2007
ANNUAL REPORT
O F D U B A I , I N C O L L A B O R AT I O N W I T H H M I , T O B E A C E N T E R O F E X C E L L E N C E F O R M E D I C A L S E R V I C E S , M E D I C A L E D U C AT I O N , L I F E S C I E N C E R E S E A R C H , S FA C I L I T I E S , I N C L U D I N G A C A D E M I C T E R T I A R Y C A R E A N D S P E C I A LT Y R E F E R R A L H O S P I TA L S , P R I M A R Y A N D S E C O N D A R Y C A R E C E N T E R S , E D U C AT I
V E L O P M E N T FA C I L I T I E S . I T S C O R E C A M P U S W I L L I N C L U D E T H E H A R VA R D M E D I C A L S C H O O L D U B A I C E N T E R ( H M S D C ) I N S T I T U T E F O R P O S T G R A D U AT E
VERNANCE INFRASTRUCTURE IN ORDER TO GUIDE CONTINUOUS IMPROVEMENT THROUGHOUT DHCC.INTUMED, DUBLIN, IRELAND, IS A JOINT VENTURE B A S I C E L E C T R O N I C S U R G I C A L T R A I N I N G ) , A N O N L I N E G E N E R A L S U R G I C A L T R A I N I N G C O U R S E F O R R E S I D E N T S P R E PA R I N G F O R A M E R I C A N A N D R O YA L OL AND RCSI. THE AWARD-WINNING PROGRAM IS BEING USED BY MANY SURGICAL RESIDENCY PROGRAMS IN THE U.S., AS WELL AS BY INDIVIDUAL
G R O U P O P E R AT I N G F O U R H O S P I TA L S , I S C O L L A B O R AT I N G W I T H H M I O N T H E D E V E L O P M E N T O F N E W C E N T E R S O F E X C E L L E N C E I N O N C O L O G Y A N D N E U P A R T N E R S H I P A L S O F O C U S E S O N T H E A D V A N C E M E N T O F N U R S I N G P R O F E S S I O N A L D E V E L O P M E N T, C O N T I N U I N G M E D I C A L E D U C AT I O N , A N D Q U A L I T Y
G E S T H O S P I TA L I N K O R E A , C O L L A B O R AT E S W I T H H M I O N I N I T I AT I V E S T H AT A D D R E S S F A C U LT Y A N D P R O G R A M D E V E L O P M E N T, A C A D E M I C E X C H A N G E S , T I N G - E D G E I S S U E S I N M E D I C A L S C I E N C E A N D T E C H N O L O G Y. T H E F I F T H S Y M P O S I U M , E N T I T L E D “ N E W F R O N T I E R S I N O N C O L O G Y, ” W A S H E L D I N J U N E N I C I PA L H E A LT H B U R E A U O F T H E P E O P L E ’ S R E P U B L I C O F C H I N A .
H M I A N D B I M C A R E C O L L A B O R AT I N G O N T H E D E V E L O P M E N T O F A 5 0 0 - B E D G E N E R -
N C L U D E A C E N T E R T O S U P P O R T P O S T G R A D U AT E E D U C AT I O N A N D C U T T I N G - E D G E R E S E A R C H I N T H E L I F E S C I E N C E S . U P O N I T S C O M P L E T I O N A N D S AT -
T Y ( T U D ) , D R E S D E N , G E R M A N Y, I S A U N I V E R S I T Y W I T H A S T R O N G F O C U S O N R E S E A R C H A N D T H E I N T E G R A T I O N O F P R O B L E M - B A S E D T E A C H I N G . T U D , U L U M F O R A L L S I X Y E A R S O F T H E M E D I C A L P R O G R A M . E A C H Y E A R A S E L E C T G R O U P O F F I N A L - Y E A R M E D I C A L S T U D E N T S C O M P L E T E S R O TAT I O N S I N G G E N E R A L H O S P I TA L S E R V I C E S T O T H E P E O P L E O F AT H E N S . H M I I S S U P P O R T I N G T H E D E V E L O P M E N T A N D I M P L E M E N TAT I O N O F A Q U A L I T Y M A N A G E -
