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V Foro De Salud Competitiva Santander1era Feria Tecnológica Y De Innovaciòn En Salud

Agosto 13 de 2019Bucaramanga

Dr. Claudia MikaFounder & CEO Temos International

The International Health & Medical Tourism Market:* An overview and best practice examples* The impact of quality, safety and operational efficiency

on patient experience, marketing and successful business © Temos International GmbH

V Foro De Salud Competitiva Santander1era Feria Tecnológica Y De Innovaciòn En Salud

Agosto 13 de 2019Bucaramanga

International Health & Medical Tourism

© Temos International GmbH

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Health tourism…

“Health tourism covers those types of tourism which have as a primarymotivation, the contribution to physical, mental and/or spiritual healththrough medical and wellness-based activities which increase the capacityof individuals to satisfy their own needs and function better as individualsin their environment and society.”

“Health tourism is the umbrella term for the subtypes: wellness tourismand medical tourism.”Source (31 July 2019): https://www.e-unwto.org/doi/pdf/10.18111/9789284420308

World Tourism Organization (UNWTO) 2018:

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Health tourism

• “Health tourism: tourism by people traveling from the place they live to anotherplace for healthcare purposes.” Ross, 2001

Hea

lth to

uris

m Medical tourism

Wellness tourism

Elderly tourism

Disabled tourism

Categorization “health tourism”

Turkish Ministry of Health and Department of Health Tourism, 2012

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Medical tourism, medical travel, …

“Medical tourism occurs when consumers elect to travel across internationalborders with the intention of receiving some form of medical treatment.This treatment may span the full range of medical services, but mostcommonly includes dental care, cosmetic surgery, elective surgery, andfertility treatment. ”

Source: https://www.oecd.org/els/health-systems/48723982.pdf

OECD Directorate for Employment, Labour, and Social Affairs (2011):

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International patients

• Live temporarily in a country as expatriate or resident and need medical treatment (emergency or scheduled)

• Visit a country as business traveler or tourist and need medical treatment (emergency or scheduled)

• Main reason: holiday and recreation• “Secondary”: medical treatment

• Visit a country for a scheduled and elective treatment • Main reason: medical treatment • “Secondary”: holiday and recreation

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International patients

Tourism medicine versus/plus medical tourism

The medical tourism market

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The medical tourism market?

Source (01 August 2019):http://healthcaremangementit.blogspot.de/

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The medical tourism market?

Market size: 36.9 billion USDCAGR: 21.4%

CAGR: Compound Annual Gross RateSource (01 August 2019): see in the graph

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The medical tourism market?

Market size: 29 billionUSD by 2024CAGR: 7.3%

Source (01 August 2019): https://www.reuters.com/brandfeatures/venture-capital/article?id=76552

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Visa and Oxford Economics:Mapping the future of global travel and tourism

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Corrected after international complaints

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Updated version

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How big is the market?

http://www.patientsbeyondborders.com/medical-tourism-statistics-facts

• USD 65-87.5 billion, based on approximately 20-24 million cross-border patients worldwide spending an average of USD $3410 per visit, including medically-related costs, cross-border and local transport, inpatient stay and accommodations.

• About 1.9 million Americans will travel outside the US for medical care this year (2019).

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Source (31 July 2019): https://apps.who.int/iris/handle/10665/271774

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WHO: evidence on global medical travel

• Yes, medical travel is projected to expand globally in the next decade

• Growth in medical travel is largely due to improved availability of healthtechnology, decreasing costs for travel and advertising by companies wishingto attract patients

BUT• There are considerable gaps in the current literature on reliable data

Published by WHO in 09/2015

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What are the top destinations?

Source (2017): http://www.patientsbeyondborders.com/medical-tourism-statistics-facts

• Costa Rica• India• Israel• Malaysia• Mexico• Singapore• South Korea• Taiwan• Thailand• Turkey• United States

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What are the top destinations?

Source (01 August 2019): https://www.forbes.com/sites/reenitadas/2014/08/19/medical-tourism-gets-a-facelift-and-perhaps-a-pacemaker/#12e8c1bc391b

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Why these destinations?

Source (01 August): https://www.medigo.com/blog/medical-tourism-facts-figures/

Only a cost destination?

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What are the specialties?

