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Ensuring Overseas Quality for Medical Travelers The Case for Costa Rica

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Mr. Smith is a top executive at INTEL Corporation. He travelled to Costa Rica for a meeting with local directors at INTEL Costa Rica plant one of the biggest outside the US of the California based multinational. The Corporation booked a room at Marriott Hotel a 5 star hotel just 5 minutes away from INTEL offices in Costa Rica.

When asked about his preferences when travelling Mr. Smith said he doesn like surprises while abroad for business. He wants to be sure to receive a warm welcoming a clean room 24 hour services WI-FI connection and easy access to the airport and commercial areas. This is what most recognized hotel chains offer to their guests: high standards of services wherever you are in Asia America or Europe whether in downtown or in a tourist area.

Comparable High Standards of Services

What Mr. Smith found in Marriott Hotels is called comparable high standards of services. But can medical travelers expect high standards of quality wherever they go? Can they trust they will receive what they expect and mainly what they are used to receiving at home?When talking about medicine not everything is as predictable as in other social or economic activities.

Nevertheless when countries are committed to quality and patients security much can be done for ensuring a positive experience for medical tourists. It does not just involve healthcare providers like hospitals and clinics but also hotels transportation companies and recovery centers among others.During the last 4 years Costa Rica has been working to establish a 360o quality environment for companies dealing with global patients.

An effort focused on ensuring overseas quality for medical travelers from the moment they land in Costa Rica to the time they leave the country. The result of this process is a unique medical tourism package made up of:

  • 3 Joint Commission International accredited hospitals 100% of the private hospitals of the country
  • 8 ambulatory surgery facilities and dental clinics internationally accredited
  • 5 recovery centers in the process to be accredited by the Costa Rican Norms Institute INTECO
  • 2 accredited Medical Schools
  • A unique Country Seal of Quality named PROMED identifying all those providers (health and tourism) that comply with national and international requirements such as Ministry of Health authorization JCI AAAASF or AAAHC accreditation among others.

Countries seeking good outcomes with respect to continuing quality across sectors involved with medical tourism should develop a strategy focused at least on three main elements:

  1. National Commitment with the country and with quality
  2. Comparability of Quality Standards
  3. Public Private Partnership

A National Commitment

When in 2006 the former Minister of Competitiveness Eng. Jorge Woodbridge called for a national meeting to any company interested in medical tourism the response was enthusiastic. Hospitals physicians providers and hoteliers decided to work together for a common goal: making Costa Rica a World Center of Medical Excellence within 2020. It is an ambitious objective for a visionary group of leaders that put aside their differences and rivalries to together build a better future for Costa Rica.

This is a country firmly seeking an innovation-based development where high value added services and R&D in medicine biotechnology nanotechnology and information technology have taken the place of manufacturing and agriculture: in other words Costa Rica works to be a country of mind-facturing.The formal commitment with the country and a quality-based offer of services arrived in July 2008 when the decision of creating an association was taken.

The Council for International Promotion of Costa Rica Medicine was created with the support of the National Program for Competitiveness the Ministry of Foreign Trade the Ministry of Tourism and the Ministry of Health of Costa Rica.

But above all the decision was taken to only admit institutions committed with Costa Rica and committed with quality in fact the Statutes established that in order to be part of the association institutions must comply with strict quality requirements both national and international.

Comparability of Quality Standards

Take a medical tourism magazine or visit any international providers Web page and you will discover that in the world there are at least 30-40 leading destinations for medical travels and probably thousands of leader hospitals. But who decides it? Marketers Web page developers consultancy firms? You? Me?First you cannot compare what you cannot measure. Second it is too easy to go for auto proclamation.

This is why quality must be measured and certified by independent qualified and recognized international bodies.Costa Rica has decided to compete in the World League and submitted itself to the criteria of those accreditation bodies recognized by the Governments of its three main markets: the U.S. Canada and Europe.First its private hospitals entered the Joint Commission process of international certification.