M I N I C A N U N I V E R S I T Y O F O R G A N I Z AT I O N & M E T H O D S ( O & M ) , S A N T O D O M I N G O , D O M I N I C A N R E P U B L I C , I S T H E L A R G E S T P R I VAT E U N I V E R S I T Y I N T H E
L L H O U S E A N E W M E D I C A L S C H O O L A N D U N I V E R S I T Y H O S P I TA L . U P O N I T S C O M P L E T I O N A N D S AT I S FA C T O R Y F I N A L E VA L U AT I O N , T H I S FA C I L I T Y W I L L I N S T I T U T I O N W I T H A S T R O N G F O C U S O N R E S E A R C H , C L I N I C A L S E R V I C E S , A N D PAT I E N T C A R E , A N D A C O M M I T M E N T T O E D U C AT I N G S T U D E N T S AT A L L E D S I N T O T A L . H M I I S C O L L A B O R A T I N G W I T H L M U O N T H E D E V E L O P M E N T O N E W A P P R O A C H E S T O M E D I C A L E D U C A T I O N T H R O U G H O U T G E R M A N Y,
R S E I N M E D I C A L E D U C AT I O N . P H YAT H A I H O S P I TA L G R O U P ( P Y T ) , B A N G K O K , T H A I L A N D , I S A P R I VAT E H O S P I TA L G R O U P O P E R AT I N G T H R E E H O S P I TA L S , F R O M H M I . C U R R E N T LY T H E H M I - P Y T P A R T N E R S H I P I S F O C U S E D O N D E V E L O P I N G H I G H - Q U A L I T Y E D U C AT I O N P R O G R A M S F O R T H E N E T W O R K ’ S P H Y S I -
S FA C I L I T I E S , C L I N I C A L P R O G R A M S , A N D O P E R AT I N G S Y S T E M S . S R I R A M A C H A N D R A M E D I C A L C O L L E G E & R E S E A R C H I N S T I T U T E ( D E E M E D U N I V E R S I T Y ) ,
Y T H E I N D I A N G O V E R N M E N T, S R I R A M A C H A N D R A H A S A U T O N O M O U S D E G R E E - G R A N T I N G A U T H O R I T Y A N D I S D E D I C AT E D T O M E D I C A L E D U C AT I O N ,
A M S W I T H H M S , I N T E G R AT E D N E W T E A C H I N G M E T H O D S I N T O T H E I R C U R R I C U L U M , A N D H O S T E D C O N T I N U I N G M E D I C A L E D U C AT I O N P R O G R A M S F O R
C O M M I T T E D T O T H E P U R S U I T O F E X C E L L E N C E I N H E A LT H C A R E , E D U C AT I O N , A N D R E S E A R C H
T R A N S F O R M A T I O N S
CENTERING EXCELLENCE WITHIN DUBAI HEALTHCARE CITY In the last four years Dubai Healthcare City (DHCC) has grown into a thriving community of licensed clinical providers including top institutions from around the globe. DHCC has been the catalyst for numerous collaborations and quality improvement initiatives, and helped spark a regional resurgence in research and education. In partnership with HMI, DHCC has not only connected patients with providers, but also created new models of governance and developed critical and sustainable health care infrastructure. The impact for patients is observable every day. The impact of DHCC’s achievements on the Dubai health care system, its current and future workforce, and the greater Gulf Region is beginning to take shape. All of this has been accomplished within a designated Free Zone wherein HMI and DHCC have a blank canvas on which to create an essentially new health care system.
