The practice of travelling across borders to receive medical treatment is becoming increasingly popular. Propelled by factors such as rising local healthcare costs, lengthening waiting times and the expanding availability of high-quality care at affordable prices abroad, medical travel represents a burgeoning market.

Many hospitals have dedicated international departments that cater to global patients, offering specialised care that takes into account diverse needs. International departments can boost a hospital’s global reputation, increase revenue and open up new collaboration opportunities. However, the process of building an international department is complex, with numerous considerations to be taken into account and pitfalls to be avoided.

Maria K Todd MHA PhD has worked in over 120 countries around the world on medical tourism startups and improvements. “The most significant challenges I believe that hospitals face when building an international department are that most don’t know what they don’t know,” she told ITIJ. “Many startup managers and programme directors are weak on international regulatory hurdles, cultural sensitivities and clinical/operational complexities. Private sector hospital managers endeavouring medical tourism programme development must navigate international regulations, which often differ from the domestic standards to which they are accustomed.”

Indeed, there are myriad barriers and complexities that hospitals must navigate and the right knowledge, strategies and resources are key to this.

Cultural barriers present significant obstacles

Dr Todd said that cultural barriers present significant obstacles, with a direct impact on patient experience. “I frequently work with hospitals that invest in cultural competency training for
staff, enabling them to understand and meet the diverse needs of international patients from their targeted source markets,” she reported. “Language differences, dietary preferences and religious practices can hinder patient satisfaction if not handled with care.”

Global authorities in accreditation play a crucial role here, as Renée-Marie Stephano JD, Chief Executive Officer, Global Healthcare Accreditation (GHA), highlighted: “Accreditation plays a crucial role in supporting hospitals to deliver culturally competent care to diverse international patient populations.
It provides a structured framework that encourages healthcare organisations to develop and implement comprehensive strategies for addressing the unique needs of patients from various cultural backgrounds. This is particularly important in the context of medical travel, where patients often face additional challenges related to language barriers, unfamiliar healthcare systems and cultural differences.”

When you get it right it’s like a butterfly effect, where your international business scales because of positive word-of-mouth referral

A further challenge is continually and consistently ensuring the highest quality of care. This is a metric that again underscores the importance of accreditation. “Putting in the right processes from start to finish to ensure patients have amazing experiences is paramount,” emphasised Jonathan Edelheit, Chairman, Medical Tourism Association (MTA). “A lot of hospitals struggle with this, and there are breakdowns across the patient journey.
When you get it right it’s like a butterfly effect, where your international business scales because of positive word-of-mouth referral. I would highly recommend hospitals go through an accreditation like GHA. This ensures the foundational elements of your international department are strong from the beginning, which is a recipe for long-term success.”

Dr Todd agreed that accreditation is an important indicator of quality: “The quality and accreditation of the healthcare providers in the destination country are critical. Underwriters
must evaluate whether the providers meet international standards for credentialing and privileging according to their chosen accreditation scheme.”

Logistics and longevity for a reputation

ITIJ also spoke with Dr Hayder Al Zubaidy, who initiated an international patient care initiative back in 2009 in Dubai; one of the first in the United Arab Emirates. He said that during this time logistics presented a key challenge. “We had several issues with patient transfer, especially country to country, which included visas, hotels for escorts and supply chains,” he confirmed.

Stephano also highlighted the complexity of logistical  considerations: “Managing complex travel logistics – like coordinating medical appointments with destination entry requirements – can further complicate patient journeys. Without proper oversight, these factors can negatively
impact their safety and experience.”

An additional difficulty is ensuring that everyone is on the same page and recognises the benefits of an international department; benefits that may not be immediately visible. James Cawood, Head of International Insurance Marketing, Bangkok Hospital Phuket, shared his thoughts on this. “Once hospital staff recognise the value that international coordinators provide – such as assisting in managing challenging patients and freeing up time for them to fulfil their regular duties – the contributions and benefits of having an international department will become clear and genuinely appreciated,” he asserted.

