30 Key Findings from Medical Tourism Benchmarking Research

When Mercury Advisory Group consultants and technical advisers are engaged on a project, we often use these findings as a guide to prepare focus groups and task forces prior to our team's arrival. We ask clients to draft brief, high-level answers about "What should [nation/region] establish as its vision, objective and unique response to this finding?"   The results give us rapid insight into the client's thinking.  From there, it becomes easier and this less costly to progress to a better better deliverable work product that delivers high value at the conclusion of the initial mission, instead of just "more questions".

These responses can then more easily be transposed to specific Terms of Reference (ToRs) that can be used to identify tasks, timelines, next steps, budget and resources necessary to achieve the goals and objectives for the project. We hope that sharing this list will help you to work more efficiently towards the development of your country's unique 5-year medical tourism development strategy. So here's the list:

1.     All leading medical tourism destinations have developed a clear vision and strategic objectives for their medical tourism sectors and set specified goals to be accomplished within specific time frames. Accordingly, relevant strategies, plans and programs to reach such objectives have been clearly identified and executed with effective techniques.

2.     Articulation and cooperation among relevant authorities is a must for any medical tourism destination to coordinate efforts for the development of the sector. Countries such as Singapore, Korea, Malaysia, Turkey, and Lebanon have formed national medical tourism councils or boards bringing together all formal and informal parties which have a say or can play a role in the development of the sector.

3.     Many benchmark destinations work to attract foreign and national investments to the sector by way of providing different privileges such as tax incentives for the development of the sector. A destination like Jordan has managed to attract Kuwaiti investors to build a competitive medical city in Amman. Colombia and others have established Free Trade Zones (FTZs) for healthcare facilities that meet criteria to participate. UAE also established a large healthcare city in Dubai which will be a landmark in the Middle East and integrate medical tourism services into its operations. Investment in the field has also been extended to the support services such as ambulance equipment, airport facilities and human resource training and development.

4.     Medical tourism destinations such as India, Singapore, Thailand and Turkey have a well-established “hospital management” concept which enabled them to have effective and efficient healthcare business models that offer competitive medical tourism products and have achieved and maintained international quality and safety accreditation. These countries also have managed to form provider consortium that collaboratively “brand” the country as a medical tourism destination and offer higher visibility and better quality marketing and advertising economies of scale than maverick standalone facility grandstanding. They effectively “raise the tide for all boats in the harbor.”

5.     Many medical tourism clusters in the benchmarked countries seemed to have common problems, starting with a common consultant that originally organized many of the clusters. In most cases, the cluster proved to be an expensive lesson learned with little value derived from its mere existence. Clusters in and of themselves produce no magic. While the “cluster” concept is a worthy endeavor if executed properly, without a very specific and unique strategy starting with true physician and hospital integration and alignment, proper inception and foundation building, effective implementation guidance and management, adequate member engagement and capitalization, a definitive role and infrastructure, and competent staffing for day-to-day operations, most “clusters” have been a disappointment to their membership.

6.     Since most benchmarked countries have several hospitals and other medical services providers interested in market entry for medical tourism, the government authority or a consortium of providers is often in the best position to organize training and professional development activities for medical tourism providers. In many medical tourism destinations, the workforce talent pool is limited and workers tend to nomadically transfer from company to company in search of higher pay, professional advancement, better working conditions, etc. By engaging trainers and curriculum specialists to develop capacity, providers could take advantage of the cluster’s crowd-sourced insight and economies of scale to identify training needs, develop specific learning objectives and fund training activities and workshops by more experienced professional trainers that deliver the training than that which the individual providers could afford on their own.

7.     Most medical tourism destinations offer transparent pricing for their surgical and diagnostic services, often quoted in the form of packages. Packages often include reference to a medical or diagnostic service, and may include ground transfer and accommodation beyond the hospital stay. These can easily be obtained from the internet or from the providers’ proprietary or contracted foreign extension office representatives, the providers’ medical tourism service bureau, or contracted marketing agents commonly referred to as “facilitators”. Many package descriptions we’ve reviewed from providers in benchmark countries are poorly articulated, ill-defined and ambiguous, use inaccurate idiomatic translation that confuses foreign prospects, and are laden with disclaimers that tend to raise suspicions and anxiety levels of potential clients. These failures frequently lead to abandonment of the medical tourism election by the potential client.

8.     Database systems are designed and implemented in some countries to standardize transactional metrics, produce clinical and customer service outcomes reports and monitor the number of health tourism patients and revenues gained from the sector. As a part of President Obama’s National Export Initiative, the USA has initiated a program to monitor economic impact of related health tourism spend on hotel, attraction, car hire, and other incidental expenditures by international medical tourism visitors.

9.     Destinations such as Singapore, Thailand, Malaysia, India, the USA and Turkey have tied their growth in medical tourism with advancement in technology and research available from Centers of Academic and Research Excellence, and invested in establishing up-to-date research centers and empowering their hospitals with the latest technology in treatment and equipment and knowledge transfer through continuing medical education by visiting professors.

10.  Destinations such as Hungary, Spain, Croatia, and Turkey have tied their growth in medical spa tourism with the local abundance of natural approaches to health and healing that incorporate hot spring water, gases, mud, and climatic factors (balneotherapy) and seawater (thalassotherapy) to deliver evidence-based rehabilitative and palliative care for a variety of health conditions, relaxation, and rejuvenation.

11.  Healthcare providers at destinations such Dubai, Malaysia, Korea, and Thailand frequently develop strong ties with highly-regarded international medical educational institutions for knowledge and technology transfer and for marketing as well as image building.

