How Systems Engineering Can Help Fix Health Care

Critics have long faulted U.S. medical education for being hidebound, imperious and out of touch with modern health-care needs. The core structure of medical school—two years of basic science followed by two years of clinical work—has been in place since 1910.

Now a wave of innovation is sweeping through medical schools, much of it aimed at producing young doctors who are better prepared to meet the demands of the nation’s changing health-care system.

But as these American patients leave the country for care, millions more international citizens will travel to the U.S. to be seen and treated by physicians regarded as some of the best in the world.

According to research in the November 2016 Global Citizen Index™, just under 40 percent of these patients travel to the U.S. or to Canada to receive medical treatment.

Their international voyage to seek better medical care often underpins a multitude of challenges. Increased costs are obviously huge concerns for these traveling patients and often total in the tens of thousands of dollars, forcing many of them to dip into savings in order to pay for procedures.

But those are far from the only challenges international health care patients face. According to Josef Woodman, CEO of Patients Beyond Borders, an informational resource for patients in need of medical care abroad, foreign patients often face significant cultural and language barriers in addition to the typical stressors of medical care itself.

PYMNTS recently spoke with Woodman about patients traveling to the U.S. (or inbound patients) and the international health care industry as a whole. Woodman told PYMNTS that there are a variety of difficulties for inbound patients, including increased costs and vast cultural and linguistic gaps.

Finding the funds

The U.S. has the most expensive health care in the world, whether patients travel from abroad to receive care or already living and working in the country. According to research from the Agency for Healthcare Research and Quality, the average daily stay in a hospital for an admitted patient in the U.S. runs more than $2,000.

Woodman noted, however that many patients who choose to travel internationally to the U.S. for medical care do so because of acute or serious complications and the perceived quality of care. PYMNTS research found that roughly a third of the patients who come to the U.S. for medical treatment are seeking treatment for lifesaving conditions, which often increases the cost of treatment.

Patients who leave their home countries to come to North America must also cover additional expenses such as for travel and lodging for themselves and any family, friends or caretakers who may be traveling with them. Add it all up, Woodman said, and it makes for an expensive final bill.

“Costs are a huge challenge for the inbound patient,” he said. “The United States is by far the most expensive place one can be treated. Based on the [amounts for] services we’ve received from hospitals, the cost for the average patient in the United States is $35,000 to $50,000.”

It’s no surprise then that many patients are forced to dip into their savings to pay for treatment. According to the Index, 54 percent of patients used their savings to cover the cost of international health care, and 45 percent relied on funds from their immediate or extended families.

These high prices also mean it’s often the wealthiest and most elite citizens in foreign countries who can afford to and obtain care in the U.S. PYMNTS research revealed that 37 percent of international health care patients own a second home, often in the country in which they received care.

Cultural conflicts

Traveling across borders and overseas for medical care poses more than just financial challenges. Woodman pointed out that some of the most difficult challenges around receiving medical care abroad come from simply overcoming language and cultural barriers that can complicate interactions between a patient and their physicians.

Matching up cultures also creates a major challenge for inbound patients, Woodman said. “A patient coming to the U.S. who doesn’t speak English is going to have a real tough time.”

Nearly half of all foreign patients are age 55 or older, almost 60 percent come from Asia and Africa, and only 2 percent have immigrated to a new country before.

Woodman noted that many large hospitals in the U.S. are either currently offering or assembling international services departments or culture centers that can help patients deal with these challenges. However, many cater solely to South American or Hispanic populations, even though these patients account for just 10 percent of international health care recipients. They also often do not have employees who speak Asian or African languages, which can encompass many different dialects.

Until more hospitals bolster these departments and add diverse employees, Woodman said it will continue to be difficult for many of these African and Asian patients.

“Many times Americans are not equipped to handle different cultures or different languages,” Woodman said. “There can be a real challenge for a patient coming into the U.S. who just doesn’t speak English.”

Making care worth the challenge

Despite the cultural and financial barriers, millions of foreign citizens come to the U.S. every year seeking the best medical treatment available.

According to the Index research, they come for a variety of reasons. Thirty-three percent came to the U.S. to battle cancer or other life-threatening diseases. Twenty-three percent traveled for a specialty treatment or to consult with a specialist, because the treatment or a similar one was not available in their country.

In order to best serve these patients, whose numbers are projected to increase in the near future, hospitals must invest in infrastructure, Woodman said. Specifically, they should look for investments that can help them adapt to and care for patients who speak different languages and are from different cultures and keep costs as low as possible for those in need of lifesaving medical care.

“It’s about matching up cultures,” Woodman said. “Finding a way to address some of the nuances of language and culture is absolutely critical.”

As more global citizens travel to the U.S. seeking medical treatment, hospitals may have no choice but to find ways to extend more services and resources to these patients if they intend to keep up in this rapidly growing industry.