Disintermediation in medical tourism through blockchain technology: an analysis using value-focused thinking approach

Abstract

Medical tourism (MT) is a promising industry that has shown significant growth in the past few decades. Patients often travel abroad to seek treatment, conventional and otherwise due to a myriad of reasons. The reasons include but are not limited to rising costs in their home country, experimental treatments only available abroad or better standards of care. However, MT has also created room for intermediaries to grow. These intermediaries are known as medical tourism facilitators (MTF), and as the name suggests, they provide patients services to make their experience easier and more convenient. MTFs often under deliver on their claims to the detriment of the patient. Given the varying legal jurisdiction, the sensitive nature of the healthcare process, and the arduous process of seeking and claiming settlements, most medical tourists are unlikely to pursue cases where they have been cheated. To understand the system of MT and the key issues faced by stakeholders, we used Value Focussed Thinking (VFT). VFT assists to arrive at the fundamental objectives that need to be addressed for mitigating these problems of MT. Based on the findings of VFT; we present a linkage or equivalence between the fundamental objectives for mitigating the problems of MT through Blockchain Technology. We present our findings on how Blockchain Technology can assist to increase disintermediation, transparency, and trust by bringing in aspects of optimizing time and efforts; optimizing expense required to settle disputes, automating disbursement of payments and enforcing mutually accepted agreements among other benefits.

This is a preview of subscription content, log in to check access.

Fig. 1
Fig. 2
Fig. 3
Fig. 4
Fig. 5

References

  1. Abe R et al (2018) Storage protocol for securing blockchain transparency. In: 2018 IEEE 42nd annual computer software and applications conference (COMPSAC), pp 577–581. https://doi.org/10.1109/COMPSAC.2018.10298.

  2. de Arellano ABR (2007) Patients without borders: the emergence of medical tourism. Int J Health Serv 37(1):193–198. https://doi.org/10.2190/4857-468G-2325-47UU

    Article  Google Scholar 

  3. Arya V et al (2019) A blockchain framework for proptech: success model through disintermediation and self-regulation | SpringerLink. In: Intelligent computing, information and control systems. https://doi.org/10.1007/978-3-030-30465-2_58.

    Google Scholar 

  4. Azaria A et al (2016) Medrec: using blockchain for medical data access and permission management. In: 2016 2nd international conference on open and big data (OBD). IEEE, pp 25–30

  5. Bach LM et al (2018) Comparative analysis of blockchain consensus algorithms. In: 2018 41st International convention on information and communication technology, electronics and microelectronics (MIPRO), pp 1545–1550. https://doi.org/10.23919/MIPRO.2018.8400278.

  6. Balaban V, Marano C (2010) Medical tourism research: a systematic review. Int J Infect Dis 14:e135. https://doi.org/10.1016/j.ijid.2010.02.1784

    Article  Google Scholar 

  7. Baliga A (2017) Understanding blockchain consensus models. In: Persistent

  8. Baliga A (2019) Understanding blockchain consensus models. Persistent Whitepaper. https://www.google.com/search?q=Baliga%2C+A.+(2017%2C+April).+Understanding+Blockchain+Consensus+Models.+Persistent+Whitepaper&rlz=1C1CHBF_enUS718US718&oq=Baliga%2C+A.+(2017%2C+April).+Understanding+Blockchain+Consensus+Models.+Persistent+Whitepaper&aqs=chrome..69i57.441j0j9&sourceid=chrome&ie=UTF-8, last accessed 08 Apr 2019

  9. Beck R et al (2016) Blockchain–the gateway to trust-free cryptographic transactions. ECIS 2016 Proc, pp 1–15

  10. Beladi H et al (2019) Does medical tourism promote economic growth? A cross-country analysis. J Travel Res 58(1):121–135. https://doi.org/10.1177/0047287517735909