12.  Each country has attempted to position itself in the international medical tourism market as destination of excellence in certain treatments or specific medical products.

13.  Findings also show that international safety and quality accreditations have become a prerequisite for any healthcare provider to position itself in the international market.

14.  Besides international accreditation, India, Australia, Thailand, Malaysia, Colombia, South Africa, and others have managed to develop their own ISQua-accredited national accreditation system and have managed to control quality through their national accreditation systems. Malaysian and Thai national accreditation is highly-regarded due to strict verification procedures.

15.  International medical tourism destinations such as India, Turkey, Thailand, Malaysia and Jordan have attracted international affiliations and partnerships for quality assurance and marketing.

16.  A great number of physicians working in the field of medical tourism at the leading destinations such as India, Singapore and Thailand or at promising destinations such as Lebanon and UAE, have international credentials or holding US or UK professional qualifications. In addition, many are fluent in English and many other languages.

17.  While countries such as Hungary, Turkey and Thailand have managed to develop a good base of skilled therapists working at spas and health resorts, many spa tourism countries still lack allied health competency standards and English-language fluency for therapists and other specialized human resources to work in such centers. This can result in quality, safety and customer satisfaction failures if therapists cannot explain treatments, chemical and botanical ingredients, and safety precautions and follow up instructions in a language understood by the patient.

18.  The quality of nursing staff has been a key element in the success of medical tourism destinations such as South Africa, Thailand and Malaysia.

19.  South Africa, Colombia, Germany, Thailand, and Hungary have been benchmarked as destinations having a well-established ground and air ambulance systems and traumatology excellence while other countries were identified as emerging destinations employing technology to support advanced ambulance service. Thailand has implemented paramedics and highly-trained nurses that respond on scooters that can maneuver quickly through bumper-to-bumper traffic jams until the arrival of a ground or air ambulance. South Africa utilizes the U.S. FDA-approved Statscan Critical Imaging System, a low-dose, digital X-ray system that can take images of the entire body in 13 seconds. This technology provides trauma doctors with critical information about a patient's injuries and enables trauma team members to remain by the patient’s side during the examination because emissions contain up to 75% less radiation. The digital technology allows doctors to magnify or rotate the image without affecting picture quality. The technology was originally developed for use in South African diamond mines to scan workers at the end of the day to detect diamonds that could be hidden in clothing or swallowed.

20.  Airports of Singapore, Bangkok, Johannesburg, Frankfurt, Madrid, and Dubai are considered the best practices offering specialized medical services and facilities.

21.  Countries such as India, Thailand, and Malaysia have special visas for long-stay medical tourism while many other countries grant special accommodation to facilitate visa applications and extensions for medical tourism visitors.

22.  Specialized travel agencies with medical tourism logistics competencies have proven essential, as evidenced by Tunisia, USA, Singapore, Korea and South Africa.

23.  Airlines such as Lufthansa, Malaysian Airways Turkish Airlines, and Etihad are models of best practices offering medical tourism packages and special services to the international patients which have helped in the promotion of their countries as destinations for medical tourism.

24.  Hotels and resorts used by international patients in the medical tourist destinations such as in Germany, Singapore, Malaysia, Thailand, USA, Mexico, Korea, and Jordan are well-equipped and prepared to respond to the special needs of patients. In some countries, hotels are now embedded into hospitals through a collaborative space-sharing arrangement to accommodate companion travelers and/or remove the patient from the hospital inpatient setting during peri-operative stays before and after surgery.

25.  Best practices have identified a national marketing strategy as in Korea, Malaysia and Thailand where collaborative and joint marketing is in use, or on individual or corporate levels such as in India and Singapore where healthcare providers use highly-developed marketing campaigns using competitive prices, stand sponsorship at international industry and tourism conferences, and effective promotional tools and direct marketing to persuasively influence the choices of international patients.

26.  All benchmark destinations use websites as an important tool to promote their medical tourism products. Some of the websites are developed by trade councils, such as in Singapore, representing the whole sector and offering information on all its members. Malaysia has created an attractive, large magazine format directory that features members of the Malaysia Health Tourism Council (MHTC), while Korea has published a booklet highlighting each member provider of its Korea Health Industry Development Institute (KHIDI).

27.  Countries such as Turkey, Jordan, India, Malaysia, Germany, the USA, and Thailand have managed to build strong ties with international health insurance companies which in turn influence the flow and trust of international patients.

28.  Best practitioners such as Turkey frequently attend and sponsor international medical tourism events whether they are mega events or smaller events such as conference and exhibitions and providing showcase panel speakers at those events. Also, Asian countries as well as Dubai have shown a growing interest in hosting such events at their destinations.

29.  While many countries such as India and Thailand suffer from crowded cities, poverty, and environmental degradation, they have managed to rise to the forefront as a leading medical tourism destination. Other countries share some constraints with regard to human resource development and technology deployment and suffer marketing deficiencies; however each has managed to develop its reputation as a pioneer destination for health tourism. The use of competitive advantage approach optimizing unique points of strength while minimizing the negative impacts of the points of weaknesses has helped developing nations to gain recognition in the medical tourism market backed with a well-organized sector.

30.  Some benchmark medical tourism providers have expanded beyond one-off casual consumer-directed selection to corporate tie ups with international employers to steer exclusive expatriate health services relationships with international employers. Providers have hired marketing and business development specialists to, in some cases, arrange introductions to self-insured plan administrators and benefit managers, while others have hired consulting firms to arrange these negotiations on their behalf.