Changing the Face of Stroke Recovery – Part 2

In Part 1 of this series, we commented on our surprise at learning that 12 of 16 important stroke rehab criteria are not reported in the US.  We then took the results that could be found and shared them with doctors and therapists involved in stroke rehab.  The light for us went on when an occupational therapist made this telling comment: “If people in the US knew these kinds of results were possible, no one would put up with [these results].”

We spoke with Dr. Lee Schwamm, Professor of Neurology at Harvard Medical School and Vice-chairman of Neurology at Massachusetts General Hospital.  Dr. Schwamm also chairs the American Stroke Association’s Get with the Guidelines committee looking at stroke care.  ”Millions of dollars are being spent on acute care, but almost nothing is being focused on the costs of long-term rehab,” he commented.  “It’s a part of the story that’s not being told.”  We spoke with an insurance executive who described stroke rehab as being one of many “futile cases.”  A futile case, he shared, is one that is too expensive for the results being achieved.

The result is that the expectation for recovery is lowered from an active life to an adaptive lifestyle.  Here’s how one insurance company defines it:  “Do as well as you can and be as independent as possible. Learn to live with the changes to your brain and body caused by the stroke.  Adjust to living within your home, family, and community.” Another insurer defines the end for benefits as reaching the ability to “with limited assistance, perform the minimal activities of daily living.”

However, stroke survivors and their families almost unanimously define recovery differently.  They understand the difficulty.  They understand that rehabilitation cannot cure the damaged parts of the brain.  However, they also know the wonder of the brain’s ability to reroute some functions and recover areas that are not permanently damaged.  They recognize recovery as regain as much independence as possible, not some minimum level.  They understand that 95% is pretty good, if 100% isn’t possible.  They are prepared to work toward recovery.

When they see what is possible, they too express feelings much like the OT above.  They are pleasantly surprised to learn how accessible it is.  What they don’t understand is the opposition they experience in trying to get there.

In Part 3 of this series, we’ll look at some of the statements made by well-meaning family, doctors, therapists and others, and why those statements are more myth than reality.

For more information about what you can do to help someone you know, contact us at www.chinaconnection.cc.

Changing the Face of Stroke Recovery

About every 45 seconds in America, someone suffers a stroke.  In fact, more than 780,000 people suffer a stroke each year, and estimates put the number of families impacted by stroke survivor at more than 6 million.  It is the 3rd  leading cause of disability in the US.

Because we work with many stroke survivors and their families, we wanted to take a serious look at recovery, the side of the story less often told.  This post is the first in a four part series focused on what we learned as we took a fresh look at what we thought we knew.

First, we were reminded when it comes to stroke recovery, outcomes matter.   Consequently, we reviewed the stroke outcomes at our Destination HealthCare Stroke Recovery™ provider, First Teaching Hospital in Tianjin, and those reported by US providers.  To ensure a fair comparison, we used three major resources: US News & World Report’s Best Hospitals in America as a source for the best neurological hospitals, Healthgrade’s ratings of stroke care, and the American Stroke Association’s 2010 report.

Here’s how First Teaching Hospital compares with the top five neurology specialty hospitals in America as ranked by US News & World Report along with their Healthgrade rating.  We elected to use the neurology hospitals, rather than rehabilitation hospitals rated by US News & World Report, because the latter are ranked solely on the basis of reputation.

Hospital	Number of Stroke Cases	Number of Hospital Admissions	Healthgrade Review of Outcomes[1]
First Teaching Hospital	358,000	1,867,380	Best[2]
Mayo Clinic	4,000	514,000	As Expected
Johns Hopkins Hospital	Not available	97,440	As Expected
University of California Hospital (San Francisco)	Not available	29,043(inpatient only)	As Expected
Massachusetts General Hospital	1,303	1,500,000	Poor
NY – Presbyterian University Hospital of Columbia & Cornell	Not available	114,628	Best

When it comes to your recovery, we know good isn’t good enough.

While access and affordability are important, we understand that a premier outcome must be foremost.  We monitor patient results, in person and through reviews of records, using 16 separate factors.  The table below shows five of the key criteria in comparison to results reported by the American Stroke Association and others.

