Evidence shows that if patients seeking specific high-risk surgeries or treatments would chose high-volume hospitals for their care, this could save more than 4,000 lives annually. However, due to the lack of data currently available today and interoperability issues in EHRs, evidence based referrals are not widespread.

MedVoy’s evidence based referral workflow has the ability to incorporate any evidence based metrics into its referral process thus making sure that the patients are referred to the right facility with the better processes, and positive outcomes.

source http://www.academyhealth.org/Training/content.cfm?ItemNumber=1691

Using a referral system, such as MedVoy can integrate with your existing EHR to help fill these gaps

Enhances Provider Communication

Healthcare relies on effective communication amongst the providers, specialist and staff.  MedVoy enables the ability to track and manage referrals – even across disparate EHRs and patient management systems.  A specialist can understand their cases before they see the patients – allowing them to use their limited patient time most efficiently.

Improved Documentation

MedVoy’s secure, HIPPA compliant platform has a very lightweight workflow and then uses push/pulls to other EHRs to allow access to all documentation in one place and to help avoid the duplication in procedures – eliminating the onerous data entry and documentation concerns.

Feedback Loops Aids with Continuum of Care

A current constraint with referrals is that they often fall into a “black hole”, where the referring providers do not know what happened with the patient.  Using MedVoy, the referring providers can easily look at the referral status, follow up notes, appointments and ongoing patient care.

So, what does a surgical hotel offer?

How does a hotel providing services to a postoperative patients and their companions provide value and differentiate themselves?

A surgical hotel, part hospital-part hotel, would offer the following:

1. location convenient to healthcare facilities
2. transportation to facilities/airport/other
3. availability of emergency medical care
4. amenities
5. sensitivity to the needs of specific postop patients; connected rooms.
6. things to do for companions
7. information and communication technology links with providers
8. alternative/complementary services for postop patient
9. security
10. privacy/confidentiality in check in and exits
11. disability accommodations in architecture, transportation vehicles
12. medical concierge
13. accommodate in-room stay by nurse or companion
14. availability of equipment to take vital signs by medical professional
15. availability of wound management supplies
16. online medical education and postop care resources
17. nutrition counselor, special dietary restrictions
18. evacuation preferences
19. brand awareness and snob appeal
20. new design for bedding and furniture?
21. allergy free environment
22. medication reminder system (part of automatic wake-up call system?)
23. mini-kitchen facilities
24. real time patient feedback and request system
25. panic button
26. prevention of nosocomial (need a new word for hotel acquired) infections
27. modified housekeeping schedule
28. separate parking a minimal distance to room
29. wheelchair management
30. quiet
31. bathroom amenities (antibacterial soap, hand lotion, etc)
32. antibacterial surfaces on furniture
33. billing and collecting interface with medical insurance ?
34. disposable cell phones for companions
35. pet accommodations?

The global medical travel industry in rapidly growing and expected to reach $1B by 2012. Developers and the hospitality industry have an opportunity to participate and profit by offering differentiated, value added services to patients and their family members and companions that accompany them for care away from home.

In my view, five things will need to happen before medical tourism and global healthcare referrals get real traction: 1) the creation of a sustainable business model, 2)global healthcare IT connectivity and integration, 3) a physician generated global healthcare referral network, 4) a global regulatory, legal and socioeconomic ecosystem, and 5) patient awareness and acceptance.

The creation of a sustainable business model
Industry players including payors, providers, partners and facilitators are still looking for the the most successful way to make a profit and scale the business. With an eye towards what happened when Expedia disrupted the travel agency business, participants understand that margins for travel arrangement services are thin and that there is high price elasticity for global medical care. Few have found the magic key that fits the lock that opens the doors to profits. Payors and employers are hesitant to accept the value proposition without a better way to reduce their risk and demonstrate tangible, meaningful cost savings to their insureds and employees.

