To enable patients from around the world to have a platform that allows them to easily learn about and connect with healthcare providers across the United States, ChooseUSHealth (www.ChooseUSHealth.org), a collaborative initiative between American hospitals with international programs and the US federal government, was created to serve as a resource for these international patients.

ChooseUSHealth’s nearly 70 hospital partners are global leaders in the diagnosis and treatment of childhood diseases. Pediatric patients who come to the United States often seek cancer, transplant, neurological, and gastroenterological treatments, as American medical institutions offer the most specialized and innovative care available for these and other complex procedures. Clinical outcomes following care received in the United States reflect that it is home to the world’s top doctors, most advanced medical technology, and best-respected hospitals. ChooseUSHealth’s hospital partners have collaborations with organizations across the Middle East, such as Dubai Healthcare City, United Arab Emirates University, King Fahad Specialist Hospital, National Guard Health Affairs in Riyadh, and Kuwait Life Sciences.

American hospitals are known for their “solution shop” medicine that requires highly specialized medical experts and highly specialized wrap-around support services that are designed to diagnose and treat complex symptoms and conditions. Diagnosing and treating these complex and often unique symptoms and problems require interprofessional teams that include the continuum of medical specialties and support services and who are “ready for anything.”  For complicated problems, solution shop medicine is more effective and efficient, because diagnostic and laboratory test results and medical information can be seamlessly communicated among providers within the same organization, eliminating duplication that often occurs with hand-offs across separate organizations and providers. A few examples of specialized treatments and diagnostic services that pediatric patients travel to the United States from across the world include brain tumors; transplants; chemotherapy; cardiothoracic procedures; complex orthopedic procedures; and brain, bone, and liver biopsies.

Addressing the Complex Psychosocial Needs of Pediatric Patients

In addition to the complex medical needs, pediatric patients traveling to the United States also have complex psychosocial needs due to often long travel distances, cultural differences, and medical complexities. Hospitals catering to international pediatric patients have developed processes, systems, and protocols to ensure the highest quality care is provided from a holistic perspective that addresses patients’ medical, family and psychosocial needs.

Tailored “Pedia-Centric” Care

One unique aspect of pediatric hospitals (both standalone and those within a larger acute care hospital) is that they provide “pedia-centric” care that focuses on the pediatric patient and family’s experience. Treatment is family centered and spans the continuum of care. This focus on the patient experience begins with the initial inquiry with the provider and extends to the medical aspects of the diagnosis and treatment, patient and family education through post-operative care, and after the patient and family return home.

With the Middle East being one of the largest regions of home origin for pediatric patients traveling to the United States, US hospitals are well prepared to provide outstanding medical care that is culturally appropriate with patient education that is designed for the patient and family.

Pediatric hospitals are designed for the child. Waiting and exam rooms, patient rooms, and other spaces are designed for both the child and family. Pediatric hospital rooms are family centered and furnished for caregivers to be in the room 24 hours a day. Many pediatric units, including neonatal intensive care units, have family-designed private rooms. Everything from wayfinding to books and murals are designed for children of all ages. With some treatments requiring very long hospital stays, pediatric hospitals also provide activities that engage children and take their minds off their health conditions and treatments.

Pediatric hospitals have physicians, nurses, and clinical staff who have in-depth training in pediatric care. Pediatric subspecialty physicians are first trained in general pediatrics and then complete specialized training in a subspecialty that includes both clinical and scholarly training.

Telemediated Care

Nearly all ChooseUSHealth hospital partners provide some telemediated care to international patients. The use of both remote second opinions and telemedicine continues to grow for US hospitals that serve international patients. Before a patient even decides to travel to the United States, hospitals can provide remote second opinion services to verify a diagnosis or treatment and confirm that the hospital can address the unique medical needs of the patient. These services are often provided via video conference.

Telemedicine includes a broad range of services provided via telecommunication. Store-and-forward telemedicine is asynchronous and includes services that do not require both the patient and provider to be present at the same time, such as a radiologist reading radiography images or a pathologist interpreting pathological data at-distance. Remote patient monitoring includes the electronic transfer of health information for health professionals to monitor a patient, with activities ranging from monitoring patient weight or blood pressure at home to monitoring blood oxygen, heart rate, or other vital signs in the intensive care unit.

Real-time telemedicine requires synchronous interactions between the patient and physician or other health professional, such as telerehabilitation, telepsychiatry, or telenursing. US hospitals may use telemedicine for post-operative follow-up care and communication with the home physicians. They work closely with the home physicians to ensure that the transition is smooth, and both asynchronous and real-time telemedicine can facilitate this transition.

Telemedicine is used to stabilize and treat critical patients not able to travel as well as to provide ongoing specialized outpatient treatments that are not available locally, such as specialized mental and behavioral healthcare and therapies. US hospitals have made substantial investments in state-of-the-art, secure technology for both real-time, high-definition videoconferencing and the electronic transmission of images and videos for asynchronous telemedicine. Videoconferences are held with providers from across the world for case conferences, education and training.

Collaborations Abroad

Pediatric hospitals in the United States are committed to improving the quality of and access to care across the world through collaborating with providers abroad in a variety of ways. They disseminate their best practices through training programs that bring clinicians and non-clinicians to the United States for a few days to more than a year, where they learn new diagnostic approaches and treatments that they then bring back to their home country. Specialists routinely travel abroad to train other providers at their home institutions on cutting-edge treatments. Hospitals offer observer programs for international clinicians to spend a few weeks to a few months watching surgeries, attending education conferences and patient rounds, and being mentored by physicians within the US hospital.

Additionally, hospitals provide consulting and management services to healthcare organizations abroad, with the goal of helping organizations develop state-of-the-art facilities and programs and put in place “best practice” systems and processes. In addition to clinical collaborations, ChooseUSHealth hospital partners also provide healthcare management programs for clinicians and non-clinicians to develop leadership competencies. Some US hospitals have joint ventures in the Middle East to expand access to high-quality, specialized care locally.

Research and Innovation

US hospitals that serve pediatric patients from across the world are also leaders in research and innovation. The US National Institutes of Health (NIH) funded $3.96 billion in pediatric research in fiscal year 2016. ChooseUSHealth hospital partners and their affiliated organizations received over one quarter of the total NIH funding for pediatric research in the fiscal year. Of the nearly $4 billion in funding, $351 million was dedicated to pediatric cancer research, with a substantial portion of this investment dedicated to pediatric genomic research. The NIH’s National Cancer Institute funds the Children’s Oncology Group, the largest pediatric cancer clinical trials network that brings together clinicians, scientists, and scholars from across the world to conduct clinical trials and other research aimed at curing pediatric cancer. These research investments, coupled with industry and philanthropic funding, will drive the discovery of cutting-edge treatments and cures for pediatric diseases in the future.

USCIPP Member Organizations (August 2017)