THE DESTINATION HEALTHCARE DIFFERENCE™

Criterion	Destination HealthCare Stroke Recovery™	United States
Walking without assistance	85%	51%
Balance (Able to rise from seated position to standing with no assistance)	85%	Not reported
Improvement in cognitive function	80%	74%
Number of medications	54% of patients reduced      number of medications 46% require no further  medications	Not reported
Return to home	98%	68%

We were interested to find that two of the five items above and 12 of the total 16 criteria have no US corresponding outcome.  We thought we were missing something until we spoke with the Centers for Disease Control National Institute of Health Statistics, which confirmed the absence of standard reporting.

We wondered why.  The rather surprising answers emerged from some unexpected sources, leading one therapist to say, “If people in the US knew these kinds of results were possible, no one would put up with [these results].”

Read more of the rather surprising answer in part 2.

For the complete statistical report, please visit www.chinaconnection.cc.

[1] 2010 Hospital Quality Ratings: Stroke, Healthgrade
[2] Based on independent assessment using Healthgrade criteria

A Light-hearted Look at Stroke Rehab

Every once in a while, one of our Destination HealthCare patients shares something with us that touches our hearts.  This one was such a delight we wanted to share it with you.

Jay is a stroke survivor undergoing treatment at the First Teaching Hospital in Tianjin, China.  First Teaching Hospital, the original hospital in CCGH’s Destination HealthCare Network™, is a leader in using Integrated Medicine, a combination of Western and Traditional Chinese Medicine for treatment of stroke and many neurological diseases.  Here is his light-hearted look at his first week of therapy.

Hey Friends,

Finished up a little early today. Went to gym where the evil twins [my physical therapists] are still trying to get me in to the pretzel hold with  no luck. My arm & leg are much more flexible than they were at the 1st of the week, but the pretzel hold is still a long way off.

Acupuncture was good, but it’s hard to believe that the doctors can put 75-85 needles in you in a matter of three minutes.  I started having feeling in my affected foot yesterday. The feeling was pain but any feeling is good feeling. That means the affected area is waking up, and the pain means she isn’t a morning person and is pissed.  When Dr. Bian was manipulating one of the needles in my affected arm, she asked if I felt an electricity.  I think the clue was when my arm left my body and my eyes bulged like Wile E. Coyote. 

Cupping was next.  Cupping appears to be a medical term for getting a hickey on all the major acupuncture points.  It does feel good though and really seems to be working.  That was followed by a herbal wrap with heat and the  delightful socks thru a leaky septic tank drink!  Actually,  it’s not that bad anymore.  I mean, I wouldn’t chose it over a beer but it’s drinkable and as they say it “does a body good”.  Based on childhood memories of bad tasting medicine that cured, this stuff must be awesome!

Had an herbal soak and a massage. Now please understand, the therapist that gives the massage isn’t there for a nice, relaxing rub-down.  I think my right thumb and my right pinkie exchanged locations for a while this afternoon.  After they coaxed me off the ceiling, I had another acupuncture session and was finished.

Please don’t take my raving as serious. It is a way to entertain myself and hopefully you.  I’m very lucky and blessed to be here. The people are top-notch and laugh  easily, the food is outstanding and I’m having a blast.

Hope this e-mail finds everyone well.
Love to all,
J

Brief History of Destination Healthcare

We’ve read a lot of articles over the last few months that describe destination healthcare (or medical tourism, its less serious cousin) as something new.  In fact, destination healthcare is a centuries-old consumer medical practice.  Today, we make destination healthcare decisions far more often than we realize.

Pool of Bethesda

Definitive records related to destination healthcare date back to the early Greeks who visited Epidauria, a territory along the Aegean Sea, in the sixth century BC.  The asclepieion at Epidaurus was the most celebrated healing center of the Classical world, the place where ill people went in hope of being cured.  Roman records from around 75BC describe the healing centers in Bath, England. The Pool of Bethesda, recorded in the Gospel of John, was surrounded by an asclepieion where the ill and infirmed traveled for healing.  The earliest references, however, seem to date to about 2650 BC, when people traveled to see the Egyptian physician Imhotep who was renowned for medicines for wound care and for relief of intestinal, muscular and skin disorders. 

