Developing quality healthcare for international patients means more than providing advanced and efficient care to the patient during his or her stay in the hospital, states Dr. Prem Jagyasi, a medical tourism expert. Dr. Jagyasi educates organizations in creating and delivering overall delightful services to the patient right from taking the case at the onset till the patient achieves the ultimate objective.
Rapid growth in the field of science and technology has paved the way for witnessing a huge growth in the field of medical sciences. Healthcare organizations are largely benefitting from this development, which has increased the number of international patients. The challenges in catering to international patients are vast as they require a deep understanding of culture, legal and ethical issues of the host country. Establishing a bilateral communication network within the healthcare authorities by a group of professionals is very essential. Skepticism should be identified, evaluated and steps should be taken to resolve them. Exceptional focus should be given to developing pre-operative and post-operative care for international patients.
The following are certain practices that need to be developed to improve quality healthcare practice for the international patients. Though the below suggestions are not comprehensive practice suggestions, and are not discussed in this document at its intensity, they give essential information in a nutshell.
Considering the Patient as an Individual
The medical tourism facility is expected to offer the best healthcare services to the international patient. However, in addition to the healthcare needs, a patient may have non-healthcare needs which should be looked after equally well. The international patient should not be considered just a case or a disease, but as an individual who may have other requirements. The patient may need recreational activities or may want to keep in touch with his family and relatives. These non-health related needs should be equally considered and fulfilled as the health-related needs.
Most of the international healthcare facilities try to provide the patient with translators/interpreters to help them communicate better with the healthcare team. The glitch here is that the translators/interpreters are language experts and not adept at understanding medical terms themselves and in turn cannot really help the patient understand them either.
This language dilemma may result in a huge communication gap and may have serious consequences to the patient’s health and the facility’s reputation. There are two options at hand—either the translators/interpreters are given some basic training in medical treatment and conditions or the healthcare professionals are trained in language basics. In the case of healthcare professionals, linguistic ability could be considered an additional qualification. The responsibility of bringing about these changes lies with everyone in the industry, especially the promoters of medical tourism. Whatever the solution adopted, the whole objective is to avoid ambiguity, prevent confusion and improve the overall patient experience.
Globalization of healthcare has brought all people—be it any country, race or religion—under the same umbrella. As a result, confusion and insensitivity towards the other culture is inevitable. However, culture being a sensitive and important component for an individual, is better handled with care. For example, an Arab woman seeking healthcare in another country cannot be asked to unveil in front of other male members of the health team. In such cases, the international healthcare facility should not be insensitive to her cultural decorum, and should respect this by providing female healthcare professionals or availability of female healthcare professionals in the room. Basic training in cultural sensitivity should be made an indispensible part of medical tourism practices.
Providing Support Through Reputable Facilitators
How troublesome would it be for a patient to obtain medical counseling from one organization, then call another agency for travel inquiries, thereafter contacting an agent for Visa arrangements, calling insurance companies for approval, booking the tickets with another agent and finally calling another for tourism interests—a Herculean task! It would be far more convenient for a patient if the international healthcare facility has facilitators or third parties that would do the logistics and travel arrangement for the patient. Accomplishing this would require the international healthcare facility to have a strong network of agents, hospitals, logistic and travel agencies. Not only would this save time, it would also project medial tourism as a convenient option to obtain healthcare.
A medical tourist may find it discomforting when he is informed that the healthcare facility does not have an MRI or CT Scan facility. What would the patient do if he requires one? By not providing comprehensive services under one roof, it often results in poor inflow of international patients, especially when it is an essential component of selective procedure. Ideally, the healthcare facility should be able to provide all diagnostic and curative services to the patient. If they cannot, they should then prepare the appropriate arrangements for the patient to get it done elsewhere. It should not be the patient’s headache, but rather the facility’s responsibility.
Paperwork is an important component of medial tourism. It includes various kinds of documentation including medical consent, contracts, request forms, patient case papers and other documentation related to visa and travel requirements.
These important documents should be made available prior to the patient’s decision to travel to a particular destination.
Sometimes, there are hidden phrases that hold significant meaning in the patient’s decision making, but go unseen or unattended by the patient. In addition, the patient’s medical case papers may not be available to the patient and if a patient requires it in his home country, this could prove to be an unnecessary problem. The industry requires a robust solution for overcoming the hurdle of paperwork. The healthcare facility should work towards providing simple, efficient and transparent paperwork to avoid any ambiguity. Preferably, a facilitator should be appointed to explain it to the patient and help him complete it.
The documentation should also be arranged for the patients who are covered by insurance or are corporate or government funded. The facility should also help the patient obtain reimbursement, if possible.
Pricing and treatment costs are essential components to consider when a patient decides on obtaining healthcare outside his or her home country. Billing an international patient more than the domestic patient for the same procedure is prevalent in all medical tourism destinations, although considered unethical. Owing to the fact that the international patients are offered better quality and additional services, the prices can be increased, but only to a certain level. In some cases, the cost is not explained properly to the patient, and the heavy bill comes as a surprise to the patient at the time of settling expenses. These unpleasant situations can be averted if the pricing is transparent and all hidden costs are duly explained to the patient at the start—that’s called an informed decision in medical care!
