By Ron Johnson, M.D., F.A.C.S., Chief Medical Officer, Satori World Medical

Satori World Medical is a payer-supported, employer-sponsored, and consumer-choice medical tourism facilitator and global healthcare network.  We use the Joint Commission International (JCI) as a “gating” issue, and our Quality Assurance Program, assisted by our Medical Quality Advisory Board and Nurse Patient Advocacy Program, goes beyond this to ensure excellent patient outcomes and service at our International Centers of Excellence. 

JCI, the international arm of the Joint Commission Resources, was created in 1994, awarded its first international accreditation in 1999, and now has accredited over 300 institutions around the world.  In 2005 the World Health Organization designated the Joint Commission and the Joint Commission International as the WHO Collaborating Centre for Patient Safety Solutions, and in 2008 the JCI announced its accreditation by the International Society for Quality in Health Care (ISQua). 

One of the reasons Satori uses JCI as a gating issue for quality and participation in our network is our focus on the financially sponsored (U.S.) patient.  U.S. payers are familiar with the Joint Commission and their standards and surveys.  Similarly, the American Medical Association and the American College of Surgeons are two of the largest and most influential physician organizations in the U.S., so when they independently came out with guidelines for medical travel, we were pleased that we already met or exceeded them.  U.S. payers know and trust the AMA and ACS on quality matters.  These are important guidelines, and Satori’s Quality Assurance Program adds on-site due diligence visits – to review JCI accreditation reports, hospital performance measures, physician credentials and outcomes, interview hospital management teams, and tour and evaluate clinical areas including the operating rooms – as well as our own proprietary medical travel and procedure eligibility guidelines, monitoring of quality and clinical outcomes and continuous quality improvement.

Working collaboratively with our comprehensive quality program, all network hospitals and physicians share in the common goal of excellent patient outcomes and services.

By Ron Johnson, M.D., F.A.C.S., Chief Medical Officer, Satori World Medical

It has been almost a year since the American Medical Association addressed the issue of “medical tourism,” travel for medical care outside of the US. The AMA supports patient choice, wants it to be informed choice, sees many advantages in medical care outside the US and an opportunity to learn from international competition and recommends principles to provide the best care possible. Now the American College of Surgeons has issued a statement on medical and surgical tourism.

The American College of Surgeons (ACS) is a scientific and educational association of surgeons that was founded in 1913 to improve the quality of care for the surgical patient by setting high standards for surgical education and practice. The ACS currently has over 76,000 members, referred to as “Fellows,” including more than 4,000 Fellows in other countries, making it the largest organization of surgeons in the world. The ACS Committee on Perioperative Care developed a statement on medical and surgical tourism that was approved by the Board of Regents, the ACS governing body, at its February 2009 meeting. (To read the full statement, go to the Bulletin of the American College of Surgeons, Volume 94, Number 4, pp. 18-27.)

The American College of Surgeons’ statement, along with the AMA guidelines, together provide an important set of principles for consideration by patients, employers, insurers, and other third-party groups responsible for coordinating such travel outside of the country. The ACS has adopted the following position with respect to medical tourism.

1. The ACS encourages patients to seek care of the highest quality and supports their rights to select their surgeons and health care institutions without restriction.
2. The ACS encourages its Fellows to assist all patients in reaching informed decisions concerning medical care, whether at home or abroad.
3. The ACS advises patients to consider the medical, social, cultural and legal implications of seeking medical treatment abroad prior to deciding on a venue of care.
4. The ACS encourages patients electing to receive treatment abroad to seek care at health care institutions that have met the standards for accreditation established by recognized accrediting organizations, i.e. Joint Commission International (JCI), Trent International.
5. The ACS encourages patients electing treatment abroad to seek care from surgeons and anesthesiologists certified in their specialties through a process equivalent to that established by the member boards of the American Board of Medical Specialties.
6. The ACS encourages patients receiving treatment abroad to obtain a complete set of medical records prior to returning home, and follow-up care at home should be organized prior to travel whenever possible.
7. The ACS encourages patients contemplating medical tourism to understand the special risks of combining long international flights and certain vacation activities with anesthesia and surgical procedures.
8. The ACS opposes the imposition of provisions for mandatory referral of patients by insurers to health care institutions outside the US, unless such provisions are clearly and explicitly stated in the insurance contract and accepted by the subscriber.
9. The ACS supports the view that payors referring patients for mandatory treatment abroad should be responsible for the coordination and reimbursement of follow-up care in the US, including the management of postoperative complications, readmissions, rehabilitation and long-term care.