In the United States, destination healthcare took root in the late 19th and early 20th centuries when Americans suffering from tuberculosis traveled to sanitoria in places like Colorado Springs; Battle Creek, Michigan; Louisville, Kentucky; and Saranac Lake, New York.  In the second half of the 19th century, destination healthcare developed further as patients traveled cross-country to leading specialty and teaching hospitals including the Mayo Clinic, the Cleveland Clinic, Johns Hopkins, the MD Anderson Cancer Center, and St. Jude Children’s Research Hospital among many others.  Simply put, we’ve made going to doctors and hospitals based on access (Can I get an appointment?), affordability (Is it in my health plan or, if not, can I afford to go there?), and premier quality (I need a great specialist.).

Today, advances in medical techniques and technology, international partnerships between hospitals and medical universities, and internationally trained doctors combine to deliver medical outcomes and standards of service equaling or surpassing those in the US.  Patients take advantage of the ease of global travel to access world-renowned international hospitals in China, India, Thailand, and other countries that provide premier medical care with costs far less than those in the US.  The number of Americans receiving medical care internationally, including vacationers and expatriates, was estimated at one million for 2008.

Medical associations have also recognized the value of destination healthcare.  In 2009, both the American Medical Association and the American College of Surgeons issued new position statements recognizing the important role destination healthcare can play when properly structured and delivered.  The American College of Surgeons recommends that patients “seek care of the highest quality” and encourages its member physicians to “assist all patients in reaching informed decisions concerning medical care, whether at home or abroad.”  Both groups have adopted a set of principles to guide destination healthcare decisions.  Physicians are a frequent referral source for China Connection Global Healthcare.

It’s important to remember that destination healthcare isn’t for every patient or medical procedure.  It cannot replace a routine visit to the doctor or a 911 call in an emergency.  Neither is it a good option for those who cannot travel safely.  However, for the more than 59 million hospital admissions that are candidates for destination healthcare, it is a safe, accessible, affordable avenue to premier quality medical care and outcomes.

For more information, download the new white paper, Introduction to Destination Healthcare, available at www.chinaconnection.cc.

Introduction to Destination Healthcare – a new white paper

Destination healthcare is the term for traveling from one’s home to another location for medical care.  It is founded on three inextricably linked principles: access, affordability and quality of care.  While few think of the decisions they make regarding where to seek medical attention, destination healthcare decisions are common in today’s society.  It is not unusual for a family to prefer a particular hospital or doctor, because the provider is in their health insurance company network (affordability), nor is it uncommon to select a specialist based on how quickly an appointment can be scheduled (access). Whether across town, across a state or province, or across national borders, quality of care and medical outcome directly influences whether someone makes a destination healthcare decision.

Today’s destination healthcare difference is inclusion of international destinations.  Premier hospitals spanning the globe provide exceptional medical care and attention.  Michael. D. Horowitz, MD, MBA, a cardiothoracic surgeon who studies destination healthcare, states, “It is naive to think that just because someone practices elsewhere they are not as well trained, or qualified, or artistic as a physician in the United States.”  The World Health Organization designates destination healthcare hospitals in a number of first-world cities as being among the best in the world, and prestigious news outlets such as the Wall Street Journal and Reuters cite them similarly.  At the same time, many of them deliver care with no wait times and at rates well below those experienced by patients in North America and Europe. 

Unfortunately, there is little well written information on which people can depend.  Much of the existing information comes from destination healthcare’s less sophisticated cousin, medical tourism.  Destination healthcare is exclusively health care focused, emphasizing medical care and outcome.  In contrast, medical tourism agencies also serve patients seeking medical care; however, they quickly diverge by integrating luxury trips to exotic locations and using terms such as “recuperation resorts”, “surgical safaris”, and “cancer cabanas”.  This failing can be found in  the premise of articles such as “Convention & Visitors Bureau Role in Medical Tourism” in the July/August 2009 issue of Medical Tourism Magazine.

