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How to conduct a medical tourism hospital familiarization (fam) tour (Part 1)

Hospital corridor

Maria K Todd MHA PhD, CEO of Mercury Healthcare Advisory Group, looks at the planning and hosting of the  “fam” tours that a hospital should be prepared to conduct for medical tourism facilitators.

 

She considers who should be involved and provides guidance on the level of detail that should be provided. Failure to do this wastes everyone's time which is counterproductive and can be frustrating for both the visitor and the hospital. 

 

Not all familiarization tours are the same...

As a medical tourism destination, you may have many opportunities to show interested visitors your hospital. But not all familiarization tours should be conducted the same way, or even by the same person.  For one thing, if the information sought by the one taking the tour is not available, incorrect, or the guide is unprepared, the visitor leaves with a less than favorable impression of the the hospital or clinic.  If the tour highlights parts of the hospital that the guest is not interested in or is not likely to use (for example, maternity services and medical tourism are not usually a match) that time is taken away from parts of the hospital for which there may be greater interest, but is passed over.

I always provide a checklist of questions, concerns, and statistics I would like to know in advance of my arrival. With an extensive healthcare background, I may have a completely different orientation to a hospital tour than an inexperienced but enthusiastic facilitator.  I am also the eyes and ears of international health insurance plans and employers who are my clients. While it is nice to know about the upscale VIP rooms, and I certainly want to see them, if only briefly, I know that my health plan clients and insurers are probably only going to consider coverage for a private or semi-private regular room in the event a plan subscriber takes ill or is injured while in their area.

I need to know about the amenities and basic products for medical tourists who choose to travel to the hotel and may select one hospital over another for a myriad of personal reasons.  If I am accompanying an insurance executive or a human resources benefits buyer for a self-insured, employer sponsored health plan, the tour agenda and information highlighted will be completely different.

 

Where to start

The first order of business is to determine the type of visitor you will host. This article will focus on planning a fam tour for a typical medical tourism facilitator who is interested in what they can sell, how much it costs, value for the price paid, and who knows their typical client.  They are also interested in the financial relationship and how much income they will generate if they feature your hospital or clinic over another.  They will also be interested in meeting the person who will take their calls and answer their emails to arrange a patient interview, prepare a price quotation and handle monetary transactions, and who will interact with the patient at checkout time.

A medical tourism facilitator may have no clear understanding about international hospital accreditation beyond the fact that many articles state that a hospital should have a certain "brand" of international accreditation over another. They may not have a grasp of exactly what is surveyed during the biennial inspection survey. They may also have no background in statistics and lack the  ability to critically evaluate clinical outcome data presented by doctors, hospital quality personnel and healthcare executives. It may suffice to simply tell them that your facility is or is not accredited and by whom and where you are in the accreditation process if you are not, and when the next inspection is scheduled if you are.

Facilitators come from varied backgrounds. Bear in mind that he or she may not understand the medical technology or terminology.

As a facilitator, they should be interested in talking with the arrival coordinator for the hospital, and learning where their client will initially be received and by whom. They may also wish to see the car or mode of transportation that will be used to collect the patient on arrival at the airport and understand what happens to their client from the moment they step off the aircraft. They will want to assess the English (or other) language fluency of the hospital staff.  Their job is to prepare their client for what to expect through the entire episode of care. This in turn contributes to higher patient satisfaction scores when outcomes are measured.

 

Structuring the tour

One way the hospital can help with this is to structure the tour so that they not only experience the on-site arrival process, but also experience a typical patient meal, view the patient menu selections, review the availability of television station options, internet connectivity, and expected behavior or rules that the patient must follow during their confinement.  For example, is the patient permitted to go to the gift shop or food establishments in the hospital lobby if their condition permits? What if they would like to purchase stationary, postage stamps, a magazine or shampoo?  If there is a telephone in the room, is the patient permitted (and is the telephone enabled) to call mobile phones and landlines alike? Where will their luggage be stored while they are confined in the hospital? Can they smoke in their room? Are they permitted to request a snack from the dietary department any time of the day  or night? What about a cup of coffee or tea?

If their client has a question or concern while confined in the hospital, who will be their advocate? How will they be summoned to the bedside? If they have a problem with an internet connection in their room, who will troubleshoot it? Will the internet connection have enough bandwidth to use VOIP connections such as Skype of Google Chat? Is the connection wireless or LAN?

The facilitator should also be interested in bilingual signage and patient information resources. Are the exit maps in each room in more than one language? What about telephone dialing directions? Patient instructions?  In every hotel in the world, there exists a guest services directory. It lists information about guest mail, laundry and dry cleaning, automated teller machine (ATM) availability to access cash for incidentals, internet service, spa menus, room service and restaurant options, gift shop hours, telephone surcharges and dialing instructions, etc.

Finally, they should be interested in the discharge process that their client will experience. How will their coordination back to the airport be handled and by whom? Will a hospital employed driver take them to the airport or a taxi? If they recently had surgery, who will assist them with their luggage? Are they expected to tip? If so, how much? Will someone accompany them to the gate? Will a wheelchair or other assistance be provided?

What if their client has pain after discharge? Will they be discharged with adequate pain medication for their journey home? How and when will the patient receive a copy of their medical records? Will the records be translated to the language they need to share the records with their aftercare provider? What about x-rays, MRIs and other diagnostic imaging reports? Are they supplied on a CD, DVD or USB drive? Transmitted directly to the aftercare physician? To the facilitator? When will they be available?

