A First Resource for Keeping Abreast of Globalized Healthcare’s Progress

Healthcare institutions, related businesses, patients and solutions are increasingly crossing national borders. That’s a challenge and an opportunity for the healthcare delivery world, which for the most part has long been primarily locally focused.

Much of what’s done in a local healthcare framework applies to international collaboration, of course; it’s not as if those of who have moved into global efforts are starting from scratch. But these collaborations also present unique demands, and require special perspectives and tools, so that every project is appropriate to the disease burdens, resources, health interests, culture, governance and socioeconomics in which the project will be embedded, as well as to the strengths and limitations of the collaborators driving and executing the project.

All of which is to say those of us committed to this new healthcare sub-industry have a lot to learn and take into account. And one of the best ways to do that is to look around the world and see what others are doing, what challenges and demands are grabbing attention, and what different perspectives and insights are being offered by a variety of observers.

But where today can you go to get this sort of information about globalized healthcare? The field is so new that it lacks a resource as basic as a centralized source of news and information. Over time, I’m sure we’ll have many good ones. But we have to start somewhere, so I’ve kicked off a small effort to round up on an ongoing basis some of the news stories and articles of special relevance to globalized healthcare.

The effort takes the form of a simple “content curation” site, based on a Pinterest “board.” If none of that means much to you, don’t worry–when you look at the site, you’ll instantly get it, it’s just a simple display of the latest articles that I think are likely to be of interest. It’s titled “Globalizing Healthcare.” You’ll have to sign up with Pinterest to look at it, if you’re not already a Pinterest user, but that’s not much of a burden. (And you might find a lot of other interesting things on Pinterest, it’s one of the most popular social media platforms in the world.)

As you’ll see, this new site is far–very, very far–from exhaustive. It’s really just a very small collection of articles at this point. But it’s being updated daily, and it should be at least be of some interest and help to this new and growing field. And I hope to increase its scope and utility in the months to come.

Perhaps some of you will have ideas for expanding and improving it. If so, please do share!

Are Globalized Healthcare Projects Too Risky?

Working with collaborators internationally to improve health care systems around the world is risky.

But what isn’t? Ordinary, local health care projects certainly aren’t without risk. In fact, given some of the changes roiling the U.S. health care system these days, I can think of any number of countries, including several non-fully-industrialized nations, where health care systems might face a lot less uncertainty than in the U.S.

We know the financial service industry lives with all kinds of risk. What manufacturing industry doesn’t have its unexpected ups and downs? So does the hospitality industry, the media business, and on and on. Even government workers in the U.S. have discovered their field is not risk-free.

I doubt there are any industries without risk. One can be as risk-averse as possible in one’s own industry. But there’s a price to pay for taking less risk. If you look at the organizations that perform well in most industries, you’ll find that they were among those companies that were willing to take some chances. It’s true, the worst-performing companies tend to be risk-takers, too–their risks blew up on them. But the point is that an insistence on minimizing risk, while it may prevent disasters, tends to virtually guarantee mediocre performance at best.

To put it differently, organizations that focus on minimizing risk take on the risk of missing out on opportunities to have more impact, do more good, and return more value to their stakeholders. You can’t avoid risk! All you can do is swap one kind of risk for another.

So asking if an organization is taking risks is the wrong question. Of course it does. The better question is this: Is the organization informed about the specific nature of the risks and how to manage them? The goal is to get very good at understanding which sorts of new projects carry acceptable levels of risk, be it acquiring a hospital, investing in a new type of care, taking on a new partner, or making changes in how it trains doctors. Also critical is mastering ways of analyzing and managing projects and investments so as to avoid needless risk, and to have the best possible chance of realizing the benefits of the risks it takes while reducing the chances that these risks will materialize as serious problems.

Collaborating internationally on health care projects is a relatively new industry. But those of us in the field have learned quite a lot in recent years. If some of these projects still seem risky to outsiders, it’s not because the risks are necessarily greater than in other areas of health care. Rather, it’s because most people in health care aren’t familiar with the ins and outs of this field and its particular risks. And the unfamiliar seems riskier. In fact, though, many of us are developing a pretty good understanding of the projects we take on, and, with the help of our collaborators, have come a long way in understanding how to manage risk in this field.

But all of us in this industry have to get even better at understanding and managing the risks of global collaborative health care. Doing so will enable working with more collaborators in more countries on more types of health care projects. No one does this to avoid risk; the goal is to have a positive impact on health care everywhere. I think it’s the sort of risk–if managed wisely–that’s well worth taking.

