Monthly Archives: February 2009

MedVoy participates in Medical Tourism Facilitator Certification Program

We are happy to announce that MedVoy is participating in the Medical Tourism Facilitator Certification Program conducted by a non profit organization, Medical Tourism Association. The certification is a detailed process of evaluation which may take up to 90 to 120 days to complete. We strongly believe that this will strengthen us in delivering medical tourism packages to customers and focus on having the right medical tourism processes, procedures in place that can reduce the likelihood of errors and problems and increase the chances of positive outcomes

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Medical Tourism Destinations

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We have compared below top four medical tourism destinations based on various factors – Travel duration, Procedure cost, JCI accreditation, Common procedures patients travel for

1. Malaysia

Travel duration relatively longer (>20hours).
Prices are cheaper compared to Costa Rica, Mexico but very similar to India.
Malaysia has 4 JCI accredited hospitals and majority of physicians are from India.
Patients mainly travel for cosmetics, orthopedics, ENT, cardiac procedures.

2. India

Travel duration relatively longer (>20hours).
Prices are cheaper compared to Costa Rica, Mexico but comparable to Malaysia very closely.
India has 13 JCI accredited hospitals and majority of the physicians are educated and have gained experience in US, UK.
Patients mainly travel for orthopedics, ENT, cardiac, neuro and spinal procedures.

3. Costa Rica

Travel duration relatively shorter (< 10hours).
The prices are little more compared to India and Malaysia however very similar to Mexico.
Costa Rica has 3 JCI accredited hospitals and majority of the physicians are familiar with U.S customer needs.
Patients mainly travel for cosmetic, dental procedures.

4. Mexico

Travel duration relatively shorter (< 10hours).
The prices are little more compared to India and Malaysia however very similar to Costa Rica.
Mexico has 8 JCI accredited hospitals and majority of the physicians are familiar with U.S customer needs.
Patients mainly travel for cosmetic, dental, bariatric procedures.

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Traveling with the Patient: The surrogate's role in medical tourism

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Research indicates that 95% of patients traveling out of their country for medical care go with a friend, family member or escort. Unfortunately, like those who have to care for chronically ill family members and are under a great deal of stress as a result, most of the attention goes to the patient at the expense of the care-giver. If you decide to accompany someone traveling for care, here are three things to consider to make your job easier.

1. One of your roles will be to serve as the “eyes and ears” of the patient when they interact with healthcare professionals. Because of the anxiety surrounding the trip, patients don’t always listen or understand what they are being told and have a hard time remembering instructions. Accompany the patient to visits, listen to what is being said, record the information and discuss it. Serve as another patient advocate, asking questions or requesting clarification of details of care.

2. Be sure you understand your role as a surrogate medical decison maker should it be necessary. If you have not been given power of attorney to make medical decisions for the patient, be sure you have the contact information of the person who does.

3. Be sure you get the schedule and intinerary for the trip sufficiently ahead of time to confirm appointments, make reservations and develop contingency plans should you need to make alternative arrangements because of unforseen circumstances like flight cancellations, delays or delays at the consulting facility.

There are several options for those traveling overseas for care who want someone to accompany them. Levels of expertise range from friends and family to licensed traveling nursing professionals to patient advocates. Your research and planning for your trip should include who will go with you and what they should do.

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Top 10 Medical Tourism Trends

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It’s time for new year’s lists. Here are my Top 10 Medical Tourism trends for the new year.

1. Global healthcare information exchanges
2. Commoditization of healthcare and the disintermediation of professionals
3. eBay mechanism to auction global healthcare services
4. Erosion and redefinition of professionalism and ethics
5. New heatlhcare insurance products designed to empower patients
6. Changes in global healthcare workforce
7. Global quality and price information exchanges and growth of domestic medical tourism
8. Growth of programs offering MBA’s in medical tourism
9. Evolution of medical toursm nurses and advocates
10. Electronic markets offering unused healthcare capacity.

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Why should doctors care about medical tourism?

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Medical tourism, defined by Deloitte as the process of “leaving home” for treatments and care abroad or elsewhere domestically, is growing rapidly. The recent US healthcare reform debate has heightened awareness of global healthcare options that are affordable, high quality, accessible, and, in some instances, not available or approved in the US. These options are so attractive, that an estimated 750,000 US citizens traveled abroad for medical care in 2007 and the number is expected to double next year.

While medical tourism represents a small sliver of the total US healthcare bill, it will continue to expand and surgeons should be aware of this emerging industry for several reasons.

First, patients are inquiring about global healthcare options because they have high insurance co pays and deductibles and are looking for less expensive care. Second, more and more health insurance companies are offering medical tourism plans to their customers to save money. Consequently, the role of the specialist as the treating physician may morph into something else.

Surgeons may increasing be called on to deliver preoperative assessments, communicate with consultants overseas and follow the patient after surgery. Finally, the globalization of healthcare will challenge the existing models of care in the US and providers, including otolaryngologists, will need to adapt to thrive.

While medical tourism is growing, there are significant barriers to widespread adoption. These include, among others, establishing normalized quality of care measures, malpractice issues, health insurance coverage, continuity of care challenges, international health care information exchange, security and confidentiality, global infection disease control, and the challenge of developing trusted international referral relationships. New reimbursement models, for example, paying for otolaryngologists to communicate with foreign providers by email, telemedicine or other electronic medical records systems will be necessary to create an incentive to participate.

While these obstacles are daunting, I believe they will be rapidly overcome and medical tourism will continue to emerge as an attractive option for a small but significant part of the healthcare marketplace. Surgeons should educate themselves and prepare for the change.

