strategies to ensure a successful medical tourism industry goes conjointly with the principle public health objectives and resident population needs? It would be sensible to conclude that strong public-private cooperation in developing a strong strategy could be a key to success. Early involvement of all the relevant stakeholders, that is to say Ministries of Health, Tourism, Industry, health care professional associations as well as the health care providers and investors, in a coordinated and transparent approach appears important and has some precedents. An impact assessment is paramount in order to assess the strengths and weaknesses, identify the right markets as well as implementing a system for monitoring and coordinating.

GOVERNMENTS’ STRATEGIES The strong commitment of government and the public authorities is key to provide the right climate for success. In its support and governance role it needs to create the right regulatory framework for providers to ensure quality and patient safety – an industry can quickly be damaged if foreign patient expectations are not met. This means a review of the registration and accreditation procedures and existing practice barriers to provide the right incentives for investment in the industry. Some countries such as South Korea have also played a key role in developing a central one-stop information site for medical tourism in the country to provide coherent information for potential visitors and in case something does go wrong.

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So, in order to make two-tier health system fears best allayed, there is no single solution – as hinted before, the allocation of a certain proportion of beds or services reserved for local needs is not always the optimal way and is often difficult to enforce and not necessarily the right type of services needed by the local population. Investing ear-marked funds back into the local health system from resulting health tourism revenue has been adopted in a number of regions and may have more of a desired and targeted effect. In general though, the introduction of high quality state-of-the-art treatments within a country may in itself be a more effective driver in raising the population health standards. In addition to any natural flow of health care professionals back to their country of origin, some countries have developed effective human resource planning strategies to combat the loss of health care professionals abroad or to the private sector. In some cases there may be a deliberate surplus training in order to adequately cover the ‘export’ of doctors and nurses. In another example, the Philippines has ‘allowed’ nurses to work abroad or in the private sector if they repay a part of the cost of their training covered by the public purse. There may also be certain incentives or obligations to doctors towards the local population while still working in the private sector. Of course, there is a fundamental need to continually monitor and report the state of the industry: providing information to adapt and reform the strategies and make such information transparent to all the relevant stakeholders. In summary, health is a major and growing sector of the economy and while medical tourism is still marginal it is growing even faster and can have impacts in many areas of health policy. While the effects of medical tourism on importer and exporter need more evidence and monitoring, it is suggested strong public-private partnerships and a clear and consistent medical tourism strategy appear key to success.

* The views contained in this article represent the personal views of the author and not necessarily those of the OECD.

About the Author David Morgan is a Health Expenditure and Financing Analyst in the Health Division of the Paris-based Organisation for Economic Co-operation and Development (OECD). Responding to the important public health and trade policy issue raised, Mr. Morgan has been leading a two-year project in order to improve the measurement of international trade in health goods and services. The project aims to identify the diverse and developing range of transactions and flows between the domestic healthcare sector and non-residents. Mr Morgan has ten years of experience at the OECD, predominantly in the area of health statistics and heath expenditure accounts. Working closely with the public administrations of OECD countries and other international organizations, the OECD aims to provide internationally comparable data on health care spending and financing for analysis and decision making.

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MEDICAL TOURISM

Providing

Aftercare Services to the Global Patient By JEAN FORBES

[San Jose, Costa Rica] Recently a patient, referred to as G.L. from Florida, United States had his gall bladder removed at Costa Rica’s Clinica Biblica Hospital. In recuperation, afterward G.L. spent time at the Casa Conde Recovery Center and received aftercare services from Homewatch CareGivers.

s an innovator in the caregiving field with over 30 years of experience, one of the ways in which Homewatch CareGivers has responded to the growth of medical tourism and global healthcare is developing a comprehensive Aftercare Program. The company’s Costa Rican office, for example, provides post-surgical care for patients recovering in San Jose and upon return to the United States that same patient can opt to continue his or her caregiving treatments with one of Homewatch CareGivers’ many US-based offices. Continuity of care plans are therefore assured for a patient opting for medical care overseas. G.L. was pleased with his overall experience and says, “The care provided by Homewatch CareGivers was excellent. Besides the highly professional skills and capabilities extended

by their staff, having them by my side gave me the extra peace of mind I needed to have a more relaxed recovery process.” Another patient who goes by E.M. from California, U.S. recently received a gastric sleeve procedure at Costa Rica’s Clinica Biblica Hospital. After the procedure, she too, decided to spend her recovery at the Casa Conde Recovery Center and also received aftercare services from Homewatch CareGivers. “I was afraid to have this surgery, even more so to have it done in a foreign country. Knowing the high quality of medical services in Costa Rica, and the fact that I had access to Homewatch CareGivers services down there and back at home helped me make the decision of having my surgery done in Costa Rica,” E.M. stated.

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MEDICAL TOURISM Based on the astounding growth and expansion statistics related to medical travel, we see our aftercare program as the clear solution for completing the continuity of quality care for all patients. We have a robust employee and associate training, and quality assurance program that includes an online university platform to ensure we have caregivers who are trained on the intricacies of working with people with greater medical needs, worldwide.

We know the industry of medical tourism is growing significantly, and we believe the caregiver component is a critical aspect of overall quality care coordination. Since global patients or medical tourists have varying care objectives, the Homewatch CareGivers’ Aftercare Program helps provide clients with the best customized care plan for their specific recovery needs through streamlined communication tools and a quality assurance process. The program recognizes and customizes the varying needs of different clients in all stages of care and works toward a seamless and coordinated plan of care for each client in conjunction with their medical facilitator or physician/clinic. We believe strong, established relationships with facilitators, physicians, and facilities are critical to the overall quality of care that is successfully extended to patients. The primary goal of all services is to increase post-surgical or posttreatment compliance and thus the desired recovery outcomes by supporting clients with highly trained, knowledgeable and compassionate caregivers, providing the highest quality of care outcomes possible. Homewatch CareGivers continues to expand this program by identifying potential franchise partners for care coordination through home care services by studying the most prevalent

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locations for procedures and treatments and identifying growth areas around the globe. Homewatch CareGivers has identified several emerging hubs in Mexico, Brazil, Malaysia, South Africa, India and other areas around the world for their services and programs. Homewatch CareGivers currently has 180 offices throughout the U.S. and internationally in Costa Rica, Guatemala, Panama, Canada and New Zealand. This international network enables Homewatch CareGivers to meet the aftercare needs of many people traveling for medical care. “We know the industry of medical tourism is growing significantly, and we believe the caregiver component is a critical aspect of overall quality care coordination,” says company President Leann Reynolds. “Through Homewatch CareGivers University we train our caregivers to understand the diseases, health conditions, procedures and vast cultural differences that are inherent in working internationally, in order to serve as ancillary support to the patient experience.” n Homewatch CareGivers was a Silver Sponsor of the 2010 World Medical Tourism and Global Healthcare Congress. Learn more about Homewatch CareGivers at: www.HomewatchCareGivers.com

About the Author

With more than 15 years of experience in international relations and operations, Ms Forbes spearheads the efforts of Homewatch CareGivers’ global healthcare and medical tourism initiatives. She works directly with the network of Homewatch CareGivers’ offices to support, grow and expand their operations that includes a directed focus on global development efforts. She has been instrumental in the design and administration of the Aftercare Specialists Program of Homewatch CareGivers.

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Providing end-to-end solutions for medical tourism The chances of being readmitted to a hospital after a procedure go down significantly with proper attention and care. Our highly trained caregivers and ClientCare Coordinators bring compassion and expertise to the entire recovery process. As a leader in the caregiving field, we understand exemplary caregiving practices are a critical step to ensure a successful recovery. We promote compliance with your prescribed rehabilitation program, and maintain a stress-free balance in the recovery environment. The key to delivering quality care lies in caregiver education. Homewatch CareGivers University is our professionally developed caregiver training platform designed to train our caregiver employees, family members providing care, and the greater caregiver community. Whether your patients are traveling across town, across country, or around the globe, we deliver premier home care services wherever home may be.

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December 2010/January 2011

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MEDICAL TOURISM

Dubai

Diamond Sponsor at the World Medical Tourism Congress

By ANNE LINE CROCHET, VIVIAN HO and CAYLA LAMBIER

Dubai Health Authority (DHA) led as the Diamond Sponsor at this year’s Congress; the 3rd Annual World Medical Tourism & Global Health Congress (WMT&GHC) in an effort to strengthen its assets in medical tourism and further establish its position in the medical tourism industry. Dubai is a cosmopolitan hub, global city, and an attractive destination for tourists from all over the world. As a leader in medical tourism amongst healthcare clusters around the world, Dubai is continuing to rapidly work towards strengthening its healthcare assets and service capabilities.

he Gulf Cooperation Council, one of the seven governing components of the Middle East, includes the United Arab Emirates with Dubai as its commercial capital. Dubai has a population of 2.2 million people, predominantly young, and Dubai’s population is expected to grow by more than one million by 2020. Active, young and urbanized, Dubai sees its residents’ needs and lifestyle changing. The GCC population is growing and developing special healthcare needs, especially in terms of chronic diseases. According to Ms. Laila Al Jassmi, CEO Health Policy and Strategy Sector at Dubai Health Authority, life expectancy is rising in the GCC, but obesity, cardiovascular

diseases and diabetes are increasing as well, due to a more sedentary lifestyle. Today, the GCC has among the highest obesity rate in the world when compared to the health status of other nations. “The healthcare service market was valued at $18 billion in 2008 and is expected to grow to $47 to 55 billion by 2020 in the GCC,” Al Jassmi said. Thus, by increasing and improving its health care system in terms of access and service delivery, Dubai is well supplied with health professionals in comparison to the other countries and

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MEDICAL TOURISM emirates in the GCC, ranking third behind Bahrain and Qatar according to the McKinsey report on healthcare in the GCC. Both the public and private sectors of the healthcare industry is expanding. Today five public hospitals, twentysix primary healthcare centers, seven specialty centers and sixteen dental clinics are registered in the public sector. In the private sector, eighteen hospitals have been listed as healthcare service providers. Dubai has planned an expansion of 19 more hospitals by 2013 according to Ms. Al Jassmi, increasing the total bed capacity to 63,650. A world famous medical tourism destination for cosmetic surgery and rejuvenation packages, Dubai Health Authority is looking to position Dubai as an even more attractive hub in the medical tourism sector. DHA was created three years ago by His Highness Sheikh Mohammad Bin Rashid Al Maktoum, UAE Vice President, Prime Minister and Ruler of Dubai. As the strategic health authority for the Emirate of Dubai, the DHA is empowered to set, implement and assure policies and strategies for health.

Medical tourism is an integral aspect of healthcare, especially in the context of today’s global world. “The DHA’s aim in Dubai is to provide an accessible, effective and integrated healthcare system, protect public health and improve the quality of life within the Emirate,” as stated by DHA Communications Analyst Kamakshi Gupta in a press release. With expansion and progress in mind, Dubai assumed the lead this year at the World Medical Tourism and Global Health Care Congress by participating at the highest level as a Diamond Sponsor. “In recent years, Dubai has seen a phenomenal growth in the health sector,” His Excellency Qadhi Saeed Al Murooshid, Director General of the DHA said. “Medical tourism is an integral aspect of our healthcare strategy, especially in the context of today’s global community and the DHA is keen to further strengthen and establish Dubai’s position on medical tourism and global healthcare map.”

His Excellency Qadhi Saeed Al Murooshid, Director General of the DHA and Renée-Marie Stephano, President of MTA signing Memorandum of Understanding.

Thus, His Excellency Murooshid on behalf of UAE Vice President, Prime Minister and Ruler of Dubai, Sheikh Mohammed’s vision signed a Memorandum of Understanding with the Medical Tourism Association at the 2010 WMT&GHC in Los Angeles. The MOU serves as the beginning step in a bilateral agreement where both parties intend to work cooperatively towards further strengthening the medical tourism sector in the emirate of Dubai. Buyers, sellers and facilitators are looking forward to seeing the positive outcomes of the MOU agreement, considered a major step for Dubai and a “great advantage for the medical tourism industry,” said MTA President Renee-Marie Stefano. As medical tourism continues to progress amongst nations solidifying their positions as world-class healthcare clusters around the world, the opportunities for healthcare advances, technological progress and improved population health status abounds as well. n

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Renée-Marie Stephano, President of MTA, His Excellency Qadhi Saeed Al Murooshid, Director General of the DHA and Laila Al Jassmi, CEO Health Policy and Strategy Sector

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MEDICAL TOURISM

Brand

Creation~ A Roadmap for Medical Tourism By BRIDGET ALGAN

Visioning and Branding are a means to an end. That end is a unique, compelling and flexible set of verbal, visual and spatial tools that express the character, capture and project the essence and key attributes of a place. Great projects begin with great ideas. It is those ideas that must be embodied and then projected from the very inception of the project in creative and memorable ways.

n order to successfully and effectively connect in an enduring way to the local culture, the market and the community of stakeholders, ideas must relate to the unique qualities and values of the place they are to represent. The brand strategy must seamlessly align with both the realities and the aspirations of the market. The brand expression must also reflect the values of the developer and result in outcomes that are seen as compelling and advantageous to all stakeholders

What are the overall stages for branding?

Key Factor: The owner should have a detailed market research analysis performed from a regional and global perspective before creating the brand for a sustainable development

3. Continuation; to clarify a brandâ&#x20AC;&#x2122;s positioning

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There are four stages of branding which needs to be considered and executed. 1. Creation; to create or articulate a new business model 2. Transformation; to push a brand into new markets or channels 4. Application; to create a consistent brand experience

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In this report, we are going to be focusing more on the first stage and how to create a brand from scratch.

What are the initial key principles to consider? The owner has to consider identifying and articulating the organizing principles and animating ideas behind the new economic development during the initial phase. The brand consultant may also provide professional direction and services during this brainstorming sessions related to the following: • Cultural Research and Discovery • Vision Statement Development • Naming Strategy and Messaging Development • Visual Identity and Service Mark Development • Verbal and Visual Articulation of Brand Attributes

Where to start? Regardless of the industry, every project should start with a visioning / kick-off session where owner, developers and consultants to analyze and assess ideas based on the vision.

The consultant should capture in an illustrative way the overarching vision, values and beliefs and identify and recognize the linkage between goals, issues and strategies.

• Summarize the market study • Determine the current brand equities

The primary purpose of this process is to establish a clear team understanding of owner’s goals and to create a framework that will inform and become the foundation for subsequent phases which might include the following: • Tactical directives as they pertain to the brand, operations, products and services, personnel, systems (invisible), and customer facing (visible) • Programmatic issues, including usage guidelines. • Tone of voice (visual & verbal) of print & web ads, reports, statements, industry publications, etc. • Definition of the visitor to the facility/campus/country and the desired message to be communicated. • Security and user confidentiality issues

• Determine the future demand • Define the customer • Define the service provider • Describe the product lines • Attributes of owner’s style of service • Key factors such as competition in the market from regional and global perspective

What should the consultant present to the owner during the kickoff meeting? Information that the owner should anticipate being complete and available to facilitate the project kickoff should include the following:

The consultant should capture in an illustrative way the overarching vision, values and beliefs and identify and recognize the linkage between goals, issues and strategies. Seeing ideas expressed in real time significantly reduces miscommunication and misinterpretation, and allows all involved to arrive at mutually agreed upon strategies and directions.

• Owner internal team structure, approval process, and progress made relative to the project.

What information needs to be analyzed before the kickoff meeting?

• Detailed information on the proposed function and type of the new development

First the client should select the consultant carefully especially based on their capabilities of developing the unique brand. This will also impact the roles and responsibilities of expectations from the consultant over the long term of the brand development. The consultant should analyze the following items which include, but are not limited to the following:

• Existing brand/product display standards or protocols. (i.e., trade show, recruitment fair material)

• Detailed information, in the form of a briefing or presentation of existing useable images and copy and creative strategy from the marketing and advertising strategists.

• Summary of market understanding – local, regional and global • Personnel, staff roles and training approach/guidelines

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MEDICAL TOURISM What are the initial deliverables and outcomes of the initial study? The purpose of this study is largely for the consultant to become acquainted with all relevant issues and to gather information. It is a chance to discuss “what ifs” of an exciting opportunity. The consultant should document all discussions that take place, and would suggest information transfer take place in one workshop. The consultant should provide the following deliverables at the end of six to eight weeks based on the location, complexity and scale of the development. • Visual directions: a collage of images that echo owner’s vision and set the tone and direction for the design > Name - Exploration and Trade marking > Identity system - Document Templates/Production/ Brochures > Tone of voice > Prototype environment • Brand Audit - discovery session w/ brand story/mission statement • Public facing brand experience diagrams – Web/ Advertisement templates • Written documentation of each interview • Functional requirements summaries

Conclusion For any product, service or economic development strategy to be successful, it must contain a clear and easy to understand brand attributes and values. Starting with this approach will ensure the best chance to enter the market and sustain growth over time. After this initial first “creation” step, it is important to maintain the brand through subsequent efforts including; transformation; continuation; and application stages. n About GD3 Solutions GD3 Solutions methodically analyzes the options and strategies that best support real estate development for developers and investors in the short and long term, continually driving towards a sustainable return on investment from local, regional and global market perspectives. Our experience spans a variety of industries including real estate developers, corporations, institutions and governments. We are members of a variety of professional associations GD3 Solutions uses a collaborative approach to identify the ultimate brand of new business models and real estate development. This requires interaction with local professionals, government agencies, institutions, corporations, developers and investors to create a robust strategy for the development. For more information – info@ gd3solutions.com / www.gd3solutions.com

First the client should select the consultant carefully especially based on their capabilities of developing the unique brand.

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MEDICAL TOURISM

Caring for Out-of-Town Patients ~

Lessons Learned By EMILIO WILLIAMS

or decades, patients from all over the world have come to our institution, The Johns Hopkins Hospital in Baltimore, Maryland, in search of the latest diagnostic services and treatments. It was not until 1999, that the efforts of coordinating care for out-of-town patients were better structured and formalized. Since then, we have learned a lot. And we would like to share with our colleagues in other hospitals around the globe some of the lessons we have learned. These lessons, I believe, go beyond international patient programs. What I have learned in this journey, is to expand my own notions about clinical quality and marketing, to include in our strategic priorities the need for outstanding services and impeccable non-clinical patient coordination for patients from home and abroad.

OUR INSTITUTION, OUR CHALLENGE The Johns Hopkins Health System is now an enterprise that includes four acute care hospitals with a total of 1,897 beds. Our School of Medicine employs 2,590 faculty members. Our flagship hospital is The Johns Hopkins Hospital. This hospital is within a cluster called Johns Hopkins Medical

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Institutions, a campus with more than 25 interconnected buildings that include not only the hospital but also our Schools of Medicine, Nursing and Public Health. As you can imagine, this environment could be very challenging to navigate for ourof-town visitors. Hopkins has been ranked the number one hospital in the US for 20 years in a row. But the truth is that good customers and non-clinical patient services have never been our strength. Until the late 1990’s, many accused Hopkins of being a narcissistic enterprise, the type that at times would treat its patients as “you’re lucky we’re taking care of you”. We were painfully aware that our service did not match the excellence of our science. We knew things had to change. According to McKinsey Quarterly, “More and more patients are likely to base their choice for hospital on nonclinical aspects of the visit-like convenience or amenities.” Most patients perceive their experience not through the science of the encounter, but by the human touch of each encounter during their hospital visit. No wonder research after research shows that the key factor for a patient to choose a hospital is the perception that “Staff is caring and supportive.”