    Article  Google Scholar 

  11. Bramstedt KA, Xu J (2007) Checklist: passport, plane ticket, organ transplant. Am J Transpl 7(7):1698–1701

    Article  Google Scholar 

  12. Burkett L (2007) Medical tourism. Concerns, benefits, and the American legal perspective. J Leg Med 28(2):223–245. https://doi.org/10.1080/01947640701357763

    Article  Google Scholar 

  13. Burns LR (2015) Medical tourism opportunities and challenges: illustration from US–India trade. Int J Healthc Manag 8(1):15–26

    Article  Google Scholar 

  14. Cai W et al (2018) Decentralized applications: the blockchain-empowered software system. IEEE Access 6:53019–53033. https://doi.org/10.1109/ACCESS.2018.2870644

    Article  Google Scholar 

  15. Calvaresi D et al (2019) Trust in tourism via blockchain technology: results from a systematic review. In: Information and communication technologies in tourism 2019. Springer, pp 304–317

  16. Carrera PM, Bridges JF (2006) Globalization and healthcare: understanding health and medical tourism. Expert Rev Pharmacoecon Outcomes Res 6(4):447–454. https://doi.org/10.1586/14737167.6.4.447

    Article  Google Scholar 

  17. Chen R-Y (2018) A traceability chain algorithm for artificial neural networks using T-S fuzzy cognitive maps in blockchain. Future Gener Comput Syst 80:198–210

    Article  Google Scholar 

  18. Christidis K, Devetsikiotis M (2016) Blockchains and smart contracts for the internet of things. IEEE Access 4:2292–2303. https://doi.org/10.1109/ACCESS.2016.2566339

    Article  Google Scholar 

  19. Cong LW, He Z (2019) Blockchain disruption and smart contracts. Rev Financ Stud 32(5):1754–1797

    Article  Google Scholar 

  20. Connell J (2006) Medical tourism: Sea, sun, sand and … surgery. Tour Manag 27:1093–1100. https://doi.org/10.1016/j.tourman.2005.11.005

    Article  Google Scholar 

  21. Connell J (2013) Contemporary medical tourism: Conceptualisation, culture and commodification. Tour Manag 34:1–13

    Article  Google Scholar 

  22. Crooks VA et al (2011) Promoting medical tourism to India: messages, images, and the marketing of international patient travel. Soc Sci Med 72(5):726–732. https://doi.org/10.1016/j.socscimed.2010.12.022

    Article  Google Scholar 

  23. Crosby M et al (2016) Blockchain technology: beyond bitcoin. Appl Innov 2(6–10):71

    Google Scholar 

  24. Datta A (2019) Blockchain in the government technology fabric. arXiv:190508517

  25. Dhillon G, Torkzadeh G (2001) Value-focused assessment of information system security in organizations. Inf Syst J 16:293–314. https://doi.org/10.1111/j.1365-2575.2006.00219.x

    Article  Google Scholar 

  26. Dhillon G et al (2016) Defining objectives for securing the internet of things: a value-focused thinking approach

  27. Dorri A et al (2017) Blockchain for IoT security and privacy: the case study of a smart home. In: 2017 IEEE international conference on pervasive computing and communications workshops (PerCom Workshops). IEEE, pp 618–623

  28. Eggertson L (2006) Wait-list weary Canadians seek treatment abroad. Can Med Assoc J 174(9):1247. https://doi.org/10.1503/cmaj.060219

    Article  Google Scholar 

  29. Ehrbeck T et al (2008) Mapping the market for medical travel

  30. Fearne A et al (2012) Dimensions of sustainable value chains: implications for value chain analysis. Supply Chain Manag Int J 17(6):575–581

    Article  Google Scholar 

  31. Feng H et al (2020) Applying blockchain technology to improve agri-food traceability: a review of development methods, benefits and challenges. J Clean Prod, 121031

    Article  Google Scholar 

  32. Ferrer M, Medhekar A (2017) The factors impacting on the management of global medical tourism service supply chain. GSTF J Bus Rev GBR 2:2