Since this is a medical "tourism" facilitator, they will likely be interested in what is nearby to the facility. Hotels, tourist activities, safety concerns, approved tour guides, historic and cultural sites, restaurants, and other travel and hospitality topics should be discussed.  It is helpful to have brochures and a contact list handy for the facilitator and to note whether or not the hospital will be involved in any of those relationships or if the information is supplied simply as a courtesy.  There should be transparency with regards to any commissionable relationships already established between the hospital and those other companies or providers so that there are no misunderstandings.

 

Legal, malpractice and insurance issues

Some of the more established medical tourism facilitators may carry professional liability insurance for their own actions. A knowledgeable representative from the hospital should be prepared to discuss matters surrounding a negative turn of events, including patient falls and other injuries, iatrogenic injuries, anaphylactic reactions, and things for which there may be professional liability on the part of the hospital or physician or nurse.  What happens if the awareness of the matter occurs after discharge and after the patient returns home? An open and honest discussion of these topics should be a part of any tour, but especially for the facilitator who is giving their personal recommendation of the provider. Another related matter that should be discussed is what to expect if their client unexpectedly dies during the episode of care?

If the facilitator is based in the United States, he or she will be subject to the certain federal regulatory compliance, including Health Insurance Portability and Accountability Act (HIPAA) of 1996 (P.L.104-191), Health Information Technology for Economic and Clinical Health Act ( HITECH), the Privacy Act of 1974, among others. As such, they will be interested in how the hospital, physician and others will assist them to maintain compliance with these regulations. There are similar regulatory compliance concerns in other countries. Regardless of where the facilitator is located, the hospital, its employees and subcontractors and attending physicians will be expected to maintain seamless compliance with any of these as a vendor to the facilitator.

 

Marketing and sales

From a marketing and sales perspective, what should you share with the facilitator who will be your extended sales agent? Of course, pricing and service lines or products is key. But what about recent or differentiating services, innovations, packages, amenities, etc.? Upcoming additions to the service lines, new technology and what it does (in lay terms), new physicians of regional or international renown, physicians who have recently been recognized or published for a certain technique or discovery or advancement (again, translated into lay terms. You may wish to share with them the products or services that the hospital wishes to launch, push or feature.  In the same regard, the hospital may wish to downplay certain services it will soon abandon, has determined to be unprofitable, inappropriate for high satisfaction medical travel outcomes from both a clinical and/or patient satisfaction perspective, hospital will soon lose the key physician who will provide them due to retirement or job change. Does the hospital or physician provide a confidential newsletter update especially for facilitators to apprise them of special promotions, events, or featured new services since their fam tour?

Handbook of Medical Tourism Program Development to be published later this year by (2010, Productivity Press, New York)

 

In Part 2:

In the second part of this article, Maria continues her look at how to run a successful fam tour for a medical tourism facilitator. She considers the agenda for the tour and the practicalities of running a tour that meets the real needs of the typical medical tourism facilitator.

Comment

Profile of the author

Maria K Todd

Maria K Todd is CEO at Mercury Healthcare Advisory Group and she serves as the President of the Council on the Global Integration of Healthcare, a nonprofit association that supports program development and education in international health and medical tourism. She is a consultant, speaker, and author of 10 books, and over 28 years of healthcare administration including integrated health delivery systems development, health plan provider contracting, healthcare organization life safety and disaster recovery planning, and managed care and global healthcare program development in several countries.

 

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Comments provided below do not represent the views of IMTJ. Comments will be published "as is" and will not be edited by IMTJ staff. IMTJ is hosting these comments, and is not  undertaking an editorial role in the content of these comments. However, it is editorial policy not to publish comments which have been submitted anonymously.

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Maria's report is very helpful to some of the beginners In MT who are accredited travel agents with a decade and more years of established business. I personally feel that only serious service providers will venture into MT,he must be able to invest in professionals,medical consultants,lawyers to ably take on this business model. It is an enormous project by itself ! We are dealing with the most important aspect of human existence,that is health and any error can close the business,while good and caring facility for a patient will get a facilitator more recommendations..it is a step by step move to success.

Guru Prasad (21/06/2010 08:10:06)

Maria has described the role of facilitator to improve the understanding between facilitator and hospital facilities,
I hope this will help to enhance quiality of services, any facilitator can start this type of survey.

Manohar Gemawat (12/06/2010 13:04:12)

As the owner of a travel wholesaler, I have been organising fam tours for Australian travel agents to inspect hotels and resorts in the Philippines for over 20 years. Previously I was involved in hotel management so I certainly have the knowledge to ascertain the quality of the properties. When it comes to hospitals that is a very, very different case. As Todd points out, you really need to know what is right for your patients and a hospital administration background should be mandatory for trusted facilitators. Our company, All About Asia Pty Ltd, arranges all of the travel components for Meditour in the Philippines and we trust their people there to make sure the medical facilities are of the highest quality for foreign patients.

Robert Graham (12/06/2010 02:19:23)

Seems to me if the facilitator doesn't understand much about hospital operations they probably should not be evaluating a hospital or facilitating cases. Customers should look for facilitators who have experience with health care administration and ideally have previously been a CEO of a hospital.

If a facilitator doesn't know what they're looking for at a hospital, they probably aren't the best suited evaluate them.

Todd Madden (11/06/2010 14:52:11)