The first and the most important goal is to improve the service quality and achieve the highest standard of care

This recognition is crucial as only with buy-in across the board can hospitals successfully work towards building a thriving international department. 

Where communication and care intersect

A successful international department is one that prioritises patient care and communication, not only with patients but with all stakeholders. “The first and the most important goal is to improve the service quality and achieve the highest standard of care,” Dr Zubaidy advised. “This requires setting a proper and effective communication line and training staff to provide the highest level of communication, including medical services, cost and process for patients and families. It’s also important to have proper feedback loops and consider the patient’s ideas and comments to improve the service. Continuous training of staff and development of processes is essential.”

Lara Helmi, Managing Director of CONNEX Assistance, agreed that the success of an international department hinges on flawless communication and coordination. “Strong communication means responding swiftly to requests by phone or email, and also efficiently handling coordination with different internal hospital departments like patient services and billing, all the while working with an attention to detail that ensures all the information shared is timely and accurate, avoiding unnecessary administrative delays,” she told ITIJ.

This relies on an expert team that functions like clockwork. Dr Todd explained: “Establishing a team of dedicated international patient coordinators around the clock can ensure that price and service enquiries, logistics, travel arrangements, and management of post-operative care are managed efficiently, reducing stress for both patients and their families. Stress reduction aids compliance which, in turn, improves outcomes in most situations.”

Danny Quaeyhaegens, Manager, International Service Division, Bangkok Hospital Pattaya, concurred: “Our coordinators, whether translating for patients or managing insurance claims, handle sensitive and private information, necessitating strict adherence to confidentiality, professionalism, and diplomacy. Since most coordinators work full-time and many foreign patients frequently visit or reside in Thailand, strong relationships often develop. This familiarity can be advantageous when referring patients to specialists, as coordinators can assess which doctor suits a patient’s needs based on personality and rapport,” he highlighted. “Additionally, as many coordinators are native speakers, they better understand patients’ reactions and can provide cultural training to front-office staff, fostering better communication between patients and clinical or administrative teams.”

The centrality of patient outcomes

The impact of an international department on patient outcomes is significant, with the potential to reap huge benefits. “International departments facilitate specialised services not offered in their country of residence by scheduling specialists and presenting innovative treatment options, promoting cultural sensitivity and a dedicated support system, including travel coordination and language translation,” said Diamela Corrales, Director of International Programs and Guest Services, Jackson Health System International.

Edelheit pointed out that a good patient outcome is influenced by more than medical excellence. “The quality of the medical procedure is just one part of the equation. If patients have a poor international department experience, or that department dropped the ball, it lowers the score and patient satisfaction with the medical outcome. International departments have a huge impact on overall satisfaction and how patients view their outcome, as they see it as a 360-degree experience and they don’t separate the medical from the patient experience,” he asserted.

The evolving role of technology

Technology contributes to enhancing patient care and streamlining communication in international departments and, as progress accelerates, its role is evolving. “The benefits of communication tools beyond email and phone calls have opened doors to ensure swift and cost-effective ways to resolve patient issues,” stated Helmi. “We’re excited to see how artificial intelligence (AI) will transform processes in our industry; simultaneous translation and medical triage at the start of a case could potentially make the work of both assistance alarm centres and international departments a lot easier.”

Technology plays a crucial role facilitating direct communication without putting at risk patient privacy

Corrales agreed: “Technology plays a crucial role facilitating direct communication without putting at risk patient privacy. By embracing new technologies, organisations can streamline processes, enhance collaboration, and make data-driven decisions to drive growth and success.”

Cawood shared an example of technology facilitating communication with significant impact. “In one notable case at Bangkok Hospital Phuket, a deaf and mute patient and her equally distressed husband, who could not understand the local language, successfully communicated with medical staff using translation apps,” he said.

