How Do You Define Quality in Medical Travel?

May 11, 2017

Imagine for a moment that you woke up this morning with a very sore throat. You decide to take some zinc lozenges and head to work. However, by early evening you are feeling worse so you go to your local clinic to see a physician.  An hour later you are being examined by a doctor as you describe your symptoms.  After giving you the once-over he opens a cabinet, takes out some slimy gray wiggly creatures and slaps them on your arm. He then matter-of-factly explains to you the benefits of bloodletting.  While this may sound like a nightmare or something you’d see in a low-budget horror movie, this was actually common medical practice as recently as a hundred and fifty years ago. In fact, George Washington, the first president of the United States, underwent a similar “treatment,” - right before he passed away.
Why don’t we usually recommend bloodletting as a treatment option for our patients?[1] Two words: Quality Improvement. Over the last centuries, our human yearning to “make things better,” coupled with a larger body of knowledge and improved technology, has resulted in better medical practices and outcomes.

What is quality in medical travel?

But how do we define “quality” and consequently “quality improvement” in medical travel where ‘care’ does not always equal healthcare?

According to The Institute of Medicine, quality in the healthcare space can be defined as "the degree to which health care services for individuals and populations increase the likelihood of desired health outcomes and are consistent with current professional knowledge.” This definition would probably bring no argument from most healthcare experts.

In medical travel, however, the patient experience extends beyond the care delivered in the actual healthcare facility - it starts from the point of inquiry through the ongoing communication after service has been provided. This means that any ancillary and hospitality services we have in-house or outsourced should also increase “the likelihood of desired healthcare outcomes” as well as a high-quality medical travel experience. However, to achieve this goal we must enlist, educate and empower other stakeholders (internal and external) who have contact with or who are responsible for the patient/guest during their medical trip. Remember, from the first interaction with your call center to pick-up at the airport to the hotel and hospital stay, medical travelers are forming a perception about the quality of care you provide – regardless of where it is delivered.

Yet, while defining ‘quality’ in medical travel is an important first step, it offers our patients little value as an inert concept. For real transformation to occur, we must take action and identify ways to improve quality in medical travel.

Quality Improvement

Quality Improvement can be defined as “a series of systematic and continuous actions that lead to measurable improvement in health care services and the health status of targeted patient groups.”[2]

Are international patients or medical travelers one of your targeted patient groups? If the answer is yes, then you should be measuring and benchmarking key performance indicators specific to the medical travel care continuum. Otherwise, how will you know if your actions are actually improving the quality of care provided to this patient segment?

What to measure?

When deciding whether or not to measure a certain metric, always ask yourself, “Will this data allow us to add value to our customers, employees and, ultimately, to our bottom line?” If the answer is no, then don’t waste your time. There are certain metrics that most hospitals are already measuring: e.g. readmission rate, occupancy rate, length of stay, infection rate, medication errors (though you may not be doing it specifically for medical travelers). But there are others you may have not considered: e.g. patient satisfaction at key touchpoints along the medical travel care continuum (such as hotel or transportation), average treatment charge, service delivery times, the average time it takes you to respond to a prospect, and return on investment from advertising campaigns, are some key indicators you should be tracking. Finally, measuring results is important for any organization to have long term sustainable success as it allows them to identify problems and opportunities, and to increase productivity.

Focusing on quality is good for your bottom line

Yes, focusing on quality is obviously beneficial for our patients. But did you know it is also good for your organization’s bottom line? New research has found that superior customer experience doesn’t just strengthen patient engagement — it also correlates to 50 percent higher hospital margins[3]. If this news doesn’t make your CFO dance a jig, then nothing will. However, to gain these rewards you and your team must constantly be on the lookout for ways to make your systems, processes, and services better. Whether it is something as simple as ensuring all email inquiries are responded to in under 24 hours to a more complicated initiative such as training hotel staff about medical travelers’ needs, we must change our mindset from “out-of-sight-out-of-mind” to understanding that we are ultimately responsible for facilitating quality services across the entire medical travel care continuum.

[1] Certain cultures still use leaches in medical treatments and it is currently used in some very specific cases during reconstructive plastic surgery. https://www.ncbi.nlm.nih.gov/pubmed/26297126

[2] Health Resources and Services Administration (HRSA). https://www.hrsa.gov/quality/toolbox/methodology/qualityimprovement/ Accessed 5/8/17

[3] Accenture – Patient Engagement: Happy Patients, Healthy Margins. https://www.accenture.com/t20160923T044902__w__/us-en/_acnmedia/Accenture/Conversion-Assets/DotCom/Documents/Global/PDF/Industries_17/Accenture-Happy-Patients-Healthy-Margins.pdf#zoom=50. Accessed 5/10/17