Healthcare Tourism International

Revised 12/31/2007

Guide to Accreditation for Health Tourism Organizations

HealthCare Tourism International Accreditation Service

Healthcare tourism or the act of traveling abroad to receive healthcare is not new to our world. But recently, we have experienced rapid global growth in the number of people engaging in this phenomenon. With this rapid increase in scale, additional implications have been created for the quality of service, which often cannot keep pace with the quantity of services. The majority of the booming healthcare tourism industry has been swept up under the jurisdiction of the Tourism Departments and Ministries in the countries that have been reaping financial rewards in increased tourism. While HTI holds a neutral political stance on health tourism, we do publicly support safe health tourism practices and the safety of patients. In a globalized and patient driven healthcare economy, no single entity and no single country can demonstrate an unbiased approach to accreditation.

HealthCare Tourism International is proud to launch a new wave of healthcare safety services for healthcare tourism service providers, whether they are tourism agencies, ground transport companies for patients, accommodation providers, translator service providers or even other types of providers. Our services are made to help create a level of basic safety procedures and guidelines for these types of service providers who provide at least one link in the healthcare tourism chain. HTI’s accreditation service is the direct result of interest from health tourism companies to create a voluntary self-regulation model for health tourism.

Mission Statement:

Our Mission is to uphold and improve the reputation and safety of the healthcare tourism industry by promoting safe healthcare tourism practices among our member organizations. We develop and employ safety, accreditation and technology solutions to improve the health care system for those who choose the avenue of receiving health care abroad. We maintain a neutral stance on the policy of health care tourism promotion and health care outsourcing, but support safe and effective services for foreign patients.
Our goals are to:

• Protect patient rights, quality of care and business practices in the health tourism industry.
• Protect the integrity and reputation of the health tourism industry against companies and organizations that may jeopardize the future of the industry.
• Create a "United Nations" roundtable for the health tourism industry in order to establish health tourism standards and principles for credentialing purposes.
• Become the international authority on international health tourism company governance through administration of a comprehensive accreditation system.

HealthCare Tourism International, Inc. is a non-profit organization and is currently a non-profit 501 (c) (3) organization in the United States.

What types of organizations do we accredit?

The accreditation service is called HealthCare Tourism Accreditation Service and is meant to provide basic guidelines and safety precautions that various service providers in the industry should follow.

We accredit the following types of organizations:

-  Single or Chain-based Accommodation Units (hotels, resorts, bed & breakfasts, guesthouses, other hospital owned recovery locations.)

-  Concierge services of independent clinics, hospitals and hospital providers.

-  Healthcare tourism operators/booking agencies.

Organizations to be accredited in the future:

-  Assisted home-living companies (home-nursing staffing companies, etc.)

-  Ground Transport companies (companies providing transportation to patients, to/from hospital/airport)

-  Translator / Conveyance Service companies (companies that help organize patient’s activities such as treatment date with the hospital, and companies that provide language translation services)

-  Airlines (companies that provide air transport to patients traveling abroad for healthcare tourism services)

-  Insurance Providers (companies that provide payment to healthcare providers in return for health services provided to their member patients)

How do our services differ from International Standards Organization (ISO) and Joint Commission International (JCI)?

The Joint Commission International accreditation service limits its services to hospitals/clinics and ground transport companies such as ambulance companies. While JCI takes a clinical approach to accreditation, our accreditation is focused around general safety precautions and guidelines focused specifically on international and multi-national patients. Our accreditation is not focused on clinical standards of healthcare in institutions that deliver healthcare to patients. We realize that JCI provides these services and their accreditation standards include on-site agent visits of hospitals and other health providers. We aim to accredit other service providers in the health tourism industry.

Why have we chosen to accredit HealthCare Tourism organizations?

We chose to accredit these organizations because we represent a group of clinicians, business leaders, tourism experts and health policy researchers that has extensive collective experience in clinical healthcare, tourism, travel and language in multi-national environments. While we represent a strong contingency of clinicians, our group also has extensive experience in the tourism industry.

