PHMI Blog - Blog from Partners Harvard Medical International

Lebanese newspaper The Daily Star reports that construction has begun on the LAU Medical School. From the article:

Once completed, the 12,500-square-meter 21st-century structure will house both the new medical school and the Alice Ramez Chaghoury School of Nursing. The $18-million state-of-the-art complex will be the nation’s most technologically advanced medical school - a world-class facility with video streaming, videoconferencing, digitized collections of microscope slides, multi-disciplinary laboratories, an electronic library, and 24/7 cyber cafe.

The new medical school will contain a simulation and skill assessment center for patient encounters, including a mock-up laboratory, full-scale-simulation surgical-procedure room, multi-purpose bays and control room.

“The underlying concept behind the design is to build the medical and nursing school around people rather than just technology. Fundamental human needs like comfort, and social ambiance will take prominence. The blueprint allows for ample natural light and large windows to maximize daytime illumination for a motivating atmosphere and inspirational view,” said LAU’s public relations director Christian Oussi.

. . .

Since becoming LAU’s president in 2004, professor Joseph G. Jabbra has been the driving force behind LAU’s aggressive and unprecedented $100 million expansion campaign.

“The establishment of the Medical School is an integral part of our exceptional achievements; building upon past successes,” said Jabbra. “The Medical School was also established to fill the void created by not having proper indigenous disease research in the region,” he added.

See additional coverage from this blog and revisit the beginnings of the LAU-PHMI collaboration.

We know that increasing numbers of patients around the world are traveling outside their own country for health care, whether they’re looking for better quality, affordability, or both. An entire industry is growing out of the need to connect patients with faraway providers, manage travel and logisitics, and ensure that patients’ experiences abroad are satisfactory. One of the big questions raised by skeptics of “medical tourism” is this: how is one to assess the quality of hospitals abroad?

In recent years, accreditation by Joint Commission International has served as a kind of stamp of approval that patients look for when considering foreign providers. But JCI accreditation — like accreditation by the Joint Commission (formerly JCAHO) — isn’t really a measure of clinical quality. What it is, says PHMI Senior Consultant Dr. John Helfrick, is an indication that a hospital has the systems and processes in place to support high-quality, safe patient care:

“Accreditation” is generally not well understood. It is a process, not an event. There is a “validation” survey but it’s the maintenance of good processes and the improvement of deficient ones that occurs between surveys that really constitutes accreditation. Most “accreditationists” believe that health care outcomes are dependent on the quality of the structures and processes in place in a health care organization. The accreditation process is designed to assist organizations in implementing and then improving their structures and processes. The effectiveness of this process is borne out by the measurement of and, hopefully, the improvement in the outcomes of care.

In recent years PHMI has worked with several health care organizations who have used the JCI accreditation process as a guide for instituting a culture of quality. The process provides a roadmap that helps the provider to develop the kinds of structures they need to produce good outcomes. And while the distinction of earning JCI accreditation can be used as a marketing tool for as long as it is viewed as an indicator of attention to quality care, most clients believe that the process of earning accreditation is most important. From Dr. Helfrick:

Some hospitals pursue accreditation to give themselves a marketing advantage; others do it for the right reason. Interestingly, it’s this latter group that has the most effective marketing approach: commit to high-quality, safe care, and the patients will come. Hospitals that go through the triennial cycle once and then drop out have most likely become accredited for the wrong reason. 

Read what else Dr. Helfrick has to say about hospital quality improvement in the July-August issue of PHMI WORLD.

www.phmiworld.org

In this issue: The Wockhardt Hospital network looks to capitalize on the progress it has made in building a culture of quality, while nursing leaders from the U.S. and Dubai work to institute a professional practice model for the University Hospital in Dubai based on Magnet principles. Elsewhere in the Middle East, Alfaisal University and Lebanese American University prepare to open new medical schools. Also: PHMI’s Bruce Dowton chairs a panel of internationally renowned scientists who are looking at the future of research in Australia, John Helfrick talks about hospital quality improvement and accreditation, and faculty from Harvard Medical School and other institutions converge to discuss what lessons a unique student exchange program can provide for understanding health care systems.

The Cay Compass  reports that PHMI Director N. Lynn Eckhert recently gave the commencement address at graduation ceremonies for the St. Matthews University School of Medicine in Grand Cayman. This graduating class began their studies just days before Hurricane Ivan hit Grand Cayman in September 2004. The hurricane caused widespread damage in the islands and left much of Grand Cayman unhabitable for several months. St. Matthews medical students wound up taking classes on the school’s campus in Maine campus.

From the article:

Dr. Eckhert reminded the students that being a physician meant that their learning was not over because medical knowledge, technology and procedures were progressing constantly.

“It means that you will still be studying far into the future and as long as you have a career in medicine,” she said.

“Your graduating from medical school is just one more step in your education, for you will need to keep up with the current state of medicine in your area of expertise.”

St. Matthew’s Dean of Clinical Sciences Dr. John Randall said he was proud of the graduating class, many members of which had to go to study in Maine after Hurricane Ivan, until repairs to the dormitories and campus here could be made.

“You probably could be called Ivanites,” he said.

Did you read the Forum article in the September-October 2007 issue? The article, entitled “How Doctors Talk: Improving Physician-Patient Communication,” was written by longtime PHMI freelance writer Natalie Engler. It’s a great piece about an important issue in health care practice and education.

We thought Natalie did a great job, and the New England Chapter of the American Medical Writers Association agrees. Natalie was recently announced as the winner of a Will Solimene Award, given by the Association for excellence in medical, biomedical, and health communication.

