Quality in translation: case management in the international marketplace

This article identifies three categories of case management (CM), in-country, international, and micro, that are poised to serve as the quality proxy for the international medical patient in the rapidly emerging globalized healthcare marketplace. The content concentrates on describing in-country CM and international CM (ICM). Because CM professionals are the providers of patient-centered quality and safety improvements, they are capable of filling the chasm between the travel industry and the regulators who specialize in accrediting hospital systems. In-country and ICM case managers are equipped to perform surveillance and intervention at the level of the international patient's bedside, activate network connections, and use culture-sensitive communication skills to safeguard patients in their individual sojourns abroad. The article discusses useful concepts and sources, including an algorithmic tool under development that is geared to identify and quantify risks for lay and business individuals who seek to engage the global medical market.

The article's information is provided for front-line and front-office healthcare practitioners to understand or enter the worldwide medical marketplace. Content is targeted to CM generalists, specialists, and business developers interested in learning about safeguarding the patients who travel internationally to receive medical care. It can also be applied by those within and outside the healthcare practice arena, particularly those interested in the development of quality initiatives.

All research and syntheses were executed by the authors. Sources included scholarly treatises, business correspondence, medical tourism literature, corporate Internet profiles, news releases, and healthcare industry investigative and monitoring agencies. International health insurance, economics, and financing expertise stems from one author (L.B.). Clinical competencies stem from the international practice experiences of one author (K.C.).

This article identifies Web sites and sources that constitute high-quality resources for ongoing reference by ICM practitioners. Two strategic tools are introduced: one for assessing the readiness of the regional marketplace for CM and the Beichl-Craig Medical Travel Risk Evaluator for international medical consumer risk identification.

The emerging global healthcare marketplace is certain to change the way case managers anticipate and respond to care delivery concerns in different regional systems. A systematic structure for analyzing specific country and CM "readiness" is introduced. For case managers who assist clients to receive care internationally, the application of these concepts will help them know where a range of potential obstacles lie and how to calibrate risks and set realistic expectations. For healthcare product developers and quality analysts, the information will help stimulate discourse regarding innovative strategies, tools, and metrics geared to identify, measure, and mitigate risks for patients in the global medical marketplace.