    Google Scholar 

  33. Galvin D (2017) IBM and Walmart: blockchain for food safety. PowerPoint Present

  34. Gan LL, Frederick JR (2011) Medical tourism facilitators: Patterns of service differentiation. J Vacat Mark 17(3):165–183. https://doi.org/10.1177/1356766711409181

    Article  Google Scholar 

  35. García-Altés A (2005) The development of health tourism services. Ann Tour Res 32(1):262–266

    Article  Google Scholar 

  36. Griggs KN et al (2018) Healthcare blockchain system using smart contracts for secure automated remote patient monitoring. J Med Syst 42(7):130

    Article  Google Scholar 

  37. Haber S, Stornetta WS (1991) How to time-stamp a digital document. In: Menezes AJ, Vanstone SA (eds) Advances in cryptology-CRYPTO’ 90. Springer, Berlin, pp 437–455

    Google Scholar 

  38. Hall CM (2011) Health and medical tourism: a kill or cure for global public health? Tour Rev 66(1/2):4–15. https://doi.org/10.1108/16605371111127198

    Article  Google Scholar 

  39. Heung VCS et al (2010) A conceptual model of medical tourism: implications for future research. J Travel Tour Mark 27(3):236–251. https://doi.org/10.1080/10548401003744677

    Article  Google Scholar 

  40. Hopkins L et al (2010) Medical tourism today: what is the state of existing knowledge? J Public Health Policy 31(2):185–198. https://doi.org/10.1057/jphp.2010.10

    Article  Google Scholar 

  41. Hossain MM et al (2018) Probe-IoT: A public digital ledger based forensic investigation framework for IoT. In: INFOCOM workshops, pp 1–2

  42. Hughes L et al (2019) Blockchain research, practice and policy: applications, benefits, limitations, emerging research themes and research agenda. Int J Inf Manag 49:114–129

    Article  Google Scholar 

  43. Hussein AF et al (2018) A medical records managing and securing blockchain based system supported by a genetic algorithm and discrete wavelet transform. Cogn Syst Res 52:1–11

    Article  Google Scholar 

  44. IMTJ (2019) IMTJ: 16-point agenda to position India as a preferred medical tourism destination | IMTJ. https://www.imtj.com/news/16-point-agenda-position-india-preferred-medical-tourism-destination/, last accessed 16 Nov 2019

  45. Keckley PH, Underwood HR (2008) Medical tourism: consumers in search of value. Wash. Deloitte Cent Health Solut, Washington

    Google Scholar 

  46. Keeney (1992a) Value-focused thinking: a path to creative decision making. Harvard University, Cambridge

  47. Keeney M (1992b) Value-focused thinking about strategic decisions at BC hydro. Inf J Appl Anal 22(6):94–109. https://doi.org/10.1287/inte.22.6.94

    Article  Google Scholar 

  48. Keeney (1993) Creativity in MS/OR: value-focused thinking—creativity directed toward decision making. Inf J Appl Anal 23(3):62–67. https://doi.org/10.1287/inte.23.3.62

    Article  Google Scholar 

  49. Keeney (1994) Creativity in decision making with value-focussed thinking. Sloan Manag Rev 35(4):33

  50. Keeney (1999) The value of Internet commerce to the customer. Manag Sci 45(4):533–542

  51. Kennedy ZC et al (2017) Enhanced anti-counterfeiting measures for additive manufacturing: coupling lanthanide nanomaterial chemical signatures with blockchain technology. J Mater Chem C 5(37):9570–9578

    Article  Google Scholar 

  52. Korcok M (1997) Excess demand meets excess supply as referral companies link Canadian patients, US hospitals. CMAJ 157(6):767–770

    Google Scholar 

  53. Kramer MR, Porter M (2011) Creating shared value. Harv Bus Rev 89(1/2):62–77

    Google Scholar 

  54. Kshetri N, Voas J (2018) Blockchain in developing countries. IT Prof 20(2):11–14. https://doi.org/10.1109/MITP.2018.021921645