Finding a Doctor When You’re Traveling: Consult Your App?

One concern of travelers, especially those traveling internationally, is the ability to find good medical care if they’re unfortunate enough to need it while abroad. (I’ve been unlucky that way more than once.) People often tackle this dilemma from an insurance-coverage point of view–that is, they try to make sure the costs of care will be covered while on the road, up through being airlifted back to a hospital near home. While that’s not a bad idea, it doesn’t necessarily do anything to help you make sure you’re finding the right doctor, and that can be the bigger problem in some cases.

So, how do you find a good doctor when you’re far from home? In a more serious urgent-care situation, you might have little choice but to head to nearest emergency room and take who you get. At most, you might have an opportunity to ask or do a bit of quick research to make sure you’re being taken to one of the local hospitals with better reputations. Even when it’s an illness or problem that lets you be a bit choosier about who is seeing you–a gastric upset, a bad rash, an intense pain, a problem with vision–many travelers suddenly realize they’re clueless about how to find a good doctor or other clinician.

Obviously, you can ask the concierge at your hotel, but that’s going to be hit or miss. You can try searching Google for obvious terms like “doctor” and “Berlin,” but that’s hardly reliable–online doctor information and ratings tends to be thin and less than fully reliable even in the U.S., land of the online rating, and it gets worse outside the U.S. It’s possible you actually have access to a pretty good local health care network via your health-insurance provider, employer, credit-card company, frequent-traveler club, or other organizations with which you’re affiliated. It’s worth a little research to find out, and it might be a good idea to do it before you get sick and actually need it.

Should all these options fail to provide you with the name of a good doctor, you may be able to solve your problem, as is increasingly the case these days, by turning to a smartphone app. I’d rather not name specific products, lest any of my comments be interpreted as an endorsement, but I can at least describe in general terms a few types of apps that are already available.

One type specifically addresses finding a doctor while traveling. This sort of app enables you to plug in your location (and in some cases your language), and then to specify the type of doctor you’re looking for, be it primary care, or a particular type of specialist. Depending on the app, you might be given not just a name, but also information about the doctor’s experience and credentials, patient reviews, contact information, directions, and, if you want it, an appointment complete with scheduled reminders. All this is typically free.

These apps tend to be limited in geographical coverage right now, though presumably that will improve with time. A bigger question is how reliable the referrals are. Some apps claim to have screened the physicians that are listed. Patient reviews might be helpful, if there are enough of them, but user reviews are often gamed in many websites, and it’s hard to know if there’s much protection in any given app against that sort of thing. These uncertainties are par for the course with recommendation websites and apps of any sort, but the stakes are a lot higher when you’re looking for good medical treatment than when you’re looking for a good book, meal or hotel. Still, the potential here is enormous, and I hope these services prove to be reliable, and that they expand their geographical territories.

Another type of app-based service out there, also free, provides a different sort of solution for someone suffering from an on-the-road illness. Rather than helping to set you up with a doctor’s appointment, it gets you a doctor’s personal advice. These apps accept your email or text-message question, and get you an answer the same way from a doctor.

Is the answer likely to be reliable? Even assuming the doctors providing the responses are well-credentialed and are taking their roles seriously, there are still obvious limitations here. The big one is that you might really need to see a doctor and not realize it, and you might not even know to report the symptoms that would tip off a doctor off to that fact. Doctors are trained to spot all kinds of things in exams that you’d never discover in yourself, from tenderness in a particular area to your pallor to the way you walk. At the very least, giving you a good assessment of your situation might require a series of far more detailed questions than is likely to take place via text message. Still, when you need a simple answer to a simple health question–something like, “Is it OK to combine Pepto-Bismol and Advil?–these sorts of apps might prove invaluable and render the significant hassle of finding and seeing a doctor unnecessary.

I don’t think either of these types of apps, or the two types combined, for that matter, are likely to solve all the woes of most travelers who become ill. But they could help some people, and they’re surely steps in the right direction. Here’s hoping you never need to find out.

Welcome!

Welcome to my new blog. It’s actually more or less a continuation of my former blog at Johns Hopkins Medicine International (you can find an index of the posts from that blog here), and I expect to be addressing many of the same topics–namely, the opportunities and challenges facing the healthcare industry, particularly with regard to international collaboration. But I expect I’ll be addressing some new areas as well.

Meanwhile, I encourage you to take a look at the JHI blog, which not only contains my past posts, but new posts from others at the organization.

More very soon!