Epworth International

Developing international healthcare in Victoria: Opportunities and obstacles

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Professor John Catford, Executive Director Academic and Medical November 2014

Overview

• Epworth Current State

• Victorian Government

• Victoria China Collaboration

• Healthcare demand in China

• Opportunities for Australia

• Epworth International

• Epworth Model of

International Healthcare

• Benefits for Victoria

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Epworth Developments • Established in 1920 through a charitable gift from Sir

Aaron Danks with its own Act of Parliament

• Victoria’s largest not-for-profit private healthcare group, renowned for excellence in diagnosis, treatment, care and rehabilitation.

• Operates 8 hospitals and 5 health services with a combined 1,190 beds, 133,000 patient admissions and over 85,000 operations in 2013.

• Capacity will increase by one third from 2016

• Strong commitment to quality improvement, education and research which is currently organised through 11 Clinical Institutes and 9 Professorial Departments

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Epworth Developments • Epworth Research Institute supports a wide range of

clinical research projects including the Australian Prostate Cancer Research Centre, funded by the Australian Government.

• In 2014 more than 23,000 clinical placement days will be provided across 11 disciplines together with over 90 Intern, Registrar and Fellow positions.

• Unique affiliation with the Cleveland Clinic, a leading US Academic Health Centre

• Many ‘firsts’ for private health sector eg teaching hospital, open heart surgery, laser guided pacemaker, intensive care, renal dialysis, stroke unit, radiotherapy, acute emergency department, robotic surgery

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Epworth: Current State

• Many longstanding overseas relationships

• In 2013 Epworth treated 612 international patients from 31 countries:

oNew Zealand (135)

oUSA (101)

o China/Hong Kong (76)

o Indonesia (49)

• Plus pro-bono surgery on patients from the Pacific and other regions through Rotary International and Children First

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International Patient Groups A. Tourists visiting Australia who become ill and need

treatment

B. Expatriates working In Australia who may be referred by their Consulates

C. Overseas residents who have business, family or friendship connections in Australia who recommend treatment at Epworth, eg children studying at a Victorian university

D. Overseas residents who seek out surgical/medical treatment at Epworth or through one of Epworth’s specialists

Epworth sees greatest opportunity to expand C and D

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Victorian Government: Global Health Melbourne Plan

• Developed by the Health Exports Advisory Committee

• Focuses on identifying, developing and growing opportunities in health exports and related investment to generate more economic growth and jobs in Victoria

• Ensures the benefits and opportunities generated by a thriving health exports sector will drive improved health and aged care services for Victoria

• Enhances our national and international leadership in health and aged care

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Victorian Government: Global Health Melbourne Plan Launched April 2014 by Deputy Premier/Health Minister

Focuses on seven key strengths with significant potential for global growth including:

• Provision of medical services – diagnostic, medical and clinical services to international patients both on- and off-shore

• Workforce training – particularly health and aged care medical education and training for students and clinicians

Epworth sees most alignment in these areas

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Victoria China Collaboration • China will surpass the United States economy in 2018

• Chinese share of GDP expected to exceed 33% (twice the US and larger than the US and Europe combined).

• Australia is currently China’s 7th trading partner

• China has been Victoria’s largest goods export market since 2007-08 ($3.8 billion in 2013)

• 17% of Victorian exports destined for China

• Increasing capital flow from China to Victoria expected to grow

• Chinese immigrants have been the largest and fastest growing group in Victoria over the last decade

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Victoria China Collaboration • 5 Victorian Government Business Offices located

throughout the whole of China

• Extensive sister relationships:

o Victoria with Jiangsu Province

o Melbourne with Tianjin, near to Beijing

o Geelong with Liangyungang (Jiangsu)

o Bendigo with Tianshui (Gansu)

• 3 Super Trade Missions to China organised by the Victorian Government since 2011

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Healthcare Demand in China • China’s health outcomes have dramatically improved

over several decades

• Concomitant with economic growth, demographic and social developments.

• In 2009 a three year reform commenced:

o extending health insurance coverage

o establishing primary care services

o hospital management reform

o improving medication access and affordability

o expansion of public health services

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Growth in Consumption 2012-2022 (McKinsey 2013)

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Annual average growth rate in health spending and GDP per capita 2012 (WHO and IMF)

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Opportunities for Australia • China currently has limited availability of

appropriately skilled medical and nursing staff as well as the shortage of world class facilities

• Increasing demands for high quality health care will be impossible to satisfy in China

• Wealthy Chinese patients will increasingly look to off- shore providers

• Growing unmet need for chronic conditions that can be treated as bundles of care (eg cancer, cardiac, renal, liver, orthopaedic)

• Australia could lever healthcare quality, economic, cultural, travel, time zone and price advantages

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Epworth International: Future State Key requirements are sound market intelligence, effective partners, clear strategies and plan of action:

• Short term, medium yield strategy

o Direct marketing of international services through agency arrangements in China and Australia

• Medium term, high yield strategy

o Indirect marketing through medical referral pathways established through partnerships with reputable health care organisations in China

o Provide advanced clinician training, service development support and research collaborations

Epworth International Project Office, fluent in Mandarin

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Epworth International: Actions

• Undertaking investigations in China to identify clinical service needs and opportunities

• Assessing Epworth’s internal capacity including clinician availability and suitability, appropriate locations, clinical and cultural capacity, and existing international activity and relationships

• Engaging with internal and external stakeholders to facilitate new partnerships

• Preparing option appraisals for potential business models, trial regions and service mix

• Developing a model of international healthcare

• Commissioning a series of pilot projects

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Model of International Healthcare Very high quality ‘end to end’ patient pathway for each care stream focused on time limited treatments:

• Patient recruitment

• Clinical assessment, prior and on arrival in Australia

• Consent, medical and financial

• Billing arrangements

• Visa (medical treatment up to 3 months)

• Family/ support staff needs

• Pre-travel medication

• Flights, Transport in Victoria

• Accommodation, Concierge services

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Model of International Healthcare • Preadmission services

• Inpatient services

• Post discharge services

• Interpreters, Cultural appropriateness

• Expectations management

• Indemnity assurance

• Repatriation

• Discharge information for referring doctor

• Clinical follow up

• Risk management

• Regulatory requirements

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Epworth International: Benefits

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International

Investment

Education Quality

Economy Innovation