Dr Todd discussed the importance of remote clinical care for international patients: “Telemedicine allows for remote consultations, minimising the need for international patients to travel prematurely and to check in post-operatively. Wearable technology allows for continuous monitoring of international patients, ensuring that recovery can be closely observed even after they return home.”

Stephano agreed: “GHA accreditation mandates the development of comprehensive post-treatment care plans that account for the patient’s return journey and follow-up care in their home country,” she said. “This could involve establishing telemedicine protocols for remote check-ins or partnering with healthcare organisations in the patient’s home country to ensure continuity of care. By adhering to these standards, healthcare organisations can create a more inclusive and supportive environment for international patients, ultimately enhancing their reputation in the global healthcare market and improving patient outcomes.”

Technology can be a driving factor in why a patient may wish to travel to a particular international department. “AI-driven diagnostics offer enhanced precision and accuracy combined with minimally invasive access that improves outcomes and attracts patients seeking advanced treatments that may be unavailable, unaffordable, or illegal in their home communities,” Dr Todd pointed out.

Edelheit shared with ITIJ a technology-related bottleneck, with a lack of technological integration across systems hindering progress. “Technology is key,” he said. “This is one
piece that is lacking in the industry. We have failed in the technology area and it is incredibly difficult to connect with hospitals as a patient or insurer, difficult to transfer medical records, track cases and difficult to make payments or get refunds. The industry is a big silo.”

A unified system would facilitate connections between patients and providers, helping them to navigate the complexities of healthcare.

Relationships built on trust

Another crucial piece in the complex puzzle of international hospital departments is the relationships between hospitals and international insurance or assistance companies.
These must be built, above all, on trust and accuracy. 

“A strong foundation of trust is essential, where both the hospital and insurance company rely on each other to act in the patient’s best interest, prioritising the patient’s needs and experience, including providing clear communication and timely updates to both the patient and the insurance company,” underlined Corrales.

Helmi pointed out that strong communication with in-depth information sharing is essential. “Ensuring detailed information regarding cases helps to instil and preserve trust between the hospital and international partners,” she affirmed. “For example, if additional investigations have been requested by a treating doctor, and the hospital doesn’t explain clearly why they have been requested, it will be seen as unnecessary and avoidable, putting into question the medical expertise found at the facility. Strong communication goes a long way in preserving trust between international companies and hospitals.”

By harnessing strong communication built on transparency and trust, employing innovative technologies and ensuring that patient outcomes and experiences remain central, hospitals with international departments can elevate their competitiveness in the global healthcare market

Such a relationship is not built overnight but takes time. Dr Lynn Gordon, Chief Medical Officer, Charles Taylor Assistance, shared with ITIJ her thoughts on maintaining a fruitful relationship. “Communication is key – both at the onset of building a relationship and then maintaining swift and effective communication. This is applicable to all departments, from the financial and accounting teams to the medical and international patient departments. Agreeing fair fees, settling bills in reasonable time periods and having access to the medical staff to discuss treatment plans and obtain medical reports are all important elements. Lastly, having a process
in place to investigate complaints related to patient care is vital – whether minor, such as food choice, or more concerning, in terms of standard of medical or nursing care,” she stated.
“As an assistance company we need to have confidence in the capability of the hospitals we refer our clients to and this is built up over years of experience, regular interactions and
often physical visits.”

By harnessing strong communication built on transparency and trust, employing innovative technologies and ensuring that patient outcomes and experiences remain central, hospitals with international departments can elevate their competitiveness in the global healthcare market. Accreditation is key to this, indicating that an international department is of the highest standard. Stephano highlighted the crucial role of accreditation: “We see ourselves as more than just an accreditation body – we’re strategic partners dedicated to improving patient experiences and advancing global healthcare practices.
Our mission is to raise healthcare standards across the globe by connecting the dots between medical tourism, healthcare services, hospitality, and wellness. The results? Higher patient volumes, increased satisfaction, and a stronger, more successful business strategy for our partners,” she concluded.