Destination healthcare is not a panacea for the issues facing healthcare in the United States.  It does not replace either routine doctor visits or emergency room care.  Neither is every medical procedure or patient a candidate for destination healthcare.  It is an increasingly popular alternative to high medical care costs, insufficient medical outcomes, delays in access to specialist care, and lack of patient control. 

This paper is written to provide straightforward information regarding destination healthcare and to help build a context in which individual patients and corporate administrators can evaluate its benefits.  To get your free copy of Introduction to Destination Healthcare, visit  http://tinyurl.com/y8wpy9y.

Looking at Care from Both Sides

Like many of you, I’ve had a lot of different job titles.  Most of them, including nurse, paramedic, and clinic manager, have been in medical care roles.  In 2001, following a catastrophic stroke, I added disabled patient to the list.  Where I was accustomed to helping patients, my view was now from the hospital bed looking up at those caring for me.  That will snap your view around in a big hurry, and it certainly did mine.

After getting past the touch and go fears over immediate survival, I began learning the hard realities of being a patient with a disabling medical condition.  I was now viewed as a long-term disability patient and told to accept my condition and apparent disabilities.  I learned that insurance placed limits on the treatments and therapies I needed that did not allow enough care for me to recover.  The nursing shortage that had been a worrisome statistic for a clinic manager had become a harsh, personal reality.  Delays in getting appointments followed by endless minutes in the waiting rooms of doctors’ offices suddenly became a source of added stress in my patient role.  Worse, I wasn’t recovering the way I hoped and believed was possible.

When we find ourselves in need of healthcare, whether planned or unexpected, catastrophic or routine, we become reliant on a medical care system that is stretched to its breaking point.  Hospitals and physicians’ offices are staffed with good people who are often tasked with doing too much with too little.  The floor nurse in the hospital isn’t being short with me because she doesn’t care.  She has many other patients, too many probably, whose needs are equally important and too few other nurses on duty to support them.  It’s not that the doctor doesn’t want to spend time reviewing my condition.  She, too, has patients who have already waited well past their appointment times.  The harried guy in admitting is already doing the job of three people, all while trying to determine whether the crying baby is a higher priority than the guy with the visibly fractured elbow.  I never doubted that they cared.  I just knew that in order to recover I needed more.

With the encouragement of two exchange students from China and the support of family, I embarked on a non-traditional journey toward recovery through medical care in China.  What hadn’t happened in three years of therapy began to return through the patient treatment offered by doctors and nurses at the First Teaching Hospital in Tianjin.  I found myself regaining sensation and movement.  Thoughts came clearer and my vision, which had bounced like a television with bad vertical hold, began to focus.  I learned that my doctors were not focusing only on my symptoms.  They were working toward improved function and overall medical outcome.  I got my life back!

That experience became the foundation for China Connection Global Healthcare, our company that today has served hundreds of clients seeking hope and health.  In just the past few months, we’ve helped families from Canada, England, Mauritius, South Korea, the Netherlands, and across the United States.   One of the great compliments we hear from all of them is how wonderfully patient and caring the doctors, nurses, aides, administrators, and even the cleaning staff are.  One patient commented that a highlight of his stay was a standing ovation from the housekeepers who stopped to encourage him as he was relearning how to walk.

One of the exciting differences in the hospitals in China Connection Global Healthcare’s Destination HealthCare Network™ is the abundance of nurses and experienced physicians.  They know and live the Chinese phrase “bing ren shi shang di”, which translates to a central focus on each patient.  The focus placed on each individual patient’s emotional and physical well-being by each of the members of the healthcare team is evident in all they do.  They know and practice the principle, that attitude is just as important in treatment as medication, surgery, massage or acupuncture.

This superior, compassionate delivery makes Destination HealthCare™ a source of renewed hope, health, and healing, along with its benefits of premier medical quality, accessibility and affordability.  Please contact us to ask how it can benefit you.

Ruth Lycke, President & CEO

The Importance of Access in Healthcare

Medical patients who look outside their home community for medical care do so for three basic reasons.  They are looking for access to care, affordability, and outstanding care.  These same factors form the three-legged foundation of Destination HealthCare™.  Access to quality medical care is a critical concern for people around the globe.