Accreditation Eligibility

To become eligible for accreditation and affiliation with HTI, accredited businesses must meet accreditation standards and these additional standards:

1. Organizations interested in accreditation must be engaged in a business that either directly or indirectly provides services in the health care tourism industry.

2. Accredited health tourism businesses must be in business for at least six months, unless at least one of the following is true: (1) the principal owners / operators of the company previously operated a firm with a satisfactory record in this or another of HTI's service area or (2) the firm is a branch of an existing accredited business that has met the accreditation eligibility standards.
3. In the case of unresolved patient or customer complaints, the accredited businesses must agree to participate in and comply with any decisions rendered through a formal dispute settlement process. HTI-Accredited businesses may identify themselves in print and broadcast advertising (newspapers, periodicals, billboards, posters, telephone, TV and radio ads, flyers and direct mail, web sites), in yellow page or other directories, on business cards, and on stationery, invoices, facsimile cover sheets and other business documents in any vicinity as allowed by local and international laws. HTI Accredited Businesses may also display an HTI-Accredited Business decal or magnet on company-owned or -operated vehicles.

Accreditation Protocol and Guidelines

The HTI Accreditation protocol is broken down into two categories: statutes and principles. Statutes are precise requirements in order to maintain eligibility for accreditation. Principles are loosely defined moral and ethical standards of business and health care. Principle assessment is based off of subjective criteria based off independent non-paid surveyors volunteering with HTI. For an organization to be accredited, statutes must be met exactly while principles must be upheld to a degree deemed adequate by HTI. The HTI protocol follows a “least burdensome” approach in two ways: (1) the organizations may claim equivalency to a certain principle in more than one way and (2) the organizations may demonstrate equivalency to a principle in the least burdensome manner possible to their organization, while still demonstrating reasonable equivalency to the principle. If a response from an agency is found to be in conflict with Principles, HTI will inform the organization and allow them to respond with corrections as required.

Privacy

HTI values Agency privacy and understands that certain trade secrets and company data are proprietary information. We will not publish company data unless it poses a threat to patient safety. In this circumstance, before publishing any such data, HTI will attempt to make contact with an Agency in order to negotiate the diction of any such publication.
I. Medical Tourism Operators/Agencies (“agency” or “agencies” or “tourism operators”)

Definition

Healthcare tourism agencies are those whose primary purpose is not the provision of direct healthcare services to their clients, but who engage in facilitation of health services by acting as a liaison between patients and providers. (Ex: Hospital concierge services, agencies that book airline flights, hotels/accommodations, hire translators, ground transport companies, and trip coordination services for patients)

STATUTES:

A.1) An agency must continue support for a patient no matter what financial constraint or debt a patient may express, after an initial act of conduct to initiate a dependence of the patient on the agency has been established, which for this purpose construes a relationship between patient and agency. Support for a patient is defined as providing all those services required by the patient to successfully receive the treatment at the hospital originally secured by the agency and clinician or service provider originally agreed. In addition, support for a patient includes ensuring that after a patient receives treatment they are supported with all services required to return the patient safely to their home country via the transportation method originally offered by the agency. This does not prevent an agency from receiving payment from a patient in full prior to establishing any type of relationship; though if payment is accept by the agency, this can be construed as an establishment of a relationship between patient and agency. (An example of an act that makes a patient dependent on an agency is an agency’s booking of an airline flight for a patient).

A.2) Agencies that have governmental or other legal actions pending or issued against their organization should report all such incidents to HTI prior to accreditation or within 30 days of incident, whichever is earlier in time.

