Editor’s Note: In our last issue we featured the first half of a conversation with Jim Tate of the Medical Travel Commission. In that discussion we explored what prompted Tate and his colleagues to establish a new certification program for medical travel and what aspects of care they evaluate. The conclusion of the exchange follows below.

MTT: And was there a process for vetting the criteria? JT: Absolutely. Once we had our initial version compiled we spent a significant amount of time at a number of prestigious institutions in the US and abroad. Validating with leading-edge hospitals was essential. These are folks with years, in some cases decades, of international patient operations experience. They’ve already confronted and dealt with many of the minor and major challenges. We wanted to know that what we created made sense to them. MTT: I’m curious. Was there anything that you missed or got wrong in that first pass? JT: Yes, there were a few things we needed to adjust. First, I thought it would be important for any hospital that took care of international patients to supply their medical records in a patient’s native language. Every hospital we reviewed the criteria with said they would never do that. The reason being that if a physician is doing dictation and the records will be transcribed, the physician might say the patient’s breathing was labored. The nuance of an adjective like “labored” is extremely important from a clinical standpoint. Physicians and providers aren’t willing to sign off on a document that has been altered in translation. That surprised me. What they do instead is to direct patients to a certified medical translator. That removes the liability from their shoulders. Another thing we didn’t initially include was related to what to do when someone dies. The proper way to handle a body varies widely based on different cultures, customs and religions. We incorporated criteria to address that, as well as probing a facilities relationship with local funeral homes, embassies and consulates. MTT: How does your program compare to existing programs in terms of cost and timeframe for completion? JT: Our certification is good for two years. Every year we modify the criteria and we will continue to elevate it every year. The cost today is $14,000, plus travel. As for timing, it takes about three months to complete the process. The initial effort includes an online presentation where we familiarize them with what’s required. They then set to task compiling a great deal of documentation related to communication, customer services, provider interaction, quality care, and medical information exchange. Then, of course, we need time to review the provided data and offer feedback or request clarification.  Lastly, we schedule a site visit to validate compliance with all of the criteria. MTT: How might a facility prioritize which program(s) to pursue? JT: There is no doubt that the first thing to pursue is something like JCI or another well known, documented and verified international quality accreditation. That’s the foundation for quality care and patient experience, and what international patients should be interested in first. And then, if you’re taking care of international patients you have to really start building support services and resources for this unique type of patient. Certification from the Medical Travel Commission demonstrates your commitment to this patient base, builds credibility with potential patients, and enhances a medical travel facilitator’s abilities to educate prospective patients. It’s really a meaningful quality assurance promise to patients and their providers that cultural or communications issues are being addressed thoughtfully, thoroughly and respectfully. MTT: How many certifications have you issued thus far? JT: Â Both the Moffit Cancer Center and The Rehabilitation Institute of Chicago have been certified, and we have a few more that are in the process. They should be done within the next few weeks. MTT: Do you intend on raising consumer awareness of and appreciation for the certificate and, if so, how? JT: We’re taking a word-of-mouth approach to informing consumers of what we do. Within the industry we’ve met a lot of key stakeholders and legitimate leaders in medical travel to share what we’re doing and why it is important. We’re also communicating with many embassies in the US as, often, they’re the ones really in charge of bringing patients in and making decisions about where they receive care. Our thought is that the word of respected professionals within the industry is far more meaningful to consumers than any message we attempt to direct to them. And in a way, it serves to reinforce the integrity and credibility of the certification. About Jim Tate Jim Tate has worked as a consultant with over 175 healthcare-related companies across the world, ranging from Sri Lanka and Israel to Pakistan and Peru, providing health information technology services in both ambulatory and in-patient environments. He has directly led healthcare implementation projects throughout the world. Having witnessed disparities in services provided to international patients, he felt compelled to create “best in class” service standards that would benefit hospitals, travel facilitators, and prospective patients.