Editor’s Note: Part One of our conversation with Cliff Orme and Balbina Lakenau appeared in Issue 9 of Medical Travel Today. Click here to read. Medical Travel Today (MTT): What are your expectations for growth in the future?

Cliff Orme (CO): Well we certainly expect it to continue growing, but it will never be more than 20 percent of our overall business. We’re truly designed to serve the local patient base. The business we get through Medical Value Travel (MVT) is certainly desirable but it will never be our core business. MTT: What do you base your growth expectations on? CO: There are two factors that impact our projections. The first is the overall state of the economy in the US where most of our international patients originate. Right now there’s a lot of concern about the viability of the US healthcare model. And given the economic pressures and constraints, and tightening of reimbursements for physicians and hospitals, the issue of whether or not the US can provide adequate care over the long run is questionable. As that continues to surface and draw attention, we certainly become more attractive. The second factor is the demand for services and the perception people have about availability of healthcare in their area at an affordable price. Right now Americans in particular do not perceive US healthcare services as affordable, and I don’t see that perception changing much in the future. That said, some areas, such as plastics, are becoming more competitive in the States. Doctors and hospitals are making adjustments to stop the outmigration of patients, and that shift has had an impact on the number of plastics patients we’ve seen. I imagine that could and will happen in other areas, but I’m not sure how quickly or aggressively it will occur. Actually, another factor that gives me confidence in growth is International Health Corporation’s (IHC) ‘dual citizenship,’ if you will. What I mean by that is IHC is a company with its headquarters in the US and operations in Latin America. Given that, we understand the business and what the international patient is looking for in terms of experience, and processes and structure. We have experiencing running US hospitals and have applied that learning to our Latin American facilities. Plus, we understand the Latin American culture because we’re rooted here. It’s a win-win. In fact, we’re the only Pan-Latin healthcare system operating in five jurisdictions – a Netherlands company with offices in the US and hospitals operating in Mexico, Costa Rica and Brazil. As a result, a lot of global knowledge and understanding comes to bear on everything we do. I think this positions us well to grow the business over the long run with a goal of increasing the number of hospitals and our presence in Latin America. MTT: Do you have any specific marketing initiatives in the works? Balbina Lankenau (BL): Well, certainly increasing our presence on the Web is very important as that’s where most folks turn to when in need of medical services. We’re also looking for ways to improve the usability of our site. But in terms of individual efforts, not so much. It’s just so easy to get lost in all that’s out there. We find it’s much more effective to collaborate with other groups for a marketing presence. For example, rather than trying to target large employer groups ourselves, we work with groups that have established relationships already. They have the experience to effectively pitch that kind of business and develop contracts, whereas we have the experience to provide the desired service. It’s just a much more effective and efficient way to go about generating interest and business for everyone. MTT: I noticed your tagline: “Your Safest Medical Care Close to Home.” What exactly does that mean? CO: That refers to the Toyota Production System model that we use here to ensure quality at every turn and every day. I became familiar, actually immersed in it, a number of years ago when I was involved with the Pittsburgh Regional Healthcare Initiative (PRHI). Very briefly, in the late 1990s the Institute of Medicine (IOM) issued a report entitled “To Err is Human” that revealed that 98,000 people were dying annually from medical errors in US hospitals. A later report from the Centers for Disease Control (CDC) added to the concern by highlighting that another 80,000 people were dying from preventable hospital-acquired infections. In 2005 or so, the IOM called for the application of engineering principles to the daily work of healthcare. Under the direction of Alcoa Chairman and US Treasury Secretary Paul O’Neill, PRHI and partners began applying the Toyota system with tremendous, positive results. CIMA has adopted that same approach at every facility, reporting daily on every problem we see. We report it and work to correct the root issue with the goal of providing the best of care every single day. That approach, combined with our nurse-patient ratios, allows us to pay better attention to each individual patient, and reduce infection and errors. We really do mean it when we say “Your Safest Medical Care Close to Home.” I’m not exaggerating when I say care at CIMA is extremely safe. In fact other hospitals in Mexico and Central America have sought us out to teach them the same principles. It’s that recognized and, fortunately, valued. About Clifton Orme Clifton N. Orme has served as chief operating officer of the CIMA Division of International Hospital Corporation since September 2006 and currently is president and COO of the Division. Prior to joining the company Mr. Orme was administrator/chief executive officer of LifeCare Hospitals of Pittsburgh, which now has 283 beds and four hospital campuses in the Greater Pittsburgh, Penn., area including Bellevue, Natrona Heights, Monroeville and Wilkinsburg. Early in his career he served in various executive capacities including: director of Physician Relations for the HealthTrust Mountain Division, which was subsequently bought by HCA/Columbia; assistant administrator for Columbia Eastern Idaho Regional Medical Center, a 312-bed general acute care hospital; and executive director of Valley Hospital Association, now Mat-Su Regional Medical Center, a 74-bed general acute care facility. With over 20 years of experience in hospital leadership, Orme excels at leading turnarounds and continuous improvement at small to mid-size hospitals, has served on the boards of two state hospital associations and was adjunct professor for the University of St. Francis, associate professor at the University of Phoenix and is a fellow of the American College of Healthcare Executives. He received his MBA from Brigham Young University and graduated with distinction. About Balbina Lankenau Balbina Lankenau de la Garza, regional manager, International Patient Services “Medical Value Travel” department for International Hospital Corporation (IHC). She graduated cum laude from the Universidad de Monterrey, specializing in International Marketing. She has an extensive background in international customer service and is a highly qualified manager with experience in the field of medical tourism. Balbina has held the position of general manager for the Canadian Chamber of Commerce in Mexico and most recently managing director of a global healthcare company specializing in matching international patients with accredited hospitals in Latin America. Also, she has consulted to numerous professionals and physicians, US health plans and American medical tourism entrepreneurs. Since the exponential growth of travel for healthcare, the CIMA and VITA hospitals have found the need to aid international patients by being directly involved with the patient’s personal needs before, during and after they receive care in the CIMA and VITA hospitals located throughout Latin America in Mexico, Costa Rica and Brazil. Balbina is currently managing a staff of bilingual coordinators and nurse coordinators. She manages the day-to-day operations between the MVT offices, its US clients, CIMA & VITA hospitals and their physicians.