building a business case - hgk
TRANSCRIPT
Dr. Paul van OstenBerg, Consultant/Surveyors
Building a Business Case
February 22, 2017
Best Practices in Medical Travel
Topics• A look at national readiness
• A look at facility readiness by understanding risks in the medical travel care continuum
• Turning readiness into a successful medical travel program.
Agenda
www.globalhealthcareresources.com 2
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Medical Tourism Defined …
Medical tourism can be defined as
the process of traveling outside one’s
local area of residence for the
purpose of receiving medical
services.*
*Medical Tourism Association ®
Medical Travel.
Integrating :
– Hospitality,
– Clinical and
– The Patient Experience.
These three component are
important at the National and
Facility levels.
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National Readiness for
Medical Travel has many Dimensions
….
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Mortality & Health Indicators in Croatia2000 - 2012
2000 2005 2010 2012
Life expectancy at birth, total 72.8 75.2 76.5 76.9
Life expectancy at birth, male 69.1 71.8 73.5 73.9
Life expectancy at birth, female 76.7 78.8 79.6 80.1
Total mortality rate, adult, male (per 1000 male adults) 174.6 158.8 143.2 138.4
Total mortality rate, adult, female (per 1000 female adults) 71.0 65.5 60.0 58.4
Source: WHO (2014)
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Maternal, Child & Adolescent Health Indicators2000 - 2012
Source: WHO (2014)
2000 2005 2010 2011 2012
Infant Mortality Rate 7.4 5.7 4.4 4.7 3.6
Probability of dying by age 5 (per 1000 live births) 8.4 6.6 5.3 5.2 4.4
Maternal mortality rate (deaths per 100,000 live
births)
6.9 7.1 9.2 9.7 7.2
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Trends in Health Expenditure in Croatia2000 - 2012
EXPENDITURE 2010 2011 2012
THE AS % OF GDP 6.82 7.82 6.82
THE in US$ PPP per capita 1461.7 1361.72 1409.78
Public sector expenditure as health as % of THE* 84.8 82.5 82.32
Private expenditure on health as % of THEa* 15.2 17.5 17.68
OOP payments as % of THEa* 14.58 13.75 13.89
OOP payments as % of private expenditure on health* 95.92 78.56 78.56
Source: WHO (2014)
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Rights guaranteed by the 2004 Act on the
Protection of Patients’ Rights
Right to information
Right to accept or refuse specific diagnostic and therapeutic procedures
Right to protection whilst taking part in clinical trials
Right to access to medical information
Right to confidentiality
Right to maintenance of personal contacts
Right to leave the health institution voluntarily
Right to compensation for damages
Source: WHO (2014)
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Patients and Cross-Border Healthcare in EU
Patient mobility, both inward and outward, is not significant in Croatia. Patients coming from
abroad to use health care services in Croatia are mainly motivated by lower prices for some
services, such as dental care or cosmetic surgery. No records about patients coming from abroad
to use health care services in Croatia on an elective basis are maintained; only the use of
emergency care is monitored. From 1 July 2013, Croatian patients have been able to use their
European Health Insurance Card to access care in providers from other EU countries with which
the CHIF has an agreement – not only emergency care but other types of care as well (e.g.
dialysis in the case of patients with chronic conditions). A great challenge for EU Member States is
Directive 2011/24/EU on the application of patients’ rights in cross-border health care. The
Croatian Parliament accepted the Directive in June 2013. While Regulation 883/2004 only
determines treatment and reimbursement of expenses to persons in cases of using health care in
health care institutions working under a contract with an insurance fund, the Directive expands
such rights to treatment provided in the private sector (Government of the Republic of Croatia,
2012).
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Key Elements of a Successful National Initiative
Government
Support
Public-Private
Partnerships
Tourism
Planning
Human
Resources
Planning
Accreditation
& Certification
Marketing &
Promotion
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Understanding Risks to Understand
Facility Readiness….
Medical Travel.
Integrating :
– Hospitality,
– Clinical and
– The Patient Experience.
There are risks in each component
through the Medical Travel Care
Continuum.
APPROPRIATELY TRAINED STAFF
DEFINED CLINICAL AND NON-CLINICAL
PROCESSES
DEDICATED
FINANCIAL
RESOURCES
PATIENT EXPERIENCE
METRICS &
ADVOCATES
LEADERSHIP
ENGAGEMENT
BRAND
MANAGEMENT
Components of Facility Readiness …
THE MEDICAL TRAVEL CARE CONTINUUM
The Entire Care Continuum.Integrating Medical, Hospitality and Patient Centered Services.
Enhancing patient experience and engagement underpins each touch point of the cycle
Clinical Risk - poor or non-satisfactory clinical outcome and short-or long-term complications.
Financial Risk - International Patient Department can lose money on its services, litigation
costs may become excessive.
Brand or Reputation Risk - Your organization can have a negative outcome that gets into the
media, resulting in a loss of new business. An event can occur in your country, which may
negatively reflect on the “medical tourism brand” of your country and your organization’s
services.
Operational and Capacity Risk - Your organization may find it does not have the business or
clinical expertise to deliver the services that you have promised the International Patient
community. You find that you cannot provide the services promised due to a lack of number
of staff or shortage of hospital beds in your organization.
Traditional Categories of Risk …
• Give non-diagnostic information such as: Services provided,
locations, costs, local information, explain to caller/inquiry how
to complete any on line forms and the “next step” in the
process. Only explains any consents as a non-licensed person.