Non-clinical services are usually the areas where, with the lowest investment, we can have the highest impact on the way a patient perceives his or her hospital experience. With more than 300 hospitals around the globe certified by JCI, hospitals who aim at attracting patients from other cities will have to offer an outstanding level of service, and have that service be a differentiator in an increasingly competitive global market where good physicians, facilities and international accreditations will become the norm.

TEN LESSONS LEARNED These are the ten lessons I would like to discuss today:

1. Hospitals Need a Sound Loyalty Plan In an increasingly competitive healthcare market, patient loyalty has become the keystone of a sound branding strategy for any hospital. Loyal patients are those who are the most likely to return to your hospital and, most importantly, are the most likely to recommend your facility to friends and family. Since 2004, Johns Hopkins Medicine International has worked in a comprehensive strategic approach to improve all the operational aspects of coordinating care for out-oftown patients. We call our loyalty program CRM (Customer Relationship Management). Evidence shows loyal patients are the most cost-effective marketing a hospital may have in place. Especially when trying to reach out to an array of distant markets.

More and more patients are likely to base their choice for hospital on non-clinical aspects of the visit-like convenience or amenities. Because of the increasing choices that patients have when deciding where to go for their medical care and all the logistics inherent in traveling for healthcare, impeccable non-clinical services are a “make-it or break-it” business requirement for any facility or cluster of hospitals who want to increase their reach to attract patients from other cities or countries. CRM is not just a type of software you buy to track your patient’s experience. CRM is a shift in the culture of how we do business. It is comprehensive, measurable and systematic. This is not your typical service excellence program. CRM goes well beyond service excellence to involve your patient safety, quality, billing and finance, marketing, and human resources departments.

2. It Is All About the People, Our People.

Additionally, in order to have satisfied, engaged employees who are part of the solution and not part of the problem, you will require a committed human resources department that will support your CRM initiative with strategies for career development, for hiring, evaluating, and placing employees in the correct positions. Human capital requires also investment: on training, tools and ways to work more efficiently. Long gone are the days where a hospital can only afford training for the top management.

3. Focus On Your Advocates Loyalty programs divide the market following a pyramid model. The bottom of the pyramid is where the unknown potential patients are. It is large. Above the unknown, we have the target. Those populations we want to reach. Above the target, we have the prospects. Those are the patients who have shown an interest in coming to your institution. Above prospects, we have clients, those patients who visit once. We are now getting close to the narrower top of the pyramid. We have two more segments, the two most important from a marketing perspective: customers, those who visit your institution more than once and finally at the very top of the pyramid sit the advocates. Advocates are your most important champions. Those are the patients who are so loyal to your institution that they will recommend everybody to come to you.

4. Map the Experience of Your Patients

In a hospital, your human capital is your best asset. Without satisfied employees you cannot have satisfied patients or clients. Therefore, any sound strategy must include tactics to engage the frontline employees.

What are we putting our patients through? From the moment they contact us to request an appointment to the moment they go back home, there will be dozens of touch points, places where you will have the opportunity to get it right or wrong, delight them or frustrate them.

CRM cannot be something imposed from the top. You cannot mandate good attitude. Rather, make your staff part of the solution, engage them into how to make things easier for themselves in their daily lives. Chances are, those things that make your employees‘ life difficult is what is preventing your patients from getting the best service possible.

Do we really know what all the steps a patient has to take before, during and after their appointments are? You should look at the experience form the patient’s perspective. It teaches you about your redundancies, your deficiencies. It helps you understand what improvements can be made to become “easy to do business with.”

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MEDICAL TOURISM After we developed our map, we created tools, checklists, processes and service standards for each “touch-point” with the patient.

5. Secure the Continuity of Care In large hospitals, with many decentralized services, there is always a risk to lose track of the continuity of care. This happens because our processes were not developed from the point of view of a patient, but rather from the different, competing and redundant needs of each of the silos that touch the patient. This is why in quality and patient safety we strive to come back to a patient-centered model of care. Through CRM, we pay special attention to continuity, through two processes: one more clinical considering care management and another one non-clinical involving the figure of the patient coordinator.

communicate with our customers and advocates before, during and after their visit to Hopkins.

8. Measure Results The functional units that piloted this loyalty program within Johns Hopkins Medicine were able to double their number of patients in only four years. Patient satisfaction for these units was up to 95 percent. Your CRM program should include a clear list of indicators that you can track and report. Some ideas include: Unique Number of Patients, Patient Discharges, Downstream Revenue (Financial Impact), Number of New Patients vs. Number of Repeat Patients, Word of Mouth Impact, Patient Satisfaction, Likelihood to Recommend, Employee Satisfaction as well as any ad-hoc ROI (Return On Investment) for specific initiatives, such as loyalty events, the original social networking.

9. Celebrate Success

When somebody does something wrong, tell them. When somebody does something right, tell everybody. The clinical team assists in-patients and families with education, discharge and follow-up care. Additionally, the team serves as clinical liaison with international insurance companies. This care management takes the traditional US care management process one step further, taking into consideration the specific needs of international patients. We also improved the figure of the non-clinical patient coordinator. This is “one call, full service” concept that allows our patients to have only one contact point for everything related to their Hopkins experience. When needed, the navigators are certified medical interpreters who are familiar not only with the linguistic needs of the patient, but also with the cultural nuisances and issues. These navigators act, in fact, as cultural brokers, making sure that all aspects of the experience are culturally competent.

6. Use Technology to Support Processes In our case, the CRM technological solution was not expensive software but rather a fairly simple database that allows us to have the whole picture of a patient’s interaction with our institution. We called our solution UTOPIA, because our employees were so exhausted of having to input the same information over and over again in different databases, that when we offered them the opportunity to have everything in one place, they thought it was too good to be true. This solution allows us to understand each patient as a unique individual; we can track his or her personal preferences, as well as understand the referral pattern, where did they hear about us, and why they did decide to come to Hopkins.

7. Involve the Marketing Department One of the key success factors was to recognize the fact that our best marketing was good service. Therefore, we structured our marketing department under our operational leadership, and we engaged their expertise on how to communicate to create extensive plans on how to

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Pamela Paulk, our VP for Human Resources once told me: “When somebody does something wrong, tell them. When somebody does something right, tell everybody.” Employee recognition can be a great learning and teaching opportunity for all, when we establish through awards, for example, who are the leading employees, those who we, as leaders, believe are the best of the best, those who impresses us, inspires us, those who we want to emulate.

10. Practice Continuous Improvement The key of any great quality intervention is to secure its continuity and momentum. Improvement must be part of your hospital’s DNA. Every time we improve, we must think about what is next, what is the next best thing that we can do for our patients. This is why changing our corporate culture, should be the most important, and maybe is the most difficult aspect of any quality intervention. I hope this article has provided you with some ideas on how to make everlasting changes to the way you coordinate your out-of-town patients. Trust me. It pays. n

About the Author

Emilio M. Williams is Managing Director at Johns Hopkins Medicine International since 2001. In the last 10 years, Williams has led several high-profile, innovative projects within Johns Hopkins Medicine in Baltimore. In this capacity, he lectures and offers consulting services to healthcare organizations around the globe in the areas of strategic marketing, customer loyalty, and cultural competence. As a Director at JHI, Williams was in charge of using traditional and new ways of communication to expand around the globe the mission of Hopkins in patient care, biomedical research and education. (www.jhintl.net) As part of a comprehensive marketing strategy, Williams conceived and launched the first formal Customer Relationship Management (CRM) initiative within Johns Hopkins Medicine, a program aimed at securing the loyalty of Hopkins’ customer base. Additionally, he supervised the communications and marketing efforts of affiliated Hopkins entities around the globe. He might be reached at ewilli24@jhmi.edu

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December 2010/January 2011

Where does excellent healthcare meet exceptional savings?

Mexico City. SOPHISTICATED, COSMOPOLITAN Mexico City is emerging as the healthcare destination of tomorrow. And it’s not just because patients—and their insurers—save up to 40% compared to U.S. healthcare costs. No, it’s also because it’s the home of Latin America’s largest hospital network and most comprehensive selection of diagnostic and treatment services. This international hub of healthcare excellence features state-of-the-art equipment, accredited hospitals, many U.S.-trained specialists, and a level of personalized care rarely found anywhere else.

No wonder the world is looking to Mexico City for healthy outcomes, healthy savings— and the hope of a healthier tomorrow.

WWW.MEXICOCITYEXPERIENCE.COM

December 2010/January 2011

MEDICAL TOURISM

Health Care Reform ~

Think

Medical Tourism By ANNE-LINE CROCHET

The American health care system is mostly employer-based, however 46 million residents remaining uninsured, adding to the fact the U.S is the only industrialized country which does not guarantee access to health care as a right to citizenship. The World Health Organization ranked the U.S 37th in this matter of health-care in 2000. Ten years later, the numbers of uninsured keep growing and a significant number of employers are moving in the direction of shifting health care cost onto workers by increasing co-pays and deductibles. After one year of struggle, the 23rd of March 2010, the Obama administration passed the health care reform bill into law reforming the system that Democrats battled to change for 20 years.

eforming the health care system brought the concept of medical coverage available for all. To do so, employers are now playing a bigger role in providing or encouraging health care coverage for the employees.

For small employers, there are no consequences in not providing health coverage to their employees. In the case that they do so, tax credits will be available up to 35 percent of health insurance premiums starting in 2010.

Starting in 2014, large employers must offer health coverage to every full-time employee under penalty of $166.67 per month and per employee starting at the 31st employee. Plans offered should not include pre-existing condition exclusions and the waiting period should not exceed 90 days.

However, lots of large employers are responding to growing cost pressure by dropping their employeesâ&#x20AC;&#x2122; health insurance coverage. Indeed, paying the penalty fee became cheaper under the health care reform law than paying for coverage.

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December 2010/January 2011

MEDICAL TOURISM What if, employers could provide coverage to their employees and reduce their cost? Alternatives exist and medical tourism is one of them. Traveling abroad to undergo surgery is an ancient, yet becoming an altogether new trend in the corporate world and destinations are numerous: Latin America, Asia, Middle East, offering cheaper first-class surgery.

Medical Tourism, Land of Opportunities Medical tourism remains a new concept for employers and employees. The idea of traveling abroad seems seductive to employees and attractive to employers who are seeking cheaper healthcare. “American Apparel is strongly researching about it,” American Apparel Benefits Manager Jacqueline Madrigal said. “I think lots of employers are going to look outside the box.” Employers all over the country are looking for ways to decrease their employees’ medical expenses providing appropriate health coverage concurrently.

Employees don’t understand how lower care can still be high quality just by traveling but they need information and motivation.

However, the medical tourism concept at first sight can appear hostile to a lot of people. In that way, according to Midwest Group on Health, President and CEO Larry Boress, employers should promote their medical tourism program and educate employees about it. “Employees don’t understand how lower care can still be high quality just by traveling,” Boress said. “But they need information and motivation.”

Medical tourism, when well supported, provides high quality health care at low cost. Applying that concept to the health care reform law issues would benefit the employers and the employees.

According to him, the biggest failures happen when the employees don’t have enough information or trust about medical tourism. That can include peers testimonials or credible sources of information.

Indeed, having any surgical procedure is expensive in the United-States, so why not go abroad and spend, two, three, ten times less money on the same surgery and for the same results as quoted by Medical Tourism Association President Renée-Marie Stephano and CEO Jonathan Edelheit in their book: “Medical Tourism, An International Healthcare Guide For Insurers, Employers and Government.” For example, a heart bypass costs more than $144,000 in the U.S while it costs only $5,200 in India, they write as an example of the cost differential.

Some employers made a start applying medical tourism concepts domestically. Employees are traveling within the U.S seeking cheaper and high quality health care.

“Providers compete on the basis of price – they also compete on the basis of quality, which is why we’re seeing an interest in medical tourism,” Devon Herrick, senior fellow for the National Center for Policy Analysis said. Besides, even though medical tourism is a growing industry, stable basis have been settled. Being a knowledgeable hospital does not happen overnight. International accreditation and ratification systems have to be implemented such as ISQUA or JCI accreditation, making it easier for patients and employers to determine the quality of services in a specific hospital. Local accreditations can be a sign of quality, however, international standards are considered more reliable. In that way, medical tourism offers a low cost high quality alternative to companies and employees. Also, employees choosing to go overseas can receive extra-incentives while the company can significantly decrease its health care expenses. Employees are willing to learn more about medical tourism and its opportunities. “I have employees asking me about it (medical tourism), I received letters and e-mails,” Madrigal said. “They are sending me e-links.”

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Case Study: Lowe’s Companies Few years ago, Lowe’s Companies launched a partnership with Cleveland Clinic in Ohio. Cleveland Clinic is rated number four in Overall Best Hospitals and first place in Heart Care by US World & Report as they provide care at cost well below the national norm. Thus, Lowe’s employees are able to travel for complex surgery. So far, 15 employees have completed surgical procedures here. Lowe’s Companies Senior Vice President Robert Ihrie said: “Employees hope they don’t have to use this option but they are proud to be part of the program.” A first step in medical tourism who can lead the way and show that traveling for medical care can be a safe alternative. n About the Author Anne-Line Crochet is Communications Intern for Medical Tourism Association. With a Masters degree in political science, a Minor in journalism, Anne-Line provides professional expertise to our public relations and editorial functions. Previously a staff writer for French publications Fragil and Ouest-France, she is fluent in English and French; and conversant in Spanish and Russian languages. Anne-Line writes for MTA’s Medical Tourism Magazine and Health Tourism Magazine. She can be reach at AnneLine@ medicaltourismassociation.com

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December 2010/January 2011

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MEDICAL TOURISM

Global

Healthcare and Wellness ~ An Evolving World of Benefits By RENÉE-MARIE STEPHANO and GABRIELLA VICUÑA In a global market environment experiencing exponential growth, corporations with employees all around the globe, corporate executives have the task of researching, evaluating and implementing a Global Healthcare and Wellness Strategy that will cover the lives of their workers wherever they may be situated in the world. IBIS Advisors Co., Discovery Communications, Citigroup and Mary Kay were among the corporations that presented their model International Healthcare & Benefits Plans and Wellness Programs, addressing the compensation and benefits packages their employees receive in an international market.

MULTINATIONAL EMPLOYERS

Mary Kay

Multinational companies comprised of employees working in multiple countries require quality healthcare as local nationals and expatriates. For international employers, finding the right health insurance and receiving high quality of healthcare for their employees is a top priority.

As one of the major direct sellers of skin care and color cosmetics in the world, Mary Kay achieved $2.5 billion in wholesale sales worldwide in 2009. Mary Kay products are sold in over 25 markets and their global sales force exceeds two million. Muna Almualiem, International Benefits Manager for Mary Kay, shared their focus on understanding the driving factors. Separate unit costs and utilization by service, review of benefit design, and comparison of current and prior period results as well as one of market or insurer portfolio results are among the measures in place at Mary Kay within their International Benefits Plans. Interventions based on specific cost drivers are developed, global healthcare trends are constantly monitored and ongoing improvement of the Global Wellness Program offered is a priority.

Citigroup As one of the largest financial services firms in the world, Citigroup is doing business in more than 140 countries with some 200 million customer accounts. Justine Mitsock, Manager of International Benefits for CitiGroup stated, “Citi has almost 260,000 employees worldwide; the goal is to provide a more seamless benefits experience. Employees are included in the decision-making process and may choose when to spend or save their healthcare dollars. Employees and their families are encouraged to take more responsibility for their health.” CitiGroup reduces costs by improving employee health in conjunction with a thoughtful benefits design. In addition, Wellness Plans are also widely supported as a preventative measure of cost control and conducive to better performance and a healthier lifestyle.

Discovery Communications “With distribution in over 170 countries, 715 million cumulative subscribers, 431 million households and content in 35 languages, Discovery’s global reach is extensive, ” said Anthony Amato, Vice President of Compensation & Benefits, Discovery Communications. Currently allocating a Global

December 2010/January 2011

MEDICAL TOURISM Benefits Budget totaling at $42 million, this multinational corporation home to 1,156 Employees in 22 countries offers 16 Retirement Plans in 10 Countries with $230 million in assets, 188 Disability Cases (US), 308 Leave Requests (US) and 63 Global Relocations Annually. Offering over 100 benefit plans has created the need for over 70 vendors and/or providers worldwide. Discovery takes a holistic approach to wellness as well. In the US, Discovery Communications contracted with a provider to operate workplace clinics staffed with physicians and nurses. Discovery estimates it has saved $1 million a year since starting its clinic in 2004. Discovery believes healthy employees are productive employees and stress reduction improves overall health. Accordingly, the company focuses on helping employees juggle their responsibilities of work and home through their programs for employees at home and abroad.

United Health International As the global arm division of UnitedHealth Group, UnitedHealth International is one of the largest and most diverse health care companies in the United States. Headquartered in Minneapolis, Minnesota, UnitedHealth Group is uniquely focused on the health industry, as opposed to other companies that manage a broad portfolio of insurance products. UHI brings UnitedHealth Group’s wealth of experience, skills and tools to the international marketplace, which is seeing a dramatic increase in health care costs, demand and private markets to insure for those costs. UnitedHealth International UHI offers solutions for a wide range of needs for US expatriates, US inpatriates and third country nationals, offering all with the assurance of affordability, quality, usability, and access that is the hallmark of UnitedHealth Group. “Medicine is increasingly and globally recognized as a science, and therefore subject to its laws”, said Ori Karev, Chief Growth Officer, UnitedHealth Global, going on to share the “ABC” drivers for Globalization of Health Care Insurance:

ABC DRIVERS FOR GLOBALIZATION OF HEALTH CARE INSURANCE ATTENTION Mobility Knowledge Familiarity of needs Exposure to quality care Rising individual wealth

BASIS Increasing demands Increasing supply More sophisticated health care delivery systems

CONDITION Risk players Care facilitators Intermediaries Government planning 38

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Also influencing global healthcare, its presentation and delivery are factors such as technological advances, applications and infrastructure.

TECHNOLOGICAL ADVANCES Communication Presentation and Execution of Services Medical Equipment

APPLICATIONS Social Media Avenues Consumer Education/Impression Building Providers Must Assimilate

INFRASTRUCTURE Access to Information Speed of Communication Delivery Mr. Karev added, “Medicine is increasingly and globally recognized as a science, and therefore subject to its laws. Health care delivery and administration is a process, and is therefore manageable. The risk of financing health care across populations is well managed/financed in developed countries; less so in emerging economies. “

Blue Shield of California Cross-Border Healthcare Blue Shield of California is California’s third-largest health plan with 3.5 million members and an annual revenue of $9.7 billion. As a Not-for-profit mutual benefit corporation, Blue Shield donated $125 million over the last four years to the Blue Shield of California Foundation to fund nonprofit organizations which improve access to quality healthcare in California.

