Fontenelle Forest Nature Center

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2005-2008 Strategic Planning Retreat

Fontenelle Forest Nature Center Friday, March 25,
2005 730 a.m. 300 p.m.
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Staying Competitive in the Global Health Care
Market

Rubens J. Pamies, M.D., FACP Moderator
Mr. Nizar MandaniExecutive director
Mr. Joe B. Graham Chief Operating
Officer Nebraska Medical Center
Rodney S. Markin, M.D. Associate Dean, COM
Sheila Ryan, PhD Professor, CON-Parent-Child,
Admin Ed Science
Panelist
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Board of Directors
Dennis P. Andrulis, MPH, PhD Research Professor
Department of Preventive Medicine at the State
University of New York Health Science
Center/Brooklyn
Sheila A. Ryan, PhD, RN Professor University of
Nebraska Medical Center College of Nursing
Donald W. Fisher, PhD Chairman President and
CEO American Medical Group Association (AMGA)

Roger J. Bulger, MD Secretary President and CEO
Association of Academic Health Centers (AHC)
Daniel P. Bourque, MBA Senior Vice President,
System Operations VHA Inc.
Louis W. Sullivan, MD President-Emeritus Morehou
se School of Medicine
Larry S. Gage, JD Past Chairman President
National Association of Public Hospitals and
Health Systems (NAPH),and a partner at Powell,
Goldstein, Frazer Murphy, LLP
Henry A. Fernandez, JD Vice President and CEO
New York State Historical Association the
Farmers' Museum in Cooperstown
Alan Weinstein, MBA Consultant to healthcare
companies
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 International Health Medical Education
Consortium
Sara E. Pirtle, MBA Update Co-Editors Internation
al Studies and ProgramsUniversity of Nebraska
Medical Center985735 Nebraska Medical
CenterOmaha, NE  68198-5735 Tel [phone]
/ Fax [phone]sepirtle_at_unmc.edu
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GLOBAL INVOLVEMENT OF AHCs AHCs is Growing
Rapidly
Columbia Ben Gurion University
N.Y.U. Sackler
Cornell Quatar
Duke Singapore
Harvard Macy Institute Multiple countries including Germany
Dartmouth Copenhagen
Johns Hopkins Several Asian countries
University of Minnesota SON Central Asia Republic
Some recent examples include
And many more . . .
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GLOBAL HEALTH/PARTNERSHIP UNMC , NMC, UNeMed,
IMA
46 collaborative partnerships with medical
institutions in 25 countries
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Export Control Regulations
Commerce Department Export Administration
Regulation

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Next Steps in our global presence
Where are we now? Where do we want to be in the
future?

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STAYING COMPETITIVE IN THE GLOBAL HEALTH CARE
MARKET
Mr. Nizar G. Mamdani Executive Director of
International Healthcare Nebraska Medical Center
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GLOBAL HEALTHCARE REALITIES
1. The revolution in communications technologies
has raised our hopes that earth's current
patchwork of countries may yet become a true
global community. The growing globalization of
businesses and enterprises has already begun
2. One major arena that stands to gain the
greatest benefit from globalization is
healthcare 3. Key components of understanding
the dynamics of global health systems are
policy, financing, education, organization,
leadership, and management 4. Regardless of
the country, the health sector generally responds
to the same political, social and financial
pressures as other industries
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US GOVERNMENT POSITION

• The US Government, NIH, AHC, WHO, World Bank
  all deliver the same message that the Global
  Health Care is vital to the growth and stability
  of the countries and that the developed nation
  have a social and sometimes a selfish reason to
  help in the promotion of decent healthcare
• USAID Director Natsios speech in Spain this
  month reinforced USs committed 16 billion to
  country stabilization programs

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What Other US Medical Institutions Are Doing

• 1. Realizing the in inevitable progression and
  opportunities in the Global Healthcare Markets,
  most major medical institutions have substantial
  commitments to their international programs
• 2. Some institutions have also already taken
  their programs overseas in light of the post 9/11
  situation about visa in the US
• John Hopkins in Singapore, Thailand, Panama,
  China
• Harvard in India, United Arab Emirates, Japan
• Cornell in Qatar
• Emory University in India
• 3. GLOBAL-HEALTH is a reality today-UNMC needs
  to make a move now to secure a prominent position
  in this important market place and attain a
  long-term global presence

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Current Handling of International Initiatives at
UNMC

• 1. Several departments at UNMC are pursuing
  international
• activities in a variety of ways - there are no
  cohesive institutional policies or objectives
• 2. There is no ongoing sustainable follow up
• 3. Counter-productive to pursue international
  programs without adequate planning and follow up
• 4. International programs are discouraging
  because they take a longer time to mature - can
  only be effectively achieved through
  institutional commitment, persistence and support

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Take Advantage of International Assets at UNMC

• Partnerships with 76 medical institutions in 28
  countries
• Over 400 professional researchers/students from
  40 countries
• Provide training to 100s of international
  professionals
• Hundreds of international patients have come to
  the Medical Center for their treatments
• Have created a dynamic 2nd opinion consultation
  program, currently being utilized by over a dozen
  global institutions
• Have signed significant cooperative agreements
  with key institutions in Japan, India and China
  for educational and research initiatives
• Have people with great international contacts and
  network
• Proven viability - have generated millions of
  dollars for the Medical Center in patient
  billings

