World Affairs

June 24, 2011
Delivery of healthcare services may be local, but it is also a global concern. And never more so than now as international travel, high-speed

Delivery of healthcare services may be local, but it is also a global concern. And never more so than now as international travel, high-speed networks, global trade agreements, offshore contracting and outsourced services shrink perceptions of space and expand business opportunities.

For many years, the United States was a medical destination for those seeking the highest quality medical care. It still is, but it has competition. In countries, especially those in Southeast Asia and the Indian subcontinent, where English proficiency is high, many physicians are U.S.-trained and prices for procedures are significantly lower. These countries are touting themselves as tourist cum medical care destinations. A package deal would offer a unique travel experience, such as visiting the Taj Mahal, for example, with a medical procedure.

Crossing national borders is nothing new for large, multi-national corporations, but what is new is the increasing numbers of those in the healthcare IT market with corporate headquarters outside the United States. Among them are Siemens Medical Solutions Group, which is part of Munich, Germany-based Siemens AG; Philips Medical Systems, a division of Royal Philips Electronics of the Netherlands; and Agfa HealthCare, a business unit of the Belgian Agfa-Gevaert Group. Although GE is a U.S.-based company with corporate headquarters in Fairfield, Conn., its GE Healthcare division is in Chalfont St. Giles, United Kingdom.

U.S.-based healthcare IT companies have not been laggards. Many have established footholds in the international marketplace where they are growing markets. Each year, the percentage of companies in the Healthcare Informatics 100 doing business globally grows.

Readers are crossing borders, too. Online access enables visitors worldwide to access our site and use our resources. In a typical week, readers are logging on from India, Canada, the United Kingdom, Germany, Australia, Singapore, Saudi Arabia, the Philippines and Malaysia. And even this visitor list doesn't quite capture the global flavor as it only reflects the top 10 countries of origin among site visitors. The common thread among the top 10, of course, is the high levels of English proficiency within those countries.

China is a different story. That country is undergoing a remarkable transformation, says Chicago-based entrepreneur Sheldon Dorenfest, whose assessment is based on more than the fast-growing numbers of tall buildings in Beijing and Shanghai. Unlike India, which can draw call centers and other businesses dependent on English proficiency, China's strength is its low manufacturing costs. But perhaps more importantly from a technology standpoint, China's infrastructure is far superior, he says.

After divesting the last of his businesses (The Dorenfest IHDS+ Database to HIMSS Analytics, a subsidiary of the Chicago-based Health Information and Management Systems Society), Dorenfest says, "I had given up on doing business in the American healthcare organization. I ran an improvement business and while I could take big checks from my customers, I wasn't improving healthcare." He thinks he can make a difference in China.

Since his early investigative visits in 2005, Dorenfest found healthcare IT opportunities in China non-existent. The country's financial systems were good, he notes, but clinical systems weren't — and the two didn't work well together. However, by the end of 2006, things had changed. China's Ministry of Health now has a goal to have electronic health records (EHRs) and regional networks implemented throughout that country by 2010, and all over China, hospital leaders are budgeting money to create EHRs and digitize, he reports.

The race to improve healthcare is global, and IT remains central to achieving the goal.