Medicine is increasingly and globally recognized as a science, and therefore subject to its laws. Nearly one million people cross the border to Mexico to seek health care in a one- year period, of which half are Mexican immigrants. An estimated 150,000 are insured through private health plans in the U.S and Mexico. The two major gateways into Baja California, Mexico are Tijuana and Mexicali. Blue Shield of California’s Access Baja was implemented in 1999, operating the same way as traditional U.S. health plans. In order to qualify for a Blue Shield Access Baja plan, employees and/or their dependants must reside or work within the service area, which is approximately within 50 miles of the Mexican/ U.S. Border. Rates are lower in Mexico due to the lower healthcare costs as well as cost of living in these areas in comparison with patient home country. Blue Shield Access Baja plan contracts with providers that are certified and meet quality standards and members have the same rights as any other HMO member in California. Jose Loazia, Senior Network Manager for Blue Shield of California offered helpful “Now is the time to seek and embrace

accreditation. Develop and Protect the Brand, as perception is everything!”

GLOBAL BENEFITS PHILOSOPHY In looking at the growing trend towards providing benefit plans, CitiGroup raised a significant understanding about a general Global Benefits Philosophy which stands true in the face of perpetual healthcare reform. At the forefront, it is most important to provide a level of protection to all employees in a fashion which allow the employees to “think like owners, act like owners and be owners.” In effect, it is most important to provide the level of meaningful benefits that employees cause employees to take charge of their healthcare needs and live better lives. Employees should be included in the decision making process to choose when and where they wish to spend their healthcare dollars and therefore encouraging their families to take more responsibility for their health. The 3rd Annual World Medical Tourism & Global Healthcare Congress served as a platform for these industry experts to share their company philosophies, provide insight into their mission and commitment to providing a Global Healthcare and Wellness to their employees and their dependants. Realities, opportunities, and obstacles were presented and left all in attendance with a comprehensible approach from which to build upon in their own way. It is quite clear that Global Healthcare and Wellness will continue to grow as more companies continue to embrace this global environment, employers seek viable options to manage costs and patients invest valuable time in education on their alternatives for healthcare around the world. n

About the Authors: Renee-Marie Stephano is the President of the Medical Tourism Association™ . Ms. Stephano is also the Editor-in-Chief of the Medical Tourism Magazine and Health Tourism Magazine. Having a background in international marketing and relations, health law and litigation, she provides a valuable service to the Medical Tourism Association™ in these fields. Ms. Stephano speaks regularly at international healthcare conferences on the Legal Issues Surrounding Medical Tourism and in the United States to employer groups, insurance groups and physician associations. Renee-Marie consults international government ministries, private sector organizations and NGO’s about the growth of the global healthcare industry and accreditation, providing marketing assistance to promote their countries high quality of care. Ms. Stephano works with governments and healthcare clusters in the development of their Medical Tourism Initiatives. Ms. Stephano recently is the co-author of three books : “Developing an International Patient Center: A Guide to Creating the Best Patient Experience”, the book “The Medical Tourism Facilitator: A Best Practices Guide to Healthcare Facilitation for International Patients” and the book: “Medical Tourism ~ An International Healthcare Guide For Insurers, Employers and Governments” Gabriella Vicuña serves as a Global Program Coordinator for Medical Tourism Association in areas which span events, membership, and publications. As an Associate Editor of the Medical Tourism Magazine and Health Tourism Magazine, Ms. Vicuña also provides editorial leadership for the MTA’s publications. Ms. Vicuña holds a degree in Business Administration and Tourism from the University of Florida. Prior to joining MTA, she was involved in patient services within an academic setting and in the private sector. Ms. Vicuña can be reached at Gaby@medicaltourismassociation.com

Employees are included in the decision-making process and may choose when to spend or save their healthcare dollars.

December 2010/January 2011

Where do world-class facilities meet medical innovation?

Mexico City. MEXICO CITY IS TODAY’S emerging destination for medical tourism and is one of tomorrow’s leaders in medical innovation. It’s earning a reputation for clinical and research excellence and attracting major global investments in facilities such as Campus Biometropolis—a new world-class center for biomedical and nanomedical research that aims to create breakthroughs in cancer, nutrition, geriatrics, cardiovascular and infectious diseases, as well as develop new, life-saving pharmaceuticals. No wonder the world is looking to Mexico City for healthy outcomes, healthy savings— and the hope of a healthier tomorrow.

WWW.MEXICOCITYEXPERIENCE.COM

December 2010/January 2011

MEDICAL TOURISM

Choosing the

Right Hospital ~ Interview with

Armando Polanco By ANNE-LINE CROCHET and VIVIAN HO

n the healthcare industry, broker and third party administrators, intermediaries between buyers and sellers, -- employers and insurance companies – seek to provide the best policy to self-funded employers in terms of employees healthcare insurance plans. Armando Polanco is the Principal Managing Partner for Texas Benefit, an independent insurance and financial service brokerage firm located in San Antonio, Texas. Polanco created Texas Benefit in 1993 and is chiefly responsible for the business

development and marketing aspects. A few years ago Polanco, in observing the healthcare landscape changing at a rattling pace, decided to get involved in the medical tourism industry. “During the spring of 2007 health insurance rates continued to climb at a quicker pace than inflation and there was no end in sight. The country seemed poised for a dramatic change in political parties,” Polanco said. “That’s when I began to study what countries like France, Germany, Great Britain and Canada were doing in order to prepare for their futures.”

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MEDICAL TOURISM After becoming a Medical Tourism Association member, Polanco went on familiarization trips to enhance his education on medical tourism as a whole and build Texas Benefit a network. “Patient migration was evident but only self-insured plans would allow global claims to be paid so a course was set to learn about distant hospitals. Since making that decision to engage in medical tourism, I have been extremely fortunate to have participated in Costa Rica, Jordan, Malaysia, Turkey, Korea, Colombia and Mexico FAM tours with approximately 35 hospitals in total,” he said.

The FAM Tour Review acts as a quick guide to recommend certain locations with specifications sought by the patient. Today, well established in the medical tourism industry, Texas Benefit offers health insurance plans including medical travel options. In addition Polanco created a four page FAM Tour Review questionnaire guide aimed at compiling information on different hospitals visited, that may be eligible as a medical tourism service provider. The guide is largely meant as an evaluation tool for both treating facilities and touring members to help buyers and sellers interpret the offer. “The FAM Tour Review may be completely adopted, amended or not even used,” Polanco said. He added that the advantage of the FAM Tour Review is that it’s a compilation of information accessible and understandable to everyone. Because each hospital has its own assets and approach medical tourism differently, Polanco tried to establish basic evaluation criteria. “All hospitals from varying countries will be best suited for patient populations with specific attributes and characteristics of patients,” Polanco said. “Often times ethnicity, proximity of region, tourism appeal and business influence will play a role in the decision making process along with other normal measures such as cost savings, success rates and service capacity.” According to him, the evaluation is extremely important in order to keep some level of uniformity and consistency commensurate with standards that are global and world class. The FAM Tour Review is divided into four categories: Transnational Hospital and Clinics Review, Clinical Confidence Review and International Department Service, and Tourism Value Review. The two first sections being addressed focus on the visiting hospitals and the last section is primarily from the tour guide perspective. Transnational Hospital Review section provides information about the type of accreditation the hospital owns, the academic medical centers, the expectations the international patients can have in terms of protocol and languages speaking, and chances of continuity of care. The Clinical Confidence Review section seeks outstanding values such as telemedicine or for numbers: Mortality rate, complication rate, surgical site infection rate and hospital acquired infection rate of:

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• Heart by-pass • Hip replacement • Hip resurfacing • Knee replacement The section dealing with the international department services focuses on the ancillary services incorporate and provided for by the hospitals. That can include: Airport pickup, wireless in the hospital or even facilities for the companion traveller. This section also provides information relevant to the decision makers such as primary care physicians and emergency contacts in the home country. The Tourism Value Review category deals with the chances an American can adapt to the country easily inclusive of food services and cuisine that they are normally accustomed to, types and range of accommodations available, modes of transportation or safety issues and areas of caution for travellers as a whole. “The FAM Tour Review acts as a quick guide to recommend certain locations with specifications sought by the patient,” Polanco said. “I only wish I had developed this guide from my first hospital visit during the first FAM tour I was involved in. However, I am reaching out to all of the hospitals I had previously visited for updates.” n

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December 2010/January 2011

For a free advertising kit call: 305•600•5763 Or email: info@medicaltourism.com

Where does specialized medical expertise meet personalized care?

Mexico City.

IT’S NOT JUST THE WEATHER that’s warm in Mexico City— it’s the way we welcome visitors. And when it comes to healthcare, that means you’ll find the most attentive, personalized patient care combined with an enviable range of specialized expertise. Whether it is in cancer treatment or heart surgery; fertility treatments or eye surgery; orthopedics or cosmetic surgery, the nationally and internationallyaccredited hospitals, universities, laboratories and diagnostic centers here combine to deliver the best in contemporary healthcare—at a better price than you ever imagined. No wonder the world is looking to Mexico City for healthy outcomes, healthy savings— and the hope of a healthier tomorrow.

WWW.MEXICOCITYEXPERIENCE.COM

December 2010/January 2011

MEDICAL TOURISM

Baby Boomers ~ Unprecedented Global Issue By VIVIAN HO and CAYLA LAMBIER At this year’s World Medical Tourism and Global Health Congress, keynote speaker Dr. Jeanette Takamura, Dean of the School of Social Work at Columbia University, cast Baby Boomers in a global light while discussing what role medical tourism might play as the world’s population of Baby Boomers begins to hit the age of 60.

echnically speaking, a Baby Boomer is anyone born within the year span of 1946 to 1964. Generally speaking, they are our parents, our teachers, our CEOs and our politicians. Doctors, bus drivers, novelists or celebrities – there is not one demographic, occupation or personality type that does not include at least one, if not several dozen, Baby Boomer by definition. “What makes the baby boomers so interesting is that there are 76 million of them,” Columbia University Dean of the School of Social Work Dr. Takamura said, “and the fact is, they all are different.” According to her, being healthy means something entirely different to each and every individual within the Boomer generation and their healthcare needs will never be met as a whole. Each person is different, each segment of this generation adheres to different concepts and each social class has different needs. Consequently, products cannot be delivered in a one-size fits all for this eighteen year-span generation. “Those who are born in 1946 knew well the music of Mick Jagger, and those who were younger, really don’t consider Mick Jagger their musician.”

The aging process for Baby Boomers will be unlike any other generation before them, according to Dr. Takamura, largely due to rapid globalization, medical advancements, healthcare reformation and the unfortunate presence of degenerative diseases like Alzheimer’s and cancer. And in general, the top five factors affecting all generations where the aging process is concerned include chronic disease, prevention, education, mental health and physical activity.

As we see a more rapidly aging population, we will also see more cancer and more healthcare costs coming heavily out of pocket. “Over time we will see aging enriched by multicultural perspectives,” Dr. Takamura said. “As we see a more rapidly aging population, we will also see more cancer and more healthcare costs coming heavily out of pocket.” In the case of medical tourism, costs associated with this phenomenon will be mostly out-of-pocket. Not just for those who want surgical

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MEDICAL TOURISM procedures for improvement, such as cosmetic surgeries, but also for those who are born with deformities, who are able to travel to countries that can assist them. Truly understanding the implications of globalization as the force majeure’s impact on our world is a long path but health tourism, in terms of medical travel, may be a good option for Baby Boomers. While the 21st century will be primarily considered the century of the developing world, Dr. Takamura espoused a number of key concerns over global aging as a whole. More people are living longer, which is often a sign of high quality of care within a country, therefore being older in larger numbers over a longer period of time is another matter. Approximately two billion persons will be 60 years of age or more by the year 2050. Retirement pensions are shrinking while the full retirement age and the healthcare costs are increasing. Today, governments from all over the world are looking at the Baby Boomer generation with pride, apprehension and perplexity. Pride as long life represents a form of national achievement, apprehension as to the implications for a nation, and perplexity as to how to solve this universal trend.

research universities and teaching universities as well, there is value to be gained from examining evidence based information. Because, to thrive in any industry, as in the case of healthcare services, working hand in hand with partners to understand clients’ needs is essential to fully satisfy any target market; boomers or otherwise. In terms of representing the needs of boomers and the aging population within the hospitality industry; cruise ships are currently doing a better job than airlines today and some hotel chains with a focused eye on their respective target markets are skyrocketing to the top within their industry in terms of quality of services. With respect to senior living communities, in the U.S. or abroad, the more home-like the environment and surroundings, the better this is in attracting and retaining this market segment. “Those nations with medical tourism professionals who understand the distinctive interests, needs and capabilities of older travelers will be rewarded with their enthusiasm and loyalty,” Dr. Takamura said. n

About the Authors

According to Dr. Takamura, we may tend to think of aging as one broad phenomenon. However, for example, one aspect of aging we do not often pay attention to is the gendered nature of old age and aging. “We ought to remember that women tend to out-survive men, and that about 55% of elderly people globally are women.” From the perspective of a work environment, it is not an advantage for women to look older in the work place, like it can be for men. This unfortunate dynamic which is part of an aging trend, that of living longer and working longer into the sunset years, though, is beginning to creep across gender lines and we are seeing a great number more of older men elect cosmetic surgery procedures as well.

Cayla Lambier is a recent graduate of Washington State University and possesses Bachelors degrees in both Communication, with an emphasis on journalism, and English. She considers herself to be an incredibly versatile writer, with several years of professional experience ranging from reporting and magazine editing, to public relations and technical writing. Cayla is currently engaged as an editorial intern with the Seattle branch of Where Magazine and as a freelance staff writer for Medical Tourism Magazine.

“As we see transformative changes occurring globally, this demographic reality – the longevity revolution that has been emerging over the last several decades will have profound implications for the medical tourism industry,” Dr. Takamura said.

Vivian Ho is President of AGHP, a 501c3 that works on global health philanthropy ventures. She also serves as Managing Director, Asia Pacific for MTA, and CoEditor of MTA’s health tourism e-magazine. Prior to this, Vivian was President & CEO of Queens International in Honolulu, Hawaii building Hawaii’s medical travel & health tourism initiative. She currently advises on country, sector and organization initiatives in Medical & Health Tourism. She may be reached at Vivian@MedicalTourismAssociation.com.

In terms of looking at ageing and potential medical tourism opportunities, according to Dr. Takamura, it is important to gather evidence based information as to what the elderly want. More and more people in a variety of industries will need to work ever more closely with scholars and researchers who are doing groundbreaking research in universities. In both

What makes the baby boomers so interesting is that there are 76 million of them, and the fact is, they all are different.

December 2010/January 2011

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December 2010/January 2011

MEDICAL TOURISM

Sustainable Hospitals~ Consider Going Green? By ANNE-LINE CROCHET

“Going green” are two words politicians, media and activists around the world are heard articulating on a daily basis. However, sustainability is not a new emerging trend but a philosophy, that has been present for over 20 years. In 1987, the United-Nations was defining sustainable development as meeting the needs of the present without compromising the ability of future generations to meet their own needs. Nowadays in the healthcare industry, landscaped green hospitals are flourishing offering patients a better, and cleaner healthcare environment.

hospitals’ energy use is considerable. In terms of numbers, the U.S. healthcare sector’s total carbon footprint is approximately 546 million metric tons of CO2, exceeding by far any other country’s comparative carbon footprint. According to the U.S Department of Energy, just 20 percent reduction in this carbon footprint can save billions of dollars.

GOING GREEN

“The healthcare industry is by far one of the more important sectors that can benefit from the practice of green building design and construction,” said U.S. Green Building Council President, CEO and Founding Chair, Rick Fedrizzi.

Green hospitals buildings are conceptualized to interact with natural elements and designed by specialized architects focusing on natural lights, open space and the use of organic materials.

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Becoming a sustainable hospital involves many aspects such as green building design, energy efficiency plans, alternative energy generation, transportation, food and management of waste and water according to Syria’s Managing Director Health Insurance, Ministry of Health, Hisham Diwani.

Assistant Professor and Chief Communications Officer at University Medical Center Hamburg-Eppendorf in Hamburg, Germany, Mathias Goyen articulated that “the comfort and warm colors used in a hospital setting directly impacts the creation of a non hospital atmosphere.” The use of energy represents a huge share and percentage in the implementation of a green hospital program. To regulate energy usage, the focus in generally based on the regulation of CO2 and mercury. Doing so, green hospitals are mainly establishing an energy management system that re-evaluates the energy waste to adapt to the hospital’s needs. That can go from using led lamps, powering down the computers to re-dimensioning tubes, pumps and valves for consumption oriented heating, which is what the University Medical Center Hamburg Eppendorf does. “Adjusting PC monitor settings to automatically power down activity will maximize the energy used during the product lifetime to then recycle it,” Goyen said. On the issue of transportation, this is also an important variant when it comes to greening. There’s no doubt in Europe that the use of public transportation or encouragement of biking as a mode of transport is easier than in the U.S or in the Middle East. However, hospital vehicles can also use alternative energy such as electricity or hydrogen. Healthy food for patients and staff in addition to consumption of local, organic and sustainable food is expected in a green hospital according to Diwani.

Many green healthcare programs stall because organizations reach for a large, expensive initiative before they are culturally ready. Management of water resources and the management of waste can be illustrated by recycling, reusing, conserving and composting programs.

PATIENTS, STAFF AND LOCAL POPULATIONS “Patients in green hospitals have greater emotional wellbeing, require less pain medications and other drugs and have shorter hospital stays,” Fedrizzi as noted in the California for Green solutions website said. The medical staff is then also working in a healthier environment on a daily basis. Usually exposed to stress, long working hours and diseases, working in a green building reduces absenteeism and increases productivity, according to a 2009 University of San Diego and CB Richard Ellis study. Moreover, by buying local products such as food, hospital and building materials to decrease CO2 emissions from transportation services; green hospitals privileged national market and local suppliers.

STANDARDS AND CERTIFICATION The U.S Green Building Council’s website stated that the Leadership in Energy and Environmental Design rating system is a voluntary, consensus-based standard used to support and certify successful green building design, construction and operations. LEED provides a nationally recognized certification

system to promote integrated, whole-building design practices in the building industry. According to their commitment to going green, hospitals can reach different levels of certification - platinum, silver and gold. Only four hospitals have attained the gold level so far.

SUSTAINABILITY AROUND THE GLOBE University Medical Center Hamburg-Eppendorf, Hamburg, Germany University Medical Center Hamburg-Eppendorf works on hospital eco-footprint by providing an eco-friendly and sustainable environment to patients and staff. Among others, University Medical Center Hamburg-Eppendorf does not use air conditioning but installs large windows in a patients’ room which can be opened widely if desired. The hospital also has been awarded the 2009 Caterer of the Year award. On alternative energy uses, Medical Center Hamburg-Eppendorf is emission free inside and outside. The Medical Center uses H2 energy storage and electric motors for the property according to Goyen.

King Faisal Specialist Hospital, Jeddah, Saudi Arabia This public government funded hospital, King Faisial Specialist Hospital, situated in a desert climate is focusing mainly on water and air resources. “All waste water is being recycled and used in the chilled water plant,” RTLK Vice President Stanly Chiu said. “All air handlers have high performance sand filters which are combined with energy recovery.”

Baptist Health South Florida The largest non-for-profit organization in the region, Baptist Health South Florida considers itself committed to green with respect to LEED’s criteria. Controlling waste, repurposing and recycling also are a few key components Baptist Health South Florida has implemented according to Assistant Vice President, Eric Wenke of Baptist Health South Florida

December 2010/January 2011

MEDICAL TOURISM Hospital Clinica Biblica, Costa-Rica “Clinica Biblica is pioneering sustainable health care in Costa-Rica,” Hospital Clinica Biblica Assistant Director Alekcey Murillo-Alfaro said. By offering a range of sustainable services Clinica Biblica received the LEED certification. Clinica Biblica uses power-saving technology, compostable utensils, integrated water management and responsible water disposal. Also, carbon mitigation has been initiated.

