Global collaborative healthcare: assessing the resource requirements at a leading Academic Medical Center

Abstract

Introduction: Academic Medical Centers ("AMCs") have served as a hub of the United States ("US") health system and represented the state-of-the art in American health care for well over a century. Currently, the global healthcare market is both massive and expanding and is being altered by the unprecedented impact of technological advances and globalization. This provides AMCs a platform to enter into trans-national collaborative partnerships with healthcare organizations around the world, thus providing a means to deliver on its promise globally while also expanding and diversifying its resources. A number of leading US AMCs have engaged in global collaborative healthcare, employing different models based on services offered, global distribution, and inclination to assume risk. Engaging in these collaborations requires significant effort from across the health system, and an understanding of the resources required is paramount for effective delivery and to avoid overextension and diversion from the primary mission of these organizations. The goal of this paper is to discuss the role of US AMCs in this current global healthcare landscape and to also investigate our institutional faculty and staff resource requirements to support the operating model.

Methodology: We extracted and retrospectively analyzed data from the JHI Global Services database for a 3-year period (Jan, 2013-Dec, 2015) to determine total utilization (hours and full time equivalent (FTE)), utilization by profession, and clinical and non-clinical areas of expertise.

Results: JHI utilized on average 21,940 h annually, or 10.55 FTEs of faculty and staff subject matter experts. The majority of the hours are for work performed by physician faculty members from 23 departments within the School of Medicine, representing 77% percent or on average 16,894 h annually. Clinical and allied health departments had an average annual utilization of 17,642 h or 7.8 FTEs, while non-clinical departments, schools and institutes averaged 4298 h or 1.9 FTEs, representing 80.4% and 19.6% respectively.

Conclusion: We found that significant human resources are required within a broad range of AMC subject matter expertise across multiple disciplines, and that with adequate forecasting AMCs can successfully engage in these collaborations while continuing to fulfill their core mission.

Keywords: Global collaborative health; Globalization; Resource utilization academic medical centers.

Fig. 1

Depiction of Johns Hopkins Medicine International’s (JHI) structured collaborations which have increased in complexity over time

Fig. 2

The levels of engagement of United States (US) academic medical centers (AMC) in the global healthcare market. With increased involvement, there is increasing complexity and risk attached to these collaborations as well as return on investment (ROI)

Fig. 3

a Total faculty and staff utilization by calendar year (CY) for 2013–2015. b Percent effort based on areas by professional category

Fig. 4

a Annual utilization trends of clinical and allied health departments versus non-clinical departments, schools and institutes for 2013–2105. b Average annual percent effort clinical and allied health departments versus non-clinical departments, schools and institutes. c-d Break out of annual utilization of clinical and allied health department utilization (c) and non-clinical departments, schools and institutes (d) for 2013–2015

Fig. 5

a-b Annual faculty and staff utilization by region for 2013–2015 (a) and project type (b) for 2013–2015