    Article  Google Scholar 

  55. Kuo T-T, Ohno-Machado L (2018) Modelchain: decentralized privacy-preserving healthcare predictive modeling framework on private blockchain networks. arXiv:180201746

  56. Lee HK, Fernando Y (2015) The antecedents and outcomes of the medical tourism supply chain. Tour Manag 46:148–157. https://doi.org/10.1016/j.tourman.2014.06.014

    Article  Google Scholar 

  57. Lin I-C, Liao T-C (2017) A survey of blockchain security issues and challenges. IJ Netw Secur 19(5):653–659

    Google Scholar 

  58. Lone AH, Mir RN (2019) Forensic-chain: blockchain based digital forensics chain of custody with PoC in Hyperledger Composer. Digit Investig 28:44–55

    Article  Google Scholar 

  59. MacReady N (2007) Developing countries court medical tourists. Lancet 369(9576):1849–1850. https://doi.org/10.1016/S0140-6736(07)60833-2

    Article  Google Scholar 

  60. Mamoshina P et al (2018) Converging blockchain and next-generation artificial intelligence technologies to decentralize and accelerate biomedical research and healthcare. Oncotarget 9(5):5665

    Article  Google Scholar 

  61. Mamun MZ, Andaleeb SS (2013) Prospects and problems of medical tourism in Bangladesh. Int J Health Serv 43(1):123–141. https://doi.org/10.2190/HS.43.1.i

    Article  Google Scholar 

  62. Marlowe J, Sullivan P (2007) Medical tourism: The ultimate outsourcing. Hum Resour Plan 30:8–10

    Google Scholar 

  63. Martínez Álvarez M et al (2011) The potential for bi-lateral agreements in medical tourism: a qualitative study of stakeholder perspectives from the UK and India. Glob Health 7(1):11. https://doi.org/10.1186/1744-8603-7-11

    Article  Google Scholar 

  64. Mashamba-Thompson TP, Crayton ED (2020) Blockchain and artificial intelligence technology for novel coronavirus disease-19 self-testing. Multidisciplinary Digital Publishing Institute

  65. Mattila J (2016) The blockchain phenomenon. Berkeley Roundtable Int. Econ. BRIE. 2016-1

  66. Medhekar A (2014) Government policy initiatives for developing sustainable medical tourism industry. GSTF J Bus Rev GBR 3:3

    Article  Google Scholar 

  67. Medical Tourism Magazine (2019) Medical tourism industry valued at $100B poised for 25% year-over-year growth by 2025, https://www.medicaltourismmag.com/article/medical-tourism-industry-valued-at-439b-poised-for-25-year-over-year-growth-by-2025, last accessed 04 July 2019

  68. Mehrwald P et al (2019) Blockchain technology application in the sharing economy: a proposed model of effects on trust and intermediation. In: Proceedings of the 52nd Hawaii international conference on system sciences

  69. Mettler, M.: Blockchain technology in healthcare: The revolution starts here. In: 2016 IEEE 18th international conference on e-health networking, applications and services (Healthcom). IEEE, pp 1–3

  70. Milstein A, Smith M (2006) America’s new refugees—seeking affordable surgery offshore. N Engl J Med 355:1637–1640. https://doi.org/10.1056/NEJMp068190

    Article  Google Scholar 

  71. Mingxiao D et al (2017) A review on consensus algorithm of blockchain. In: 2017 IEEE international conference on systems, man, and cybernetics (SMC), pp 2567–2572. https://doi.org/10.1109/SMC.2017.8123011

  72. Ministry of Tourism, Government of India (2019) Revised guidelines for the promotion of wellness and medical as niche tourism products | Ministry of Tourism. https://tourism.gov.in/revised-guidelines-promotion-wellness-and-medical-niche-tourism-products, last accessed 16 Nov 2019

