Tips for targeting international patients

In an article in ITIJ, Danny Quaeyhaegens, Head of the International Insurance Department at Bangkok Hospital Pattaya, Thailand, talks about what hospitals can do to attract more international patients – and their insurers.

The article provides detailed recommendations for hospitals wanting to build their international business, starting with defining who or what ‘international patients’ are, and tailoring an approach according to each segment’s needs. For example, the American who travels alone and needs acute medical care will check Google. To attract such a Google searcher, Quaeyhaegens suggests it’s about social media, ad words and Google rankings. In comparison, long-staying or permanent retirees know the local situation better so there’s the potential to offer satisfaction with the service provided (adjusted to the needs of the foreigner) to turn customers into returning customers. Word of mouth in local expat clubs and local internet forums, combined with ads in local foreign media, might be ways to attract them.

Specifically for attracting medical travellers, Quaeyhaegens says that having the right products with high quality and at the right price is crucial. He argues a smooth process pre-, per- and post-treatment and availability when the patient wants it (not when it’s convenient for the hospital) are also crucial. Competition isn’t just the clinic across the road and the other hospital three blocks away, it’s the whole world.

Quaeyhaegens recommends that agents and third-party administrators have a role here. Insurance companies could have a larger role than they currently do, but even after all these years, in reality there is very little ‘global steering’ of insured customers for elective care due to the well-known challenges as distance, air travel, liability, follow-up care etc.

Quaeyhaegens states that a significant proportion of medical tourists are individuals looking for a solution that has a perfect price-quality level for them. To lead them to a particular hospital, to get them to know the hospital, worldwide advertising via the classic channels as magazines, newspapers, television is extremely expensive and probably not too effective. This must be solved, he suggests, by having a strong digital presence.

Challenges providing care to international patients

The ITIJ International Hospitals & Healthcare Review, in which the original article was published, asked Quaeyhaegens what the main challenges were when hospitals provide care to international patients. His top five were:

• Obtaining accurate and complete medical history
• Being clear on what a procedure costs
• A lack of trust in the healthcare being offered in the destination country
• Stress around repatriation
• Insurance company ignorance of what a local healthcare system can offer

Bangkok Hospital Pattaya tries to ameliorate this situation about lack of trust by improving the information given. For this, Quaeyhaegens says they translated all the important documents, information leaflets, brochures, screening documents, patient information, consent forms, into the 12 most frequently used languages for the patient to be able to read and better understand the information in his/her own language (note: signature for consent etc. still needs to be done on the original Thai and/or English forms for reasons of legality but at least the patient will know exactly what they are signing for).

International accreditation – is it worth it?

For some third parties (insurers / assistance companies / TPAs), Quaeyhaegens says the accreditation in itself is important as they may only send customers to accredited facilities, as it will give these clients the indication that a minimum of quality standards will be in place.

It may be the same for some patients, but many (non-US) probably have no idea what JCI, for example, means. Showing them a seal may be helpful, but the main thing for any hospital will be to show quality and safety standards in daily practice, with each patient contact.

Quaeyhaegens believes that, especially in underdeveloped or developing countries, accreditation is more necessary. He says: “If I were a tourist myself in Germany, France, Switzerland … and I needed to be admitted, I would (I may be wrong, I don’t know) not worry for a single second about the quality of the nearest hospital. However, if I needed to be admitted to a Thai hospital (or in a hospital in any other developing country) I’d possibly be more worried about the care I’m about to receive. In such a case, seeing some indications of international quality would probably increase my trust and peace of mind.”

Key changes to attract the international patient or insurance company

Quaeyhaegens recommends that transparent pricing structures, and demonstrations of quality (accreditation etc.) are vital components, but there are also language and cultural hurdles that must be overcome if a hospital is to truly cater to an international patient base.

There should be an acceptable level of English for all staff depending on position, tasks and responsibilities. If possible, he says, do not employ ‘English translators’ as they will take away the need for all staff to improve their own level of English; they become dependent on these English translators.

Cultural training programmes for nurses and doctors are also very useful, as every culture has its own peculiarities. Quaeyhaegens gives several examples incidences and differences he has noted when treating international patients, including:

• Why does an Arabic translator use 10 sentences to translate one simple question? Why is this Dutch patient so loud and why does the Italian look so angry with all his arm gestures?
• Why do we need to explain each step carefully to the European patient (where to some of the local patients the doctor is ‘the one who knows all’ and is blindly trusted)?
• How to deal with Islamic patients? Can we give them porcine valve implants? Should we give blood to this traffic accident victim who’s a Jehovah’s Witness? Should we use male / female staff?

Co-operation with third parties

To make a patient’s journey through a hospital a smooth process, Quaeyhaegens recommends a facility should accept GOPs, and have an open and accepting attitude toward third party (credit) payers. To facilitate this, the provider must enable good co-operation with the insurance companies.

Insurance companies also need to have fast and complete information on every case so that they can assess the coverage. Clear and detailed cost estimates must be provided prior to the treatment, clear and detailed invoices are needed to conclude the process.

Medical information Quaeyhaegens says must be clear, detailed and in English; treatments must be administered according to international standards, with no under- or over-treatment, and should be of the highest quality. Updating each other regularly about the activities is important.

Communication with customer pre- and post-treatment

Finally, Quaeyhaegens says in a digital era, patients shop around and make inquiries about treatments and costs. International patients expect fast, clear and complete answers, if the answer doesn’t satisfy them, they may move on to the next potential provider in whom they have, based on the reply to their inquiry, more trust due to a ‘more professional style of communication’.

He concludes that after-sale-service is very important to ensure satisfied customers. Hospitals should be prepared to learn from previous customer experience in order to be able to continuously improve the product which is delivered, so it is worth following-up with contacts to check-up on the patient’s condition, the patient’s satisfaction and to pro-actively manage any complaints or dissatisfactions the patient may have is more and more important.