Global healthcare IT connectivity and integration

The US national healthcare information architecture is evolving. Eventually, the network will be a portal to the world and will allow for seemless, secure, confidential transfer of personal health information thus assuring some continuity of care and quality improvement. Similarly, it will take a while for health information systems to evolve in host countries that can talk to non-host systems. Short term solutions, like personal health records or mobile health applications, might fill the void temporarily.

A physician generated global healthcare referral network

Most medical tourism models connect patients to healthcare facilities, bypassing doctors in the initial stages. Doctors will get in the game when the model feels better, and they have the resources and ability to make referrals to consultants directly, like they do now. Since MedVoy was founded by an American doctor, MedVoy connects patients directly to doctors which is unlike other facilitators. Given the rise of international members, professional medical societies should be more proactive in building global referral networks, rather than seeing them as threats to existing domestic members.

A global regulatory, legal and socioeconomic ecosystem

The barriers to adoption and penetration of medical travel are many and include liability, reimbursement, quality assurance and impediments to continuity of care. As healthcare goes global, so will the rules and regulations that facilitate or obstruct its use. How about a World Trade Organization Treaty on Medical Travel?

Patient awareness and acceptance

According to the most recent polls, 50% of consumers understand the meaning of the term “medical tourism”, leaving home for care. Social network buzz and media stories find the medical travel story sexy, particularly given all the noise about escalating healthcare costs and consumers, employers and payors are hungry for more information. Moving patients from awareness to intention to decision to action, however, will take more time and use innovative marketing approaches directed towards granular market segments.

Global medical travel is projected to be a $1B industry by 2012. While the bones are in place, it will take more time to add the flesh. Until then, to quote Karl Mauldin, people won’t leave home without it.

Secondly, ask how and where they practice. For example, plastic surgeons and dentists are likely to practice and operate in private clinics or ambulatory surgery facilities removed from a hospital setting. Some may even own the clinic and they should divulge that information to you. If something goes wrong during a procedure, make sure you understand how and where you would get emergency care, how you would be transported there, and who would pay for it. In addition, unlike more and more hospital facilities that are being accredited by the Joint Commission International, (click for a list of accredited hospitals) the organization responsible for making sure hospitals adhere to acceptable practices and procedures, independent, free-standing facilities frequently are not similarly examined or accredited.

Finally, and perhaps the most difficult information to find, is the outcome and results of a given procedure. Ask ” How many of these operations do you do in a week, a month or a year ?” Also, inquire about the number of cases that result in complications, the need for revision surgery or significant morbidity i.e. something that unexpectedly doesn’t work the way it should after surgery, or postoperative death. Most doctors, including those in the US, will be unable to give you an accurate answer because they don’t keep good records or have an unreliable system to keep track of results. Sometimes the best you can do is to talk to someone who has had a similar procedure.

Getting information about a doctor and his or her results in not easy, wherever they practice. The more information you know, however, the better you can determine whether surgery away from home makes sense.

The CDC updates its Health Information for International Travel (also called the “Yellow Book”) every two years. The latest edition discusses the pros and cons of medical tourism, and explains why the practice is on the rise.

“In recent years, standards have been rising in other parts of the world even faster than prices have surged in the U.S. Many physicians abroad trained in the U.S. and the Joint Commission International (JCI) applies strict standards to accreditation of offshore facilities. Those facilities use the same implants, supplies, and drugs as their U.S. counterparts. However, a heart bypass in Thailand costs $11,000 compared to as much as $130,000 in the U.S. Spinal fusion surgery in India at $5,500 compares to over $60,000 in the U.S.”

The CDC guide quotes the American Medical Associations tip for planning a surgery abroad:

–Patients should check to see if the medical facilities abroad have been accredited by recognized international accrediting bodies such as the Joint Commission International or the International Society for Quality in Health Care.

– Prior to travel, arrange local follow-up care to ensure continuity of care when you return from medical care outside the US