Transcript Slide 1

The Globalization of Healthcare
Leveraging the National Healthcare Workforce
Kuwait Medica Conference and Exhibition 2011
April 12, 2011
Robert K. Crone, MD
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Healthcare Overview
Drive for Improved Quality of Care in the Region
• GCC’s population is expected to double in 20 years to 80 million.
• The population is aging and acquiring chronic medical conditions,
• Governments are becoming more reluctant to fund medical travel
• Governments are encouraging the development of the private sector in
healthcare.
• Consumers are becoming more discerning about quality
• Healthcare insurance coverage is being mandated in all GCC
countries.
> USD $10 Billion investment in healthcare infrastructure
projects underway in the GCC today*
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*Source: Huron experience and interviews; MEED publication 2009; Grant Thornton publication, August 2008
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Trends in the Gulf States
Advanced, patient-centered healthcare facilities
•Rapidly changing demographics &
burden of disease
Intensive Care Medicine
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Cancer Care
Healthcare Spend by Region 2010:
- No place to go but up!
% of GDP
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Economist Intelligence Unit 2010
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Shift from Public to Market Model of Payment
•Government moving from provider of care to
regulator of care and social safety net
oPrivate sector development
oMandatory insurance for all employees
•Requiring hospitals to develop:
oAbility to negotiate contracts with 3rd party payers
oAbility to track costs, bill and collect from patients
and payers
oAbility to track and report outcomes
oNeed for sophisticated data systems
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Implications for Hospital Operations
• Cost Reduction and Utilization Management:
Efficient hospital operations will become increasingly
important
o Revenue cycle
o Supply chain
o Pharmaceuticals
o Clinical practice model
o HR functions
• Business Model Shifts: Anticipate the shift from
a public to a market model
• Changing Role of IT and the Value of Data: Invest in data systems
• Consumerism and the Patient Experience: Will become increasingly
important for patient-centered, cost-effective, high quality
• Physician Integration and Clinical Process Improvement: Invest
in, and assure the quality of your professional health care workforce
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Who is going to Staff these New Hospitals?
•70 - 80% of physicians, and 90% of
nurses in the GCC are expatriates.
•Fewer than 5% of Arab students
pursue studies in science.
•Kuwait projects a need for an
additional 4,000 physicians and
10,000 nurses by 2016.
•Saudi Arabia plans to import 5,000
expatriate physicians
The Lights are on, but Nobody’s Home !
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Two Sources of Healthcare Professionals
• Educate and Train your own
Challenges:
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Need to build the Educational Infrastructure
Each Physician requires a 10+ Year Process
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Two Sources of Healthcare Professionals
Recruit migrating previously trained professionals
Challenges
•Quality Assurance: Are they who they say they are?
•Divergent Patterns of Practice
•Knowledge of local culture
•Public confidence
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Medical Schools
Medical Education in the Middle East
Middle East
Total 19,500 medical school students in the Middle East
~4,500 students graduate annually in Middle Eastern countries
2X students per capita vs North America (.12/1000 vs .06/1000)
Lebanon
420 annual grads
7 schools
Kuwait
90 annual grads
1 school
Bahrain
200 annual grads
2 schools
Qatar
50 annual grads
1 school
Saudi Arabia
3,200 annual grads
25 schools
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Source: WHO – 2006; IMED
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UAE
320 annual grads
4 schools
Oman
230 annual grads
2 schools
Rapid Expansion of the Healthcare Workforce
- Implications for the Ministry of Health & Hospitals
In an immature regulatory environment, quality assurance of the
workforce falls to the hospital.
• Recruitment
• Primary source verification of credentials
• Licensing
• Credentialing
• Maintenance of licensure and certification
• Continuous professional development
• Workforce oversight
• Outcomes and critical incident reporting
• Malpractice and professional disciplinary action
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How Do you Assure the Quality of your Medical
Graduates & Imported Physicians?
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Setting & Maintaining International Standards
• Global standards at all levels of the educational continuum that
facilitate local, regional and international migration for trainees &
practitioners
o Entrance
to medical school (MCAT)
o Medical school accreditation at a global standard
(WFME, ? LCME)
o Global standards for assessment of medical students
(NBME)
o Graduate medical education accreditation (ACGME)
o Medical specialty certification (Royal Colleges, ABMS)
 MOC
o International portability of medical licensure
 MOL
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Leveraging Your Existing Healthcare Workforce
• Invest in health professionals’ education, including Post Graduate
Training
• Institutionalize continuous professional development
o Enforce rigorous standards for migrating physicians
o Introduce maintenance of certification and licensure
• Encourage the development of medical care teams
o
o
o
o
Recruit/train/retain a strong nurses allied healthcare professional workforce
Expand the role of nurses, pharmacists, therapists, managers
Simulation training in teams
Embracing the ACGME core competencies
• Develop and implement clinical practice guidelines
• Focus not just on treatment, but on public health and disease
prevention
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Embrace the ACGME Core Competencies
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CPD Medical Simulation
Team-Based Training
Technical Skills
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Communication
Skills
Physical Diagnosis
Adopt Clinical Practice Guidelines
• Diabetes care
• Hypertension
• Heart failure
• Otitis media
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Develop and Support Team-Based Primary Care
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Public Health and Disease Prevention
• Genetic testing
• Newborn metabolic disease screening
• Comprehensive immunizations
• Hypertension screening
• Diabetes screening
• Cancer screening
• Mental health screening
• Public health education
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Focus on Care Outside the Hospital
HOME TELEHEALTH REDUCES HEALTHCARE COSTS
Helen C. Noel, Ph.D., A.N.P.,
Donna C. Vogel, M.S.N., C.C.M.,
Joseph J. Erdos, M.D., Ph.D.,
David Cornwall, R.N., M.B.A., and
Forrest Levin, M.S.
TELEMEDICINE JOURNAL AND e-HEALTH
Volume 10, Number 2, 2004
© Mary Ann Liebert, Inc.
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