COST CONSIDERATIONS AND PROJECTIONS Being sustainable is not a matter of cost according to NHS Sustainable Unit Operational Director, Sonia Roschnik. “It’s not a question of whether a hospital can afford to be more environmentally responsible, but whether it can afford not to be environmentally responsible,” she said. “For example, reducing drugs wastage could save the NHS £89 Million ($137,337,000) a year.” According to Kahn, who is Chief Strategy Officer of Clift Montague, sustainable investments cost money but in the long term it will cost even more not being sustainable.

It’s not a question of whether a hospital can afford to be more environmentally responsible, but whether it can afford not to be environmentally responsible. Moreover, green buildings can improve returns on investment by six to seven percent according to the Bulding Owners and Managers Association. “Many green healthcare programs stall because organizations reach for a large, expensive initiative before they are culturally ready,” Wenke said. “Often they would be better off starting with smaller initiatives to show immediate results and build on success.” Going green, are two words which can provide benefits to medical staff, patients and the environment. Currently, on the healthcare landscape, being a sustainable hospital improves your hospital’s image, reputation and wallet as well. n

About the Author Anne-Line Crochet is Communications Intern for Medical Tourism Association. With a Masters degree in political science, a Minor in journalism, Anne-Line provides professional expertise to our public relations and editorial functions. Previously a staff writer for French publications Fragil and Ouest-France, she is fluent in English and French; and conversant in Spanish and Russian languages. Anne-Line writes for MTA’s Medical Tourism Magazine and Health Tourism Magazine. She can be reach at AnneLine@ medicaltourismassociation.com

December 2010/January 2011

ÂŠ Copyright Medical Tourism Association

December 2010/January 2011

Congress 2010

World Medical Tourism and Global Health

SNAPSHOTS

Dr. Ali Al Sanousi - Consultant Medical Informatics, King Faisal Specialist Hospital & Research Centre

Bhavdeep Singh, CEO, Fortis Healthcare Limited

Renée-Marie Stephano and His Excellency Qadhi Saeed Al Murooshid, Director General of the Dubai Health Authority (DHA) signing Memorandum of Understanding (MOU)

Tony Elzoghbi ~ Dubai Health Authority Director – Audit Networking at Dubai Booth, Laila Al Jassmi - CEO Health Policy and Strategy Sector, Dubai Health Authority, Brittany Rustman and Jerad Bachar Dubai Convention Bureau

December 2010/January 2011

Jerad Bachar ~ Dubai Convention Bureau Director, Tony Elzoghbi ~ Dubai Health Authority Director - Audit, His Excellency Qadhi Saeed Al Murooshid ~ Director General of the Dubai Health Authority, Renée-Marie Stephano ~ President of the MTA, Laila Al Jassmi ~ CEO Health Policy and Strategy Sector

Brittany Rustman, Dubai Convention Bureau Networking

You can’t appreciate the length of the Me and bread dical Tour th ism Indus get all tho tr y until you se folks in a to their sh ared expe room and listen riences. T Medical T he World ourism an d Global H Congress e althcare wa bringing to s the perfect foru m g all over th ether stakeholder for s from e world to ground on help find co s an absolu hared health resou mmon te must fo rces. It is r any med looking fo ica r global r each for th l provider eir servic es. - Michael Be Carlos Beer ~ PROCOMER Costa Rica Networking

Amelia Fernandez, Bill Cook, Brad Cook, Jonathan Edelheit, Gabriella Vicuña, Michael Quiros, Sarah Hunt

Senior He rtaut althcare In telligence Blue Cros An s and Blue Shield of L alyst ouisiana

Pamela Frank Int’l Health Services Director Children’s Hospital Boston

December 2010/January 2011

Mário Augusto Lopes Moysés Vice-Minister of Tourism Brazil

Fred Hagigi ~ Director, Executive Education Programs Professor of Health Services ~ UCLA School of Public Health

are ople that e p f o m o o . This is a r the future looking to f Strategy

er, Chie rvices Fickensch for Dell Se - Dr. Kevin r e c ffi O t n pme and Develo

Dr. Jeanette Takamura - Dean of School of Social Work, Columbia University

Dr. AnupamSibal ~ Apollo Hospital

December 2010/January 2011

Stuart Barton ~ President, American Seniors Association speaking, Dr. Jeanette Takamura - Dean of School of Social Work, Columbia University, moderating

September Secrist ~US Department of Commerce

Dr. Guillermo Gonzalez-Prieto SubSecretary ~ National Ministry of Health of Argentina MTA Strategic Development Executive

The World Medical Healthcar e Congres Tourism and Globa s provided l to explore the oppor many new tu nity programs clients cu to help m t benefit c y employee osts and o s more ch ffer their oices in g healthcar etting the e possible best . Without I would ha th e ve missed this valua VIP Program, I made m ble oppor any, many tunit gre so much. I can’t wa at contacts and lea y. it to com rned - Stephan ie R. Manle e back next year! y, RHU, C Sen ior Associa te

~ Mercer

PIW

Dr. Abdallah Al-Bashir ~ Chairman of the Board of Directors for Jordan Hospital

Dr. Andrés Aguirre ~ General Director of Pablo Tobón Uribe Hospital in Medellín Colombia and Julia Lima ~ International Advisor for Department of Tourism for Porto Alegre City Council Brazil

Dr. Prem Jagyasi ~ MD & CEO of ExHealth

December 2010/January 2011

Domestic Medical Tourism Panel: Bob Ihrie ~ Sr. VP of Employee Benefits of Lowe’s Companies Inc.; Michael C. McMillan ~ Executive Director of Market & Network Services of Cleveland Clinic; and Dr. Alejandro Badia ~ CEO & Founder of Int’l Orthopedic Group, Badia Hand to Shoulder Center in Florida

Laila Al Jassmi ~ CEO Health Policy and Strategy Sector of Dubai Health Authority UAE

at is a field th are m is r u to l lthc Medica lobal hea g s e it n u y nd I don’t essentiall ue way, a iq n u y r e mated. in a v underesti e b to ’s it think – Partners elt rick Van P ational - Dr. Frede ical Intern d e M rd a v Har

Michael Hess - Managing Principal, Health Practice Leader, Perkins+Will, Chicago, USA Kristina Zanic - Founder & Executive Director, DWP, Interior Design, Bahrain Curtis J. Schroeder - Former Group CEO, Bumrungrad International, Bangkok, Thailand

Dr. Frederick van Pelt Director, Global Programs Partners Harvard Medical International

December 2010/January 2011

Employer Panel: Missy Jarott ~ Director of Human Resources of Chatham Steel Corp.; Jack Norton ~ Human Resources Manager of Blue Lake Casino; and Tom O’Hara ~ President, Surgical Trip, LLC

Dr. Hee-Won Jung CEO of Korea International Medical Association (KIMA)

His Excellency Qadhi Saeed Al Murooshid, Director General of the Dubai Health Authority (DHA)

It’s my fir st particip a I like the internatio tion to this congres n s; a l pe people fro m all over rspective: meeting the world fruitful. O , it’s very rganizatio ns like MT importan A are very t; the con gress is a reaching b s o lutely my expec - Mathias tations. Goyen Ass istant Co

Jonathan Edelheit ~ CEO of the Medical Tourism Association, His Excellency Qadhi Saeed Al Murooshid, Director General of the Dubai Health Authority (DHA), Laila Al Jassmi - CEO Health Policy and Strategy Sector, Dubai Health Authority and Tony Elzoghbi ~ Dubai Health Authority Director – Audit

Dr. Arthur Diskin - VP and Chief Medical Officer, Royal Caribbean and Dr. Mohammed Saeme - International Expert on Maritime Health and Wellness

mmunicati Professor ons Office Center Ha r at Univer and Chief mburg-Ep sity Medic pendorf in al Hamburg, Germany

Dr. Casey Chosewood ~ Center for Disease Control

December 2010/January 2011

www.MedicalTourismCity.com

A New Social Network Has Been Launched!

Join “The City” Today and Begin Networking on a Global Scale >> Medical Tourism City helps facilitate an open forum and communication amongst those professionals involved in medical tourism and global healthcare and to facilitate business networking. >> The social network has reached over 1300 members from over 75 different countries since it started. >> Users range from insurance companies, health insurance agents, medical tourism facilitators, hospitals, doctors, governments, consultants and more. 58

December 2010/January 2011

www.MedicalTourismCity.com

MEDICAL TOURISM

E-Health and

Telemedicine ~ A Matter of Buying Solutions By VIVAN HO

From computers to RFID chips, technology is part of our daily lives. In the healthcare arena also, e-health and telemedicine practices are raising offering to patients and hospitals a new relationship and state-of-the-art medical services. Dr. Dennis J. Streveler, HMIS Consultant from The World Bank provided a virtual presentation to a select group of healthcare cluster participants in presenting his views on technology in healthcare.

onnecting in from Algeria, Dr. Streveler shared that e-health along with telemedicine are truly large domains. According to him, through his experiences working with developing countries, the application of e-health and telemedicine can be diverse according to the environment they are use in. E-health is an extension to the internet of existing core business processes in healthcare. E-health simplifies the exchange of information and services for health consumers such as citizenry, patients or even participating providers. However, e-heath can only work if providers, insurance or buyers are taking the time to upload and update their information on internet. “A good example of this type of structure is eligibility checking for insurance,” Streveler said. “We can check by

Internet if we are, or not, eligible for insurance. However, if the database containing the eligibility information is not accurate, then not much will be accomplished. Also, e-health is enabling and allowing secure email between patients and their providers. This has proven to have an enormous impact in improving quality especially for chronic disease situations. A Kaiser Permanente study

Those avoiding jumping on the bandwagon will surely be pushed aside in the globally competitive market. December 2010/January 2011

MEDICAL TOURISM discovered that email alone had as much impact as the billions of dollars spent to date on Electronic Medical Records. Another e-health capability typically explored into by many hospital providers is telemedicine. In terms of telemedicine capabilities the answer and solutions are not so simple. Depending on coordinating time zones, real-time applications can take place, but, have an expensive cost. Indeed, the providers’ schedules tend to require large telecommunications networks which translates into significant expenses. Nonetheless, there currently exist some simple off-line methods. For teleradiology it’s all about improving the coverage area of scarce well-trained radiologists, telecardiology easily enables the suitability for surgery process for patients, and teledermatology permits to take a quick look at nasty lesions. In the medical tourism arena, e-health applications are an advantage in terms of pre and post surgery, patients will feel more confident about their medical travel and host hospital. Dr. Streveler qualified e-health as crucial for the medical tourism industry. “It serves as a glue for the patient referral process, and later, as part of the follow up process,” he said. However, according to Streveler, the modalities chosen will depend on the nature of the referral network, the nature of the procedures performed at the medical tourism site and the means used to market its services.

THE PATIENTS’ EXPECTATIONS Nowadays, patients have come to expect technology to be everywhere. From a hospital provider perspective, competitors are using state-of-the art and advanced technology to their market advantages. “Those avoiding jumping on the bandwagon will surely be pushed aside in the globally competitive market” Streveler said. However, one must keep in mind it is not an inexpensive investment to make. Therefore, done properly would require strategic input in terms of what an institution is trying to accomplish; ways to measure its success based on objectives determined in advance; and a keen eye on finding the right modalities that are bought or built-in house to meet the hospital provider and/or organization’s needs.

Telemedicine serves as a glue for the patient referral process, and later, as part of the follow up process. Finally, Dr. Streveler stressed that integration is the key and makes the difference between effective technological capabilities and ‘toys’. E-Health applications must be considered as part of the biggest health informatics initiatives of any particular institution. Rather than considered and applied within a microcosm, they are best served if the platforms wrap around all of the other systems initiatives. Undoubtedly, this giant puzzle is a challenge; even for the most tech-savvy of worldclass institutions. “In effect, keeping one’s eye clearly on the objective and not being swayed by gadgetry of the day, fads and other distractions should serve a hospital, clinic or country in good stead,” Streveler said. “The key is that one is buying solutions, not buying technology.” Some of the distinguished delegates from countries that are all engaged in various stages of healthcare cluster development

December 2010/January 2011

included: Dr. Awni Al-Bashir ~ Chairman ~ Jordan Private Hospitals Association, Dr. Abdalla Al Bashir ~ Chairman Board of Directors ~ Jordan Hospital, Caroline Haddad ~ Medical Services Sector Lead ~ USAID Jordan, Laila Al Jassmi and Tony El Zoghbi of Dubai Health Authority UAE, Dr. Mukitani and members of Japan’s Ministry of Health, Labour and Welfare; Ministry of Global Health; Massimo Manzi ~ Executive Director at Council for International Promotion of Costa Rica Medicine - PROMED ~ Costa Rica, Nixia Lasso ~ Marketing Executive and Product Development~ Authority of Tourism Panama, Julia Lima ~ Director of Public Relations ~ Porto Alegre Healthcare Cluster Brazil, David Morgan of OCED, James Bae and Dr. Do Hyun Cho of KHIDI, Seoul – Korea. This group also heard from David Morgan of OECD, who commented that there is a growing importance of medical tourism in terms of overall trade and services between countries. Understanding the extent of this bilateral, multilateral trade is of importance to many agencies. Currently, OECD is championing the lead in evaluating ministerial guidelines as one project in medical tourism. Dr. Jeanette Takamura, also provided a short summary overview of the keynote speech during WMT&GHC. Drs. Streveler, Takamura and Morgan provided an opportunity for Q&As; while delegates discussed their respective clusters amongst each other. n About the author Vivian Ho is President of AGHP, a 501c3 that works on global health philanthropy ventures. She also serves as Managing Director, Asia Pacific for MTA, and Co-Editor of MTA’s health tourism e-magazine. Prior to this, Vivian was President & CEO of Queens International in Honolulu, Hawaii building Hawaii’s medical travel & health tourism initiative. She currently advises on country, sector and organization initiatives in Medical & Health Tourism. She may be reached at Vivian@MedicalTourismAssociation.com.

ÂŠ Copyright Medical Tourism Association

December 2010/January 2011

MEDICAL TOURISM

Smooth Sailing ~ Cruise Lines and Medical Tourism, a Budding Relationship

By CAYLA LAMBIER Cruise ships, such as those from popular cruise lines like Royal Caribbean and Carnival, are designed from hull to mizzenmast to provide complete luxury and comfort for every passenger who steps foot on deck. As established travel venues, cruise lines are immensely successful, with reliable track records of safety and satisfaction that appeal to potential travelers, which is why cruise lines were such a hot topic at this year’s World Medical Tourism and Global Health Congress.

he subject of incorporating on-board medical treatments into cruises was brought up and thoroughly discussed by two prominent figures in the industry: Dr. Arthur Diskin, Vice President and Global CMO of Royal Caribbean, and Dr. Mohammed Saeme, International Expert on Maritime Health and Wellness. Both speakers gave very frank presentations on the topic, in which they discussed both the opportunities and limitations of medical tourism at sea. “The cruise industry is a special part of the travel industry,” explained Dr. Saeme. “The main purpose of a cruise ship is leisure and vacation – the medical services we currently have are primarily for emergencies.”

December 2010/January 2011

Most cruise ships are currently equipped to handle medical emergencies that may occur at sea, while onboard medical staff direct their efforts at the stabilization of injured or ill passengers, Dr. Saeme said. Incorporating medical tourism into cruise lines would not be overwhelmingly difficult – with almost entire decks already allocated for the purposes of emergency care and spas, outfitting a cruise ship with additional resources for procedures commonly undergone by medical tourists could just be the next logical step. “Many of the cruise lines already subcontract with vendors who provide minor aesthetic procedures on board,” Dr.

Diskin said. “The applicability of performing more complex procedures on board has been proposed at a theoretical level.” Already available on most cruise lines are many cosmetic and wellness treatments, such as botox, therapeutic massage, acupuncture and dermatological procedures. All of today’s cruise ships have a “spa for relaxation and pampering,” though a few have started to venture further than “basic beauty treatments,” Dr. Saeme said. Dr. Diskin cited Royal Caribbean Cruise Lines as an example, pointing out that the cruise line conducts 34 remote dermatological consultations each month, and utilizes the most current telehealth technologies, including digital x-rays and electronic medical records. Royal Caribbean has also proved itself capable of conducting more complex procedures while traversing the oceans through its relationship with Dialysis at Sea. “I do foresee [Dialysis at Sea] going worldwide,” Dr. Diskin said. “It allows us to take dialysis patients who wouldn’t be able to cruise otherwise.” As various cruise line corporations begin to test the waters of medical tourism, experienced industry players like Dr. Diskin and Dr. Saeme are weighing the pros and cons.

environment in which to conduct lengthy or dangerous operations. In addition to these limitations, both speakers emphasized that incorporating medical tourism into the cruise industry is a work-in-progress. “This will take great cooperation between the cruise lines to build a network between medical providers and hospitals,” Dr. Saeme said. “In my opinion, we need some work before we really target this market.”

Already available on most cruise lines are many cosmetic and wellness treatments, such as botox, therapeutic massage, acupuncture and dermatological procedures. Dr. Diskin stressed the importance of seeking out medical professionals as partners in any cruise-based medical ventures, so that each party is able to focus on doing what they do best: “We’re not in the medical business, we’re in the tourism and travel business.”

On the positive side, for one, cruise ships operate under international maritime regulations. “The advantage of international regulations is they allow us to hire capable people from all nations,” Dr. Saeme said, giving cruise lines their pick of the globe’s best medical personnel. This also opens up many treatment options for traveling patients seeking procedures unavailable in their own country.

Though there is much work to be done, the opportunities are appealing. There is already evident success for simpler outpatient procedures, and even if receiving a quadruple bypass at sea never becomes a viable option, recovering from one in the luxurious atmosphere of a beautiful cruise ship likely will be. n

Dr. Diskin elaborated on the recuperative opportunities that cruises offer medical travelers, explaining that a patient who travels to Costa Rica for an operation can board a cruise ship for a very calm, pampered ride home.

About the Author Cayla Lambier is a recent graduate of Washington State University and possesses Bachelors degrees in both Communication, with an emphasis on journalism, and English. She considers herself to be an incredibly versatile writer, with several years of professional experience ranging from reporting and magazine editing, to public relations and technical writing. Cayla is currently engaged as an editorial intern with the Seattle branch of Where Magazine and as a freelance staff writer for Medical Tourism Magazine.

“Cruise lines are a definite potential provider of services of the rehabilitation component,” he said. “Patients can travel home safely and comfortably in an environment catered to meet their post-operative needs.” However, there are certain aspects of the cruise experience which are not exactly conducive to complex surgeries. Unpredictable weather, limited space and distance from mainland medical centers all make for a less than ideal

As various cruise line corporations begin to test the waters of medical tourism, experienced industry players like Dr. Diskin and Dr. Saeme are weighing the pros and cons.