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Possible Areas of Global Opportunities for UNMC

• UNMC's Research program expansion in key
  countries
• Foster strong relationships for UNMC's Biotech
  initiatives/markets
• Promote UNMC CON's RN to BSN programs
  internationally
• Create a Telehealth Center of Excellence in
  collaboration with the Peter Kiewit Institute of
  Technology UNMC's Allied Health Dept.
• Take advantage of USAIDs new Country
  Stabilization programs, especially in Haiti,
  Somalia, Iraq and Afghanistan
• Take advantage of professionals on our campus who
  have very valuable relationships and networks to
  help us achieve our goals

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Benefits to UNMC

• Make UNMC's global presence a REALITY
• Research collaboration opportunities
• Initiate BioMed programs to enhance international
  reputation and revenue
• Strong international presence will enhance UNMCs
  reputation, help attract top researchers/professio
  nals to our institution
• 6. Establish UNMC's Educational and TeleMed
  Programs globally
• 7. Be a pioneer to take up the much needed
  standardization of the international medical
  education accreditation
• 8. Opportunities for UNMC faculty, physicians,
  healthcare professionals, researchers and
  students to experience medical diversities in
  other countries
• 9. Faculty and students exchange programs in over
  two dozen countries
• 10. Build professional and personal international
  relationships

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CONCLUSION

• Global healthcare has become a reality to reckon
  with
• UNMC has the assets and the stature to have a
  positive impact in the Healthcare Globalization
• Priority must be given to developing a viable
  infrastructure at UNMC that can follow through on
  international developments on a sustained basis
• Important to embark on a coherent program to
  fulfill the social needs of helping the less
  fortunate nations will also give us an
  opportunity to closely work with international
  NGOs and Federal programs
• The program will significantly raise UNMCs
  standing and reputation in the US and Global
  healthcare arena
• A well conceived international program will be
  self-sustaining, revenue generating and
  gratifying undertaking for UNMC

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Global and International Healthcare
Sheila Ryan, PhD Professor, CON-Parent-Child Admin
istration Education Science
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The Globalization Of Society Places Increasing
Demands On Us To

• Understand differing perspectives, traditions,
  religions, politics, cultures, health behaviors
  and health systems.

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NURSING, as the largest health workforce, is
essential to add value to global partnerships

• Collaborate with international research to
  promote health and well being and better manage
  chronic care for all
• Examine lessons of emerging and remerging threats
  to international health
• Reduce burden of disease and disability

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UNMC - CON asThe Global Leader in International
Nursing Education

• Leader in distance education
• Leader in instructional technology
• Leader in online course access
• Leader with international connections

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Mexico
China
Jordan
India
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Leader in Online Program Access

• RN-BSN
• BSN
• MSN
• 8 specialties, 2 with combined and integrated
  areas
• CE models

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Benefits to UNMC

• Increase cultural sensitivity of faculty/students
• Internationalize our curriculum
• Increase faculty and student exchanges
• Global classroom model for global outreach
• Add to research site and samples
• Multidisciplinary international doctoral program
• Additional international students to all programs

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Profitable and Cost-Effective Online
Tele-education

• By 2010
• Increase enrollment by 1500/year from five
  country
• New financial models Cost plus
• High Revenue Product with Low Cost Risk
• Partner with international societies and
  organizations

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Leading Infectious Causes of Death Worldwide,
2001
Cause Rank Estimated Number of Deaths
Respiratory infections 1 3,871,000
HIV/AIDS 2 2,866,000
Diarrheal diseases 3 2,001,000
Tuberculosis 4 1,644,000
Malaria 5 1,124,000
Measles 6 745,000
Periussis 7 285,000
Tetanus 8 282,000
Meningitis 9 173,000
Syphilis 10 167,000
SOURCE WHO, 2002b
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Global Partnerships of dialogue, collaboration
and shared planning can

• Decrease international nursing shortage
• Increase professional standards and stature of
  nursing
• Prepare nurse leaders for emerging healthcare
  roles

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International BusinessStrategic Fit
Mr. Joe B. Graham Chief Operating
Officer Nebraska Medical Center
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International Business Strategic Fit
How does it advance our mission For Education? Res
earch? Service? Outreach?
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• As positioned today
• International Business can advance the
• Mission(s) at the margin.
• If embraced more fully, it has the potential
• to be a separator in all of our missions.

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• However,
• it must produce
• cash.

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High
Winner
Cash Cow
Profit
Houdini
Keeper
Low
High
Mission
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High
Cash cow
Winner
Profit
Houdini
Keeper
Low
High
Mission
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High
Winner
Cash Cow
X
Profit
Houdini
Keeper
Low
High
Mission
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High
Good Risk
Calculated Risk
Profit or Mission
Bad Risk
Low Risk
Low
High
Risk (legal, distraction, etc.)
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High
Good Risk
Calculated Risk
Profit or Mission
Bad Risk
Low Risk
Low
High
Risk (legal, distraction, etc.)
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High
Calculated Risk
Good Risk
X
Profit
Low Risk
Bad Risk
Low
High
Risk (legal, distraction, etc)
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High
Mission
X
Low
High
Risk (legal, distraction, etc)
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• Requirements for Success
• Sound Plan
• Commitment
• Time / Patience
• Adaptability