  73. Moghavvemi S et al (2017) Connecting with prospective medical tourists online: a cross-sectional analysis of private hospital websites promoting medical tourism in India, Malaysia and Thailand. Tour Manag 58:154–163

    Article  Google Scholar 

  74. Morais DC et al (2013) Using value-focused thinking in Brazil. Pesqui Oper 33(1):73–88

    Article  Google Scholar 

  75. Mudur G (2003) India plans to expand private sector in healthcare review. BMJ 326(7388):520

    Article  Google Scholar 

  76. Nakamoto S (2008) Bitcoin: a peer-to-peer electronic cash system. https://bitcoin.org/bitcoin.pdf

  77. Nguyen QK (2016) Blockchain-a financial technology for future sustainable development. In: 2016 3rd International conference on green technology and sustainable development (GTSD). IEEE, pp 51–54

  78. Olnes S et al (2017) Blockchain in government: benefits and implications of distributed ledger technology for information sharing. Elsevier, Amsterdam

    Google Scholar 

  79. Onder I, Treiblmaier H (2018) Blockchain and tourism: three research propositions. Ann Tour Res 72(C):180–182

    Article  Google Scholar 

  80. Park J, Park J (2017) Blockchain security in cloud computing: use cases, challenges, and solutions. Symmetry 9(8):164

    Article  Google Scholar 

  81. Patel V (2019) A framework for secure and decentralized sharing of medical imaging data via blockchain consensus. Health Inform J 25:1398–1411

    Article  Google Scholar 

  82. Patients Beyond Borders (2019) Medical tourism statistics and facts. https://patientsbeyondborders.com/medical-tourism-statistics-facts, last accessed 09 June 2019

  83. Penney K et al (2011) Risk communication and informed consent in the medical tourism industry: a thematic content analysis of Canadian broker websites. BMC Med Ethics 12(1):17

    Article  Google Scholar 

  84. Peterson M (2018) Blockchain and the future of financial services. J Wealth Manag 21(1):124–131. https://doi.org/10.3905/jwm.2018.21.1.124

    Article  Google Scholar 

  85. Pilkington M (2017) Can blockchain technology help promote new tourism destinations? The example of medical tourism in Moldova. Ex. Med. Tour. Mold. June 11 2017

  86. Porter ME (1985) Competitive advantage: creating and sustaining superior performance. Free Press, New York

    Google Scholar 

  87. Price Water House Coopers (2019) Blockchain is here. What’s your next move?. https://www.pwc.com/gx/en/issues/blockchain/blockchain-in-business.html, last accessed 06 June 2019

  88. Rayport JF, Sviokla JJ (1995) Exploiting the virtual value chain. Harv Bus Rev 73(6):75

    Google Scholar 

  89. Reddy S, Qadeer I (2010) Medical tourism in India: progress or predicament? Econ Polit Wkly 45:69–75

    Google Scholar 

  90. Selart M, Johansen ST (2011) Understanding the role of value-focused thinking in idea management. Creat Innov Manag 20(3):196–206

    Article  Google Scholar 

  91. Shank J, Govindarajan V (2004) Strategic cost management: the value chain perspective

  92. Shukla RG et al (2020) Blockchain-powered smart healthcare system. In: Handbook of research on blockchain technology. Elsevier, pp 245–270

  93. Shukla S et al (2018) Strategizing sustainability in e-commerce channels for additive manufacturing using value-focused thinking and fuzzy cognitive maps. Ind Manag Data Syst 118(2):390–411

    Article  Google Scholar 

  94. Simatupang TM et al (2017) The emergence of value chain thinking. Int J Value Chain Manag 8(1):40–57

    Article  Google Scholar 

  95. Smith M, Puczko L (2008) Health and wellness tourism. Routledge, London

    Google Scholar 

  96. Solomon H (2011) Affective journeys: the emotional structuring of medical tourism in India. Anthropol Med 18(1):105–118