December 2010/January 2011

50 million americans need your healthcare services.

the healthcare crisis in the u.s. presents opportunities to those ready to offer solutions through medical tourism. our services include: • Consulting - Governments, Hospitals, Clinics and Medical Tourism Companies • Media/Public Relations - Communications plans targeting specific audiences and markets • Marketing Assistance - Brand building services that speak to your target markets • Marketing Workshops - Customized assistance for specific market penetration goals

To find out how OneWorld Global Healthcare Solutions can benefit your organization, please call 248-250-3221 or visit www.OneWorldGlobalHealthcareSolutions.com. © Copyright Medical Tourism Association 64 December 2010/January 2011

MEDICAL TOURISM

Hospitality~

Creating Alliances and

Developing Services

By ANNE LINE CROCHET, VIVIAN HO and CAYLA LAMBIER An increasing number of destinations in countries throughout all regions of the world are tourism hot-spots for adventure, eco-travel, edu-tourism, leisure travel and medical tourism, in the health and wellness travel niche. As with any other service industry, growth in a region’s or specific country’s tourism trends directly impacts their hospitality sector’s development. Where growth is present, the hospitality sector expands and jobs are created, more services are provided and a larger volume of export dollars are earned and received by a country.

oday, inbound tourism is a major international trade category. It ranks fourth worldwide as an export category, behind fuels, chemicals and automobile products, and is the main source for foreign exchange income. These dynamics apply equally in the medical tourism sector as more and more countries develop a thriving healthcare cluster to cater to potential patients, medical travelers, and wellness seekers. In any country looking to fully develop a medical tourism market, travel and hospitality service providers must be part of a formulated development plan. From travel agencies handling inbound and outbound flights and local on the

ground transport, to hotel stays before and after procedures and companion tourist attraction services, the need to pair up service providers into a ‘seamless continuum’ is becoming crucial and integral to a country’s development of a growing medical tourism niche market. To the degree that this is done well, a destination’s earned reputation and credibility as a healthcare cluster hub is directly impacted. Some travel agencies, airlines and hotels have already taken the lead, partnering with hospitals in order to get a share of the medical tourism pie. This trend will only continue to grow because, in essence, medical tourism is a bridge between two worlds and a link between two industries: that of health care and

December 2010/January 2011

MEDICAL TOURISM hospitality. Common sense dictates that more integration and merging can only increase and improve efficiencies, financial and otherwise; inter-dependence is the theme ‘du jour’. “We should be married but separated,” Executive Vice President of Well-Being Travel Anne-Marie Moebes said. “What we do well is travel, it may not be as complicated as the medical industry but it is a complicated business.” According to Moebes, patients need face-to-face contacts but Well-Being Travel does not want its agents involved in the medical side.

…in essence, medical tourism is a bridge between two worlds and a link between two industries: that of healthcare and hospitality. “Finally, the time is right for the medical and travel industries to work together to provide consumers with a consulting service that expertly manages all of their medical travel needs around the world from one source. Currently a $20 billion market, studies have predicted that medical tourism could reach $100 billion by 2012. The market opportunity is tremendous, and now is the time to tap this trend.” said Moebes, in a recent press release. “In that way we partnered with Companion Global,” she said. “We believe strongly that we need to partner with medical specialists and we will stay on the travel side of this business.” Moebes suggests that the medical industry can act as a distribution side since they already have established relationships and credibility with the travelers, or potential patients. It would take place as an exchange of services between the two industries, rather than as a fusion. “The database that the travel industry owns will turn on the medical tourism industry because the travel industry knows how to market,” She said. Therefore, the medical tourism industry could benefit from the travel industry’s marketing skills while the travel industry would extend its market offerings for medical travel services. In Turkey, travel agencies target medical tourism clients, offering a range of diverse services: accommodations, transfers, translation services, tours and sightseeing packages before or after treatment. Travel agencies are also organizing

familiarization trips for facilitators, press and media members to promote the destination, according to Emin Cakmak, Hello Tourism and Travel Inc’s founding partner and founding chairman of the Turkish Healthcare Tourism Development Council. “Moreover, discounted prices and extra services are offered for medical tourists,” Cakmak said. In addition to these services, airlines do their part by offering 25 percent fare discounts for persons traveling from the U.S. as a departure point for medical tourism. His or her companion or attendant traveler is also offered a 20 percent discount from departure points of over 150 destinations in the world. We will continue to see more and more combinations of packages, pricing mechanisms and process efficiencies similar to the examples discussed above as the medical services and tourism industries explore further the opportunities to be found in integrative collaboration. n About the Authors Cayla Lambier is a recent graduate of Washington State University and possesses Bachelors degrees in both Communication, with an emphasis on journalism, and English. She considers herself to be an incredibly versatile writer, with several years of professional experience ranging from reporting and magazine editing, to public relations and technical writing. Cayla is currently engaged as an editorial intern with the Seattle branch of Where Magazine and as a freelance staff writer for Medical Tourism Magazine. Vivian Ho is President of AGHP, a 501c3 that works on global health philanthropy ventures. She also serves as Managing Director, Asia Pacific for MTA, and Co-Editor of MTA’s health tourism e-magazine. Prior to this, Vivian was President & CEO of Queens International in Honolulu, Hawaii building Hawaii’s medical travel & health tourism initiative. She currently advises on country, sector and organization initiatives in Medical & Health Tourism. She may be reached at Vivian@ MedicalTourismAssociation.com. Anne-Line Crochet is Communications Intern for Medical Tourism Association. With a Masters degree in political science, a Minor in journalism, Anne-Line provides professional expertise to our public relations and editorial functions. Previously a staff writer for French publications Fragil and Ouest-France, she is fluent in English and French; and conversant in Spanish and Russian languages. Anne-Line writes for MTA’s Medical Tourism Magazine and Health Tourism Magazine. She can be reach at AnneLine@medicaltourismassociation.com

Where growth is present, the hospitality sector expands and jobs are created, more services are provided and a larger volume of export dollars are earned and received by a country.

December 2010/January 2011

The Best of Health Care in the Best of Brazil

Porto Alegre is a cosmopolitan metropolis with small town flavors in southern Brazil â&#x20AC;&#x201C; a Brazil you haven't experienced yet. The most European state capital city of Brazil is revealed in its architecture, history, mild climate, security, international cuisine, and its people's origins: mostly Portuguese, German, and Italian descendants.

Also, Porto Alegre is among the cities with the highest Economic and Human Development Index in Latin America. With its cutting-edge medicine, and a variety of quality services and infrastructure rarely found in one place, Porto Alegre joins the medical tourism industry offering guarantee of a satisfying experience, with a high degree of commitment to the patients. Surprise yourself in Porto Alegre!

ÂŠ Copyright Medical Tourism Association

December 2010/January 2011

From Health to Home Assistance, We Make People’s Lives Easier. With a presence on 5 continents, and more than 410,000 approved partners offering assistance services in 208 countries and territories around the world, Europ Assistance places an exceptional international network at its clients’ disposal. EA Group operates worldwide in 4 key assistance service areas: Health, Home & Family, Automobile, and Travel. Key EA Group Stats: • Owned by Generali Assicurazioni • Over 150 million cases managed in our 47-year history • Average of 11.5 million assistance cases opened per year • Average of 53.8 million phone calls per year • 300 million customers worldwide • Credentialed provider network in over 130 countries • Ground agents located in 208 countries and territories • Over 6,800 employees worldwide • 38 call centers located around the globe • 80 consolidated companies in 35 countries • 400 medical professionals (doctors and nurses) Solutions offered by EA Canada • Travel for Treatment • Cost Containment • Expatriate Insurance & Assistance • Medical Concierge • Medical Travel Assistance • Medical Tourism Solutions offered by EA USA • Medical Travel Assistance • Identity Theft Resolution • Data Breach Response • Beneficiary Assistance

www.europassistance-canada.ca 68

December 2010/January 2011

www.europassistance-usa.com

MEDICAL TOURISM

Cross Border Health Care ~ A European Union Phenomenon

By ANNE-LINE CROCHET Medical Tourism is not only a US phenomenon, but some Europeans are also looking for better, cheaper and more accessible treatments abroad while staying within the EU borders. Commonly referred to as cross border healthcare, European residents are travelling from Finland to Spain specifically for healthcare services while their national governments reimburse the procedures.

he notion of a European Union was established 60 years ago. Today, the EU is composed of 27 sovereign member states. A common market was created within the EU more recently guaranteeing free movement of persons, goods, services and capital with the purpose of stimulating the economy. The European Union member states offer high quality medicine and almost all European countries have a universal health care system. Universal health care systems are primarily funded by multi-payer systems or tax revenue, providing health care accessible for all. Each member state is responsible for the organization and development of their health care system and services rendered. For example, Germany has a multi-payer system while Italy is using a tax funded system, while both of the governments are regulating and coordinating healthcare. In some cases, European citizens may seek healthcare in other EU member countries, according to District Hospital

Mainkofen CIO Professor and Doctor, Kunhardt Horst, with the costs covered by their own health system. According to Horst, 90 percent of European citizens are treated in their own country but more than 50 percent of them are willing to travel to another EU country for healthcare. “Germany, Spain, Hungary and Belgium are examples of countries that offer the infrastructure and possibility for patients from abroad to be treated,” UKE Consult and Management CEO Mathias Goyen said. “Whereas Germany focuses on highend medicine at an affordable price, countries like Hungary found their niche within plastic surgery or wellness treatments at far more reasonable budgets.”

A key priority of the European Union is achievable and effective mobility for EU citizens. December 2010/January 2011

MEDICAL TOURISM

The idea of medical tourism within the EU is becoming more attractive for many Europeans due to a myriad of factors. According to Horst, four factors predominate: the movement of citizens and professionals, the unequal dissemination of new medical technologies, the common public expectations across Europe and the easy access to medical information through technology.

Many patients from Northern states such as Sweden or Finland come to central Europe for treatment because of long waiting lists. European patients, looking for healthcare seek treatments undeveloped in their country, better treatments than at home, receiving a treatment by a renown specialist, receiving a treatment more quickly than at home or receiving a better value for treatment than at home, according to Horst. These tend to be the reasons for travelling out of country but within the Union for healthcare services. “Many patients from Northern states such as Sweden or Finland come to central Europe for treatment because of long waiting lists at home or as a results of treatments not being offered due to a lower number of cases,” Goyen said. “Another example is patients from the UK. Those patients often seek treatment abroad due to waiting lists and very high prices at home.” However, seeking care internationally remains more difficult than being treated within the confines of a resident’s national borders; patients must seek prior authorization from their home state, regarding the procedures they plan to undergo, in order to claim reimbursement expenses. “Europe still has a long way to go in order to reduce bureaucratic hurdles for those patients seeking care abroad and for clinics and hospitals to be reimbursed properly and smoothly for their services,” Goyen said. Recently the EU Commission published a Directive proposal on the application of patients’ right who are interested in cross border healthcare.

December 2010/January 2011

“A key priority of the European Union is achievable and effective mobility for EU citizens,” Goyen said. According to Horst, the Directive provides a framework and clarifies the patients’ right to seek health care in another EU member state while being reimbursed by their national system. This October, upon a Bulgarian Court request, the European Court of Justice determined a preliminary ruling, entitling the defendant, a Bulgarian patient who crossed EU borders to undergo surgery before seeking prior authorization, for reimbursement of the procedure by his insurance - the national health insurance fund - disregarding this lack of prior authorization. This ECJ preliminary ruling, while pertaining to this specific case, could be the first step to a new medical tourism arena, for European patients, European hospitals and member states. “A concerted European strategy is being developed to further facilitate the movement of patients and professionals, simplify procedures and increase the quality of and access to cross-border care,” Goyen said. Some governments are already taking the lead encouraging the development of medical tourism and cross border health care. In 2011, Germany’s National Tourism Board will launch a cross-media campaign on health and medical tourism funded by the German Ministry of Economics. n

ÂŠ Copyright Medical Tourism Association

December 2010/January 2011

“Your Guide to Overseas Health & Medical Wellness”

�Integrative �Alternative �Homeopathic �Preventitive

www.HealthTourismMagazine.com 72

December 2010/January 2011

MEDICAL TOURISM

Branding

Wellness ~

Increasing Business Opportunities

Through Natural Resources By ANNE-LINE CROCHET

Wellness quest started centuries ago when Romans and Greeks were nourishing the vivid tradition of thermal spa and traditional medicine the unique way to heal. Nowadays, wellness is becoming a state-of-mind and a quality of life, however competition is tough and branding its services becomes a requirement in the health tourism industry.

odern concept adapted from ancient traditions, wellness is a mainstream industry with 289 million consumers in the world’s 30 wealthiest countries according to a 2009 Stanford Research institute study representing a $2 trillion industry. Wellness displays a wide range of business opportunities and undeniably has its place in the health tourism panorama. Thus, branding wellness can be crucial to enable business growth. Director Global Spas & Programming, Mia Kyricos, enounces four preliminary questions to examine motivation in branding wellness. • Does your product or service exist within an established business / company, or are you attempting to bring something new to market? • Are you trying to develop / deliver a service to simply remain competitive, or is it critical for your consumers to develop an emotional connection to your offering?

cost for multi-unit operations and often yields greater return on investment.”

The Case of Latin-America ~ Playing of Your Strengths Branding wellness tourism in Latin America can appear difficult. Indeed, a center of history, wellness is not a traditional tourism motivator. Generally people travel to Latin-America for its archeology, heritage, culture and gastronomy according to Aranwa Hotel & Spas Deputy General Manager Gabriel Alvarez. However according to him these can be an asset, “take advantage and build up on it,” Alvarez says. Indeed, Alvarez takes the example of Bolivia, which has a culture of wine, or Costa-Rica, Bolivia, and Ecuador that have a history in thermals. Branding wellness would include talking about it and presenting it as an advantage, a culture of tradition. “Use it as a selling proposition,” Alvarez says.

• Would partnering with an established entity / brand ultimately give you the same result?

Moreover, in order to reinforce and implement a company in the wellness market, creating synergies is highly recommended according to him. “The key here is we are not alone, there are different spas in Latin-America,” Alvarez says. “We should not only focus on the home market.”

Branding will enable consumers to relate more to the product, keeping in mind the range of services offered and save their time and energy looking for wellness products according to Kyricos. For the business owner Kyricos precise “branding will keep management honest, saves marketing and development

In that way Alvarez explains Brazil should promote Argentina, Argentina should promote Paraguay and so on. “There is an opportunity for working together, an opportunity to learn,” Alvarez says. “Branding an area as a wellness destination is a long process.”

• Will the product / service stand-alone or will it be packaged with others?

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MEDICAL TOURISM The Case of Turkey ~ Tradition of Thermals Turkish baths tradition was created a thousand years ago when Turks arrived in Anatolia. Since ancient times, Turks followed the tradition of thermals and brought it up to the world as one of their main assets. To reach this status, health professionals worked with the Turkish government and the European Union. Founded in 2000, Turkspa, the Turkish Spas Association, became a member of Espa, the European Spas Association. “This development is hoped to be continued in coming years which in turn will result an increase in the quality standards of spas in Turkey,” President of the International Society of Medical Hydrology and Climatology, Zeki Karagülle said. Espa enables countries to bind in order to create collaborations more easily. Besides, Espa helps organizations such as Turkspa to conduct their demands with political institutions. Being a member of an European association brings legitimacy and structure to national organizations. The website Espa-ehc. com stated, “The common objective must be to establish a standardised structure in order to create more transparency on the European market.” Beyond being visable in the European market, the health tourism industry also is supported by the Turkish government. “Ministry of Tourism and Culture has led forming a so called ‘Health Tourism Platform’ consisting of the representatives of health/medical, thermal and spa wellness tourism sector of Turkey with the aim of again coordinating the separate efforts and activities of the sector,” Karagülle said.

Also, the Ministry of Health along with the Ministry of Tourism are working together focusing on three different aspects of the health tourism industry: Medical and health care tourism, thermal medical tourism and, spa and wellness tourism. Being well supported by the government enabled Turkey’s health tourism professionals to implement strict technical and medical standards, and reached out an international image of quality. To incorporate a country in the health tourism niche market, each country should focus on its own traditional health practices and systems, Karagülle adviced, while specifying treatment options and types. “New health institutions besides the JCI certificated hospitals such as ‘Spaspitals’ or ‘Estespitals’ should be created and implemented,” Karagülle said. n

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The topic of medical tourism (MT) from an ethical perspective is extensive and complex.

December 2010/January 2011

Beike Biotechnology Tomorrow's Hope Today Stem Cell Therapeutics

Beike Biotechnology is the world leader in approved stem cell therapy, a company whose scientists have been dedicated to the development and commercialization of adult stem cell therapies since 1999. Beike currently produces a full line of stem cell products derived from umbilical cord, cord blood, bone marrow and adipose (fat) tissue stem cells. Beike’s proprietary processing and quality assurance technologies prepare the cells for a variety of neurological, spinal cord injury, cardiologic, orthopedic, optic nerve, diabetic, ischemia and liver conditions. To date, Beike's stem cells have been used to safely treat over 9,000 patients from around the world. Beike brings to the industry: • A staff of over 350 scientists, medical doctors and technical personnel • Signed agreements with hospitals in Malaysia, the Philippines, Thailand, and over 30 partner hospitals throughout China where treatments have commenced using Beike's stem cells • Over 20 world class laboratories located throughout our hospital and science park network • Beike’s cGMP Jiangsu Stem Cell Storage facility is one of the largest and most advanced in the world with future capacity to store up to 1.5 million samples of cord blood, umbilical cord, adipose tissue and bone marrow derived stem cells • Cooperation agreements with renown international stem cell research institutions that enables us to increase our ability to incorporate real-time research information that can been used in our treatment network • Exclusive licensing of several core technologies that keep Beike delivering cutting edge stem cell science to patients through its partner hospitals Beike Holdings 539/29 Soi Sukhumvit 31 Klong Tan Nua, Wattana, Bangkok, Thailand 10110 Telephone 1-541-488-8899 (USA) info@beikeinternational.com © Copyright Medical Tourism Association

December 2010/January 2011

MEDICAL TOURISM

Social Media &

Marketing ~ Sell More and

Reach New Markets

By VIVIAN HO and CAYLA LAMBIER David Fincher’s film “The Social Network,” which fictionalizes Mark Zuckerberg’s creation of Facebook in college, has been a huge success in the box office, netting $10.3 million as of mid-October. A plethora of books, including “The Dragonfly Effect” by Jennifer Aaker and Andy Smith, concerning the same topic are climbing bestsellers lists and flying off the shelves. Social media, and the marketing options it creates, is one of the hottest topics of the business world and, according to Rob Passmore, co-founder and CEO of both SurgeryOverseas.com and equals3.co.uk, is destined to get even hotter.

