Continuity of Care and the International Patient

Beyond the partnerships of top U.S. healthcare providers with management responsibilities in foreign hospitals that we see today, there are the yet unseen service partnerships that may take many forms:

• U.S. cancer centers that provide several portions of specific and otherwise very expensive therapy regimens can done in combination in the US and done abroad
• Large U.S.-based specialty centers that offer value to their clients by performing high cost procedures abroad—and then returning to the US for further follow up care
• U.S. based specialty clinical laboratories that ship specimens abroad to clinical laboratories for testing
• Insurance companies that extend their physician and hospital networks to other countries.

We may also see the use of low-cost, in-home monitoring devices and online tools that would reduce the need for return visits to foreign countries, allowing individuals to be more active in their care while being monitored remotely by their physician abroad. We may also witness foreign providers partnering with U.S.-based home health agencies to monitor patients after their return home. The potential of foreign partnerships is endless.

A call-to-action for U.S. providers
The question remains: Why should US healthcare providers partner with high quality foreign counterparts? In response, consider the following: the Deloitte study as cited above asserts that U.S. healthcare providers lost billions in 2007; if their predictions fall true, these providers will lose almost $70 billion to outbound medical tourism by the year 2010. The number and rate of foreigners coming to America for healthcare services is not growing as fast as it once did.

Currently, many U.S. hospitals use the high priced fees paid by foreigners to help offset their operating deficits. It's not difficult to predict that this windfall is likely to decrease if foreigners choose high quality, accredited hospitals in their home country rather than traveling to the United States for medical care. The United States also benefited for years from an influx of foreign-born physicians, who chose to practice in the here instead of in their homeland. If more of these physicians either stay home or return home because the healthcare facilities are comparable to the U.S., there may be staffing constraints for U.S. providers.

History has shown that when there is a need, solutions always present themselves to meet those needs. Although these solutions may take several different forms, each will fill a niche in the continuity of care of an international patient.

Joseph S. Barcie, MD, PhD, MBA, is the President of Centralized Services for the Dallas-based International Hospital Corporation. He may be reached at jbarcie@intlhosp.com.