Medical Tourism: The Newest Trend

With the cost of healthcare continuing to rise, consumers are increasingly motivated to find innovative and non-traditional ways of providing healthcare for themselves and their families.  One such innovative means of delivering healthcare is the emerging trend of medical tourism.  Though medical tourism is growing in popularity, industry leaders continue to critique the lack of accountability and oversight for this method of healthcare delivery.          

Though the appeal of medical tourism can be attributed to multiple factors, critics argue that it lacks the necessary components to ensure patient safety.  Some patients travel abroad for medical care due to experiencing delays in accessing care, while others cannot afford the cost of medical care.  Proponents of medical tourism argue that there are many excellent healthcare facilities around the world that deliver a high quality of care which oftentimes is at a significantly lower cost to the patient.  As a result, medical tourism companies have now gotten involved in organizing healthcare services that cross the borders of countries (Turner, 2010).              

As the medical tourism industry continues to grow, serious consideration must be given to the role that accreditation and accountability play in the cross-border delivery of healthcare.  Those in support of medical tourism accreditation have suggested several elements to increase the accountability of this emerging industry.  Some of these suggestions include only using accredited international healthcare facilities to provide care, as well as ensuring continuity of care for the patients.  The argument is being made that steps need to be taken to ensure that the proper standards are in place to enable patients who utilize medical tourism to make informed decisions regarding their care.  Many also argue that there should be restrictions placed on what services may be provided in a medical tourism setting (Turner, 2010).             

Regardless of the specific constraints that are implemented, it remains of critical importance to ensure the safety of the increasing number of patients who are actively participating in medical tourism.  Though some industry leaders may wish to ignore the rapid growth of the medical tourism industry, innovative healthcare leaders will recognize the prominence of this trend and act quickly to advocate for the safety of patients.  Whether patients chose to receive their healthcare at home or around the world, healthcare leaders have an obligation to safeguard against the unnecessary risk of improper accountability in the medical tourism industry. 

Reference:

Turner, L. (2010). Quality in health care and globalization of health services:   Accreditation and regulatory oversight of medical tourism companies. International Journal for Quality in Health Care, 23(1). Retrieved from:intqhc.oxfordjournals.org/content/23/1/1.short

Why the Patient's Perspective Counts

The adage that perception is reality has gradually invaded every sector of society, and healthcare is no exception.  In a time when adverse medical events are constantly appearing in media outlets, the role of the patient in these events cannot be ignored.  According to statistics, errors made by healthcare workers affect about 3-4% of patients (Oetjen, 2012).  Though this may still remain a small portion of healthcare patients, there is an increased urgency to diminish the amount of adverse medical events that occur each year. 

           

As Savitz and Bernard pointed out, medical errors now make up a significant portion of the quality of care problems that are seen in healthcare (1999).  These particular errors may be active errors, which are those that are readily observed which lead to immediate consequences.  A secondary form of medical errors is errors that are latent in nature, or involve problems in design, organizational issues, or a lack of training (Savitz & Bernard, 1999).  Whether the adverse medical event that a patient is involved in is characterized as an active or latent error, the patient plays an integral role in that medical event.     

The primary reason why the perspective of the patient is the most important determinant when it comes to adverse medical events is the fact that any allegation made by a patient that suggests that such an event has occurred must be quickly investigated.  Even in instances when the validity of such a claim is questioned, when a patient states that an adverse medical event has occurred, the healthcare organization must immediately investigate that claim and take further action if necessary.  The patient's perception of a medical event quickly becomes the reality of the event, whether positive or negative, for that patient.  Therefore, to ignore the perspective of the patient is to only bring further repercussions to the healthcare organizations. Additionally, now that more and more healthcare organizations are incorporating patient advocates, if a patient does not feel as though his or her opinion is being given proper attention, that patient may take further recourse until the patient feels that their claim has been justly investigated.  As such, it is in the best interest of the healthcare organization to acknowledge the perspective of the patient and grant the patient the attention that he or she deserves.  In doing so, the healthcare organization is not subjected to unnecessary scrutiny that could have been avoided if they had just listened to the patient when the issue began.   