“This represented a unique opportunity in medicine: to create a new system, based upon best practices experiences from around the world, in a zone where essentially all regulations and standards are created, from scratch, as the system develops,” said Robert K. Crone, MD, President and Chief Executive Officer of HMI. The result of this collaboration has been a system that is unburdened by existing practices and attitudes; which is governed by its own rules and regulations, planning processes, and system for adjudication of disputes; and in which continuous quality improvement is guided by a robust licensing and credentialing process. The vision for Dubai Healthcare City since its conception has been to develop an integrated academic medical community that serves the greater Middle Eastern region, with comprehensive services, postgraduate medical training, and research programs. DHCC has progressed into the second phase of its longterm development, which will include the creation of wellness facilities, hospitals, and
other clinical centers and cover approximately 20 million square feet. DHCC’s significant investment in wellness services is key to Dubai becoming a health destination for families in the Gulf Region. When complete, DHCC will be able to offer seamless disease prevention, management, and treatment programs, as well as state-of-the-art accommodations, all in a single general locale. Dr. Muhadditha Al-Hashimi, Chief Executive Officer of DHCC, said, “We want DHCC to attract people who are taking a proactive approach to their own health, through disease screening and regular preventive check-ups.” The first phase, which is more than halfway completed, consisted of the development of clinical and retail facilities over a 4.1 million square feet area. This community has grown rapidly to include nearly 20 clinical services providers covering a wide range of specialty areas who are licensed by DHCC to ensure that the services offered in the medical complex meet international standards for quality. By the end of 2006, more than 130 health
“This represented a unique opportunity in medicine: to create a new system, based upon best practices experiences from around the world, in a zone where essentially all regulations and standards are created, from scratch, as the system develops.” — Robert K. Crone, MD P3
T R A N S F O R M AT I O N S
care professionals were practicing in DHCC, and the community had recorded more than 30,000 outpatient visits. The collaboration between HMI and Dubai Healthcare City (DHCC) has drawn on every facet of HMI’s expertise. HMI continues to play a major role in the development of DHCC. HMI and DHCC created and jointly oversee a central infrastructure for standards development, clinical planning, licensing, and quality management and performance improvement. This includes key governance entities represented by leaders at both HMI and DHCC, which, together with the DHCC Licensing Board, are responsible for licensing providers and operators to practice at DHCC, ensuring an appropriate clinical services mix, and providing regulatory oversight for all individuals and organizations operating at DHCC. HMI has also helped to develop a health informatics infrastructure.
WOCKHARDT STILL TO BE DRAFTED Wockhardt’s growing network of hospitals is at the center of South Asia’s medical tourism