“

he key to social networks is peer-to-peer dialogue: the sharing and shaping of opinion about the reform process,” Passmore said. “The internet on a broader basis offers individuals and patients the opportunity to research, learn and weigh options and choices. Choice, I believe, will be one of the key drivers for the ongoing healthcare reform process and will open up new routes for international healthcare.” Social media has an interesting role in the healthcare realm. Media, such as television and magazine advertisements, are generally paid for directly, explained Passmore, but social media is earned. Peer review and credibility are critical to a social media presence, for any healthcare professional or organization. Website rankings are more about popularity than peer review, explained Passmore. It is the online community of patients and consumers which judge the value and quality of a social media presence. “As an online market agency focused in international and domestic healthcare, we have firsthand experience of how

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the internet and social networks can be leveraged to generate demand for inbound medical tourism,” Passmore said. Specializing in generating high levels of patient flow via the internet, Passmore’s company uses a combination of search marketing, effective website design & development, and social networks to achieve an optimum level of efficient social media marketing. A current example of Passmore’s work put into action is a social media campaign he is running for a mexican hospital, focused on the new CCSVI procedure for Multiple Sclerosis. Passmore set up www.CCSVI.mx, and with daily posts on the social networks and forums, has been able to generate substantial demand very rapidly. When approaching social media from a professional perspective, it’s important to understand who’s going to be on the receiving end of marketing efforts. The younger generations, including those in their 30s, are very involved with social media

– media consumption through online social media outlets is higher than that which comes from television, said Passmore. As this population ages, their healthcare demands will increase and it is likely they will seek information to base their choices and actions on from online and social media sources. The international component of social media marketing is also important, with certain markets embracing social media more than others. For example, mobile phone based social media is very popular in Asia, while networks like Facebook and Twitter are huge successes in the United States, among other countries. Patient security, however, must always be a top priority in the medical world, and incorporating social media marketing does create new issues that must be addressed effectively and completely. “The digital world is a mixed blessing for patient safety,” Passmore said. “It enables choice and dialogue, but it is also largely unregulated. It puts the onus of quality assurance onto the patient, rather than the provider.” The solution, according to Passmore, is integration of information between the parties involved.

The key to social networks is peer-to-peer dialogue: the sharing and shaping of opinion about the reform process. For the past few years, social networking as a whole has been transforming personal and professional relationships and these networks have, in turn, been effective tools in targeting potential customers, defining parameters for optimal social networking brand strategies and essentially useful in building better products, reaching new market sectors and selling more services. When the attention is turned to this aspect of social media and the advantages and benefits produced via social media marketing are scrutinized, it is found that they are growing and evolving even as the practices are developing. Simply put, social media marketing could have as large an impact on the world, and healthcare, as the internet has been since its inception. n About the Authors Cayla Lambier is a recent graduate of Washington State University and possesses Bachelors degrees in both Communication, with an emphasis on journalism, and English. She considers herself to be an incredibly versatile writer, with several years of professional experience ranging from reporting and magazine editing, to public relations and technical writing. Cayla is currently engaged as an editorial intern with the Seattle branch of Where Magazine and as a freelance staff writer for Medical Tourism Magazine. Vivian Ho is President of AGHP, a 501c3 that works on global health philanthropy ventures. She also serves as Managing Director, Asia Pacific for MTA, and Co-Editor of MTA’s health tourism e-magazine. Prior to this, Vivian was President & CEO of Queens International in Honolulu, Hawaii building Hawaii’s medical travel & health tourism initiative. She currently advises on country, sector and organization initiatives in Medical & Health Tourism. She may be reached at Vivian@ MedicalTourismAssociation.com.

December 2010/January 2011

ÂŠ Copyright Medical Tourism Association

MEDICAL TOURISM

Sustainability Infusion as Architectural Life Force By AMANDA SHAW and ANNE-LINE CROCHET

Last month, the two themes of sustainability and hospital development intertwined as a key track, making an impact in Los Angeles, California at the Sustainable Healthcare & Hospital Development Conference. Held on September 22nd-24th, a gathering of global medical travel, hospital executives, and health & wellness leaders shared their knowledge and experience on state of the art development in this arena.

he Sustainable Healthcare & Hospital Development Conference was developed to enhance awareness of the essential parts that make up a sustainable healthcare system. Most people think of sustainability in healthcare as “going green” in the industry but there’s more to it than that. In addition to developing eco-friendly hospitals, there are integral organizational and management operations that need to be planned out accordingly to sustain any business, but healthcare in particular. Many of the guest speakers at the Sustainable Healthcare & Hospital Development Conference addressed these issues, providing business plans and/or methods to effectively implement a sustainable healthcare system. Jacques Mulder, principal of R&D Practice at Deloitte Consulting LLP, enthusiastically spoke about greening and sustainability in healthcare and life sciences at the Sustainable Healthcare & Hospital Development Conference. He started his presentation by explaining the difference of “greening” and “sustainability”. These two terms are sometimes used

as alternatives to the same definition. Mr. Mulder informed his audience that, although similar, they reference two different factors that we should take into consideration when understanding the concept of sustainability in healthcare and hospital development. He explained that the term “greening” focuses on the physical environment, whereas “sustainability” refers to the significant business, including governance, workplace, workforce, technology, supply chain, products, and services. Eric Wenke, assistant vice president of Baptist Health South Florida, proposed ideas to remedy inefficient healthcare systems. By adjusting PC monitor settings to automatically shut down when not in use can have a savings effect in many aspects of the environment and industry. In just one year, a healthcare business can save $150,000 in energy expenses. It could reduce carbon emissions by 1300 tons, direct medical by $9,500, and save 2.5 days of work. He also showed statistics of using fluorescent light bulbs, a healthcare business could

December 2010/January 2011

MEDICAL TOURISM save $125,000 in energy expenses, reduce 540 tons of carbon emission, decrease direct medical costs by $3,200, and save a day of work. In addition, Cagri Kanver, senior associate of HOK Advance Strategies, held a session on an environmental business plan in the healthcare industry and Clift Montague, senior vice president and chief strategic officer of Albert Kahn Associates Inc., touched upon sustainable design considerations for patient well-being within a constrained budget. Cagri’s presentation took a look at the structure of a business plan, what challenges will be faced, and what approaches to take in order to follow through with the business plan. Clift Montague elaborated on principles of sustaining a healthcare system. His focus pertained to the importance of establishing a strong team within a facility. He examined the value of creating a committed staff base that will then enable a healthcare facility to achieve sustainability. Once staff has fulfilled their mission, the workplace and workforce will look better and feel better providing efficient care to patients which will allow them to have a comfortable and safe stay. Clift defined employees as the number one asset of a company. He proclaimed that green buildings reduce absenteeism and increase productivity. The staff’s ability to provide care will improve with technology, logistics, and attitude. Hospital development is also an essential building block to sustainable healthcare. Erik Hokanson, senior project manager at Burt Hill, presented a case study of Al Mafraq Hospital, a hospital that promotes sustainability and wellness as an integral part of the healing environment. Al Mafraq Hospital was designed around the occurrence of wind patterns. By researching and recording the predominant wind current, the design team could develop a hospital that would use the wind as an advantage to create a cooling effect. For an opposite effect, they added solar panels for heat. Wood based material and recycled content was constructed into the design where it was suitable. Reusable water, such as grey water, storm water, and condensation, is captured for irrigation and cooling systems. Stanley Chiu, vice president of RTKL, Gregory Stackel, LEED AP Principal of RTKL, and Michael Sheerin, principal and director of healthcare engineering, displayed case studies of three different hospital development projects in three different cities: Santiago, Chile; Jeddah, Saudi Arabia; and Shanghai, China. Designed with the lotus flower in mind because of its purity and ability to regulate it’s temperature, these projects are crafted to go beyond patient expectations of quality care and to also respect the environment and its natural surroundings within a set budget. The integration of sustainable healthcare and hospital development is a lot to digest, especially in three days, but, nonetheless, the dual topics are significant as they correlate to produce evolving healthcare systems into sustainable ones. Moreover, the rise of sustainable healthcare and hospital development is spreading further than just inside the borders of North America. As you have seen in the case studies that were conducted, several countries are jumping on this opportunity to develop better quality of care, while being considerate of the environment. This provides us with a better understanding of the rationale behind integrating the Sustainable Healthcare & Hospital Development Conference with the Medical Tourism & Global Healthcare Conference. As medical tourism continues to expand, healthcare facilities around the world are more determined to renovate and build hospitals to meet the expectations of good quality care. They are combining design and new initiatives in management to create a greater experience for patients. The awareness of sustainability and “going green” is flourishing and it only

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makes sense for healthcare facilities to implement this trend. The key: Healthy environment, healthy people, happy world. The approach of sustainability is different in every country; however, the same challenge remains, decreasing the use of resources available on the planet by controlling their utilization. One step at a time, changing habits and taking new directions are trends medical players are taking in here in the US and in the UK. Instead of enforcing competition, hospitals from around the world can integrate their efforts in maintaining sustainable healthcare facilities for medical tourism patients abroad.

NHS ~ “SAVING CARBON, IMPROVING HEALTH” The National Health Service (NHS), United-Kingdom, publicly-funded health system, created in 1948, runs the majority of the healthcare services provided in its country including hospitals, clinics, and employment of doctors and nurses. The NHS is truly colossal in its impact on the environment and on the economy, employing around 1.4 million people with a $185 billion budget, according to NHS sustainable unit operational director, Sonia Roschnik. “The NHS is the fourth largest organization in the World, behind the Chinese Red Army, the Indian State Railway Company and Walmart,” Roschnik stated. “The NHS pumps out 21 million tons of greenhouse gases a year –that is more than some medium sized countries– and produces more than 3 percent of our countries total carbon emissions.” Indeed, according to Roschnik, 59 percent of the carbon dioxide that the NHS is responsible for comes from procurement of pharmaceutical products, medical instruments, business services, and paper products. Time has come for the NHS to react and try to decrease its carbon footprint, for its own interest and that of the planet. Thus, NHS sustainable development unit developed the “Saving Carbon, Improving Health Program.”

THE NHS STRATEGY To decrease its carbon emission and become more sustainable, the NHS is trying to improve the staff and patients travel loads. To do so, medical staff personnel are more likely to visit the homes of patients, according to Roschnik, avoiding

The NHS pumps out 21 million tons of greenhouse gases a year. 59 percent of the carbon dioxide the NHS is responsible for comes from procurement of pharmaceutical products, medical instruments, business services and paper products.

patients driving to the hospital or the medical center for general treatment. “Moreover, British Telecom developed an ultra fast broadband service which is inter-connecting hospitals. Called N3 it is a dedicated line that is being used to send to London angiogram images, which are moving X-ray pictures of the heart arteries,” Roschnik stated. “That means consultants have real time discussions while patients are on the table and they can discuss the best treatments quickly and safely.” Within a year, nearly 400 angioplasties took place in the region of Kent. Prior to that, all of them had to be done in London. N3 broadband has saved nearly 30,000 miles of patient travel and 5,500 hours of cancer consultants’ time in London, according to Roschnik. At a higher level, the NHS goal for the future is reducing carbon footprints significantly from 21MtCO2e a year to less than five. To meet these expectations, the NHS wants to develop telemedicine and make patients more responsible for their healthcare. “What we know we need to do is focus on promoting health than treating sickness,” Roschnik said. The NHS also encourages patients and staff to get started on an individual level using other forms of travel other than their car.

USA APPROACH OF SUSTAINABILITY The United States approach to sustainable health and medicine is working very differently from the United-Kingdom. Indeed, most of the hospitals being private, the government is not able to impact and support a sustainable change as in the U.K. However, a couple of organizations appear as guides in terms of sustainable hospitals. First, for ten years now, the U.S Green Building Council has encouraged the construction of green hospital building by instating guidelines and standards of how to become a sustainable hospital through the Leadership in Energy and Environmental Design’s certification system. The Environmental Protection Agency (EPA) is also working with hospitals. Medical waste incinerators contribute 13 percent of mercury emissions making them the fourth largest

source of mercury emissions. Moreover, hospitals contribute four to five percent of the total waste water mercury load in some communities according to the EPA. In that way, healthy hospital initiatives have been initiated to reduce mercury. However, contrary to the U.K, the sustainable programs are largely supported by the states. In that way, hospitals in some states can handle their chemical emissions efficiently while others struggle. California, for example, is initiating a green chemistry program. One of the problems the EPA and other sustainable organizations have is the Toxic Substance Control Act. The TSCA has been enacted more than 30 years ago and has never been reviewed. According to EPA assistant administrator for the Chemical Safety and Pollution Prevention office, Steve Owens, nobody reviews the safety of chemicals in the U.S. Over 20,000 chemicals have been added up at the TSCA without evaluation since 1976. “That’s the big issue about what’s called confidential business,” Owens said. According to him, business confidentiality protects formulas but also hinders the identification of some chemicals. Thus, it becomes harder to watch the different chemicals emitted in the environment. EPA has taken action to limit or ban chemicals only five times since 1976, according to Owens. For the upcoming year, EPA’s goal is to create a “chemicals of concern list”, requiring industries to submit more information to understand chemical risks and make public access on chemicals easier. Sustainability is moving quickly as medical tourism exerts itself worldwide. A strong correlation that’s growing is to enforce a healthier lifestyle and better quality care for patients. This endeavor excites healthcare leaders around the globe and ensures patients of the safety and satisfaction from healthcare services that they can expect. The healthcare disposition is impressively impacting society, making healthcare systems revamp extraordinary amenities into providing elegant and safety precautions to strengthen the future of healthcare services. n

About the Authors Anne-Line Crochet is Communications Intern for Medical Tourism Association. With a Masters degree in political science, a Minor in journalism, Anne-Line provides professional expertise to our public relations and editorial functions. Previously a staff writer for French publications Fragil and Ouest-France, she is fluent in English and French; and conversant in Spanish and Russian languages. AnneLine writes for MTA’s Medical Tourism Magazine and Health Tourism Magazine. She can be reach at AnneLine@ medicaltourismassociation.com Amanda Shaw is currently an intern at MTA, focused on Sustainable Healthcare & Hospital Development. Ms. Shaw holds a Bachelors of Arts degree in Journalism from Columbia College in Chicago. She was a member of the National Society of Collegiate Scholars at Columbia, and a journalism intern at Chicago Splash Magazine. Her interests in medical tourism include global healthcare development, healthcare reform, healthcare quality and international marketing.

December 2010/January 2011

*Data compiled by the U.S. Department of Health and the Hospital Quality Alliance. Baptist Health hospitals as a group, weighted by each hospital’s patient volume,averaged 47% of the quality measures in the top 10th percentile. For more information, go to www.hospitalcompare.hhs.gov

Baptist Health’s hospitals as a group are among the best in the country, according to a national government survey of hospital quality measures. *We scored better than all the hospitals in the U.S. News & World Report’s Honor Roll. The survey ranked hospitals on the basis of national quality measures in heart attack, heart failure, pneumonia and prevention. If you take quality as seriously as we do, you’ll choose Baptist Health. For information or a free physician referral, call 786-596-2373 or visit us at baptisthealth.net/international

December 2010/January 2011

MEDICAL TOURISM

Telehealth in Medical Tourism~

Personalizing Health Care By DR. ANTONIA ARNAERT

he substantial growth in the medical tourism and the globalization of medicine, in general, has introduced new challenges and opportunities to provide higher quality services to clients. As clients realize access to medical care has expanded and medical choices have broadened beyond the boarders of their local providers.

Monitoring (RPM), also called ‘telemonitoring’ however is another branch of telehealth. It is a medical practice involving remotely monitoring clients who are not at the same location as the healthcare provider. In addition to objective technological monitoring, some RPM programs include subjective questioning regarding the client’s health and comfort.

Clients demand and deserve a higher quality and more personalized service. One approach has come to the forefront is the application of telehealth to deliver personalized health services to clients. Although these technologies are not routinely used in the field of medical tourism at this point in time, their application and eventual integration as medical tourism tools offer the potential to expand the services of the medical tourism industry. This article summarizes the potential of telehealth in the field of medical tourism.

Telehealth is not a new concept. It has a surprisingly long history that began with the advent of the telephone. In 1906, Einthoven first investigated the use of electrocardiogram (EKG) transmission over telephone lines. In the 1920s, ship radios were used to link physicians with sailors to assist during medical emergencies at sea. In 1955, the Nebraska Psychiatric Institute was one of the first facilities to use closed-circuit television for healthcare purposes. In the 1970s, paramedics in remote Alaskan and Canadian villages were able to perform lifesaving techniques while linked with hospitals in distant towns via satellite. Today, telehealth is beginning to exponentially mature with progressive advances in technology. Despite advances in technology with telehealth and its intuitive appeal to industry and clients, its use remains in an embryonic stage.

What is Telehealth? Telehealth is broadly defined as the use of electronic and communication technologies to provide and support health care when distance separates the participants. It is a system connecting primary care physicians, providers, specialists and clients. In other words, telehealth provides health information from a remote location to a client. Basically, Telehealth allows clients to visit with physicians and health care professionals ‘live’ over video for immediate care or capture videos and still images for later consultation. The term ‘telemedicine’ is used when medical information is transferred through interactive audiovisual media for the purpose of consulting and sometimes remote medical procedures or examinations. Remote Patient

Why Would the Medical Tourism Industry Consider Telehealth? Hallmark features of the medical tourism industry are its ability to provide high quality health care services at a reduced cost and the potential to provide greater choice to clients with respect to their health care needs. The use of telehealth services has the potential to provide these as well as empowering the client to assume a nexus of responsibility for his/her own health

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MEDICAL TOURISM

care. We envision four potential benefits of telehealth to the medical tourism industry: • Improved Access: Telehealth can be used to bring health care services to client’s pre-and post-operative care. The access to telehealth, for example, could help stabilize a client’s condition: stabilize blood glucose levels prior to surgery, aid clients to lose body weight prior to a liposuction procedure and provide education on the upcoming surgical procedure. Patients even can be followed during the post-operative care to insure compliance to medications, rehabilitation regimens and to provide moral support • Cost Efficiencies: Reducing or containing the cost of healthcare is one of the most important reasons for adopting telehealth technologies. Telehealth has been shown to reduce the cost of healthcare and increase the efficiency through better management of chronic diseases, shared health professional staffing, reduced travel times and fewer or shorter hospital stays. Thus, it represents a powerful platform for the medical tourism industry to assist in reducing health care costs. The use of telehealth is generally considered positive for both patients and the economy. Through remote health monitoring, telehealth may allow countless numbers of clients to improve medical outcomes, avoid return visits to hospitals and allow them to remain productive, stay home longer and consequently incur less health care costs. The economy also benefits from the diminished need to transport patients to other facilities when a health care specialist is needed • Client Demand: Clients want telehealth. They want a closer interaction with the client manager, specialist abroad and other health care professions. The greatest impact of telehealth is on the patient, their family and their community. Using telehealth technologies reduces

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travel time and related stresses to the client. Over the past 15 years, study after study has documented client satisfaction and support for telehealth services. Such services offer patients the access to providers and medical services without the need to travel long distances. By definition, the medical tourism industry ‘spans great distances’ to assist patients with efficient and high quality medical care. Thus, the application of telehealth with the medical tourism industry offers significant promise to bridge distances in an effort to deliver a more personalized service • After-Care: Offering services in the ‘after-care’ period has not been generally considered the domain of the medical tourism industry. It is clear that the length of hospital stays for clients are becoming increasing shorter in an effort to reduce health care costs. For example, hospital stays for coronary artery bypass grafts averaged nine days five years ago, whereas the average stay in 2010 is five days. The prolonged after-care period in the home environment often creates a situation in which patients and caregivers feel unprepared during this time and lack critical information. The after-care period often creates increased anxiety and depression for clients after the abrupt removal from the hospital environment and associated availability of sophisticated medical resources. The application of telemedicine during this critical period could serve a vital role to monitor patients: medications and vital signs, and provide education to patient and family during this critical period. Simply put, the after-care period represents a substantial market for the medical tourism industry given the availability of telemedicine Collectively, the challenge and long-term goal for the medical tourism industry is to create a seamless and continual care model. That is, the goal would be to personalize patient care plans in order to improve the continuity of care. For

example, as soon as the patient is scheduled for their surgical procedure, there needs to be telehealth communication between the destination healthcare team and patient at home to establish a personal patient care plan to prepare the patients for surgery. After delivery of the surgery and when the patient returns to their home environment, a second personalized health care plan is initiated to assist in the post-surgical care period. The notion of the medical tourism industry personalizing health care pre-and post-surgery would be greatly facilitated by telehealth technology and would broaden the mandate of medical tourism professionals. Lastly, the client manager needs to play a vital and key role in the coordination of this process. This individual is the gatekeeper to the process. Ideally, these individuals should have a clinical or medical background to help speak the language and actively participate in the coordination of pre- and post surgical care.

