The next wave of medical tourism growth will be assisted by superior technological systems and services. Author: Namrata Gada, Senior Manager, Business Research and Advisory, Aranca, a global research and advisory firm Medical tourism is not a recent phenomenon. From the time of the Sumerians (circa 4000 BC), who constructed the earliest known health complexes that were built around hot springs, to the 18th and 19th centuries when Europeans and Americans travelled to remote areas with health retreats to find cures for tuberculosis, quality healthcare – wherever it could be found — has been a common pursuit. Fast-forward to 1997, when the Asian economic crisis and the collapse of Asian currencies prompted government officials in these nations to market premiere destinations for international healthcare, at a fraction of what Western countries could offer.

Traditional models that depended on cost arbitrage, reduced waiting times, a highly skilled and English-speaking healthcare workforce, and interventional government policies have helped emerging Asian nations, as well as certain South American countries, such as Brazil and Mexico, to attract healthcare tourists from the United States, Canada and Europe. What will fuel the next wave of growth in medical travel? Technology-enabled healthcare practices. The global medical tourism market is estimated to reach USD32.51 billion by 2019, clocking a CAGR of 17.9 percent from 2013 to 2019. Technological advancements that improve patient outcomes, reduce costs, and increase the availability of self-regulating social reference and review platforms will become dominant health tech themes globally. For businesses in the healthcare sector, utility bills can be incredibly high, so it is important to compare energy providers using websites such as Utility Bidder. Another way to keep bills down is by going back to the first stage and getting the construction right. Companies now specialize in cold storage construction and medical device sterilization meaning that buildings in the US can be perfectly built to sterilize medical equipment in the safest and cheapest way possible. Businesses in the healthcare sector should look here for cold storage construction services to ensure their building is built to the highest standard to meet the needs of the business. Healthcare tourism destination countries, like Thailand, China, Singapore, India, Brazil, the Philippines, and Malaysia, have already jumped on this bandwagon, investing heavily to merge technological advancements with healthcare services in order to increase their share of the global medical tourism market.

Technological Advancements That Could Revolutionize Medical Tourism Electronic Heath Records (EHR) Cloud storage enables doctors and solution providers to access medical records of patients in real-time, no matter where they are located. Patient clinical notes, diagnostic scans, medical administrator records, and discharge summaries can be accessed in flexible digital formats that are far more comprehensive and easy to read. Digitization of healthcare records has led to increased efficiency in understanding patient data, thereby enhancing patient service and safety, most of this data is sorted by robotic process automation now, and not sorted by employee’s meaning less human error, ensuring efficiency and accuracy. Cloud-based EHR solutions have also helped to lower patient costs because case studies can be accessed and leveraged for similar medical problems. Additional benefits include identification of probable drug interactions, storage of diagnostic test results and after-care. The adoption of a standardized EHR system is likely to lead to an increase in the capabilities of foreign medical facilities in developing countries to attract more medical tourists from developed/industrialized countries. In a medical tourism environment, a standardized, interoperable electronic medical record (EMR) can be utilized to manage patient care across hospital systems and across multiple countries. Telemedicine Promoted by doctors and institutions to develop a doctor-patient relationship at the consultation level first, these technologies have drastically reduced treatment times, and given patients a plethora of options to choose from before they finalize on their medical travel destination. India?s Apollo Hospitals, for instance, developed Apollo Telehealth Services (ATHS) to set up global telemedicine centers and telehealth camps, undertake remote patient monitoring, and conduct virtual rounds. The Indian hospital chain currently derives approximately 15 percent of its annual revenues from medical tourism. In 2010, the National Health Security Office and Health System Management Institute, along with Prince of Songkla University (PSU), collaborated to develop a project for introducing telehealth in southern Thailand, with the expectation of revitalizing telemedicine in that country. The main goal of the program was to connect tertiary hospitals to other hospitals by video, including conferencing, tele-home care and web-based consultation and education. To better serve a geographically dispersed population, the University of Mississippi?s Medical Center developed a 141-patient pilot telemedicine pilot program that used remote video visits. Patients in the program received tablets and connected devices to check vital signs. Physicians contacted the patient if vital signs fell below a certain level or patients failed to check in. As a result of the program, medical adherence grew from 60 to 96 percent, and nine cases of diabetic retinopathy were detected that otherwise would have been missed. Programs such as this demonstrate how mobile technology is making healthcare delivery more efficient and effective. Mhealth or Mobile Health Around 52.4 percent of the global online population access the internet from their mobile devices, and more than half of the global population is estimated to go online using mobile devices by 2020. With the rise in social media sites and apps, digital technology is championing the cause of medical tourism. Mobile apps, such as Lybrate, HelpingDoc, and online portal Fairmed, allow patients to access doctors for a second opinion. Caremondo is the booking.com for medical travel. Patients can choose, compare and book doctors, hospitals, and treatments across 22 countries while offering fringe benefits to access visa processing facilities, flight and hotel bookings, as well as translations. Apps are also being developed to improve physician accuracy of disease diagnostics and recommendation of treatment. For instance, Isabel, a differential diagnosis tool, enables physicians to confirm the patient diagnosis by covering over 6,000 disease presentations and symptoms. Medical Databanks There?s a staggering amount of healthcare data being generated every day. Governments are looking at creating digital healthcare databases meant to help hospitals and other stakeholders access information on a real-time basis from a global repository. Doctors can even view the information of their smartphones through encrypted data on the cloud and advise patients on-the-go. Governments across leading medical tourism markets have set up dedicated portals and apps to highlight services, list healthcare providers and facilitators, and assist in booking travel and lodging, among other things. Countries are participating in forums, such as World Medical Tourism & Global Health Congress and the Asia Medical Tourism Congress, with an increased focus on their advanced technological offerings. The recent Asia Medical Tourism Congress in India focused on telemedicine in the majority of its sessions: The Future of Telemedicine and Health, Using Medical Tourism Technology to Power your Healthcare Business, and so on. An entire ecosystem is being developed to ensure that inbound tourism, coupled with superior technology, resonates with medical tourists. Government and hospital portals are highlighting the availability of travel options, cheaper insurance (if permitted by law) and treatment costs, tariff options, and preparatory aspects required before visiting the country to ease the journey of inbound medical patients. Thailand, Korea and Taiwan have developed individual apps to offer similar facilities to potential medical tourists. Exhibit 2: Top Medical Tourism Hotspots

