There are several barriers to creating a medical travel ecosystem that offers patients access to quality, connected care at an affordable price whenever and where ever they want to go to get it. Medvoy is helping to solve one of those problems, lack of continuity of care, by offering services that will help patients and their doctors exchange documents and communicate before, during and after their travel.

We look forward to working with  patients and other medical travel stakeholders in dental/medical and wellness services, infrastructure development, economic development professionals and travel and hospitality to give patients the quality services they deserve.

Arlen Meyers, MD, MBA

President , CMO and Cofounder –  Medvoy

topessayservice.org

Here are some success factors to consider when building an inbound medical travel unit:
1. Tight referral networks to non-US physicians
2. Hospital infrastructure dedicated to inbound patients
3. A physician staff willing and able to accomodate the needs of inbound patients
4. Travel and hospitality destinations that are attractive to inbound patients
5. Non-hospital travel services that are user friendly-airport, customs, visas, etc
6. Profitable product and service offerings
7. Telehealth and telemedicine connections for pre and post care
8. Accomodations for insurance, cash or other revenue cycle management
9. Strong sales and marketing functions
10. Easy to get to
11.Package pricing with transparency
12.Quality metrics with transparency

Consider this “doctor’s dozen” when trying to attract foreign patients. Experience indicates that successfully accomodating non-US patients requires a substantial modification of existing policies and procedures.

Arlen D Meyers, MD, MBA
www.medvoy.com
www.careconnectix.com

That said, investors are still clinging to the promise of big returns fueled by patients losing their health benefits because of high unemployment, the aging population requiring more units of care and exploding costs of healthcare. If you think the medical travel industry is set to explode, there are some areas of investment to consider:

Foreign Healthcare infrastructure

Foreign Travel and hospitality infrastructure

Tools and support companies

Supporting global healthcare insurance and travel products

Firms in the medical travel supply chain

Expatriate retirement health cities and communities

Like other industry sectors, gold, for example, you can invest in the product itself, the people who create the product, or investments that pools risks, like mutual funds or exchange traded funds.

Look for companies in markets where the supply of care does not meet the demands of a growing middle class, that provide products and services delivering low, cost high volume care, and that provide platforms and infrastructure designed to reduce transaction costs for billing and collecting and value-based information.

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.

Despite it’s growth, I think patients are still confused  about the multiple products and services that all seem to be the same. If you are considering offering medical travel benefits to your employees or are  considering leaving home for care, here are three questions you should ask  that might help you separate the wheat from the chaff.

Who do you get connected to?

The traditional referral model is your doctor, someone you trust,  refers you to another doctor for  specialty care or consultation. In most instances in medical tourism, however,  a facilitator or other intermediary  connects you  to a hospital or ground agent partner in another country who connects you to a doctor on the medical staff of the overseas hospital. All those steps can be confusing, add middle-man costs, and create opportunities for errors.

How do you establish some kind of relationship with the consultant before leaving home?

Since it is impractical for you to see your foreign consultant preoperatively face to face, take advantage of facilitators, like Medvoy, that can help connect you to your doctor using telemedicine communications technologies.

What’s the difference between one facilitator and the other?

As the market matures, industry players are creating ways to differentiate themselves and break from the rest of the pack. In general, facilitators compete on price, access, service, experience and their product. Just as Hermes sells quality, Wal-Mart competes on price and Nordstrom’s is know for service. Decide what’s most important to you and pick a facilitator that will deliver.

Some of us will turn inward and will seek ways to set goals and fit more into our ever hectic schedules. Many will be trying to fight the holiday bulge and race off the gym holding steadfastly to our resolutions. The holiday retail numbers were strong, economic indicators are improving and even the typically droll economists are optimistic about 2011.

• Will 2011 be the year that you take care of those lagging health problems? One in five Americans put off going to the doctor due to the economic climate, so demand for procedures such as knee arthroscopy or a hip replacement is likely to increase.
• Will this be the year that you finally get over the fear of the dentist? Prothodontists can help restore your smile through implants, bridges and fixtures, while Cosmetic Dentistry deliver an entire “smile makeovers”- filling in gaps, veneers, whitening teeth, etc.
• Or will this be the year that you will finally has that cosmetic surgery procedure done? Newer methodology for facelifts and eye lifts (Blepharoplasty) utilizing a laser can significantly lower downtime and get you back to work looking refreshed in no time.

The year has just begun – what do you want to with it?

Leaving home for care is nothing new. People have been traveling around the world for treatment since the beginning of time. Now we call it medical tourism, and it is growing quickly.

Patients seek care away from home because it is cheaper, unavailable in their home location, can be accessed without waiting for a long time, can be combined with a travel experience and can be kept secret. Despite the talk of healthcare reform, patients and employers are paying more for care with no forseeable decreases and they are looking for safe, affordable alternatives to care in the US.

There are several serious barriers to adoption and penetration of the notion of leaving home for care. In fact, we’re not even sure what to call it these days. “Medical tourism” has morphed into global healthcare referral or medical travel, underlying the fact that we are talking about healthcare in a different place, not sipping Margueritas by the pool. The growth of the industry is being fueled by mostly medical outsiders who see the commercial potential of opportunities that have resulted from medical cost inflation, globalization and cheap information and communications technologies.

There are lots of opportunties for physicians in the medical travel industry. Substantial challenges to the traditional notions of face-to-face care, continuity of care, itinerant surgery and global healthcare information exchange are but a few of the issues that the medical provider establishment will have to confront as medical travel continues to grow around the world.

You might need a B-2 Visa

There are several websites that explain the process for applying for a medical visa, e.g. http://www.usavisitorvisa.com/medicalvisa/medical_visa.htm and http://travel.state.gov/visa/temp/types/types_1262.html 

Present US immigration policy presumes that every visitor visa applicant is an intending immigrant (has an intention to stay back in the U.S. permanently). Therefore, applicants for visitor visas must overcome this presumption by demonstrating that:

1. The purpose of their trip is to enter the U.S. for business, pleasure, or medical treatment.
2. That they plan to remain for a specific and limited period.
3. Evidence of funds to cover expenses in the United States;
4. Evidence of compelling social and economic ties abroad; and
5. That they have a residence outside the U.S. as well as other binding ties which will insure their return abroad at the end of the visit.

You might be eligible for a visa waiver

If you intend to visit the United States for 90 days or less, unders certain circumstances, you might be eligible for a visa waiver. To learn more about the prograsm and requirements, check http://travel.state.gov/visa/temp/without/without_1990.html

You will need to satisfy certain immigration requirements even if you are not the patient

For example , suppose you want to accompany a family member while they get care. Or, what if you intend to donate your kidney to a family member who is having a transplantation operation in the US? According to http://www.immihelp.com/visitor-visa/visitor-visa-usa-medical-treatment.html, you will need the necessary approval from US immigration officials before your US arrival.

If you plan to come to the US for care or plan to accompany someone who is, make sure you have a visa or documentation of a visa waiver.  Prepare ahead and don’t procrastinate. Getting approval can take months and you should give yourself enough time to get it.

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.