What is Remote Patient Monitoring? The RPM approach extends between personal computers and video equipment to include medical devices that are attached to the client’s computer or other mobile devices, such as iPhone and Blackberry to assess clinical problems and health status. For example, an electronic stethoscope allows a nurse to listen to the patient’s heart and lungs. A cuff and sphygmomanometer can provide measurement and transmission of body temperature, weight, blood glucose levels and pulse oximetry with the newest generation of models. This data could be sent to diagnostic testing facility for interpretation. These services or data can also be used to supplement the use of visiting nurses. Thus, there now exists the possibility to collect, transmit and interpret health information within the home of the client to assist clients in their preparation for medical procedures as well as in the aftercare period. How can the medical tourism industry use RPM? The ultimate goal of RPM is to monitor the client’s physiological responses with the goal of changing behavior and then monitor the clients’ physiological responses to this altered behavioral change. From a medical tourism perspective, RPM could be a valuable tool to enhance patient compliance to different types of interventions. That would eventually enhance the medical procedure and improve medical outcomes. We would suggest that the medical tourism industry could benefit from RPM in the following ways: • Pre-Surgery Period: To stabilize a patient’s health status, for example blood pressure or lost of body weight, prior to undergoing a surgical procedure. The patient would need to understand that improving their health status prior to undergoing a medical procedure would likely improve their overall surgical outcome • After-Care Period: To enhance compliance and increase education after a surgical procedure. For example, bariatric surgical procedures are known to be quite effective in reducing body weight in clients. It is also well-known patients will frequently regain the lost body weight and ‘lose’ many of the cardio-protective effects associated with weight loss. RPM could serve as a valuable tool to instruct and implement changes in dietary and exercise habits over time to assist patients in maintaining the lost body weight and thus, preserve the health benefits of their weight loss • Better Informed Decision Making: When patient information is limited, choosing an effective treatment can be challenging. However, RPM offers a detailed picture of each patient’s situation, based on weeks – or even months – of reliable data collection. This history enables more informed treatment decisions and helps increase the chances of a better health outcome

• Financial Benefits: In pay for-performance environments RPM helps you bring more clients through the door- by improving health outcomes, increasing clinical efficiency and providing the attraction of cutting-edge technology. In addition, a strong movement is underway for policy changes that would result in reimbursement for RPM services, from both public and private payers

A Telehealth Case Study To foster a greater understanding of the use of telehealth within a medical tourism context, we provide a case study. Client X is a man 42 years, with a body mass index of 47 kg/m2 who was referred to the pre-surgical program in April 2006 by his primary care physician after being unable to sustain weight loss and after developing multiple comorbidities. Client X has tried multiple commercial weight-loss programs but could not achieve and maintain a healthy body weight. He has never had a bariatric procedure. He has developed numerous comorbidies despite his young age related to his weight, including type II diabetes for more than 13 years, with diabetic nephropathy, hyperlipidemia, hypertension, erectile dysfunction, gout and depression. His diabetes has been steadily worsening despite his taking multiple oral polyglycemic agents as well as insulin. Client X was considered a good candidate for a laparoscopic band procedure but needed to improve his overall health profile prior to undergoing surgery. How could Telehealth and RMP help client X achieve his goals? The table below suggests several interventions that a clinically-trained medical tourism facilitator could accomplish to prepare client X for his bariatric procedure as well as monitor his post-operative period.

Telehealth / RMP Intervention Per-Operative • Reduce body • Dietary program Period weight by 10% stressing portion size control • Achieve hemoglobin • Monthly monitoring A1c <7% of body weight Period

After-Care Period

Goals

• Increase • Monthly assessment education of blood pressure regarding • Moderate exercise proper program stressing nutrition and low impact walking exercise habits • Dietary and exercise education Accelerate • Education healing process on dumping Gradually syndrome, vomiting integrate lifestyle and potential interventions (diet complications of and exercise) to surgery maintain weight • Implement loss progressive ambulation with moderate walking program • Educate patient regarding appropriate wound care • Educate patient regarding recommended dietary interventions

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MEDICAL TOURISM Potential Barriers to Telehealth While Telehealth continues to evolve, there are some barriers that may prevent its widespread use and implementation. We briefly summarize some of the challenges involved with this technology. • Access to broadband networks can still be a major issue in rural and remote communities. This is unfortunate because the populations in these areas represent target client populations for telehealth and RMP • Issues of client privacy and protection of client health information continue to plague the industry. Not only must personal records be protected, they must be seen and believed by the general public to be totally safe from abuse or misuse. Because the electronic transmission of personal health information is critical to Telehealth and RMP, it must be safeguarded through effective and enforceable privacy legislation and meticulous monitoring

• The main concern today for the implementation and integration of home telehealth in the current health system is who will pay? There is relatively little information on the economic cost perspective, although several initial studies suggest telehealth reduces hospitalization and emergency room visits. It is unclear whether clients in the Medical Tourism industry will pay ‘out of pocket’ for this service

From a medical tourism perspective, RPM could be a valuable tool to enhance patient compliance to different types of interventions. • Who is the trained professional that is qualified to deliver telehealth? The logical response is nurses who are specifically trained in Telehealth education. However, one of the greatest challenges the nursing profession faces is the current and projected nursing shortage. Hiring and training client managers with a clinical background will be an important next step • Liability is an obstacle in proving telehealth. There is debate related to whether the physician and nurses would be liable for a poor patient outcome • Despite the broad appeal of telehealth, it is unclear whether the medical tourism views telehealth as part of its mandate

The State of the Market Despite the challenges associated with telehealth and RPM, projections for the growth projections for this market are optimistic, and much of this optimism is predicated upon the increasing demand for remote medical care. It is been estimated that nearly three-quarters of U.S. consumers say they would use telehealth. The application of personal health care holds great promise for the medical tourism industry. Just as the medical tourism seeks to reduce costs of medical procedures for clients, the driving force, at least initially, underlying telehealth will be its potential to lowering costs. However, it is important to keep in mind that the Medical Tourism industry should not become intoxicated with the sexiness of the technology. The technology is the means to an end. The end is the ability of telehealth and RPM to induce behavioral change in patients in the management of their acute and chronic disease processes with the ultimate goal of personalizing health care. n

About the Author

Dr. Antonia Arnaert is the President and CEO of Debson Medical Tourism Inc. She has an active interest in the development of telehealth for patients with a chronic or life threatening disease, and for aftercare to patients who had surgery. She is currently pursuing research activities in these areas both nationally and internationally. After earning a bachelor’s degree of science in nursing, a master’s degree in public administrations, and master’s and doctorate in public health, she worked on clinical research operatives in Canada.

December 2010/January 2011

Global Benefit Options (GBO) is a Medical Tourism Consulting firm that specializes in developing strategic Medical Tourism Benefit solutions for the US Health insurance market. GBO’s main focus is US Health insurance carriers, Self Funded Employers, TPA’s, Health Insurance Agents and other US health insurance “buyers” to develop, design, implement, and enroll a tailored Medical Tourism Benefit into the US health insurance plan for employees. GBO also works with International Hospitals and healthcare providers and Government organizations in helping them implement a medical tourism initiative aimed at US buyers. Global Benefit Options is the only consulting firm in medical tourism with over 10 years of direct experience in the US Corporate Health Insurance Benefits Market. By working exclusively within the United States insurance industry GBO’s marketing strategy, and custom solutions produce efficient and effective results for clients. Global Benefit Options partners with a select few clients per year interested in penetrating the US marketplace and having business relationships with US health insurance companies, employers or health insurance agents. For more information go to: www.GlobalBenefitOptions.com info@globalbenefitoptions.com PHONE:201-433-2222

December 2010/January 2011

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MEDICAL TOURISM

Untapped and Undeveloped Markets ~

Dubai and Saudi Arabia By CAYLA LAMBIER

One of the most cited benefits of attending the World Medical Tourism and Global Health Congress is being provided the chance to network with others involved in the industry and discovering new opportunities for growth and development. Several sessions at this year’s Congress were dedicated to this idea, and showcased two burgeoning nations particularly striving to position themselves as successful medical tourism destinations.

DUBAI The population of Dubai, according to Dubai Health Authority Clinical Support Services Sector CEO Laila Al Jassmi’s presentation, increased by 43 percent from 2003 to 2008 and continues to rise by nearly 10,000 every month. To keep up with this growing population, Al Jassmi said, Dubai must strengthen its private healthcare core.

Dubai is very well established as a business climate and a growing private medical sector, Al Jassmi said. © Copyright Medical Tourism Association

“Dubai is very well established as a business climate and a growing private medical sector,” Al Jassmi said. The government of Dubai is closely involved with the quality and availability of healthcare, and takes great measures to ensure the health of Dubai residents and visitors and “promote healthcare and preventative measures,” she said. However, there are many opportunities for investment. 2025 has been declared a “goal year” by the government and a progressive list of healthcare-focused objectives has been undertaken. The objectives include reducing the burden of injuries and infectious diseases, as well as improving the health status of UAE nationals, and, in order to be accomplished, will require the implementation of educational programs, policy revisions, health screenings and national surveys.

December 2010/January 2011

MEDICAL TOURISM “The healthcare services of Dubai are being strongly enhanced and developed,” Al Jassmi said. As the government of Dubai sets out to further improve the state of its healthcare system, medical tourism investment opportunities abound. “We are looking to have some specialty centers of excellence and services that would serve the needs of those living in the Emirates,” Al Jassmi said. “Hospitals, specialty clinics, rehabilitation centers – there are many opportunities here in Dubai.”

By 2019, income from international travel and tourism to Saudi Arabia is predicted to reach $63.7 billion.

SAUDI ARABIA “We all know that tourism is a global industry and that one in every 12 people works in this industry. There are different types of tourism, but they are all connected,” said Dr. Ali Al Sanousi, Medical Informatics Consultant at King Faisal Specialist Hospital & Research Centre. “In Saudi Arabia, religious tourism is the heart and soul of all other tourism.” Dr. Sanousi, along with the many Saudi Arabian physicians, business owners and travel industry members that share his passion, believe that medical tourism will soon play a close second to the religious tourism that brings so many to his country every year. Tourism is Saudi Arabia’s second largest source of income, generating approximately $13.8 billion annually, and is also the third largest source of employment. By 2019, income from international travel and tourism to Saudi Arabia is predicted to reach $63.7 billion. “The opportunities are humongous – it’s a new domain,” Dr. Sanousi said. For participants in the medical tourism industry looking to develop new business relations in the Middle East, Saudi Arabia is promising. It has the largest economy in the region with a national budget of $144 billion and a surplus of $20.4 billion. With 386 hospitals, 54,724 hospital beds and 55,000 physicians, a successful healthcare infrastructure is well on its way to being fully established. “You should expect world class physicians, state-of-theart accredited hospitals, top of the line treatments and clinical outcomes, all for reasonable cost,” Dr. Sanousi said. Technological advancement is the current focus in Saudi Arabia, with significant investments being directed toward IT development, according to Dr. Sanousi. “Recently, IT investments are increasing because of new policies in the states and worldwide, and healthcare is now considered to be the fastest growing IT market,” Dr. Sanousi said. n About the Author Cayla Lambier is a recent graduate of Washington State University and possesses Bachelors degrees in both Communication, with an emphasis on journalism, and English. She considers herself to be an incredibly versatile writer, with several years of professional experience ranging from reporting and magazine editing, to public relations and technical writing. Cayla is currently engaged as an editorial intern with the Seattle branch of Where Magazine and as a freelance staff writer for Medical Tourism Magazine.

December 2010/January 2011

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December 2010/January 2011

MEDICAL TOURISM

Corporate Wellness ~ Healthier Employees, Better Performances

By ANNE-LINE CROCHET The Japanese call it Karōshi, meaning death by overwork; mostly caused by heart attacks or strokes due to stress. In Japan, this phenomenon was discovered more than 50 years ago, and here in the U.S, a few cases have been noted already.

ork and financial pressures are classified as two of the top stressors for workers all over the world. Sometimes, these two factors are leading employees to health-related disorders such as depression, anger or even suicide. In terms of metrics, on average, U.S full-time employees spent 8.44 hours a day working in 2009 according to statistics from the U.S Bureau of Labor. Since the office became an employee’s “second home”, an environment where employees undergo stress and pressure; corporate wellness has emerged around the world as a way to decompress, bringing some balance to ongoing stressful conditions. Corporate wellness can include a range of facilities and programs inclusive of having a fitness center in the office building, providing preventive medicine to employees or healthier foods at the office cafeterias and food courts. “It’s essential that employees in America really change the way they think because every minute of the day cannot be consumed with work,” winner of the biggest loser season 2, motivation speaker Pete Thomas said. As a simple equation, feeling better about yourself makes you feel more confident about what you do.

December 2010/January 2011

“Healthier employees are better performers and this in turn impacts the bottom line and makes your company better,” principal Buck Consultant Barry Hall said. According to Hall, the most important goals for a company with respect to healthcare is reducing the amount of financial resources spent on healthcare and also, keeping their employee productivity up. The website www.wellnessproposal.com suggests that workplace wellness can reduce absenteeism, reduce and control healthcare costs, improve productivity, reduce injuries and improve employee morale and employee retention. Today, 60 percent of deaths that occur worldwide are caused by chronic disease, these are preventable, and could be avoided or reduced effectively by corporate wellness program implementation, according to Spa, Wellness Tourism and Corporate Health Consultant Camille Hoheb. In that way, investing in corporate wellness is an avenue to keeping employees healthy and efficient within the work environment.

DOING IT STRATEGICALLY As a rule, corporate wellness program results will not happen immediately and overnight. Corporate Wellness is

a long path and should be a viewed and incorporated into company operations as a long term goal.

provide this type of relevant information to physicians about the worksite programs.

According to Hall, in order to make a corporate wellness plan a success, companies should establish a wellness strategy which addresses these three questions:

Involving employees also includes involving their family members, providing information to them or even including family members in the wellness programs.

• What are we doing? • Why are we doing it? • How are we going to know when it’s working? These questions can appear basic but many companies do not go through this thought process before implementing a corporate wellness plan, according to Hall. Indeed, to make a corporate wellness plan work to its fullest potential, companies have to advertise the plans amongst their employee base and bring employees along in developing these plans.

INVOLVING YOUR EMPLOYEES “There is more than a brochure to get a person involved,” Midwest Business Group on Health President and CEO Larry Borress said. According to Borress, people do have the desire to stay healthy but generally do not trust their employer’s health advice. Employees generally want their physician’s point of view. Knowing that 72% of physicians agree employers should have a role in improving and maintaining the health of their employees with chronic diseases it would be a good option to

Healthier employees are better performers and this in turn impacts the bottom line and makes your company better. Another technique to get an employee more involved in the program is to make the final goal of being healthy and maintaining a healthy well-being – a reward. Pete Thomas who lost 185 pounds in nine months uses the example of employees who need to lose weight. “They love to be rewarded, your goal should be rewarding,” Thomas said, adding that his personal goal was to wear a white suit from a TV show when he was losing weight.

WORKSITE WELLNESS PROGRAMS According to Hoheb, corporate health programs can be divided into five categories: medical, spa, nutrition, fitness and life/balance.

December 2010/January 2011

MEDICAL TOURISM Within the company, health programs can incorporate an array of weight loss or smoking cessation programs, discounts for spas or fitness centers, onsite fitness centers, health coaches, free flu-shots and, healthier cafeteria food and snacks. In addition, new corporate wellness trends are online wellness tools including online nutrition tips, yoga or fitness instruction. Employees can exercise at work and bring home the many online wellness tools.

CASE EXAMPLES OF KRAFT FOODS COMPANY AND NASA Kraft Foods Company launched multiple wellness initiatives which were customized by country within the multinational’s network of companies. At Kraft, wellness programs available to employees include discounts at fitness centers, flu shots, medical exams, newsletters and healthy food choice at work. According to Joanne Armenio, Director of International Benefits at Kraft foods it took several months to come up with a plan, however, today the top wellness program within Kraft is the fitness center. “We are moving forward with the Employee Assistance Program and we hope more of our organizations will implement and EAPs.” According to NASA’s Wellness Program Manager Robert Davenport, NASA started to provide a corporate wellness

program to their employees many years ago. Today, the Johnson Space Center program provides free 12 months membership to a multi-purpose facility for employees that is inclusive of a fitness center and different types of classes. These include nutrition, stress management, behavior changes, health awareness education behavior challenges and incentives During 2008 and 2009, organizational data revealed that one third of the JSC population participated in the multipurpose facility membership program. This year, in 2010, JSC also offered a wellness week inclusive of an indoor triathlon, family fitness fair and employee assistance program class complete with consultation. n About the Author Anne-Line Crochet is Communications Intern for Medical Tourism Association. With a Masters degree in political science, a Minor in journalism, Anne-Line provides professional expertise to our public relations and editorial functions. Previously a staff writer for French publications Fragil and Ouest-France, she is fluent in English and French; and conversant in Spanish and Russian languages. Anne-Line writes for MTA’s Medical Tourism Magazine and Health Tourism Magazine. She can be reach at AnneLine@ medicaltourismassociation.com

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December 2010/January 2011

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December 2010/January 2011

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MEDICAL TOURISM

Navigating the

Worst Case

Scenario By CAYLA LAMBIER

r. Casey Chosewood, Senior Medical Officer for WorkLife Programs at the Center for Disease Control, and Dr. Myles Druckman, Vice President of Medical Services at International SOS, both gave detailed presentations at this year’s World Medical Tourism and Global Health Congress about practicing safe international travel while being prepared for the unexpected. Through their expert advice, hazardous travel factors like disease and disasters become much more manageable.

it becomes their responsibility to help ensure the safety of medical travelers, said Dr. Chosewood. This can be done by learning about destination-specific health risks around the world, such as communicable diseases, cultural issues and political unrest, in combination with acknowledging health risks related to travel and providing resources and education to medical travelers.

According to the numbers cited in Dr. Chosewood’s presentation, an estimated 1.5 million Americans traveled outside of the U.S. for medical care in 2008 for, mostly commonly, dentistry, reproductive procedures and surgeries. With such a large number of medical travelers coming from America alone, medical tourism is no longer being shrugged off by insurance companies, travel agencies and medical centers as a minor, passing fad.

Dr. Chosewood also advised that travelers take charge of their own health and safety as well, through education, preparation and prevention. Travelers should always be fully aware of the health risks of the area to which they are traveling, and take precautions to avoid them. According to Dr. Chosewood’s presentation, the best way to do this is by optimizing personal health prior to travel, being open and honest with medical providers and travel planners, obtaining proper immunizations prior to travel, seek out accredited facilities with high safety records, develop a game plan for unexpected events and arrange for follow-up care in your home country before you depart.

