An Accreditation Program in Name Only?

Updated 7/23/08—Any healthcare executive who has been through the rigors of international accreditation knows the course should be deliberately plotted—not only to ensure successful accreditation, but also because the method itself of measuring against quality and safety standards holds real value for the organization and its patients.

Just as no healthcare facility should take a slapdash approach to earning accreditation, no organization should claim to be an accrediting body without fully realizing and communicating its goals and standards to salient stakeholders. The Medical Tourism Association last week launched a new accreditation program "to ensure the safety and overall positive results for patients traveling from one country to another."

On its face, an accreditation program sounds like a fine idea for hospitals, clinics, recovery centers, and facilitators in the medical travel industry. This brand of accreditation could give medical travelers a degree of comfort that their healthcare experience will meet quality standards and will provide continuity of care.

Renee-Marie Stephano, chief operating officer of the Medical Tourism Association, is quoted in the release as saying, "Having the right processes and procedures in place to assist international patients has a direct correlation to better surgical outcomes for those patients."

Then the prepared statement goes on to note that this new accreditation program will focus only on "medical tourism" and is not intended to accredit quality or replace any accreditation system; instead it complements existing accreditation systems that an organization might currently have in place.

I told David Jaimovich, MD, chief medical officer for the Joint Commission International, about the Medical Tourism Association's new program. He didn't have any inside knowledge of the association's plans, but said that he thinks the Medical Tourism Association will find starting an accreditation program from scratch to be a daunting task. For example, he says it takes JCI about six months just to revise its existing standards. "It takes significant effort," he says. "Outsourcing these things is hard to do . . . to ensure quality."

In a phone interview yesterday, Stephano says the MTA's accreditation program should not be compared to the JCI or any other accreditor of healthcare quality. "We're working with establishing standards and best practices for medical tourism companies, for hotels, for clinics and hospitals specifically in the area of international patient services, which is facilitation services primarily, which is communication services, which is informed consent forms," says Stephano. "It is procedural and not involved at all with infection rates and quality indicators or anything that really the JCI or any other accreditation system is doing."

I went to the Medical Tourism Association's Web site to see if I could find specific details about its standards and process for granting accreditation to medical travel organizations, but I came away with more questions than answers. A page about the accreditation program was easy enough to find on the site, but it amounts to a sales pitch about the "benefits of accreditation" without many specifics. A link that says it will take me to a list of MTA-accredited organizations only tells me the list will be available soon.

Stephano told me that the listing is blank because the MTA has not yet begun accrediting organizations, but the accreditation standards have been finalized and she expects to publish them on the Medical Tourism Association's Web site within two weeks.

A member of the association's quality committee says the MTA's leadership never shared plans to roll out an accreditation program. The committee had been working on developing core measures for safety, quality, and patient outcomes, but nothing has been finalized, says the committee member.

Sharon Kleefield, MA, PhD, told me she was approached by Stephano last fall to join the MTA's quality committee. Kleefield is a Harvard University faculty member who has worked with international systems to develop quality metrics. She says she was surprised to read about the Medical Tourism Association's new accreditation program in the press release and on the association's Web site.

"I'm unaware that they have the expertise and resources to build the required infrastructure," says Kleefield. "You can't just declare that you're going to be an accreditor."

Stephano says Kleefield and others have been working on the association's "quality indicator project" that is completely separate from its accreditation project. She says that in order to receive accreditation, medical tourism organizations must complete a detailed application and interview process. Then MTA's evaluators, under contract with the association, will determine whether the applicant requires a site visit. If organizations do not meet the MTA's standards, the association "will work with them to help them develop what they need to develop to achieve accreditation," Stephano says.

Although the concept of medical tourism certification is a good one that could promote industry best practices and help ease barriers to medical travel, the announcement of this accreditation program without releasing specifics is in the best of light premature. When the details are published, it will be up to the healthcare industry to decide whether this program measures up.

In next week's HealthLeaders Media Global, I will share more from my interview with Stephano. She answered many of my questions about the association's new accreditation program, including:

• What types of organizations can apply for accreditation?
• How are outside reviews conducted?
• How did MTA create its accreditation standards?
• Does this accreditation program require prior accreditation from something akin to an ISQua-accredited organization?