The Wild West of Medical Care Abroad
Take a quick look at these two emblems. Displayed online, both are supposed to convey trustworthiness to patients considering a trip to another country for medical care. Do they look similar?
The sources of the seals are very different. The seal on the right is from the Joint Commission International (JCI), which accredits hospitals abroad for safety and quality. It's an arm of the Joint Commission, which is tasked by Congress with accrediting U.S. hospitals. The other is from the Medical Tourism Association (MTA) a trade group based in West Palm Beach, Fla. Its members include foreign hospitals, health insurers, and "facilitators," a specialized category of travel agencies that arrange and book medical trips abroad.
The MTA seal is part of an accreditation campaign hatched last month after a year of study, says Jonathan Edelheit, the group's president (who says I'm the first person he's heard from who thinks the seals look similar). It's aimed mostly at identifying facilitators that are diligent about sending patients to hospitals with good records in treating foreigners. "We see problems with patients who don't have the right experiences," says Edelheit. Facilitators should not be sending patients to hospitals that don't have enough staff fluent in English, for instance, or that don't adequately protect the confidentiality of medical records, he says. "We want to have a standard in place that patients and insurers can see." Later, credentialing will be made available to hospitals.
But can a trade group "accredit" organizations that are involved, even if only indirectly, with healthcare? After the program was announced and featured on the MTA Web page, JCI President and CEO Karen Timmons resigned from the MTA's board of advisers. "I think they got ahead of themselves," Timmons says. "We are in the Wild West right now" in bringing discipline to the untamed and booming overseas healthcare market, "and JCI has been in business many years to improve quality and safety."
Edelheit says that after the accreditation program appeared on the MTA website, "the advisory board came back and told us no, no, you can't accredit." So "accreditation" has become "certification." But until this afternoon, as I wrote this post, the gold seal still included "accredited," and a link on each Web page directed users to a list of accredited organizations. (There aren't any, since the program hasn't actually started.) Thanks to the quick ministrations of a Web programmer, there are no more references to accreditation.
The seal probably will change as well. "It is very close to our seal," says Timmons. "There probably will be some confusion"—such as that expressed by a JCI-accredited hospital that contacted her for clarification. Edelheit disagrees. "I don't see how any patient, insurance company, employer, or others would somehow confuse that logo as being similar to JCI," he wrote in an E-mail. But he promised to check with the advisory board about altering it.
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Interesting Information
I found lots of interesting information on health.usnews.com. The post was professionally written and I feel like the author has extensive knowledge in the subject. health.usnews.com keep it that way.
jci suing?
Dear sir
I have heard rumours that JCI is suing for copyright and trademark infringement. Is there any substance to this?
Hospital accreditation is an issue which crosses borders
One issue which comes up time and time again here is that accreditation is equated almost totally with the activities of JCI.
Monopolies are never healthy, and when it comes to establishing if a hospital or a healthcare provider are fit for purpose, there are British options available, such as the Trent International Accreditation Scheme, and Australian options such as ACHSI. Both schemes are based in countries with first rate healthcare systems.
Intending medical tourists would be well-advised to look at all of the safety-related data when considering if a particular hospital is an appropriate and safe place for them to utilise. Thinking about the "Wild West" theme, given the recent serious political difficulties in Thailand and India (both countries seeking to develop medical tourism), they would also be well-advised to look at the US State department’s web site before travelling to any country.
Incidentally, the issue of ISQUA sometimes come up when accreditation is being discussed. IDQUA is simply an international society that assesses certain factors around the functioning of accreditation schemes themselves, and does not possess any particular status. It does not, for example, look at ethical factors around the accreditation process. The existence of variety is fundamentally valuable in any aspect of life and business, and the important factor for any accreditation scheme is that is honorable and ethical in its approach, that it encourages openness and a willingness for hospitals and their staff to share good practice with each other for the overall benefit of all patients, and does not price itself beyond the reach of the majority of hospitals, thus ensuring that hospitals and patients are not denied access to good quality accreditation simply on financial grounds. Patient safety surely cannot hinge on profit-based motives alone - this would not be ethical.
The MTA and IMTA have encouraged plurality in hospital accreditation, and this is not only to be welcomed, it is to be applauded.
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U.S. News's Avery Comarow has been editor of the America's Best Hospitals annual rankings since they first appeared in 1990. His reporting on clinical medicine, from the latest cholesterol guidelines to robotic surgery, has been driven by the question: What does this mean to patients? And that is the perspective he brings to his observations and commentaries on the increasing number of programs by hospitals and other healthcare providers to improve care and patient safety.