boom. The second largest hospital chain in India is emblematic of the new wave of high-tech corporate health care networks that are helping to reverse the medical brain drain in the developing world. Wockhardt staked its claim to regional leadership when it received accreditation from Joint Commission International in 2005, a distinction that followed an intensive quality management and performance improvement initiative with HMI. Wockhardt Hospitals has an aggressive growth strategy that is designed to take the health care network into new territory. Geographical expansion, new hospital development, and the implementation of new clinical programs and technology top the agenda for the longtime HMI partner. Wockhardt continues to attract patients from all over the world seeking affordable, high-quality interventions. But beyond giving international patients a choice when it comes to hip replacements, Wockhardt is also establishing itself as a provider of choice for India’s growing middle class. Its heart centers are operating at the leading edge of interventional cardiology, regularly performing such state-of-the-art procedures as awake minimally invasive cardiac surgery. The hope for the future is that these “corporate hospitals” will establish benchmarks for quality that will serve as a national standard, and that their example will influence the standard of care in public hospitals when more resources become available. Their growth might also contribute to reversing the brain drain of physicians leaving India due in part to poor working conditions.
S T R AT E G I C C O L L A B O R AT I O N S D U B A I H E A LT H C A R E C I T Y ( D H C C ) , D U B A I , U N I T E D A R A B E M I R AT E S , W A S E S TA B L I S H E D B Y T H E G O V E R N M E N T O F D U B A I , I N C O L L A B O R AT I O N W I T H H M I , T O B E A C E N T E R O F E X C E L L E N C E F O R M E D I C A L Clockwise from left: Preliminary plans for a new hospital; HMI’s Harvey Makadon during a primary S E R V I C E S , M E D I C A L E D U C AT I O N , L I F E S C I E N C E R E S E A R C H , A N D T E C H N O L O G Y care conference in Dubai; Judy Mitchell, architect and HMI director of planning. I M P L E M E N TAT I O N I N T H E G U L F R E G I O N . D H C C W I L L U LT I M AT E LY B E C O M PRISED OF REGIONAL MEDICAL CARE AND WELLNESS FACILITIES, INCLUDING A C A D E M I C T E RT I A RY C A R E A N D S P E C I A LT Y R E F E R R A L H O S P I TA L S , P R I M A RY A N D S E C O N D A R Y C A R E C E N T E R S , E D U C AT I E D U C AT I O N A L FA C I L I T I E S , B A S I C AND BL CLINICAL RESEARCH FACILITIES AND ANNUAL REPORT COMMERCIAL BIOTECHNOLOGY RESEARCH AND DEVELOPMENT FACILITIES. ITS CORE CAMPUS WILL INCLUDE THE HARVARD MEDICAL SCHOOL DUBAI CENTER (HMSDC) I N S T I T U T E F O R P O S T G R A D U AT E E D U C AT I O N & R E S E A R C H , A S W E L L A S A S TAT E - O F - T H E - A R T A C A D E M I C M E D I C A L C E N T E R . H M I H A S E S TA B L I S H E D A QUALITY IMPROVEMENT AND GOVERNANCE INFRASTRUCTURE IN ORDER TO GUIDE CONTINUOUS IMPROVEMENT THROUGHOUT DHCC.INTUMED, DUBLIN, IRELAND, IS A JOINT VENTURE BETWEEN INTUITION PUBLISHING, AN EL E A R N I N G C O M P A N Y; T H E R O YA L C O L L E G E O F S U R G E O N S O F I R E L A N D ( R C S I ) ; AND HMI, FOCUSED ON BEST (BASIC ELECTRONIC SURGICAL TRAINING), AN Makadon O Preliminary N L I N E G plans E N E Rfor A La new S U Rhospital; G I C A LHMI’s T R AHarvey INING C O U Rduring S E F aOprimary R R E Scare I D E conference N T S P R Ein PARING FO R AM E R Mitchell, I C A N Aarchitect N D R Oand Y A HMI L CO L L E G of E planning. BOARD EXAMS. BEST COMBINES INTERDubai; Judy director A C T I V E C O N T E N T P R E PA R E D , R E V I E W E D , A N D U P D AT E D B Y FA C U LT Y F R O M HARVARD MEDICAL SCHOOL AND RCSI. THE AWARD-WINNING PROGRAM IS BEING USED BY MANY SURGICAL RESIDENCY PROGRAMS IN THE U.S., AS WELL AS BY INDIVIDUAL SURGICAL TRAINEES AROUND THE WORLD. HMI A S S O C I AT E D INSTITUTIONSACIBADEM HEALTHCARE G R O U P, ISTANBUL, T U R K E Y, A P R I V A T E H O S P I T A L G R O U P O P E R A T I N G F O U R H O S P I T A L S , I S C O L L A B O R AT I N G W I T H H M I O N T H E D E V E L O P M E N T O F N E W C E N T E R S O F E X C E L L E N C E I N O N C O L O G Y A N D N E U R O S C I E N C E , W I T H A F O C U S O N E D U C AT I O N A L P R O G R A M S F O R I T S P H Y S I C I A N S , N U R S E S , T H E M E D I C A L C O M M U N I T Y, A N D THE GENERAL