It has been just over three months since Cayman’s new 140-bed private hospital, Health City Cayman Islands, opened its doors to patients, the first stage in a multi-phased hospital complex or “city” that will eventually make it one of the largest in the world.
The brainchild of renowned cardiologist and philanthropist and former surgeon and physician to Mother Theresa, Dr. Devi Shetty, Health City Cayman Islands follows the hospital model established by its parent company, Narayana Health, in India, where Dr. Shetty currently oversees 18 hospitals in 14 cities across the subcontinent as its chairman.
At Health City Cayman Islands, the initial focus is the provision of cardiac surgery, cardiology and orthopedics. Hospital representatives say they have already made good progress in offering a variety of diagnostic and treatment services which would otherwise have necessitated patients making costly and time-consuming trips to the United States for similar healthcare services.
Dr. Chandy Abraham is Health City’s medical and facility director. He advises that doctors at Health City have performed a number of procedures relating to cardiology, in particular, all of which had never been undertaken in the Cayman Islands up until this point.
“We’ve been doing angiograms, which is more diagnostic. Then we have been doing stenting, which is angioplasty. We’ve also been doing rhythm disturbances or electrical conduction disturbances, called electrophysiology. Patients have been mainly local,” he says, “but we’ve had patients from overseas as well.”
If a patient from the Cayman Islands were to have to undertake such procedures in the U.S., Dr. Chandy says, they would probably have had to spend two days in hospital, not to mention the time spent traveling. In the Cayman Islands, they can be in and out in a day – and for far less cost.
Better patient outcomes
In addition, Health City is also fully equipped to handle cardiac emergencies 24 hours a day, seven days a week, which means heart attack patients do not have to wait for an air ambulance to take them to Miami for treatment.
“We have dealt with cardiac arrests, many of which have occurred late at night and early in the morning,” Dr. Chandy says. “We go in and revascularize the heart muscle [a variety of procedures following a heart attack that help reestablish blood flow to the heart muscle that is fed by a blocked or narrowed artery].”
Shomari Scott, Health City’s director of public relations, says that Dr. Ravi Kishore, the chief interventional cardiologist and electrophysiologist at Health City, has said that “time is muscle,” which means that the quicker a heart attack patient can be treated, the more muscle tissue that can be saved, thereby heightening the success of the patient outcome.
“The long-term outcome is based upon how much heart muscle can be saved, especially if there is a major block to the heart,” Dr. Chandy said.
Other surgeries they have begun to practice include cardiothoracic surgery involving coronary bypass grafting, and orthopedic surgery that covers joint replacement.
“There is a huge waiting list for joint replacements in the U.S. and Canada,” Dr. Chandy said, ”and the operations are very expensive. We can offer similar procedures at a much lower cost.”
Exploring new markets
While the majority of patients have been local, Scott anticipates that as Health City moves to six months to a year in operation, it will start to see an increase in the number of international patients.
In order to increase awareness of the facilities at Health City, Scott says they are working with target Caribbean countries to boost exposure.
“We actually have a few health ministers from Caribbean countries coming to view the facilities,” he said. “This is because our pricing is working out to about half of that in the United States, so this is a potential solution for Caribbean governments with large healthcare budgets, as well as their self-insured companies that are also taking a strong look at Health City.”
Obtaining a Joint Commission International accreditation is an important step in Health City’s bid to draw patients from the United States.
The Joint Commission, founded in 1951 and formerly known as the Joint Commission on Accreditation of Healthcare Organizations (JCAHO), is an independent, not-for-profit organization that evaluates and accredits more than 15,000 healthcare organizations in the United States. JCAHO’s Joint Commission International (JCI) was founded in the late 1990s to survey hospitals outside of the United States. JCI, which is also not-for- profit, currently accredits facilities in Asia, Europe, the Middle East and South America.
“The Narayana Group in India has two hospitals which are JCI accredited,” Dr. Chandy said. “The JC looks at procedures and policies which are standardized across the group, and they also look at how we monitor quality and how we record that quality. They also look at our compliance with local regulations.” Dr. Chandy said Health City cannot apply for its JCI accreditation until it has been in operation for at least six months because it needs to supply sufficient operational data to the accreditation body. Once they’ve made the application, Dr. Chandy says, it will take around three months for the Joint Commission to come and conduct the survey.
“You are looking at about nine months from now,” he said, adding that some people are not so worried about the accreditation.
“But it’s a sort of stamp that they can say to their patients the hospital is JCI accredited, which should lead to more referrals for us,” he said.
Marketing in the U.S. will take place before the accreditation process. At the time of writing, Dr. Chandy was preparing to make a presentation on Health City Cayman Islands to a large group in the U.S. that could well be an important source of new patients for the hospital.
All in the numbers
Reaching its maximum potential of patients is a crucial element of the Narayana Health model, which anticipates offering affordable healthcare with high quality based on the high volume of procedures undertaken.
Dr. Chandy says the facility anticipates reaching these critical levels in about a year, when it is at about 80 percent capacity. There is a potential then for costs to decrease even further. However, Dr. Chandy says they would need to take a thorough review beforehand.
“We are already quite low in comparison to American prices for healthcare at just under 50 percent of U.S. prices,” Dr. Chandy says. “And that’s without their additional fees, so we are probably even less than 50 percent.”
“The pricing structure here is all inclusive, one low price, whereas the hospital fees in the U.S. may not necessarily include anesthesia, physician and other add-on fees,” Scott said.
Meeting patient expectations
Those patients who have already undertaken procedures at Health City report that they were highly impressed by the level of care they received, Scott says.
“They were talking about Health City on a radio station the other day and one local patient who had been treated for a heart attack said he felt compelled to call in and say how well he had been treated at Health City, stating that the high level of care equated to that of a spa.”
Meanwhile, Dr. Chandy said it’s important for the hospital staff to take periodic reviews of where they stand, before they move forward.
“Our big thing now is to consolidate what we have and then look at the next few services lines that we can offer,” Dr. Chandy says. “Consolidation is a big thing. It’s dangerous to move ahead without consolidating what you already have.”