Healthcare facilities should obtain malpractice insurance coverage with special clause for the international patient, especially in case the patient decides to take action in his or her home country. Hospitals should protect their organization and staff against any unforeseen situations. Many hospitals are not aware that certain insurance companies don’t cover malpractice out of their national jurisdiction which could be very difficult for the healthcare facility as well as the healthcare professional.
Pre-Operative and Post-Operative Arrangements
The medical tourist gets skeptical when opting for healthcare abroad—what if he requires elaborate pre-operative work-up before the planned procedure? Where will he go after the procedure? What healthcare organization at the destination will follow up with the post-operative care?
It’s the responsibility of the healthcare facility to answer these questions clearly. Usually, the planned trip includes the pre-operative time. The healthcare facility should make sure that the patient reaches the facility well in advance before the procedure, and it is communicated to the patient clearly that this is the case.
During the course of post operative treatment within the country, this should be coordinated if the patient would like to stay in the hospital or in a hotel. For effectively arranging these services, the healthcare facility should organize with the patient, family and other agencies.
The post-procedure arrangements should also be discussed with the patient; a complete instruction list should be provided to the patient before departure. Healthcare facilities must develop a continuity of care agreement with international organizations; this will reduce the burden and discomfort for the patient.
Consumables and Medication
It is quite possible that prescribed medicine or regular consumable medical products might not be available within a destination; many drugs are not available abroad. Many pharmacies don’t provide a control on drugs for international prescriptions; they need a local doctors’ prescription or endorsement and a healthcare provider must have such information and he should make such arrangements in advance so the patient can travel smoothly through a healing path rather than a bumpy ride once back in his home country.
Back at Home
Follow-up appointments are important after any procedure or medical care is provided. It becomes a challenge if the healthcare is provided in a foreign country. When the patient comes home after discharge, the chances are small that he will want to travel back to the destination country in case anything goes wrong or if he needs continued medical care. He will most likely want to be treated in his home country rather than make another trip abroad. The healthcare facility should provide enough options to keep the communication lines open between the patient, the facility and the healthcare team. The modes of communication could be telephone, video conference or through emails. The objective is to make the patient feel cared for once back in their own country.
On the Records
Patient records are confidential and are considered legal documents. Handling patient records becomes a challenge if the patient has come from a foreign country. The documents from his home country are required in order to have access to the patient’s medical history. These medical documents are further generated in the course of the treatment in the international patient facility. These patient records need to be transported back to the home country where it may be required by the physician attending to the patient in the home country when the patient returns. In such a scenario, the records should contain all necessary information for the other healthcare professional to take the case further. In addition, the transportation of information should be carried out in such a way that the confidential nature of the information is maintained. Electronic medical records have partially overcome this challenge but a lot of work still needs to be done in order to ensure facilitating secure data transfer.
All medical procedures carry a certain amount of risk, for which, the patient is supposed to give his consent by signing a form. However, the mere act of signing a form does not complete this work. The healthcare facility should be prepared in terms of resources to handle such a situation. The alternate plan, in case anything goes wrong, should be discussed with the patient prior to the procedure. It may include bearing cost and other arrangements of another surgery, providing compensation or any other benefits in lieu. The main objective is to support the patient in medical crisis to help him get proper care.
Unfortunate incidences may happen when the patient is in the international healthcare facility. These incidences, which may include civil war or natural calamities like an earthquake, may not be favorable enough for the patient to travel back home. Relief plans should be kept ready to handle such situations. These plans may include extended stay at the facility, compensation or special and safe transportation to the home country.
Research and Development
Research and Development are keys to upgradation in any industry, and medical tourism is no exception to it. The international healthcare facility should engage in continuous research for improving patient experience. Based on the research, strategies should be made to overcome the challenges and shortcomings. The first step in this is development of comprehensive case studies which mirror the real situations and formulating solutions for it. All instances should be duly recorded and considered when going through the decision making process. Above all, the patient should be asked to offer feedback, which should be seriously considered, in improving the practices of the facility.
“The patient’s experience” is not judged merely by the time the patient spends in the hospital. It extends beyond that; it is the relationship that hospital staffs are able to build with the patients. It starts the moment a patient visits your website and may continue forever. When a patient opts for medical tourism, they might be consumed with lots of questions regarding the destination hospital, physician, country, treatment etc. It is the utmost duty of the healthcare organization to assure or minimize the stress and confusion associated with medical tourism.
Hence, a healthcare organization that wants to delight all patients should adopt a suggestion to enhance their healthcare delivery for international patients. I mentioned some very basic points above and they are not discussed in detail in this document, however, a healthcare Facility should arrange for a workshop for their healthcare professionals and healthcare management team to better understand International Patient Care.
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