MEDICA.de spoke to Astrid Giernalczyk, research assistant at the Research Institute for Operations Management at the RWTH Aachen University, about a brand-new internet portal, untrustworthy medical tourism agencies and diagnoses from afar.
MEDICA.de: What goes awry with the hospitals attempting to attract foreign patients?
Giernalczyk: Nothing goes completely awry, yet there is room for improvement. Mistakes often result in annoyance and patients that do not return. The problem starts off with the fact that many clinics do not have an employee who is responsible for the support of the international patients. Somebody who is trained in this task, who knows exactly, what kind of service the patients expect and how the payment is processed best. If such a person is missing and a request from abroad is coming in, it is unclear who is in charge, and subsequently no case file is generated. That means the patient maybe addresses problems by telephone that are documented nowhere and, therefore, are not followed up by anybody. Of the normal hospital staff, no one feels responsible for the special requests that patients from other countries may have, such as visa service or hotel booking for the family members. Everything that exceeds the usual treatment procedures of German patients causes confusion.
MEDICA.de: So the whole workflow should be systemised. Some hospitals, such as the University Medical Center Hamburg-Eppendorf, lead the way. Why do other clinics not simply copy their approach?
Giernalczyk: The best strategy depends on the particular case. The clinic in Hamburg is huge, has many resources, and offers a touristic attractive town, very good flight connections plus many reputable physicians. It can afford a whole department that is only concerned with the international patients. A district hospital does not have all these resources. Therefore, as first step every clinic has to analyse its capabilities: Can an employee take care exclusively of the foreign patients without being missed in another position? In which field do I have a physician with a high reputation? In which country do I have established contacts, for example because a huge company regularly sends its employees for treatment? Do I have employees that speak foreign languages? What flight connections are existing? Smaller clinics should check these potentials and concentrate on their strengths. That means specialise in a certain region or in certain patients – for instance heart patients if the hospital can offer an internationally recognised cardiologist.
MEDICA.de: Your web page is to systemise the processes. With it, foreign patients can search for the right clinic for them and contact it. Such pages already exist though. What is special with yours?
Giernalczyk: Search-screens for hospitals are in fact at hand. We even were inspired by other providers when developing ours. What has not yet been offered is the conducted communication process that can take place via our portal right after the searching. The patient can use his login to send a query to many clinics at the same time. He can upload documents such as the physicians’s letter or treatment outcomes and send them together with his request. In this way, the hospitals can get a picture of what has to be done. The patient managers of the contacted clinics can access the data and can generate a form of a patient file under their login in which the whole communication process from the first contact until the discharge is documented. All organisational data, no matter whether the scheduling, the cultural needs or the billing are collected here. So far the internet portal is only a prototype though. We are still looking for hospitals that are interest in using it.
MEDICA.de: Regarding data privacy: is this secure?
Giernalczyk: Yes. The way of communication is more secure than email. It runs via an encrypted connection that is as good as online banking. And it is also safer for another reason: The direct connection between hospital and patient renders medical tourism agencies unnecessary. These agencies cost a hospital money and it cannot be ruled out that they place a patient in the hospital that pays most. That does not have to be the best for the patient.
MEDICA.de: Also the decision what treatment the patient will receive is taken via the online communication. Is a diagnosis from afar not difficult?
Giernalczyk: Yes, it is. The problem that a patient abroad does not always know exactly what he suffers from or what treatment he needs cannot be solved easily. The patient manager can at least question very detailed and ask for treatment outcomes until he has enough clarity to write a treatment offer.
MEDICA.de: According to your study results, would you advice every hospital to immediately employ a patient manager for international patients and to use your web portal?
Giernalczyk: Huge clinics should do so. Smaller hospitals should definitely check their potential. Hospitals that have no capacities left, that have bad or no flight connections or have no relation to foreign countries should refrain from doing so. But I am convinced: Many of the smaller hospitals have potential that lies idle.
The interview was conducted by Anke Barth