PUBLIC. THE PARTNERSHIP ALSO FOCUSES ON THE ADVANCEE N T toOincrease F N U R access S I N G to P Rhealth O F E Scare SION L D E V E L O P M E N T, C O N T I N U I N G M E D I C A L Large-scale development projectMaims inAPakistan E D U C AT I O N , A N D Q U A L I T Y M A N A G E M E N T P R O G R A M S . A S A N M E D I C A L C E N HMI has entered into a long-term relationship with the Defence Housing Authority Islamabad (DHAI), an organization that is planning to develop a T E R , S E O U L , K O R E A , A N A F F I L I AT E O F T H E U N I V E R S I T Y O F U L S A N C O L L E G E 60-acre health and education complex as part of a large-scale residential development in Pakistan. Current plans for Health and Education City O F M E D I C I N E A N D T H E L A R G E S T H O S P I TA L I N K O R E A , C O L L A B O R AT E S W I T H Islamabad include a 500-bed teaching hospital and colleges of medicine, nursing, and dentistry. H M I O N I N I T I AT I V E S T H AT A D D R E S S F A C U LT Y A N D P R O G R A M D E V E L O P M E N T, HMI will advise DHAI on the establishment of a tertiary care teaching hospital and associated schools for health care professionals to address the ACADEMIC EXCHANGES, INFRASTRUCTURE EXPANSION, AND ADMINISTRAhealth and medical education needs of the twin cities of Rawalpindi and Islamabad, and beyond. Although in recent years Pakistan has made conT I O N . A S A N A N D H M I J O I N T LY S P O N S O R A B I E N N I A L I N T E R N AT I O N A L S Y M siderable improvements to its health care infrastructure, the country’s supply of high-quality facilities and highly-trained health care professionals is POSIUM IN SEOUL ON CUTTING-EDGE ISSUES IN MEDICAL SCIENCE AND unevenly distributed, and inadequate to serve a nation experiencing such rapid population growth. Large numbers of Pakistan-trained physicians T E C H N O L O G Y. T H E F I F T H S Y M P O S I U M , E N T I T L E D “ N E W F R O N T I E R S I N continue to leave to practice in other countries. O N C O L O G Y, ” W A S H E L D I N J U N E 2 0 0 B E I J I N G - U N I T E D S T A T E S I N T E R N A T I O N A L M E D I C A L C E N T E R ( B I M C ) , B E I J I N G , C H I N A , I S B E I N G C R E AT E D U N D E R T H E A U S P I C E S O F T H E B E I J I N G M U N I C I PA L H E A LT H B U R E A U O F T H E P E O P L E ’ S R E P U B L I C O F C H I N A . H M I A N D B I M C A R E C O L L A B O R AT I N G O N T H E D E V E L O P MENT OF A 500-BED GENERAL MEDICAL/SURGICAL TERTIARY CARE TEACHING H O S P I TA L T O B E L O C AT E D I N T H E T O N G Z H O U D I S T R I C T O F B E I J I N G . T H E
Beginnings
H A R VA R D M E D I C A L I N T E R N AT I O N A L A N N U A L R E P O R T
2007
P4
One Renaissance Park Suite 900 1135 Tremont Street Boston, Massachusetts 02120 USA
www.hmi.harvard.edu HMI WORLD: www.hmiworld.org
WA S E S TA B L I S H E D B Y T H E G O V E R N M E N T
A N D T E C H N O L O G Y I M P L E M E N TAT I O N I N T H E G U L F R E G I O N . D H C C W I L L U LT I M AT E LY B E C O M P R I S E D O F R E G I O N A L M E D I C A L C A R E A N D W E L L N E S
E D U C AT I O N A L FA C I L I T I E S , B A S I C A N D B L C L I N I C A L R E S E A R C H FA C I L I T I E S A N D A N N U A L R E P O R T C O M M E R C I A L B I O T E C H N O L O G Y R E S E A R C H A N D D E V
E D U C AT I O N & R E S E A R C H , A S W E L L A S A S TAT E - O F - T H E - A R T A C A D E M I C M E D I C A L C E N T E R . H M I H A S E S TA B L I S H E D A Q U A L I T Y I M P R O V E M E N T A N D G O V
B E T W E E N I N T U I T I O N P U B L I S H I N G , A N E - L E A R N I N G C O M P A N Y; T H E R O YA L C O L L E G E O F S U R G E O N S O F I R E L A N D ( R C S I ) ; A N D H M I , F O C U S E D O N B E S T ( C O L L E G E B O A R D E X A M S . B E S T C O M B I N E S I N T E R A C T I V E C O N T E N T P R E PA R E D , R E V I E W E D , A N D U P D AT E D B Y FA C U LT Y F R O M H A R VA R D M E D I C A L S C H O