Reference:

Oetjen, R. (2012). Impact of Quality on the Patient [PowerPoint slides]. Retrieved from   University of   Central Florida Webcourses Website: https://webcourses.ucf.edu/webct

/urw/tp0.lc4130001/cobaltMainFrame.dowebct

Savitz, L., & Bernard, S. (1999) Continuous Quality Improvement in Healthcare.   Gaithersburg, MD: Aspen Publishers, 211-225. 

Will Medical Homes Really Work?

In an age when health care expenses are growing exponentially, companies and healthcare organizations alike are examining every possible way in which to save money, while preserving quality care.  One interesting concept that is being adopted in both private and public sectors is this idea of establishing medical homes for patients.  The idea behind this concept is that a patient will be assigned to a team of healthcare providers that will coordinate their care.  The team may consist of a physician, physician’s assistant or nurse practitioner, nurses, and technicians.  Though this is a concept that is being adopted by many providers, the effect that it will have on the quality of care remains to be seen. 

Those in favor of this concept may make the argument that medical homes provide greater continuity of care for patients, due to streamlined care that is provided in a consistent environment.  Individuals in favor of medical homes argue the nostalgic effect of medical homes, where providers actually know the names of their patients, similar to days gone by when doctors still made house calls.  However, the argument could also be made that medical homes limit the patient’s ability to select providers, forcing them to receive care from members of their medical home, rather than having the flexibility to choose their own provider.  

In order to determine whether patients are receiving quality care in medical homes, the determination will have to be made as to whether quality is determined by the patient’s freedom of choice, or by the continuity of care provided.  Even TRICARE, the military health insurance program, has now adopted the concept of medical homes.  While it remains voluntary for some, other TRICARE sites have moved exclusively to medical homes (Miles, 2011).  Proponents of the medical home have said that this new model addresses the commonly held complaint that, especially for TRICARE recipients, patients rarely see the same provider, which forces them to oftentimes repeat the same basic information at each visit (Miles, 2011).  Whether medical homes will reduce healthcare expenditures, while maintaining the same quality of care, remains to be seen.  In the mean time, advocates of the medical home model are hopeful that improving the patient experience will in turn result in an improvement in the quality of care provided to patients.  

Reference: Miles, Donna. (2011, January 12). ‘Medical Home’ Concept Improves Care, Controls Cost. American Forces Press Service. Retrieved from: http://www.defense.gov/news/newsarticle.aspx?id=62424

What Does Quality Mean to You?

Quality is an unparalleled level of excellence that leaves a customer with a sense of satisfaction with the service experience, as well as a desire to return.  In healthcare, quality is largely determined by the individualized experiences of patients and staff alike.  Whether positive or negative, an individual’s perception of quality in healthcare is a strong determinant of his loyalty to that organization, as well as his willingness to recommend the organization to others.   

Many healthcare organizations are taking great strides to address the demands of its customers by adopting amenity-driven, concierge facilities that cater to perceived determinants of quality.  Interestingly, the determination of quality seems to have shifted to focus less on the actual delivery of care and subsequent health outcomes, and more on the setting in which the care was delivered.  At the same time, healthcare organizations are realizing the validity of the perceptions of quality that are held by their employees, thus they are beginning to treat them as their internal customers.  Surveys, such as Press-Ganey, are being utilized by healthcare organizations to analyze patient’s opinions in order to achieve the desired outcome of quality, patient-centered care. 

While quality care continues to be in high demand, the question must be asked whether quality will be inadvertently sacrificed at the hands of universal health care.  Though many argue that everyone should have access to necessary care, no one has the ability to fully predict whether universal health care has the ability to sustain the same level of quality care.  As Joshi and Berwick mentioned, factors in determining quality include the underuse, overuse, and misuse of healthcare.  Though many services are currently being underused due to their cost and inaccessibility, those same services may in turn become overused in a universal healthcare setting.  Similarly, healthcare services are at risk of being misused by individuals, should accessibility of care be increased.  Whether or not universal health care is implemented, the bottom line is that quality can never be sacrificed, even if it is for universal health care.