Access takes two primary forms, being able to see outstanding doctors and being able to secure the best possible treatments for a particular injury or disease.  For centuries, people have traveled to get the care they needed.  Records about the spas in Bath, England date back to about 75BC.  At the turn of the 20th Century, Colorado was home to thousands of medical travelers who found relief in the many TB facilities located there.

Any discussion of destination healthcare today necessarily includes its relationship to the more broadly used reference “medical tourism.”  Medical tourism is a term coined by the media to describe the practice of travelling outside one’s own country for medical care.  Today, it’s being used by a myriad of people to described the practice of traveling to some exotic location for medical care with a luxury vacation thrown in.  It’s been accompanied by promises of stays in luxury hotels, with some companies even going so far as to talk about “recuperation resorts”, “surgical safaris”, and “cancer cabanas”.  The latter, frankly, gives a laugh as I envision my nurse/server bringing my IV topped with a fruit slice and a tropical flower.

Destination healthcare is medical tourism’s more serious relative, as seen in China Connection Global Healthcare’s focus.  We are a healthcare company whose sole objective is to bring you to the medical care you need, from outstanding doctors, nurses and hospitals, when you need it, and at prices that won’t empty your bank account.  According to a recent study, 94% of Americans are afraid that a major medical incident will result in a personal financial crisis, even with their health insurance.  Some care isn’t available because those who need it don’t have the ability to receive breakthrough new treatments where they are.  Destination healthcare can go a long way to addressing those concerns.

In some countries, access concerns arise because wait times to see a physician can easily reach four to six months.  According to a study by the Fraser Institute, the average wait in Canada between a primary doctor referral to a specialist and the appointment is 18 weeks.  With CCGH’s Destination HealthCare™ solutions, wait times are reduced to whatever time is required for travel.  Your physician will be ready to receive you on arrival.

Access for others can mean the opportunity to receive life changing care that is not available where the patient lives.  Access to care that can bring healing is the difference between robust, active living and merely existing.    CCGH clients come from nations around the globe because they know the benefits of Integrated Medicine, a combination of Western and Traditional Chinese Medicine, in the treatment of difficult conditions like stroke, brain injury and neurological diseases.  We’ve seen amazing recoveries from seizure disorders after care provided by Destination HealthCare™ providers who treat more seizure-related conditions than any other nation in the world.  As this is being written, our COO’s niece is finishing stem cell therapy, treatment not yet available in the United States.

Surgeons at TEDA Intl. Cardiovascular Hospital

In America, we want to believe that our medical care is the best in the world, and who can fault that desire.  Great medical care is not, however, exclusively an American product.   Nations from around the world have made and contine to make important contributions to medicine.  Remember, the first human heart transplant was in South Africa, the MRI was invented in the United Kingdom, and much of the world’s flu vaccine is manufactured by European companies.  The World Health Organization and the Wall Street Journal each cite TEDA International Cardiovascular Hospital, a member of CCGH’s Destination HealthCare Network™, as one of the top cardiology hospitals in the world.  Ease of global travel makes essential care more accessible than ever before.

Destination HealthCare™ offers solutions to access issues for people around the world.  With an exclusively contracted network of world-class doctors and hospitals, CCGH has helped hundreds of families find access to the medical care they need.  We’d love to help you too.

Christmas Greetings From China Connection Global Healthcare

"The earth may grow old with its burden of care, but at Christmas it is always young." - Adapted from Phillips Brooks

And the angel said unto them, “Fear not!
For, behold, I bring you tidings of great joy, which shall be to all people.
For unto you is born this day in the city of David
A Savior, which is Christ the Lord.” – St. Luke

 

Christmas is a time of joy and charity. 
On this Christmas,
May you be rich in both.

 

From all of us at
China Connection Global Healthcare

9000 Needles

If you have experienced a stroke or know someone who has, here’s a must see new film.