A.3) Agencies must not operate outside of local and international laws. In the event, that an agency desires advice on how to proceed in certain dilemmas, accredited agencies may request advice by mailing a written and signed request from an authorized director of the agency to:

HealthCare Tourism International

ATTN: Agency Consulting

P.O. Box 251444

Los Angeles, CA 90025-1444

Financial Limitations:

B.1) Agencies need to disclose all partial-ownership and investments in hospitals or other point-of-care centers, so that patients are aware of the financial interests of the healthcare tourism provider. (Ex: If the agency has a financial interest in a certain hospital to which it refers patients, then the agency should disclose to the patient these financial interests in verbal or written form.) Alternately, agencies may opt to publish all financial interests via HealthCare Tourism International and have HTI publish interests on its web sites.

B.2) Agencies agree to publish refund policies publicly on their web site or communicate refund policies prior to entering a contract (exchange of funds) with a patient.

Medical Limitations:

C.1) Agencies agree to receive medical clearance from a patient’s physician before critically sick or injured patients are allowed to travel on airplanes and other modes of transportation. The definition of ‘critically sick’ depends on the medical opinion of the physician. Agencies must post a message on their web site or other public notice area that claims that medical tourism operators should not be used in the event that emergency healthcare treatment is needed. In the event of an emergency, patients should be referred to their local healthcare facility. If, however, a medical tourism company does provide services for “critically sick” patients, the onus is on the company to explain for accreditation purposes how it intends to evaluate patients and ensure logistical safety for its patients.

C.2) Agencies agree to operate under medical, dental and health laws of their local municipality and acquire all licenses and documentation required prior to engaging in business.

C.3) Agencies that directly employ a clinician (i.e. doctor, nurse, physical therapist) must communicate to the patient that the clinician is employed by the Agency prior to entering into an agency-patient contract.

C.4) Agencies must attempt to follow-up on patient’s health and satisfaction status after patient returns to their home country at least two times during the period of eighteen months following date of health treatment. An attempt is construed as making a reasonable attempt to contact to a patient after they have returned to their home country.

Advertising Limitations:

D.1) Healthcare tourism operators/agencies must not falsely advertise about the quality of healthcare received with their agency.

D.2) Healthcare tourism operators/agencies cannot coerce a patient into healthcare treatment with a certain provider. Patients always have the right to refuse treatment and cancel their trip. If this happens, patients are subsequently entitled to a pro-rated refund for services not used minus expenses occurred by the agency.

D.3) Agencies should not advertise the quality of health service as being superior to another entity unless an independent study reference is cited on advertisement.

Data & Record Keeping:

E.1) Agencies must keep records of full patient details for 5 years after the completion of the patient’s healthcare treatment in case these are needed to help resolve patient post-operative complications and other unforeseen incidents arising from the health tourism experience.

E.2) Agencies that transfer patient records electronically to providers overseas must use industry standard encryption services in order to uphold patient privacy.

E.3) Agencies agree to maintain current licenses required to operate their business as required by both local and international businesses.

E.4) All patient data and information must be kept in a secure, fire-proof and locked file cabinet. In the event that patient data is stolen or lost, patients must be notified within 15 days. Annually, agencies must create an electronic or physical backup of all patient files and store this separately in a different secured location of similar security standards.

Conflict of Interest:

F.1) All employees of an agency must sign a conflict of interest statement which affirms that the employee or his/her immediate family does not have any financial or political interest in vendors used by the agency. If a financial or political interest does exist, all conflicts must be reported to HealthCare Tourism International for full disclosure.

Risk Management:

G.1) Patients must have 24 hour access to a live operator or other appointed representative from Agency while abroad in country where health service is to be delivered.

PRINCIPLES

Name of Organization:

Mailing Address:

Main Telephone Number

Organization’s Web Site:

Ownership:

Staff:

CEO Name:

Telephone Number

Fax Number

Accreditation Company Representative Name:

Telephone Number:

Fax Number:

Email Address:

What year was your company established?

What countries do you serve?

Organization Overview:

2.A) Is your business a for-profit, non-profit/NGO or government organization?