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New in Academic Medicine: Top U.S. health care institutions are going global
During the past 10 to 15 years, increasing numbers of U.S. academic health centers (AHCs) and major teaching hospitals have developed significant academic and clinical activities abroad. Harvard Medical School and now Partners HealthCare have engaged the global landscape through the programs and collaborations of Partners Harvard Medical International. Meanwhile some of the big name brands in academic medicine—Cleveland Clinic, Johns Hopkins, and Memorial Sloan-Kettering, among them—have launched a variety of activities abroad.
These activities—and the motivations driving institutions to undertake them—are the subject of an article published in the June 2008 issue of Academic Medicine (subscription required for full text). Entitled “Involvement Abroad of U.S. Academic Health Centers and Major Teaching Hospitals: The Developing Landscape,” the article is based on a study of international activity conducted by the Chartis Group in collaboration with then-Harvard Medical International.
According to the article, while top U.S. academic medical centers have historically served large numbers of international patients who travel to the U.S. for care, in recent years many of these institutions have began to consider new ways to engage foreign markets. As the international health care market has evolved during the past six to seven years, the institutions profiled in this study have begun to pursue offshore strategies that serve one, two, or all three of their core missions of providing excellent clinical care, research, and education.
In the article the authors classify the 16 institutions studied in three clusters according to the depth of their engagement abroad, and outline four stages of development of their activities, from the provision of educational programs and training (Stage One) through delivering and/or owning patient care, education, and/or research abroad (Stage Four).
Why are these institutions looking to invest time and resources beyond the border? The authors point to four general categories of motivation:
- Attract patients from abroad
- Develop an international reputation and brand
- Advance the institution’s research and education mission
- Provide financial benefit to the institution
Whatever the motivation, so far the development of these institutions’ offshore initiatives has been largely opportunistic, according to the study’s authors: “Much of the early movement into the international arena has been based on demand from non-U.S. governments and other organizations seeking to improve their health care delivery systems and leverage the skills and brand value of leading U.S. AHCs and major teaching hospitals.”
The authors conclude that while the development of international activities requires a major commitment and may be feasible for a limited number of institutions, U.S. AHCs and major teaching hospitals have a major opportunity. “The rapid development of offshore activities . . . to date suggests that global involvement could, in the coming decades, serve as a new metric for leadership and influence in health care, education, and research.”
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