9000 Needles, an award winning, new film from Bigfoot Entertainment, One In A Row Films and co-executive producers Stephen Nemeth and John Cusack, recountsthe story of stroke survivor Devin Dearth and what for many is a somewhat unconventional road to recovery.   The film premiered two weeks ago at the Louisville International Film Festival, where it was runner up in the prestigious Audience Award category.   It premiered last week in Los Angeles and appears Sunday, October 17 at The Other Venice Film Festival in Venice, CA.   You can view the trailer through its Facebook fan page at: http://tinyurl.com/yl7zo5s

Stroke affects more than 700,000 people in the US alone each year and is the leading cause of disability in the US.  Stroke recovery and rehab costs can exceed $100,000, so the course of treatment is often limited by health insurance coverage.  Like Devin, many are left to fend for themselves after being told benefits are exhausted or they have gained as much as they need to live somewhat independently for the remainder of their lives.  As Devin and his family learn, there are other options.

In concert with the producers, we can make the film available for private, corporate and community group screenings across the country.  For more information, contact the producers through their Facebook fan page or China Connection Global Healthcare.

Don’t miss this opportunity to share a new hope of recovery for those who can realize it.  Please share this with anyone you know who can benefit.

Destination Healthcare – Part III: If it’s that good, why isn’t everyone doing it?

The first two blogs in this series have generated lots of discussion.  Since Destination HealthCare™, or medical tourism as some call it, remains relatively new to most people, it’s natural for there to be important questions begging to be answered.  A friend recently asked the big picture question, “If destination healthcare is that good, why isn’t everyone doing it?”  The answer surprised him, and it might surprise you too.

In the US, we make destination healthcare decisions all the time, though we rarely call them that.  Destination healthcare is based on the act of traveling outside your home community for accessible, affordable, high quality medical care.  There are excellent medical facilities that attract patients from around the country, including the Mayo Clinic, Cleveland Clinic, MD Anderson Cancer Center, and many more.  While living near Florida’s Atlantic coast, I visited a doctor in Orlando, about a 45 minute drive away, because I could schedule an appointment more quickly than with the local specialist.  A colleague, who this week became a father for the first time, moved across town to be nearer his wife’s doctor and preferred hospital.  Each of these are examples of destination healthcare decisions we make regularly.  With average wait times to see a specialist now exceeding three weeks and out of pocket medical costs for families rising to over $3500 annually, we are making these decisions more frequently than ever before.

His next question went to the heart of the matter, what about international destinations?  Here, the answer holds the same principles:  accessible, affordable, premier quality medical care.  The key difference is in the destination.

Estimates are that over 3/4 million Americans received medical care outside the United States last year, a number that continues to rise rapidly.  Medical procedures cover the full gamut from dental care to heart surgery.  China, Germany, and a few other nations are ahead of the US in stem cell research and treatment, and we are seeing increasing numbers of patients going abroad for these treatments.  The Wu Stem Cell Medical Center in Beijing is one of the top treatment facilities in the world today and provides care for international patients daily.  The TEDA International Cardiovascular Hospital is recognized for excellence by the World Health Organization.  With a greater emphasis on outcomes over billed procedures, reduced hospital infection rates, access to premier doctors without extended waits, VIP attention to international patients, and the best in hospitals, international destination healthcare has become an integral part of the global marketplace.

Now more curious, my friend then asked, “So, why aren’t businesses covering destination healthcare in their benefit plans?”  More than any other factor, the answer is because destination healthcare is a new concept for many business executives and small business owners.  The American Medical Association and American College of Surgeons issued policy statements earlier this year, a growing recognition of destination healthcare benefits for individuals and businesses.

For business executives and owners, the increasing costs of health insurance place a serious strain on budgets.  A health plan that cost $800 per employee per month in 2001 now exceeds $1900.  Destination HealthCare™ can slow that growth by reducing the underlying cost of medical claims.  In a recent client evaluation, we found that savings could exceed $1.7 million per 100 cases.  Looking at a single process, stroke rehab expenses can easily exceed $90,000 in the US and patients are frequently on a timetable for recovery, after which coverage ends or is significantly limited. China Connection Global Healthcare is able to deliver stroke rehab and therapy for just over $20,000 with a focus on recovery instead of the number of days consumed.  These kinds of savings can go directly to relieving the financial pressures of rising insurance costs.  You can learn more about the savings at www.chinaconnection.cc/procedures.html.

Easily accessible, premier medical care at affordable costs for individuals and businesses; it is that good and more people are discovering it.  We’d love to help you learn more and become one of them.