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Choosing the right Medical Tourism Facilitator

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With rising healthcare costs, more and more patients are travelling abroad for medical treatments. However before doing medical travel, one should invest the time and effort to do some careful planning. You don’t have time to do all the research? No worries! That’s why there are medical tourism facilitators. Medical Tourism Facilitators such as MedVoy can help arrange travel, accommodations, transportation, medical procedures abroad and also provide information about the estimate procedure price, destination, hospital, and surgeons plus put together a detailed medical travel plan. So how do I know if I am working with a good medical tourism facilitator? Here are some questions to think about while choosing a medical tourism facilitator:

1. First make sure the company is legally registered and not a company with just a website. The best place to check is the Secretary of State where you can find the incorporation information plus any unresolved issues.

2. You need to make sure that you are working with a company based in U.S. not elsewhere. The legal recourses in other countries might not be as supportive as here in U.S.

3. Ask your facilitator what your recourses may be if you experience a problem.

4. Don’t let the facilitators influence or make decisions for you. Your selections should be based on your own needs and what’s important to you. However the facilitator should provide detailed information on all the questions you might have to make you well informed.

5. Make sure you are working with a reputed company that has healthcare professionals involved. You need professionals who can act as your patient advocates and understand about medical procedures.

6. Is the company insured? Ask for evidence.

7. Find out if the facilitator has visited the hospitals you are being referred to?

8. Are they a certified medical tourism facilitator ?

This is just a subset of questions but I hope you understand the importance of working with the right medical tourism facilitator.

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Medical tourism:Hype or Hope

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The US healthcare debate has focused a lot of attention on cost, price transparency and quality. As a result, medical tourism has garnered a lot of attention in the media and the press. When the fog clears,however, it is still unclear how much healthcare reform will impact whether Americans will go out of country for care. A few things seem clear, though.

First, the initial outbound medical tourism growth predictions seem overinflated. The numbers of patients leaving the US seems significantly less than originally stated. Major consulting firms are revising their growth projections downward.

Second, there continues to be low barriers to entry with providers, service providers and consultants scrambling to secure a dominant place in the market.

Finally, as I’ve written before, a crucial tipping point for outbound medical tourism will happen when referring physicians begin to trust overseas consultants. That will take a while.

In the meantime, innovators and early adoptors will continue to view medical tourism as a viable alternative, particularly when faced with the choice of getting something done at a price they can afford, versus not being able to get it done at all in the US because of high cost. The early majority will join later.

arlen.meyers@medvoy.com

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Observations from San Diego

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I recently attended the annual meeting of the American Academy of Otolaryngology-Head and Neck Surgery (AAO-HNS) in San Diego. Attended by several thousand ear, nose and throat surgeons from around the world, the meeting is the premier educational event for otolaryngologists (ear, nose and throat doctors). I heard several things that have implications for medical tourism.

First, experts are predicting severe otolaryngology manpower shortages in the US. If these predictions are true, availability for services will shrink and patients will seek care outside the US.

Second, given that 49% of the membership of the AAO-HNS now practices outside of the US, intercontinental referrals will accelerate with the consequent need for information transfer and continuity of care arrangements.

Finally, geopolitical risk (drug wars and violent regime changes
, currency fluctuations and global epidemics (swine flu) are impossible to predict and will impact global tourism numbers.

Doctors have a lot of things to think about these days. The impact of medical tourism on the practice of surgical specialists, like ear, nose and throat surgeons, is one more.

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When is Medical Tourism Itinerant Surgery?

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Itinerant surgery is defined as any surgery performed by a surgeon outside his/her community where the postoperative care is left to another physician. In this age of medical tourism, policies concerning itinerant surgery will need to be reassessed since, instead of the surgeon coming to the patient (although this is sometimes done in a third country where the patient and the surgeon meet), the patient comes to the surgeon, possibly without arrangements for postoperative care at all or arrangements are made for postoperative care with another physician in the patient’s home country. The practice of itinerant surgery is strictly proscribed by the American College of Surgeons and other specialty societies.

The primary concern with itinerant surgery is the potential compromise of quality of care. Addtional questions surround fraud and abuse when surgeons charge for postoperative care that not delivered by the operating surgeon. Given these concerns, specialty and medical societies should be asking themselves some questions concerning their present policies on itinerant surgery:

1. Under what circustances is medical tourism itinerant surgery?
2. What evidence is there that quality is compromised when patients elect to have surgery performed by one doctor and follow up care delivered by another doctor?
3. How long is “follow up care”?
4. Should there be sanctions in place for surgeons who perform surgery without making arrangements for follow up care by a doctor in the patients home area?

Medical tourism is forcing a reappraisal of several professional dogmas. The definition of continuity of care and itinerant surgery is just one of them.

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AMA recently published its new guidelines on Medical Tourism. They are as below

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(a) Medical care outside of the U.S. must be voluntary.
(b) Financial incentives to travel outside the U.S. for medical care should not inappropriately limit the diagnostic and therapeutic alternatives that are offered to patients, or restrict treatment or referral options.
(c) Patients should only be referred for medical care to institutions that have been accredited by recognized international accrediting bodies (e.g., the Joint Commission International or the International Society for Quality in Health Care).
(d) Prior to travel, local follow-up care should be coordinated and financing should be arranged to ensure continuity of care when patients return from medical care outside the US.
(e) Coverage for travel outside the U.S. for medical care must include the costs of necessary follow-up care upon return to the U.S.
(f) Patients should be informed of their rights and legal recourse prior to agreeing to travel outside the U.S. for medical care.
(g) Access to physician licensing and outcome data, as well as facility accreditation and outcomes data, should be arranged for patients seeking medical care outside the U.S.
(h) The transfer of patient medical records to and from facilities outside the U.S. should be consistent with HIPAA guidelines.
(i) Patients choosing to travel outside the U.S. for medical care should be provided with information about the potential

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