Congratulations to Natalie — time to update your CV! To read more of her excellent work, check out her most recent Forum article on integrative medicine.

Last week, Harvard University and Partners HealthCare formally executed an agreement that brings about the transition of HMI to Partners Harvard Medical International (PHMI). The full story, including perspectives from PHMI executives Andrew Jeon and Bruce Dowton, as well as Partners VP Jay Pieper, is in the new issue of HMI WORLD. Here Drs. Jeon and Dowton provide the key takeaways:

“HMI’s work since its inception has been possible in large part due to the unwavering support from the leadership of Harvard Medical School, as well as the tremendous intellectual resources of its faculty,” said Andrew A. Jeon, MD, MBA, Acting President and Chief Executive Officer. “We anticipate that in our new affiliation with Partners, we will be able to expand our mission to increase access to quality health care in countries across the world, while maintaining a vital academic partnership with the Medical School and its affiliated institutions.”

This transition comes as the result of discussions between Partners and Harvard about the best positioning of HMI for the future. Over the course of HMI’s 14-year history, its HMI portfolio has expanded beyond the organization’s original charter to extend the Medical School’s tradition of academic excellence to include a wide array of service capabilities.

“Today, in addition to working with clients to develop greenfield schools to train health care professionals, and helping existing academic institutions to innovate and improve, we are also deeply committed to pursuing collaborations focused on building sustainable models for clinical and operational excellence and designing strategies for workforce development in the health care settings,” said S. Bruce Dowton, MD, Executive Vice President and Chief Operating Officer. Dr. Dowton added that going forward, PHMI would be able to provide to clients a more comprehensive range of academic and clinical services, including facilities management, consulting services, and training of allied health care professionals.

But the transition that makes us part of the Partners family isn’t the only recent big move. We’ve also moved our Boston headquarters — a wholly separate development that happened to coincide with the move to Partners. Our new address is 131 Dartmouth Street in Boston’s Back Bay District. The PHMI Boston team is settling in and looking forward to welcoming colleagues and clients to the wonderful new office.

American Public Media’s program “Marketplace” has developed a whole series exploring the rapidly transforming Middle East – everything from the obligatory look at “indoor skiing” to stories focused on infrastructure development, new construction, and other developments that are reshaping the Middle East and creating new connections between the region and the rest of the world.

In a recent segment of the program, Marketplace focused on Harvard’s involvement in Dubai, including Dubai Healthcare City (DHCC), the University Hospital, and the Harvard Medical School Dubai Center (HMSDC) Institute for Postgraduate Education and Research. HMSDC chief academic officer Robert Thurer and DHCC CEO Muhadditha Al Hashimi talked with Marketplace about how Dubai could soon be a top health care “destination.”

Click the link to read — or listen to — the whole piece.

H. Tom Aretz, MD, HMI Vice President of Global Programs, was honored recently by colleagues at the fifth-annual Asia-Pacific Medical Education Conference held in Singapore. Dr. Aretz became the third recipient of the MILES Award (Mentoring, Innovation, and Leadership in Educational Scholarship).

The award, which recognizes outstanding contributions to the advancement of global medical education and academic medicine, is given by the Yong Loo Lin School of Medicine at the National University of Singapore (NUS). During the conference, Dr. Aretz also gave the keynote address, on medical education in the face of changes in the global health care landscape.

Dr. Aretz has been a frequent collaborator with NUS faculty on programs designed to help develop health care educators in the Asia-Pacific region. See this feature from the January/February 2007 edition of HMI WORLD to learn more.

Today the February 2008 issue of leading academic journal Academic Medicine is online and in mailboxes. The theme of this issue is global health, and the lead article is authored by Robert K. Crone, MD, the founding president and chief executive officer of HMI.

Entitled “Flat Medicine? Exploring Trends in the Globalization of Health Care,” the article presents the context in which we at HMI collaborate with our partners around the world. Drawing on examples from our work in Dubai, Turkey, and India, the article describes a global health care landscape that is undergoing a major transformation, with ramifications for patients, providers, and governments not only outside the United States, but in our own  local communities.

From the article abstract:

Trailing nearly every other industry, health care is finally globalizing. Highly trained and experienced expatriate health care professionals are returning to their home countries from training in the West or are staying home to work in newly developed corporate health care delivery systems that can compete quite favorably with less-than-perfect providers in Europe and North America. In turn, these health care systems are attracting patients from around the world who are interested in exploring high-quality, lower-cost health care alternatives. Much of this activity is occurring in the emerging economies of the Middle East, South and Southeast Asia, and beyond. Three Harvard Medical International collaborations-in Dubai, Turkey, and India-highlight these trends and demonstrate the potential for new models of global health care, as well as potential ramifications for patients and providers in the established economies of the West, including the United States. Although globalization is not a cure-all solution to achieving universal access to health care, it is not only a significant first step for patients in these emerging economies, but may also present alternative solutions for those patients in wealthier nations who nonetheless lack adequate health care coverage. The increase in health care quality and competitiveness around the globe is important, but these improvements will need to be matched by the development of comprehensive payer solutions, to benefit as many people as possible.

In the new issue of “Global Health Update” (a Partners Healthcare System publication), Dr. James Thrall, Radiologist-in-Chief at Massachusetts General Hospital, talks with the editor of HMI WORLD about his rapidly evolving field. Choice quote: “The future is going to take us to smaller dimensions. Just as scientists are very excited about nanotechnology, radiologists are very excited by our ability to image not just at the level of the whole organ, but at the level of molecules and cells.”