CH. C (9)-MEDTOUr.pdf

THE COMPREHENSIVE ROLE AND FUNCTIONS OF A MEDICAL TOURISM FACILITATOR ROLE VARIES  Medical tourism facilitator role varies according to the type of organization, the population served, the client mix, a medical tourism facilitator’s education and training, and the type of facilitation offered....

THE COMPREHENSIVE ROLE AND FUNCTIONS OF A MEDICAL TOURISM FACILITATOR ROLE VARIES  Medical tourism facilitator role varies according to the type of organization, the population served, the client mix, a medical tourism facilitator’s education and training, and the type of facilitation offered.  Virtually every category of client served will have its own needs, and these needs will dictate the scope and depth of the facilitation required COMPONENTS OF BEING A MEDICAL TOURISM FACILITATOR THE COMMON AND ESSENTIAL COMPONENTS  Identification of appropriate clients  Assessment of clients for the services they require  Coordination, planning, and identification of the level of care, and then the level of services and scope of resources required to meet patient care needs  Implementation, coordination, and linkage of clients expeditiously to the sources they require  Direction, oversight, and monitoring of the distribution of services clients require and ensuring that appropriate and effective services have been established as clients move through the episode of care THE COMMON AND ESSENTIAL COMPONENTS (CONT’D)  Advocacy and the ability to act on behalf of clients to ensure that needed interventions are obtained and clients are progressing as anticipated  Evaluation and continuous monitoring to ensure the usefulness and effectiveness of the facilitation plan and that client-desired outcomes and goals are reached  Patient satisfaction measurement  Feedback loop reporting to providers and the creation of measurable outcomes data Patient Process Model Regardless of the type of clients served or the practice setting for the health travel facilitator, the common characteristics of health travel facilitators should include the following:  Education that includes medical terminology and anatomy, physiology, pharmacology, basic health history taking, and other general medical training  Education that includes travel planning training, including geography, aircraft configuration, airport layout, a firm understanding of minimum connecting times, standard airport codes, standard carrier codes, tariff configurations, immigration and visa details, and refund and change restrictions related to airline and trouble ticketing, and hotel and ground transportation reservations  Experience and expertise in the specialty to be facilitated  Ability to have a holistic perspective and see the client as a whole person, rather than a dis-ease or a case CONT’D..  Knowledge of international protocols and health systems  Knowledge of how to procure resources to accomplish your goals  Medical communication skills and the ability to interact effectively with both the client and the healthcare team  Ability to solve problems and overcome hurdles and obstacles and plan for the unexpected  Ability to be creative and innovative  Ability to be self-directed, because often there is no role model to follow THE HEALTH TRAVEL FACILITATOR ROLE HAS THREE DIMENSIONS  Clinical role--requires collaboration with the interdisciplinary team and involves the development of protocols for the key tasks or events that must be accomplished to assist clients through globally integrated healthcare access.  Managerial role--refers to the scope of managerial responsibilities it takes to coordinate the care of clients.  Financial aspect of planning--access to information about the cost of each care service, and information on allocated length of stay or the number of treatments or procedures that will be necessary to accomplish goals. TO BE EFFECTIVE  Health travel facilitators must have access to information on the cost of resources and consumption  Must be familiar with payment systems including foreign currency, wire transfer, refund, cancellation, change fees, prepaid deposits, and overcharge policies and procedures  Because all care in today’s healthcare arena is very time-sensitive, many facilitation firms will attempt a multidisciplinary collaborative approach so that many hands are helping to do the tasks of one.  Health travel facilitators must be realistic and assume that many case management goals will remain unmet as a result of noncompliance by the patient or family or the lack of a source of payment for needed care and services  Health travel facilitators should be expected to review efforts for continuous quality improvement (CQI) programs and ongoing management by healthcare providers and their own health travel facilitation organization. CAUSES OF MANAGEMENT SETBACKS IN FACILITATING  Lack of understanding of the complexities of the disease process on the part of the facilitator  Lack of a formal training program for the health travel facilitator  Lack of the tools needed to do the job: policies and procedures, a computer system that can cap-ture and report details and outcomes, and manage health data and medical records appropriately  Lack of strong leadership, or leadership that micromanages  Caseloads that are too high  Poor planning, resulting in crisis intervention or putting out fires as events occur  Lack of cooperation by physicians when specific requests are made  Lack of understanding by the health travel facilitator of the requirements, processes, and modalities of reimbursement and risk arrangements  Inadequate staffing by external organizations such as the social services support for the psychosocial aspects for care needed by clients during aftercare To identify issues and come up with solutions, the health travel facilitator should do the following:  Audit medical records to determine whether unnecessary tests, treatments, or procedures are planned or have been performed and whether other factors are contributing to increased costs, length of stay, or use of resources.  Review complaints and incident reports, as well as other documents that identify issues, to determine whether opportunities for improvement exist.  Interview key hospital staff, including the medical staff, to solicit their input and identify areas for improvement.  