As players in the travel and tourism industries begin to acknowledge, assess and become involved in medical tourism,

The importance of selecting an accredited facility is paramount – by choosing a medical center that has proven itself

AVOIDING DISEASE

December 2010/January 2011

MEDICAL TOURISM through the Joint Commission International (JCI) or another comparable accrediting body, medical travelers will lower their risk of exposure to viral and bacterial infections like MRSA, drug-resistant TB, SARS, influenza and other communicable life-threatening illnesses. “We all know that any accreditation process, from the very minimal to the most complex to attain, is not 100 percent foolproof,” Dr. Chosewood said. “Even under the most ideal circumstances, people will have adverse health events. There’s a human factor to medical care: it’s not only a science, medical care is an art as well. Accreditation is the strongest instrument we have to ensure continuous quality improvement and is a vital, important step.”

According to the numbers cited in Dr. Chosewood’s presentation, an estimated 1.5 million Americans traveled outside of the U.S. for medical care in 2008 for, mostly commonly, dentistry, reproductive procedures and surgeries. Despite a traveler’s best efforts, it is still possible they could find themselves in a situation similar to the one that occurred in Mexico just last year, with the outbreak of the H1N1 virus, commonly mislabeled as the “Swine Flu.” In such situations, the best course of action is to practice thorough preventative hygiene and depart from the area as soon as possible. However, with 280 CDC public health officials in over 50 different countries, medical travelers can utilize the CDC, as well as other organizations like Red Cross and WHO, as a resource when preparing for a trip, monitoring the public health status of their destination up until their arrival and during their stay.

AVERTING DISASTER Over the past decade, it seems our planet has been riddled with natural disasters. From tsunamis and hurricanes to earthquakes and volcanoes, there is little that can stand in the way of Nature’s awesome force. In some cases, early notice of an upcoming or potential disaster can allow medical tourists to change their plans and avoid flying or sailing into harm’s way, but most of the time floods, fires and other catastrophic events occur without warning. “Was it just a crazy year, or is there more to come?” said Susan Silfen of Fairmont Specialty. “In the travel insurance industry, we’re used to hurricanes and snow – we know it’s going to happen. But what happens when you have a volcanic eruption?” The large earthquake that racked the already struggling infrastructure of Haiti earlier this year is a tragic example of the suddenness which disasters can occur. According to Dr. Druckman’s presentation, the quake resulted in thousands of immediate fatalities and thousands more due to the shortage of medical and emergency response. Another example brought up by Dr. Druckman was the March 20, 2010 eruption of Eyjafjallajokull in Iceland. Though the eruption had nowhere near the devastating effect of the quake in Haiti, it did have an adverse effect on travel in most of Europe for days after due to the large clouds of ash and debris which made flight to or from the area impossible. This event

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left travelers stranded, presumably some of whom may have been traveling for medical reasons. Dr. Druckman explained that natural disasters, in every form, are a significant threat to the health and safety of travelers, and that it is the responsibility of multinational corporations, travel facilitators and medical centers to take the proper precautions and preventative measures to ensure the safety of everyone involved. Dr. Druckman advised creating a detailed response plan that includes an effective method of distributing real-time information and tracking travelers and expatriates, an evacuation plan, supplies of updated personal protective equipment (such as gas masks, flashlights and firstaid gear), and pre-prepared internal communications. Travelers themselves should take the opportunity to research and devise plans that safely address emergency situations, such as earthquakes and hurricanes, should those events actually occur during travel, said Dr. Druckman.

AN OUNCE OF PREVENTION Aside from basic safety precautions, a medical tourists most effective method of self-protection is staying as informed and educated as possible prior to and throughout their trip. Communicating failures and successes as an entire community of medical and travel providers and consumers is key to the development of safer and sounder world travel. “Learn from each other; share your wins, share your experiences,” Dr. Chosewood said. n

MEDICAL TOURISM

University of Richmond Partners With MTA ~

Earning a

Medical Tourism

Certification

Insurance company, facilitator, broker, travel agency or hospital: no matter who you are working for, medical tourism is thriving. To enhance education on medical tourism all over the world, the Medical Tourism Association and the University of Richmond, VA, have launched a Medical Tourism Certification program. The University of Richmond’s School of Continuing Studies will work in partnership with the MTA in creating a curriculum and selecting instructors.

fficially open to students in 2011, the professional certificate program will require six courses to complete and will be available in both English and Spanish, top languages learned or spoken in the world. The courses will be offered completely online, allowing the program to reach an international audience. Each course will cost $199 and will take four weeks to complete. Students will be able to participate in these courses anywhere, at any time and at their own pace during the four-week period. “We are very excited to partner with the Medical Tourism Association, which has clearly established itself as the leader in the industry,” said Stephanie Bowlin, Non-Credit Program Manager at the University of Richmond. “We feel this program will be invaluable to potential students from around the world who are looking for certification in medical tourism.” In the online classroom, students will be able to view lectures and presentations, read articles, engage in discussions with other students and faculty, answer questions and take quizzes. In addition to earning the Professional Studies Certificate from the University of Richmond, students will also earn Continuing Education Units, or CEUs, for each class they complete. Courses can be taken individually or as part of the entire certificate program. The Medical Tourism Certification will provide a standard of best practices for those who work in this field.

“This is the first certification program for medical tourism taught by an established and leading university and educational system,” said Renée-Marie Stephano, President of the Medical Tourism Association. “This program will be a great opportunity for those individuals in the industry who are looking for advanced education and to set them apart.”

We are very excited to partner with the Medical Tourism Association, which has clearly established itself as the leader in the industry. The School of Continuing Studies primarily serves nontraditional students; the certificate will cover many different topics from risks management, medical network, marketing to continuity of care. According to Bowlin, University of Richmond is looking forward to working with the MTA to bring in some of the leaders in medical tourism and international healthcare as professors and teachers for this online certificate program. n

December 2010/January 2011

World Medical Tourism &

ANNUAL Global Healthcare Congress

+ 2000 ATTENDEES

Chicago, Illinois, USA • October 25th-28th, 2011

+ 400

BUYERS OF HEALTHCARE

+ 200

EXHIBITORS

+ 10,000

NETWORKING MEETINGS “+ “ = up to

CONFERENCE HIGHLIGHTS • Over 2,000 Large Employers Invited • Up To 5,000 Voluntary Benefits, Corporate Wellness, Self Funded and Expatriate Insurance Experts Invited • The Leading Top Health Insurance Agents and Consultants • Top Insurance Carriers • Networking Sessions with One-on-One Pre-arranged Meetings • Over 100 Expert Speakers • Advanced Educational Sessions

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4th Annual World Medical Tourism & Global Healthcare Congress www.medicaltourismcongress.com Info@medicaltourismcongress.com © December 2010/January 2011

World Medical Tourism &

ANNUAL Global Healthcare Congress

2011 World Medical Touriam & Global Healthcare Congress

THREE LEADING HEALTHCARE CONFERENCES

ONE LOCATION One Exhibit Hall, 3x the Traffic Shared Exhibit Hall, Networking Lunches & Networking Receptions World Medical Tourism and Global Healthcare Congress Expatriate Healthcare, Travel Insurance & Global Health Insurance Conference Sustainable Healthcare & Hospital Development Conference

Expatriate Healthcare,Travel

Insurance and Global

H E A L T H

I N S U R A N C E

4th Annual World Medical Tourism & Global Healthcare Congress www.medicaltourismcongress.com Â© Copyright Medical Tourism Association Info@medicaltourismcongress.comDecember 2010/January 2011

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PRESS RELEASES

MTA to Launch Medical Tourism

Destination Guides T

he MTA has announced the release of medical tourism and healthcare destination guides providing exclusive highlights of a destination, country or city with detailed information about the quality of healthcare found in that region. The Medical Tourism Magazine’s Healthcare Guide will include information on hospitals, clinics, medical spas, wellness centers, hotels and tour operators for patients. It will also feature tourism information for patients with full color photos. In furtherance of the MTA’s drive for education, these guides will help patients, companions, insurance companies, governments and medical tourism facilitators gather knowledge particular medical tourist destinations. Renee-Marie Stephano, President of the MTA and Chief Editor of Medical Tourism Magazine said, “Patients have very few sources of information to turn to when researching options for medical care around the world. This book will provide new access to patients around the world to critical healthcare information. Countries or Cities who choose to publish a destination guide may see faster growth of inquiries about healthcare services in the region with the increased availability of information made available to patients. Patients will be able to access the information from the Medical Tourism Magazine website at no cost right at their fingertips. The majority of patients research for medical information is gathered online, and making this information available at no cost will increase consumer awareness of medical services worldwide. The print edition will be in color and be an invaluable resource for everyone.” The Features of the Healthcare Destination Guides will be: • Each guide covers a specific Destination, Country or City • Detailed Information about the Quality of Healthcare in the Destination Country and the Healthcare Infrastructure found in the designated region • Information on Hospitals, Clinics, Medical Spas, Wellness Centers, Hotels and Tour Operators for Patients

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• Tourism Information for Patients and their Companions during their medical stay • Expectations of patients and companions when traveling to specific countries and cities • Full Color photos of the hospitals and tourism opportunities unlike other industry guides • Instant Free Access for Patients by download from Medical Tourism Magazine website • Print edition available for purchase by patients, insurance companies, employers and facilitators through Amazon.com and other book merchants for worldwide distribution. For more information on the guides go to http://www. medicaltourismassociation.com/en/destination-healthcareguide.html. The Medical Tourism Magazine is the leading and only publication in both print and online for the medical tourism and global healthcare industries. The Medical Tourism Association™ (Global Healthcare Association) is the international non-profit trade association for the medical tourism and global healthcare industry made up of the top international hospitals, healthcare providers, medical travel facilitators, insurance companies, and other affiliated companies and members with the common goal of promoting the highest level of quality of healthcare to patients in a global environment. Our Association promotes the interests of its healthcare provider and medical tourism facilitator members. The Medical Tourism Association™ has three tenets: Transparency in Quality and Pricing, Communication and Education. n For more information contact ~ Gabriella Vicuña Global Program Coordinator Gaby@medicaltourismassociation.com US 001.561.791.2000

MTA Launches

Global Directory of Medical Tourism Leaders

Medical Tourism Association and Medical Tourism Magazine have launched the first Who’s Who Directory for Medical Tourism. The Who’s Who directory will feature the Leaders in both medical tourism and global healthcare across the globe. The Directory will be available both online all year long on the Medical Tourism Magazine website. http://www. medicaltourismmag.com/. The printed version will be distributed at the 4th World Medical Tourism & Global Healthcare Congress in Chicago, Illinois, USA September 26-28, 2011 and the electronic version will be sent by email to over 20,000 Healthcare Leaders, including Insurance Companies, Employers, Hospital, Medical Tourism Facilitators, Governments, Healthcare Providers, Healthcare Leaders, Consultants and more. “The medical tourism directory will make it easy for insurance companies, governments, agents, facilitators and others interested in medical tourism to quickly gather information about potential business contacts,” said Jonathan Edelheit, CEO of the Medical Tourism Association. MTA members will receive a free directory listing with membership recognition while others can purchase a listing or advertise in the Directory. Ad ranges from 1/8th page to full page.

For more information on the medical tourism directory go to http://www.medicaltourismassociation.com/en/medicaltourism-directory-2011.html The Medical Tourism Magazine™ is the leading publication in both print and online for the medical tourism and global healthcare industries. The Medical Tourism Association™ (Global Healthcare Association) is the international non-profit trade association for the medical tourism and global healthcare industry made up of the top international hospitals, healthcare providers, medical travel facilitators, insurance companies, and other affiliated companies and members with the common goal of promoting the highest level of quality of healthcare to patients in a global environment. Our Association promotes the interests of its healthcare provider and medical tourism facilitator members. The Medical Tourism Association™ has three tenets: Transparency in Quality and Pricing, Communication and Education. n For more information contact: Gabriella Vicuña Global Program Coordinator Gaby@medicaltourismassociation.com US 561-791-2000 www.MedicalTourismAssociation.com

The Medical Tourism Directory will feature 15 categories, namely:

Medical Tourism Facilitator Hospital/Medical Center Specialty Clinic Dental Clinic Cosmetic Surgery Clinic Practicing Physician Government Agency Healthcare Cluster Industry Association Consultant Technology Insurance Company Health Insurance Agent/Consultant Tourism/Travel Company Hotel/Recovery Retreat/Resort

December 2010/January 2011

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PRESS RELEASES

World Medical Tourism & Global Healthcare Congress Hailed a Resounding Success WEST PALM BEACH, FLORIDA--(Oct. 14, 2010) Developments in the burgeoning field of medical tourism were discussed at the 3rd Annual Medical Tourism & Global Healthcare Congress, which recently took place in Los Angeles, USA. The event, which was organized by the Medical Tourism Association (MTA), attracted over 1,200delegates from over 84 countries who came to participate in a three-day program of discussions and seminars about healthcare travel, as well as to take the opportunity to mix with industry peers from the global private and public healthcare sectors. The sold-out program was hailed by its organizers as an absolute success, with those interviewed giving the occasion a resounding thumbs up. “We were able to effectively carry out all of our planned initiatives for this congress of extending networking opportunities, holding informative sessions and creating knowledge sharing possibilities between government, insurance, healthcare, and tourism professionals. The exhibitors were pleased with the new found business prospects while our incredible speakers provided a learning platform for industry professionals,” said Renee-Marie Stephano, President of the MTA. “From the positive reviews we have received, I would like to thanks all the participants for making this congress an enormous success, and looking forward to their continued support for our annual meeting” she added. We look forward to using the delegate survey results to perfect the event each year. The theme for this year’s MTA Congress, which is the world’s largest platform for medical tourism issues, was “Progress in Motion.”The extensive schedule of talks and seminars featured key opinion leaders from the medical tourism sector, governmental bodies, and the insurance industry. There was also ample opportunity for formal and informal networking. One particular addition, the “Buyers of Healthcare VIP Program” enabled a more interactive business environment for delegates and sponsors to communicate and discuss partnerships. It brought together up to200 employers, insurance companies, agents, and medical tourism facilitators who are actively involved or interested in the issues surrounding patients travelling across borders for healthcare. Three important medical tourism books were launched during the Congress; two co-authored by industry experts Renee-Marie Stephano and William Cook: Developing an International Patient Center - A Guide to Creating the Best Patient Experience and The Medical Tourism Facilitator - A Best Practices Guide to Healthcare Facilitation for International Patients were focused on creating good practice, capitalizing on opportunities, and surmounting the various challenges facing medical tourism operators and facilitators. The third book was co-authored by Renee-Marie Stephano and Jonathan Edelheit, which focused on Medical Tourism information for employers, insurance companies, and government bodies. “These medical tourism books intend to act as a roadmap and guide for those healthcare providers and facilitators that would like to attract and serve international patients. I am certain that eventually these books will help hospitals and facilitators to serve patients better,” said Stephano. The MTA worked relentlessly to secure the presence of government officials from different corners of the world to emphasize the global nature of the congress and their participation in the 3rd Annual Ministerial Summit. The hard

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work was worthwhile, as there were delegates present from the government bodies of a number of countries that are trying to develop or enhance the medical tourism sector in their region. “What we were particularly pleased about was the extensive support we received from government officials. This indicates the burgeoning support from all sectors for medical tourism initiatives, especially ministers of health, tourism, and economic development,” said Jonathan Edelheit, CEO of the Medical Tourism Association. One of the largest government-body contingents at the congress was from the Dubai Health Authority (DHA), which took a leading step by participating as the Diamond Sponsor. His Excellency Qadhi Saeed Al Murooshid, Director General of the DHA, explained the reason for his emirate’s strong involvement at the event. “In recent years, Dubai has seen a phenomenal growth in the health sector. Medical tourism is an integral aspect of healthcare, especially in the context of today’s globalized world and the DHA is keen to further strengthen and establish Dubai’s position on the medical tourism and global healthcare map,” he said. The DHA was able to capitalize on its presence at the congress with the signing of a Memorandum of Understanding (MOU) with the Medical Tourism Association. The MOU agreed that the organizations would work together to strengthen the medical tourism sector in Dubai. “The DHA is strengthening its policies, regulations, and further developing its healthcare capabilities to strengthen the medical tourism sector,” said Laila Al Jassmi, CEO Health Policy and Strategy Sector at the DHA. “We consider the private sector to be a key stakeholder and thus both the public and the private health sector in Dubai will be a part of the medical tourism conference which takes place in 2011,” she added. Another notable initiative was the launch of two new congresses:”Expatriate Healthcare, Travel Insurance &Global Health Insurance Conference” and the “Sustainable Healthcare and Hospital Development Conference,” which contributed meaningfully in overall success of the congress. The 4th Annual Medical Tourism & Global Healthcare Congress is scheduled to take place from October 26-28, 2011 in Chicago, USA. According to organizers, it is anticipated that it will be the largest MTA event yet, with up to 2000 expected attendees, 10,000 pre-scheduled meetings, 100 speakers, and up to400 of healthcare buyers, including insurance companies, employers, and government officials. MTA is also planning a special focus on global insurance programs, medical tourism cities, and expatriate healthcare. Visit us at www. MedicalTourismCongress.com. n

For more information contact ~ Amelia Fernandez Global Congress Manager USA 001.561.792.6676 info@medicaltourismcongress.com www.medicaltourismcongress.com

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M TA M E M B E R HOSPITALS American Hospital Dubai P.O. Box 5566 Dubai - UAE Dubai UAE Phone: 971-4-336 7777 Fax: 971-4-309 6325 Website: www.ahdubai.com Ascot Hospital’s International Steve Nichols Mercy Specialist Center 100 Mountain Road Epsom Auckland 1149 New Zealand Telephone: 64-9-623-6588 Fax: 64-9-6236587 Website: www.medtral.com Assaf Harofeh Medical Center PO Beer Ya’akov Zerifin 70300 Israel Telephone: 972-8-9779589 Fax: 972-8-9779526 Website: www.assafh.org Bangkok Hospital Medical Center 2 Soi Soonvijai 7, New Petchburi Road Bangkok 10310 Thailand Telephone: (+66) 320 3000 Fax: (+66) 320 3105 Website: www.bangkokhospital.com Baptist Hospital South Florida 8940 N. Kendall Drive Suite 601E Miami Florida 33176 City : Florida Country : United States Phone : 7865964643 Fax : 7865963648 Website : www.baptisthealth.net Bumrungrad International 33 Sukhumvit 3 (Soi Nana Nua), Wattana, Bangkok 10110 Thailand Telephone: + 662 667 1000 Website: www.bumrungrad.com Doctors Hospital #1 Collins Avenue P.O. Box N-3018 Nassau, Bahamas Telephone: 242-302-4600 Fax: 242-323-4801 Website: www.doctorshosp.com FV Hospital - Far East Medical Vietnam Limited 6 Nguyen Luong Bang, Saigon South (Phu My Hung) District 7,Ho Chi Minh City VIETNAM Telephone: (84-8) 411-3333 Fax: (84-8) 411-3334 Website: www.fvhospital.com International Patient Services Telephone: (84-8) 411-3420 Email: international@fvhospital.com International Guide: http://international. fvhospital.com G.M.C Hospital and Research Centre P.O. Box 4184 Ajman, United Arab Emirates City : Ajman Country : United Arab Emirates Phone : 97167463333 Fax : 9716746444 Website : www.gmchospital.com

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