S U R G I C A L T R A I N E E S A R O U N D T H E W O R L D . H M I A S S O C I A T E D I N S T I T U T I O N S A C I B A D E M H E A L T H C A R E G R O U P, I S T A N B U L , T U R K E Y, A P R I V A T E H O S P I T A L G R O S C I E N C E , W I T H A F O C U S O N E D U C A T I O N A L P R O G R A M S F O R I T S P H Y S I C I A N S , N U R S E S , T H E M E D I C A L C O M M U N I T Y, A N D T H E G E N E R A L P U B L I C . T H E
M A N A G E M E N T P R O G R A M S . A S A N M E D I C A L C E N T E R , S E O U L , K O R E A , A N A F F I L I AT E O F T H E U N I V E R S I T Y O F U L S A N C O L L E G E O F M E D I C I N E A N D T H E L A R G I N F R A S T R U C T U R E E X P A N S I O N , A N D A D M I N I S T R AT I O N . A S A N A N D H M I J O I N T LY S P O N S O R A B I E N N I A L I N T E R N AT I O N A L S Y M P O S I U M I N S E O U L O N C U T
2 0 0 B E I J I N G - U N I T E D S TAT E S I N T E R N AT I O N A L M E D I C A L C E N T E R ( B I M C ) , B E I J I N G , C H I N A , I S B E I N G C R E AT E D U N D E R T H E A U S P I C E S O F T H E B E I J I N G M U
A L M E D I C A L / S U R G I C A L T E R T I A R Y C A R E T E A C H I N G H O S P I TA L T O B E L O C AT E D I N T H E T O N G Z H O U D I S T R I C T O F B E I J I N G . T H E P L A N N E D FA C I L I T Y W I L L I
I S FA C T O R Y F I N A L E VA L U AT I O N , T H E B I M C W I L L B E E L I G I B L E F O R H M I A S S O C I AT E D I N S T I T U T I O N S TAT U S . C A R L G U S TAV C A R U S T E C H N I C A L U N I V E R S I T W H I C H O P E R AT E S A U N I V E R S I T Y H O S P I TA L I N D R E S D E N , I S W O R K I N G W I T H H M I O N T H E D E V E L O P M E N T O F A P R O B L E M - O R I E N T E D L E A R N I N G C U R R I C
H A R VA R D - A F F I L I AT E D H O S P I TA L S . D I A G N O S T I C & T H E R A P E U T I C C E N T E R O F AT H E N S H Y G E I A , S . A . , AT H E N S , G R E E C E , I S A 3 6 9 - B E D FA C I L I T Y P R O V I D I N
M E N T P R O G R A M T H R O U G H R E G U L A R S I T E V I S I T S A N D I N T E R A C T I O N S A N D A S E R I E S O F E D U C A T I O N A L S Y M P O S I A W I T H V I S I T I N G H M S F A C U L T Y. D O M
D O M I N I C A N R E P U B L I C . O & M I S C O L L A B O R A T I N G W I T H H M I T O D E S I G N , S T A F F, A N D I M P L E M E N T A N I N T E G R A T E D H E A L T H S C I E N C E S C E N T E R T H A T W I L B E E L I G I B L E F O R H M I A S S O C I A T E D I N S T I T U T I O N S T A T U S . L U D W I G M A X I M I L I A N S U N I V E R S I T Y ( L M U ) , M U N I C H , G E R M A N Y, I S A L A R G E P U B L I C M E D I C A L L E V E L S , I N C L U D I N G T H R O U G H P O S T G R A D U AT E A N D S P E C I A L I Z E D T R A I N I N G P R O G R A M S . L M U O P E R AT E S T W O U N I V E R S I T Y H O S P I TA L S W I T H 2 , 5 0 0 B
E U R O P E , A N D A S I A . S E L E C T L M U S T U D E N T S C O M P L E T E C L I N I C A L R O TAT I O N S AT H M S - A F F I L I AT E D H O S P I TA L S A S W E L L A S A S P E C I A L LY D E S I G N E D C O U R O N E O F W H I C H H O U S E S T H E P H YAT H A I H E A R T C E N T E R , A C E N T E R O F E X C E L L E N C E F O R C A R D I A C C A R E D E V E L O P E D I N 1 9 9 8 W I T H S I G N I F I C A N T I N P U T
C I A N S , N U R S E S , A N D A D M I N I S T R AT O R S . P Y T I S A L S O W O R K I N G W I T H H M I T O W W W. H M I . H M S . H A R VA R D . E D U E X P L O R E T H E F U T U R E E V O L U T I O N O F I T S
C H E N N A I , I N D I A , I S A P R I VAT E A C A D E M I C M E D I C A L C E N T E R W I T H A 1 , 0 5 0 - B E D T E A C H I N G H O S P I TA L . A W A R D E D “ D E E M E D U N I V E R S I T Y ” S TAT U S B Y
R E S E A R C H , A N D H E A LT H C A R E . W O R K I N G W I T H H M I S I N C E 1 9 9 7 , S R I R A M A C H A N D R A H A S E S TA B L I S H E D S T U D E N T A N D FA C U LT Y E X C H A N G E P R O G R A