Review and analyze patient records to identify which costs could have been eliminated or which processes could be reviewed and improved.  Evaluate current data to ensure that the information obtained was indeed needed, and if not, what information should have been obtained to evaluate the areas that require change.  Evaluate patient, physician, and staff satisfaction surveys to determine issues and identify areas that require change.  Determine which additional costs associated with any wrong medications or treatments or placement of the client at the wrong level of care could have been avoided.  Determine the source of increased costs related to the misuse of personnel, products, or resources.  Evaluate delays in services and consequently added costs as a result of increased length of stay or additional treatments that may or may not have been medically necessary.  Evaluate loss of sales or customers, and why clients might switch to other facilitators.  Determine why high-quality providers may have dropped their contract with the facilitator, or refused to contract in the first place CONT’D…  Lack of providers who are trained to offer the level and type of care required, often resulting in fragmented care  Delays in services or lack of care altogether  Expensive or inappropriate levels of care  Fraud and abuse  Unnecessary readmissions or increased length of stay  Suboptimal use of healthcare resources, leading to either over- or underutilization  Patient and family dissatisfaction with care, and possible increased likelihood of lawsuits  Increased quality of care issues  Increased complications caused by ineffective or inappropriate care  The key to quality improvement is to have a process in place that measures the before and after events and to take the steps necessary to make changes, and then monitor the effect of the changes to ensure that they were effective. If the changes are not effective, the process should be re- examined and started again.  TOOLS OF THE TRADE  Health travel facilitation realistically requires skills far above the clinical skills needed by general hospital floor duty nurses or even nurses in an intensive care unit (ICU)  The key is ----GOOD DOCUMENTATION  The importance of documenting the facts surrounding the case cannot be understated. Documentation is also what is used to protect oneself in the event of litigation.  Keep in mind the two following quotes, “Keep it simple,” and “If it’s not documented, it didn’t happen.” JOB DESCRIPTION  A good job description should not only be used in the recruitment process, but also as an evaluation tool for periodic job performance evaluations.  A well-developed job description may also help you as a defense in the event you are accused of wrongful hiring practices, discrimination, or failure to credential.  The job description should be clear, and delineate the responsibilities and functions of the health travel facilitator, as well as reflect the expectations and level of educational background expected.  If a budding entrepreneur opens a health travel facilitation business, without the requisite training, education, and experience, the job description may also serve as a tool to hire a proper medical case manager, and trouble manager, to work as employees of the firm TECHNOLOGY  Be familiar with the technology available so that they can make informed decisions when technological changes to current processes are necessary.  Business process improvement (BPI) is a process that is used to evaluate and redesign tasks with the goal of improving business processes, such as streamlining procedures and saving time and money.  For every dollar saved and every hour saved, the result should be a lower cost, more competitive offering to potential clients, a direct advantage to the bottom line, and more cohesive, coordinated, client services  Should occur before the implementation of a new software program, to maximize the benefits of the software and to correct any problems such as duplication and unnecessary or outdated time-wasting processes.  Business process reviews may include attention to both internal and external organizational activities and the creation of business process workflows WORKFLOWS  A workflow is a narrative; a graphic depiction of the flow of a process from beginning to end, either within one organization or across multiple organizations.  The purpose of the workflow is to segment each step in the process of health travel facilitation, from premarketing through case closure and post-service referrals.  Create two workflows: The current “as-is” workflow and one that will be implemented at various stages of organizational and volume growth of the business.  The inclusion of staff time, costs, and requirements can be helpful in planning technology expansions, staff expansions, and budget and cash requirements to grow the business COMPUTER SYSTEM LIFE CYCLES  The interoperability of software is key to the efficiency, cost savings, and critical documentation necessary to run this complex business organization that likely functions across international time zones, cash currencies, languages, disparate health systems, and other cultural and organizational differences. SYSTEM DESIGN  The system design phase is a point when business and technical needs are addressed to design the application to meet the health travel facilitator organization’s needs. PROJECT PLANNING Project Management  includes identifying the executive sponsor, the steering committee, the actual project manager, and project team members who will be essential to the initiation of the project.  The project manager is the person responsible for the project and may be a member of an IT department or a medical department. If you’re a small concern, you may be “all of the above.  Project managers typically use several tools including project management software that displays the projected schedule according to major tasks, staff resources, and timeframes. HOMEWORK  Imagine you are a Human Resource manager of a medical tourism business. You are tasked to make an interview with a job applicant for a MEDICAL TOURISM FACILITATOR  Design an Interview Guide that has the questions you will be asking the target interviewee. You may create as many questions as it is needed.  The goal is to present the business of medical tourism facilitation. It is up to you to choose the highlights of the information you need.