Adoption of Disruptive Technologies Will Decide Who Wins Patients in the Future Rapid technological evolution will ensure that countries with sophisticated and highly competent technological infrastructure will gain the lion?s share of inbound medical tourists. Disruptive outcomes emerging from Internet of Things (IoT) — the inter-networking of physical devices, vehicles, buildings, and other items — 3D printing, and personalized apps will further enhance patient care and lure patients to countries that adopt them first. IoT will provide an array of data to hospitals, including patient socio-eco-demographic and cultural background, health status and medical history. This could be leveraged by hospitals to identify potential patient groups based on personal and social habits, and for sending reminders for annual follow-up visits or check-ups. Diagnostic test results, such as recordings of ECGs, digital images of X-rays, MRIs and CAT scans, could be used to create implants or replacement parts through 3D printing. The creation of personalized medicine using technology will be a potential game-changer, as well, because countries will highlight innovative treatment prescriptions customized for the individual. This could potentially lead to better “customer loyalty” among patients and increase revenues and market share. Artificial intelligence (AI) systems could also enhance the adoption of EHRs. They can scan through data from digital records and help medical practitioners provide better patient outcomes, reduce treatment costs, and simplify the workflow management of patient data. Hospitals will adopt these rapidly in order to reduce the per-hour time spent by doctors, and bring synergies across multiple hospital departments. Likewise, 3D printing systems could leverage AI networks to gather real-time data of the affected body part and create 3D printed parts or medical images. Medical destinations are eager to create the technologies or even buy them in order to enhance their medical service portfolio. Countries are eager to adopt technologies to drive medical tourism, but the protection of healthcare confidential information would be a complicated undertaking and will be the deciding factor. Countries have to overcome the various data protection hindrances like integration and intertwining of systems, data explosion and protection of confidential data without delaying and disrupting critical healthcare services. Looking ahead, any country vying for a spot among the world?s best medical tourism destinations must begin now by investing considerable time and resources in technology that will help them achieve their goals. About Namrata Gada Namrata Gada is senior manager, Business Research and Advisory, Aranca, and manager of the Healthcare, Travel and Tourism and Financial Services sectors. She has assisted and overseen a number of projects across healthcare delivery, including medical tourism in emerging markets across the Asia-Pacific region and the Middle East, and a few developed markets in Europe. Namrata has been associated with Aranca for over seven years, and has expertise in market insights, business plans, feasibility studies and market entry strategy assessments. Previously, she was associated with Dow Jones Consulting India Private Ltd. and The Hindu Business Line. She earned an MBA in Finance from SP Jain School of Global Management, Singapore and a Bachelor?s in Mass Media (Journalism) from Mumbai University.