Medical tourism is a rapidly growing, world –wide industry, and its continued expansion could have significant implications for health care delivery in the US. The Statement on Medical and Surgical Tourism drafted by the American College of Surgeons was developed with the patient’s interest in mind.

By Ron Johnson, M.D., F.A.C.S., Chief Medical Officer, Satori World Medical

Travel for medical care outside of the US for the purpose of medical treatment (“medical tourism”) is a rapidly growing trend and is gaining a lot of attention by patients, employers and insurance companies. The American Medical Association (AMA) is the largest association of physicians in the United States and works to promote the art and science of medicine for the betterment of the public health. So what does the AMA have to say about this growing trend of medical tourism?

The AMA is a voluntary association of physicians in the US which sets standards for the medical profession and advocates on behalf of physicians and patients. After several years of study and discussion and many proposals and resolutions, the AMA addressed the issue of medical care outside the US at its 2008 Annual Meeting and issued a report and recommendations. The report noted long-standing AMA policy on pluralism supports the ability of patients to choose their treatment settings and providers. It also stated that medical care outside the US provides many advantages and the opportunity to learn from international competition.

The AMA adopted the Council on Medical Service Recommendations that “our AMA advocate that employers, insurance companies, and other entities that facilitate or incentivize medical care outside the US adhere to the following principles.”

1. Medical care outside the US must be voluntary.

2. The financial incentives to travel outside the US for medical care should not limit or restrict diagnostic, treatment or referral options.

3. Medical care should be limited to institutions that have been accredited by recognized international accrediting bodies (i.e. the Joint Commission International).

4. Prior to travel, local follow-up care should be arranged to ensure continuity of care when patients return from medical care outside the US.

5. Coverage should include the costs of necessary follow-up care in the US.

6. Patients should be informed of their rights and legal recourse prior to agreeing to travel.

7. Access to physician licensing and outcome data, as well as facility accreditation and outcomes data should be arranged.

8. Transfer of patient medical records to and from facilities outside the US should be consistent with HIPAA guidelines.

9. Patients choosing to travel outside the US for medical care should be provided with information about the potential risks of combining surgical procedures with long flights and vacation activities.

The AMA supports patient choice, wants it to be informed choice, sees many advantages in medical care outside the US and an opportunity to learn from international competition and recommends principles to provide the best care possible.

One of the biggest driving factors fueling global healthcare and medical tourism in America, whereby patients seek medical care outside of the U.S., is the high quality of care now available in international hospitals. But what are the crucial attributes to look for in a high quality global health care program? If you are considering a medical tourism program, here are some important tips to help you ensure the medical care is of the highest quality and safety.

Make sure all hospitals in the network are accredited by the Joint Commission International (JCI): More than 220 public and private health care organizations in 33 countries around the world are now accredited by JCI, the international arm of the U.S. accreditor of hospitals.

1. Look for a global health network comprised of U.S./U.K. or equivalently trained and Board Certified physicians
2. Check to see if the hospitals in the global network have affiliations with prestigious medical universities and hospitals: There are several top-tier international hospitals that are directly affiliated with Harvard Medical, Johns Hopkins, The Cleveland Clinic, The Mayo Clinic, and other leading medical universities and hospitals.
3. Partner with organizations that follow AMA guidelines on medical travel: The American Medical Association (AMA) has set specific and important guidelines pertaining to medical travel. Global healthcare organizations should follow these established guidelines.
4. Determine if the program has a full-time Chief Medical Officer (CMO) and quality assurance team in place: The best global healthcare companies have a full-time CMO and Medical Quality Advisory Board to ensure ongoing quality improvements in patient care.
5. Work with an organization that offers dedicated support for the patient throughout the entire experience: Choose a medical travel program that offers a team of experts, comprised of Nurse Patient Advocates and Travel Care Coordinators, to ensure optimal delivery of healthcare services and a rewarding experience for the patient and his or her travel companion. Ideally, the Nurse Patient Advocates should be Registered Nurses with surgical training.
6. Find out if the program covers all costs for not only the patient, but a companion as well: Another important part of ensuring patients’ safety and comfort when undergoing surgery in another country is that they have a trusting companion to accompany them and be on hand to help them through the entire experience. That’s why a key distinguishing factor to look for in a global health care program is whether or not the costs of travel and accommodations for a companion are included.
7. Visit some JCI-accredited international hospitals online: To view the amenities and features international hospitals offer, take a virtual tour of them online. For instance, Clinica Biblica, a top, JCI-accredited hospital located in Costa Rica offers a virtual tour of their facilities, as well as National University Hospital in Singapore.