Source (2017): http://www.patientsbeyondborders.com/medical-tourism-statistics-facts

• Cosmetic surgery • Dentistry (general, restorative, cosmetic) • Cardiovascular (angioplasty, CABG, transplants) • Orthopedics (joint and spine; sports medicine) • Cancer (often high-acuity or last resort) • Reproductive (fertility, IVF, women's health) • Weight loss (LAP-BAND, gastric bypass) • Scans, tests, health screenings and second opinions

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How much to save (compared to US)?

Source (2017): http://www.patientsbeyondborders.com/medical-tourism-statistics-facts

• Costa Rica 45 – 65 %• India 65 – 90 %• Brazil 20 – 30 %• Malaysia 65 – 80 %• Mexico 40 – 65 %• Singapore 25 – 40 %• South Korea 30 – 45 %• Taiwan 40 – 55 %• Thailand 50 – 75 %• Turkey 50 – 65 %

Developments…

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31.03.2016

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29.06.2017

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20.07.2017

05/08/2019 © Temos International GmbH 28

28.02.2019

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05/08/2019 © Temos International GmbH 34

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Source: https://www.statista.com/statistics/795339/medical-tourism-market-value-latin-america/

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Summary part I

• It is crucial to use the same vocabulary and definitions when talking about health tourism, medical tourism, …

• Reliable data are difficult to find since it is difficult to measure international patient streams BUT they are available, e.g. in Malaysia, Dubai, and other countries

• Quality, uniqueness and costs of services are the main drivers √√

The International Health & Medical Tourism Market:* An overview and best practice examples* The impact of quality, safety and operational efficiency

on patient experience, marketing and successful business © Temos International GmbH

V Foro De Salud Competitiva Santander1era Feria Tecnológica Y De Innovaciòn En Salud

Agosto 13 de 2019Bucaramanga

Quality as part of accreditation

© Temos International GmbH

• IT IS NOT: having some “quality documents” (with copy & paste from the internet) and a certificate on a quality management system (e.g. ISO 9001)

• IT IS NOT: Payment of X, provision of some data, desktop review (if any) and receiving the accreditation award

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What is accreditation in healthcare?

• Having governmental license(s) to practice• Having quality documents and a quality management system • Having excellent doctors and very good staff• Having defined outcome and performance indicators• Having good services, processes and immediate communication,

clean and comfortable environment

these are pre-conditions

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What is accreditation in healthcare?

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Quality management is onlyone part of accreditation

What is accreditation in healthcare?

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• IT IS: A never ending story• IT IS: Following external standards that are implemented internally• IT IS: A review of policies, procedures, guidelines, work instructions,

etc. including interviews and observation conducted by external, outside experts against the standards (compliance)

Validation of existing quality, staff and patient safety, patient experience, outcome, risk management, and others

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What is accreditation in healthcare?

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It is the sum of the organization‘s interactions!

What is accreditation in healthcare?

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It is an organization‘s culture!

What is accreditation in healthcare?

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It is a commitment to quality and safety!

What is accreditation in healthcare?

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Quality outcomes for the organization

• Streamline operations to increase efficiencies• Align departments and functions to coordinate and

harmonize systems• Increase staff competencies and satisfaction

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Quality outcomes for the organization

• Benefit from larger market share• Improve outcomes• Reduce risk & liability

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Business benefits for the organization

• Differentiation from competitors• Better brand visibility• Increased marketing potential

• Leverage your accreditation in marketing your services• Build trust and loyalty – demonstrated commitment to quality

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Cost of quality

Source (31 July 2019): http://www.novaces.com/focus-pdca.php

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Quality improvement for your patients

• Better clinical and non-clinical outcomes• Improve overall patient experience• Receive treatment in a safe, secure, trustworthy and third

party accredited environment• Assure continuum of care from first contact to follow up

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Hazardous waste: challenge

Harzardous waste management: appreciated

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Kitchen: appreciated, left challenge, right

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Emergency trolley (“before and after”):Same hospital in 2013 and 2016

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Best practice

• Accreditation is a neutral, independent process to objectively assess, evaluate and validate the quality of clinical and non-clinical services

• Accreditation strives to assure optimal care, operational efficiency and adequate costs

• Accreditation strives to assure highest possible patient safety • Accreditation strives to assure best patient experience

• Quality and quality management are part of accreditation

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Summary part II

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Thank you very much for your attention!www.temos-international.cominfo@temos-international.comc.mika@temos-international.com