• Discuss/Arrange travel plans and options.
RISK POINTS
Non-licensed staff “over promises” or “recommends” specific treatment
options.
Non-Licensed Staff
Medical, Dental or other Healthcare OrganizationsInquiry Stage RISK POINTS
• Ask medical questions about current status and history, ask about permission to
communicate with the potential patient’s local physician, and agree on the next step.
• Obtain consents for any next step.
• Arrange a diagnostic follow up via telephone or confidentiality video meeting with
potential patient and home physician.
• Develop treatment plan.
Licensed Staff
RISK POINTS
Licensed person commits to admission to quickly
without having adequate medical information or
medical history.
Language presents misunderstandings that effect
evaluation process.
Disregards “red flags."
Medical, Dental or other Healthcare OrganizationsInquiry Stage RISK POINTS
Non-Licensed Staff:
• Arrange patient and companion transportation, lodging and tourism.
• Arrange for patient and companion to get to hospital or clinic or office.
• Acts as navigator for patient and companion.
RISK POINTS
Non-licensed person tries to explain the procedure or consent forms.
Licensed Staff:
• Approves admission
• Assesses patient for planned procedure.
RISK POINTS
Language presents misunderstandings that effect care.
Patient has misrepresented health status.
Medical, Dental or other Healthcare Organizations
Admission Stage RISK POINTS
Non-Licensed Staff:• Acts as navigator for patient and companion.
• Arranges hotel pick up if treatment is protracted.
Risk Points-Non-licensed person fails to arrange timely transportation for
procedure.
Licensed Staff:• Provides medical or dental or other specialty care.
• Clears patient from recovery.
Risk Points-Poor outcome from procedure or treatment.
Not prepared with all supplies and equipment necessary for timely procedure.
Medical, Dental or other Healthcare Organizations
Treatment Stage RISK POINTS
Non-Licensed Staff:• Assist patient and companion with departure planning and transportation
RISK POINTS
Non-licensed person fails to make proper arrangements for departure of patient
and companion.
Has not planned for patient and companion in the event of travel delays and
disability needs.
Patient not in agreement with final bill.
Medical, Dental or other Healthcare Organizations
Discharge & Follow-up Stage RISK POINTS
Licensed staff:• Approves discharge.
• Provides electronic and hardcopy of clinical care and recommended aftercare.
• Provides prescriptions
RISK POINTS
Patient refuses to stay in host region or country as long as physician requested.
Post surgery/procedure/treatment complications.
Poor patient and companion education on follow up so complications occur.
Poor discharge protocols are available in the language of the patient and companion.
Patient and/or companion not happy with treatment experience.
Patient experiences medical complications traveling home such as DVT (Blood clots).
Medical, Dental or other Healthcare Organizations
Discharge & Follow-up Stage RISK POINTS
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Turning Readiness into a Successful
Medical Travel
Program …
Risk Reduction through Accreditation
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Accreditation Defined …
Usually a voluntary process by which a
government or non-government agency
grants recognition to health care
institutions which meet certain standards
that require continuous improvement in
structures, processes, and outcomes.*
*ISQua ®
The Global Healthcare Accreditation Program
The Clarion Call for Accreditation
From the Wild West to Maturity
Bring Clarity, Leadership and Coordinated Effort to Resolve Issues
Engagement of Stakeholders
Engagement of Patients
Consensus on Definitions, Data Collection, Legal Liability, etc …
Facilitate Insurance Products
Raise Awareness of Employers, Insurers, and Consumers
Disruption of Market and Sharing of Innovations
Knowledge vs. Anecdotes
The Global Healthcare Accreditation Program
The Value
The patient experience is enhanced.
We offer the opportunity to collect data and benchmark for medical travel patients
We incorporate business solutions.
We share best practices.
BRANDING IDENTITY
Most designers set their
type arbitrarily, either by
pulling values out of the sky
or by adhering to a baseline.
GRAPHIC DESIGN
Most designers set their
type arbitrarily, either by
pulling values out of the sky
or by adhering to a baseline.
WEB DESIGN
Most designers set their
type arbitrarily, either by
pulling values out of the sky
or by adhering to a baseline.
SKILLS &
COMPLIANCE
REFINED
MANAGEMENT
APPROACH
UNIQUE
BUSINESS
SOLUTIONS
NEW PROGRAM ESTABLISHED
PROGRAM
STAGE OF DEVELOPMENT
VALUE DELIVERED
THE CLIENT SPECTRUM
THE STANDARDS
Complementary to existing
Quality & Safety
Achievements.
Focused on
the entire Medical Travel Care
Continuum Performance
Improvement Plans, Measurement
Collection for Quality and
Satisfaction Benchmarking.Unique Focus on Marketing,
Travel & Tourism, Cultural
Competence and Financials
Processes.
17 CORE COMPETENCIES
GHA FOCUS AREAS
Clinical Processes The Patient ExperienceHospitality & Business Processes
• Clinical Assessment &
Treatment
• Infection Control & Waste
Management
• Patient Management
• Quality Improvement
• Risk Management
• Cultural Competency
• Communication & Education
• Ethics
• Patient Advocacy
• Physical Environment
• Financial Transactions
• Health Leadership
• Marketing
• Supply Chain Management
• Technology
• Transparency & Compliance
• Travel & Tourism
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Thank You