In a new global initiative, the Hospital for Special Surgery has begun to offer an array of services to medical facilities around the world, as the New York-based specialty orthopedic center joins the expanding ranks of U.S. medical groups setting their sights on opportunities outside the country.
“Many countries, if not all, are grappling with providing good orthopedic care to growing populations who need hip and knee replacements,” said Laura Robbins,senior vice president of global and academic affairs at the Hospital for Special Surgery. “We wanted to assist but have a strategic way of going about it.”
The hospital is focusing on opportunities in Asia, the Persian Gulf states and Latin America, Robbins said. “We were getting a lot of inquiries from healthcare systems and hospitals around the world, saying, 'Help us be better.' ”
The hospital says it performs some 29,000 surgeries a year, and U.S. News & World Report regularly ranks it as the country's top orthopedic hospital
Its new initiative comprises varying tiers, from advisory and business support services—a hospital might want to reduce infection rates in its operating rooms, for instance—to membership in HSS' Global Orthopedic Alliance, if HSS deems hospitals sufficiently high caliber.
Hospitals and healthcare centers have to submit an application, including a $1,000 fee, to be considered as partners. They then send key leaders and chief surgeons to meet with their HSS counterparts in New York City. HSS returns the visit, on the potential partner's dime, to assess its clinical care and core competencies.
The partnership is supplemented with teleconferencing and professional educational platforms. “It's a combination of using digital technology to keep the relationship going …and a balance between travel here and there,” Robbins said.
The HSS decided in early 2015 to create a formal program. It picks partners based on shared values and mission, as well as their capacity to form sustainable, long-term relationships despite the possible challenges posed by differing cultures and reimbursement systems.
Under the Global Orthopedic Alliance, hospitals can become members or, if they're extremely advanced, a center of excellence. For an annual membership, they receive, at a minimum, guidance from HSS on care delivery, mentorship for leaders and access to other programs.
“We don't see this as a revenue stream that is for the sake of revenue,” Robbins said. “Whatever revenue we will bring in from these international initiatives will go back to support the mission of the hospital.”
Two organizations—the Hospital Alvorada in Sao Paulo and Bumin Hospital Group in South Korea—are already part of the global initiative.
Rising demand for orthopedic services and expertise stems from worsening population health and changing demographics.
Rates of obesity and people who are overweight are swelling around the world thanks to declining physical activity and worsening diets. A higher risk of musculoskeletal disorders, including osteoarthritis, and fractures are among the myriad of health consequences.
In 2014, nearly 2 billion adults were overweight or obese, according to the World Health Organization. The prevalence of obesity has more than doubled from 1980 to 2014.
Another factor driving the need for orthopedic services is that people are living longer. As their joints, particularly hips and knees, wear out and require replacements, “Hospitals have to figure out how to provide those to patients in a safe environment, and also deal with costs. That's the challenge,” Robbins said.
But aging hips and knees are not the only reasons U.S.-based medical groups and healthcare systems are branching out.
Pittsburgh-based UPMC is planning to build and co-own a radiation therapy center in Cork, Ireland, in a joint venture with Bon Secours Health System, Ireland's largest private healthcare system, it announced in January. UPMC also operates cancer centers in Waterford, Ireland, and in Rome and offers advisory and other services to hospitals and medical centers in China, Kazakhstan, Lithuania and several other countries.
Detroit-based Henry Ford Health System has plans to build a hospital in Saudi Arabia. It has also signed a contract to provide medical technology and services to a hospital in India.
"India has had such a huge rise in lifestyle diseases like diabetes and heart disease, they are clamoring for a westernized medicine model — outpatient focus and wellness-based," Brenda Craig, Henry Ford's director of media relations, has said.
“We see this as a growing business,” Robbins said.