One after the other opened their doors to internationally recognized quality process and standardization. Now three hospitals (Hospital Clinica Biblica Hospital CIMA San Jose and Hospital Hotel La Catolica) hold their JCI accreditation and not only international patients but also Costa Ricans can enjoy the results of these medical institutions run by strict protocols and manuals.Later small and medium enterprises applied to become part of the opportunities generated by medical tourism.

The Government of Costa Rica requested the cooperation of two of the most prestigious granting authorities in the U.S. Twelve months later in October 2009 the first three clinics (one general practice clinic one dental clinic and a plastic surgery facility) received the international accreditation by the American Association for Accreditation of Ambulatory Surgery Facilities (AAAASF). Today AAAASF and AAAHC (the Accreditation Association for Ambulatory Heath Care) together have accredited eight clinics of different specialties in Costa Rica the highest number outside the U.S.

Finally for the sectors where no international regulations were in place Costa Rica developed a unique certification through its official accrediting body: the National Institute of Technical Norms of Costa Rica (INTECO). It applies for tourist activities such as hotels travel agencies and transportation companies recovery facilities goods and services providers.

The regulation asks providers to respect strict standards of accessibility for limited mobility people to account with qualified bilingual CPR trained professionals and to establish processes for continuing quality evaluation.In order to unify under a sole seal of quality all these regulations and accreditations Costa Rica created a Country Seal of Quality PROMED which helps foreign patients to identify those healthcare and tourist providers that offers excellent verifiable and comparable quality services. The PROMED seal of guarantee becomes the entry door to the quality of healthcare in Costa Rica in the most transparent independent and recognizable way.

Public Private Partnership

Too many times we have seen excellent projects falling down from a weak interaction between public and private entities. Normally in developing countries governments have good ideas but little capacity of implementation. The entrepreneurial sector is problem-solving oriented but lack of public legitimization and strong opposition of its competitors hinder the possibility to go national with well planned projects and there often remain limited efforts of specific companies.

From the beginning public authorities and private institutions in Costa Rica understood they couldn succeed without a joint strategy focused on two main elements: regulation and international promotion without disregarding human resources training so important for ensuring long term sustainability to Costa Rican plan to become one of the leading destinations for medical tourism.

PROMED agglomerated the private sector in one sole agency where governmental institutions like the Foreign Promotion Agency PROCOMER or the Institute for Tourism ICT could find a solid counterpart to develop common projects and implement the national policy for medical tourism.The commitment of the Government was formalized in February 2009 when the President of the Republic of Costa Rica and Nobel Peace Prize winner Dr. Oscar Arias Sanchez signed a declaration of public and national interest for all activities and initiatives related to medical tourism.

The commitment was signed and for Costa Rica started a suggestive unique and challenging era of new partnerships alliances and big transformation within the tourism sector looking at medical tourism as the panacea face to an upcoming crisis.

Its the Quality…Silly!

Promotion marketing and congresses are all secondary issues when dealing with the health and life of a patient. The first and last concern must be with the medical traveler that decides to leave his home to submit himself to a medical procedure overseas. Only a patient security focus can guarantee a sustainable development and growth of an industry like medical tourism.Medical tourism starts and ends with quality! The general elections for the best world destination are opened: the secret for the success is unveiled: let the best win!

About The Author

Dr. Jorge Cortés Rodriguez is the President of the Council for International Promotion of Costa Rica Medicine – PROMED. PROMED is the private not-for-profit organization that coordinates the efforts carried out to ensure the quality of services provided by the private health industry in Costa Rica and their international promotion with the intention of consolidating the country as a center for global medicine and a major destination for medical tourism. This board was born out of the need the private sector and the State had to supervise the quality of services rendered to medical tourism patients with the purpose of guaranteeing the sustainable growth of this industry. To fulfill this goal PROMED develops regulatory standards and promotes the certification of service providers with the support of international bodies and the training of local certifiers.

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