Editorial

Mitigating Risks in Medical Travel

Editorial

Over the last few decades, the need for affordable and top-line healthcare continues to drive medical travel as more health buyers look beyond borders to find solutions for their healthcare needs. While medical travel offers a unique opportunity for health payers to access high-quality healthcare with enormous cost savings, it also comes with some risks – both to the patient and the healthcare provider.

Potential hazards of medical travel include:

  • Accepting high risk patients
  • Risks during travel (such as DVT on long flights)
  • Medical complications
  • Surgical outcome expectations not met
  • Patients with insufficient funds to cover extra costs
  • Litigation due to malpractice
  • Exposure to infectious diseases at the destination
  • Political and safety issues at destination

For medical travel programs, therefore, there is a need to adopt risk-mitigating strategies to minimize avoidable complications and ensure an excellent patient care experience. This requires a careful pre-travel assessment to carefully select patients who are good candidates for medical travel. Health payers also need to take certain steps to mitigating certain risks when they seek care abroad.

Medical Risks

Medical travel provides many benefits to patients, but it is not ideal for everyone. It may sound basic for medical travel programs to evaluate the medical background of prospective medical tourists, but certain medical co-morbidities may significantly alter treatment plans when carefully factored into clinical outcomes. For instance, elderly patients with complex medical histories may not be suitable candidates for complex elective surgical procedures as thee procedures may significantly increase the risk of death and poor outcomes.

This should be your first line of defense for signaling out potentially high risk cases. Create a detailed medical history questionnaire you send to patients to gather data about their health history including previous surgeries, illnesses, unhealthy habits or medications that they may be taking. This will be a good starting point for assessing a potential patient´s condition. A staff

member from your international office should also follow-up with a call to gather more information and to try and spot any red flags that may have not been apparent in the medical history questionnaire. You could create a script for your case managers to use when dialoguing with prospects. Below are some examples of questions you might like to use:

  • Why do you want to travel abroad for this procedure?
  • What are your expectations for this procedure?
  • What tests have you taken in preparation for surgery?
  • What medications are you on?
  • Have you had previous surgeries?
  • How are you going to pay for the procedure?
  • Do you have funds to cover the costs of medical complications if these were to occur?

When possible, try to use open-ended questions where the prospect needs to elaborate as opposed to simply answering “yes” or “no.” Allowing your prospects to “open up” and expand on their reasons for wanting to travel abroad will give your case managers a better chance of spotting potentially risky patients. Try to get a sense of whether or not the patient will be comfortable traveling to an unfamiliar country or city.

Oftentimes, the information a medical questionnaire provides is simply not enough to determine whether or not a prospect is a good candidate for a particular procedure. In these cases you will need to request additional information from your patients such as their medical records and/or diagnostic tests and medical reports. These often include diagnostic imaging such as X-rays, MRI´s, and CT scans; blood tests results, and doctor reports. Obtaining this information is especially important for higher risk procedures such as organ transplants, heart related interventions and weight loss procedures.

Infectious Disease Risks

Medical travel increases the risk of cross-border spread of infections, if essential infection control checks are carried out. Certain exotic infections, such as Classical Swine Fever, Yellow Fever, African Swine Fever, Ebola and Marburg hemorrhagic fevers, and even Bird Flu can spread easily from endemic areas to countries where such infections are rare.

Nations such as India, Thailand, Malaysia, and Costa Rica have a higher incidence of tuberculosis, hepatitis A, amoebic dysentery, and other diseases than the United States and Europe. Further, more common infections, such as COVID-19 can also easily spread across borders when an infected patient travels to the medical travel destination.

Medical providers may leverage infection control checks, including vaccination status, infection clearance certificates, and strong surveillance protocols to prevent cross-border spread of infectious diseases. Patients are also at increased risk of contracting infections endemic to the medical tourism destinations, hence, medical travel programs may also need to collaborate with local infection disease control authorities to improve disease surveillance and roll out containment plans to deal with cases to limit local spread of the infection.

A major concern among patients considering treatment abroad is the risk of nosocomial infections, which are infections associated with healthcare interventions and which are usually contracted within hospital settings. The risk of nosocomial infections is of much greater concern for patients who have medical conditions that weaken their immune systems, such as cancer, diabetes, and genetic immunodeficiency problems.

Medical travel programs must ensure their infection control policies reflect global best practices, with multi-level infection control strategies, such as gloving, maintain septic conditions for surgical procedures, deep cleaning of surfaces, use of personal protective equipment, environmental decontamination, and implementing patient safety guidelines.

For patients, identifying medical travel programs with strong infection control policies is, therefore, crucial. Safety is a crucial issue in the post-pandemic era of medical travel. Patients and insurers must look out for these clear indicators to assess a medical travel program’s infection control protocols.

Ethical and Legal Risks

Ethical considerations differ across borders and medical travel programs as well as international patients need to be well informed about the ethical issues between the patient’s home country and the medical tourism destination.

One crucial issue that forms the cornerstone of medical ethics is obtaining patient’s informed consent. While the principle of informed consent is similar across several countries, it may be significantly nuanced, requiring a better understanding of the patient’s contexts.

Language barriers and miscommunication may pose a challenge to access to accurate patient information and access to information about treatments for patients to make an informed decision and grant an informed consent. These challenges need to be addressed, and patients must be provided with as much information about their treatments and medical conditions as well as possible clinical outcomes in languages they understand to limit ethical concerns that border on consent and autonomy.

International patients need to also be well informed about data security and how their personal health information are used and stored. Usage of patient data must comply with local and international data protection guidelines to prevent breaches to personal and sensitive patient information. Medical travel providers, therefore, need to be fully aware of data protection frameworks that exist and train staff about how to use and process data to comply with these guidelines.

Finally, the medical travel provider and the medical tourists must be fully aware of the services covered under their medical travel packages. Patients should be aware of issues, such as emergency insurance, medical complication insurance, as well as follow-up services covered under their medical travel package. This helps health payers understand what services are included by the medical travel provider and have a well laid out financial plan for the care journey.

Limiting Medical Travel Risks with Global Healthcare Accreditation

Medical travel comes with enormous benefits for health payers and medical providers; however, it also poses significant risks to stakeholders if essential measures are not considered. Medical risks, the risks of infectious diseases, as well as ethical risks are considerable for all medical interventions, but more so for medical travel. Stakeholders must understand these concerns and proffer appropriate strategies to prevent or minimize these risks. Global Healthcare Accreditation (GHA) provides stakeholders the right resources and tools to make the right medical travel decisions. GHA empowers health payers with access to medical travel programs and facilitators that prioritize patient safety and an excellent patient experience across the care continuum, and also helps medical travel programs with the requisite training, partnerships, and policies to ensure they meet the needs of the international patient.

GHA, through the GHA Accreditation for Medical Travel, evaluates medical travel programs across global standards of safety and quality, ensuring the international patient can easily recognize and access top-tier medical travel organizations that prioritize the patient experience.

Limiting risks in medical travel requires understanding the context of the international patient and the dynamics of healthcare across regions. GHA’s accreditation seal means patients do not have to rely on hearsays and internet reviews to make important decisions about their medical travel journeys, but rely on expert evaluations and metrics to access medical travel programs that focus on patient safety and quality experience.

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