    Article  Google Scholar 

  97. Swan M (2015) Blockchain: blueprint for a new economy. O’Reilly Media Inc., Sebastopol

    Google Scholar 

  98. Ting DSW et al (2020) Digital technology and COVID-19. Nat Med 26:459–461

    Article  Google Scholar 

  99. Transparency Market Research (2019) Medical tourism market—global industry analysis, size, share, growth, trends, and forecast 2017–2025. https://www.mrrse.com/medical-tourism, last accessed 26 June 2019

  100. Turner L (2007) First world health care at third world prices: globalization. Bioethics Med Tour Biosoc 2(3):303–325. https://doi.org/10.1017/S1745855207005765

    Article  Google Scholar 

  101. Unti JA (2009) Medical and surgical tourism: the new world of health care globalization and what it means for the practicing surgeon. Bull Am Coll Surg 94(4):18–25

    Google Scholar 

  102. Vukolić M (2017) Rethinking permissioned blockchains. In: Proceedings of the ACM workshop on blockchain, cryptocurrencies and contracts—BCC ’17. ACM Press, Abu Dhabi, pp 3–7. https://doi.org/10.1145/3055518.3055526.

  103. Whittaker A (2008) Pleasure and pain: medical travel in Asia. Glob Public Health 3(3):271–290. https://doi.org/10.1080/17441690701463936

    Article  Google Scholar 

  104. Yli-Huumo J et al (2016) Where is current research on blockchain technology?—a systematic review. PLoS ONE 11(10):e0163477

    Article  Google Scholar 

  105. Zambrano R et al (2018) Connecting refugees to aid through blockchain-enabled ID management: world food programme’s building blocks

  106. Zheng Z et al (2017) An overview of blockchain technology: architecture, consensus, and future trends. In: 2017 IEEE international congress on big data (BigData Congress), pp 557–564. https://doi.org/10.1109/BigDataCongress.2017.85.

Download references

Acknowledgements

We would also like to thank the various stakeholders who spoke to us and were extremely kind with their time. They were integral to the VFT aspect of our research methodology and we immensely value their contributions. We are also grateful to the anonymous reviewers for their constructive comments that helped us shape our article well.

Author information

Affiliations

Authors

Corresponding author

Correspondence to Shekhar Shukla.

Additional information

Publisher's Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Appendix

Appendix

Questions asked to stakeholders as part of VFT interviews

For patient

  • Why overseas?

  • Why India (any country)?

  • How important is good accommodation for the patient?

  • How important is good accommodation for companions?

  • Would you ignore other foibles in your travel if proper treatment is delivered?

  • How off the actual cost turned out to be from your initial estimation?

  • List down a few things that would make you not travel to a foreign country again, for medical treatment.

  • Was language barrier an issue? How major?

  • Rank these items with respect to essentiality in your travel: (rate each item out of 10)

    1. (a)

      Proper treatment

    2. (b)

      Trust for the medical personnel

    3. (c)

      Trust for other personnel

    4. (d)

      Food

    5. (e)

      Complete cost of treatment

    6. (f)

      Local travel

    7. (g)

      The clarity in interaction with medical personnel

    8. (h)

      Clarity in interaction with other personnel

    9. (i)

      Physical security

    10. (j)

      Accommodation

    11. (k)

      Local weather

    12. (l)

      Affordability of bringing along multiple companions

    13. (m)

      Availability of conventional tourist activities at the destination

  • Please mention any other factors positively/negatively affecting a patient’s experience. If possible, provide a rating of its impact out of 10

  • Did you have to go through any procedure that was not part of the initial package? How much did it inflate your final cost of treatment?

  • What would be a deal-breaker for you? (i.e. anything that would discourage you from availing treatment in a foreign country)

  • Was it important that your destination also serves as a tourist location? How important?

  • Is transparency in the procedure important?

  • What aspects, when improved, would result in a more transparent procedure?

  • Did a lower cost also lower the quality of your experience? If yes, which aspects exactly?

  • According to you, what changes can be made in the process that would make more patients opt for foreign treatments?

  • Would you return to this country for further treatment in this same procedure or a different procedure altogether?

For physicians/doctors/hospital or healthcare service providers denoted as medical providers in our research:

  1. 1.

    How many medical tourists have you treated?

  2. 2.

    In your opinion is medical tourism beneficial to the MTs

  3. 3.

    In your opinion is the process transparent enough

  4. 4.

    How do patients reach you?

  5. 5.

    The average cost for medical tourist?

  6. 6.

    How off the actual cost turned out to be from your initial estimation? For her patients.

  7. 7.

    Every year, is the trend increasing?

  8. 8.

    Sourcing medical history

  9. 9.

    Follow up treatment—who is responsible

  10. 10.

    What can be done to promote medical tourism?

  11. 11.

    Barriers in communication?

  12. 12.

    Have you ever dealt with MTFs?

  13. 13.

    Do you think MTFs act ethically?

  14. 14.

    Have you ever recommended treatment for patients for which they need to travel?

  15. 15.

    Do MTs complain about conditions in the destination country

  16. 16.

    Would you prefer a system that dispensed payment for patients as they went?

  17. 17.

    Would you prefer a system that makes stakeholders accountable?

  18. 18.

    Would you prefer a system that guarantees the integrity of medical records of an overseas patient?

  19. 19.

    Does she charge more to foreign patients?

  20. 20.

    Difference in cost?

For MFT

  1. 1.

    What countries do patients mostly come from?

  2. 2.

    Are the procedures opted by them emergency treatments or elective / non-emergency?

  3. 3.

    From an agent’s perspective, it is important that patients receive a detailed and fully transparent account of the transactions involved in the procedures?

  4. 4.

    According to you, is there a need to make the current system more transparent to the patients and other stakeholders involved?

  5. 5.

    What aspects of the system can be improved to increase levels of transparency?

  6. 6.

    From your experience, what are some deal-breakers for patients? (i.e. anything that discourages patients from pursuing the treatment)?

  7. 7.

    Can you list down all things that act as incentives for patients to pursue foreign medical treatment?

  8. 8.

    From your experience, rate these items in terms of essentiality in a patient’s travel: (rate on a scale of 10)

    • Proper treatment

    • Trust for the medical personnel

    • Trust for other personnel

    • Food

    • Complete cost of treatment

    • Local Travel

    • The clarity in interaction with medical personnel

    • Clarity in interaction with other personnel

    • Physical security

    • Accommodation

    • Local weather

    • Affordability of bringing along multiple companions

    • Availability of conventional tourist activities at the destination

  9. 8.

    Please mention any other factors positively/negatively affecting a patient’s experience. If possible, provide a rating of its impact out of 10.

  10. 9.

    Are patients willing to ignore other foibles in their travel if proper treatment is delivered?

  11. 10.

    Is it important that the destination also served as a tourist location for the patients? How important?

  12. 11.

    Are there different options/plans available for patients in cost terms? How do these different plans differ in terms of services provided?

  13. 12.

    Describe the distribution of patients opting for these different plans (are there more patients opting for the cheaper plans? or is the distribution uniform?)

  14. 13.

    Do the patients complain about the conditions in the destination country?

  15. 14.

    According to you, do patients leave the country satisfied and willing to return if treatment is required again?

  16. 15.

    According to you, what changes can be made in the process that would make more patients opt for foreign treatments?

Rights and permissions

Reprints and Permissions

About this article

Verify currency and authenticity via CrossMark

Cite this article

Parekh, J., Jaffer, A., Bhanushali, U. et al. Disintermediation in medical tourism through blockchain technology: an analysis using value-focused thinking approach. Inf Technol Tourism (2020). https://doi.org/10.1007/s40558-020-00180-4

Download citation

Keywords

  • Blockchain
  • Medical tourism
  • Disintermediation
  • Value focussed thinking (VFT)
  • Healthcare