Meeting the Challenges of Health Care Reform in Singapore: Asian American Medical Group Partners with UPMC to Deliver Quality Organ Transplantation

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1 Meeting the Challenges of Health Care Reform in Singapore: Asian American Medical Group Partners with UPMC to Deliver Quality Organ Transplantation THEORY IN ACTION

2 CONTENTS 1 Meeting the Challenges of Health Care Reform in Singapore 3 Challenges of a World-Renowned Health care System 4 Enhancing an Already Successful Operation 7 Accomplishing More Together 8 Sharing Best Practices and Building Opportunities around the World 10 Promises of Further Growth from a Steadfast Commitment to Asia 12 About UPMC We are delighted with the collaboration with UPMC, as are our patients, community and shareholders. The relationship already has exceeded our expectations. Dr. Tan Kai Chah, AAMG Executive Chairman

3 THEORY IN ACTION 1 Meeting the Challenges of Health Care Reform in Singapore: Asian American Medical Group Partners with UPMC to Deliver Quality Organ Transplantation A 1984 plan that allowed Singapore s hospitals more autonomy and patients greater choice resulted in a shift toward hospital privatization and greater demands to improve the quality of care for patients. Singapore-based Asian American Medical Group (AAMG), one of Asia s foremost liver centers dedicated to the treatment of liver and gastrointestinal diseases, engaged UPMC to help it meet this challenge. These two organizations collaborated to develop Asia s first private comprehensive transplant center to treat liver, kidney and bone marrow diseases; UPMC was also asked to provide clinical oversight, strategically promote the group s capabilities and ensure that it was delivering the best evidence-based medicine.

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5 THEORY IN ACTION 3 CHALLENGES OF A WORLD-RENOWNED HEALTH CARE SYSTEM The health care system in Singapore is often heralded as one the world s best. Bloomberg ranked it as number one in Most Efficient Health Care 2014: Countries. Towers Watson, a global consulting firm, called it one of the most successful health care systems in the world in terms of efficiency in financing and the results achieved in community health outcomes. For decades, Singapore has served as a high-quality medical hub for all of Southeast Asia. Singapore s success has been attributed in large part to a national health plan introduced by the country s Ministry of Health in Before implementation of the plan, medical care in the country was provided mainly by the public sector. Then, in the 1970s, Singapore experienced rapid increases in public health care costs; government officials also recognized growing problems of hospital efficiency. The Singapore government decided to restructure its health care delivery systems, allowing hospitals more autonomy and privatizing insurance. By giving individuals greater control and increasing personalized services for patients, both the quality of care and the efficiency of Singapore s health care system were significantly improved. However, with greater demands from patients, hospitals were challenged by increased competition for talent and labor; ever-increasing complexity and costs associated with advancing technology, equipment, treatment and training; and new requirements to establish independent standards of care and reliable processes to measure outcomes. In addition, neighboring countries once dependent on Singapore to serve large percentages of their patient populations began building comprehensive hospital systems of their own. To meet these challenges head-on, Singapore-based Asian American Medical Group (AAMG) reached out to best-inclass institutions around the world, including UPMC, to collaborate. UPMC was honored to be asked to partner with AAMG, whose innovative transplantation work and stellar reputation in Asia made it an attractive match, said Charles Bogosta, president of UPMC International Services.

6 4 UPMC ENHANCING AN ALREADY SUCCESSFUL OPERATION Formerly the Asian Centre for Liver Diseases and Transplantation (ACLDT), AAMG is one of Asia s foremost liver centers. Established in 1994, the Centre attracts about 8,000 patients annually from southern Asia, the Middle East and Russia; ninety percent of those admissions are international patients. Through the subsidiary Asian American Liver Centre (AALC), AAMG also serves as an important referral center for treatment of acute liver failure and liver transplants. some of the world s most noteworthy and pioneering work in the field, including the first split-liver transplant from a single donor to two recipients. Focused on delivering exceptional patient outcomes, Dr. Tan s team of highlyitrained specialists provides comprehensive care to patients with liver and gastrointestinal diseases. The team has performed more than 200 live donor liver transplants the first team in Southeast Asia to do so. AAMG is led by renowned hepatobiliary expert and liver transplant surgeon Dr. Tan Kai Chah (K. C. Tan), who has performed

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8 An incredible mutual respect and trust developed between the teams. We were able to have meaningful conversations about clinical outcomes, potential changes to practice approach and shared best practices. Cheryl Brill, UPMC Vice President of International Clinical Operations and Quality

9 THEORY IN ACTION 7 ACCOMPLISHING MORE TOGETHER Almost immediately, the collaboration began achieving important milestones. First, AAMG successfully established the Asian American Blood and Marrow Transplant Centre. The transplant program, which treated patients with leukemia, lymphoma, myeloma and other blood cancers and disorders, reported good outcomes from the start. The partnership also produced a second-opinion clinical diagnosis process and pathology program that allowed the medical teams in Singapore to share medical records and images including information for complex cases with UPMC physicians in Pittsburgh, PA, United States, and Palermo, Italy. Having the right diagnosis for complex blood cancers meant we were able to treat our patients with the right medicines. This improved outcomes and reduced complications, including helping patients avoid long stays in our ICUs, said Kang Hoe Lee, MD, pulmonologist and director of ICU for AAMG. These partnership successes led to additional collaborations on clinical and translational research projects, the adoption of more innovative surgical procedures and advanced nurse and physician education. Within two years, the AAMG-UPMC partnership had also resulted in implementation of a quality scorecard, benchmarking clinical outcomes for liver cancer transplant patients in AALC in Singapore and comparing them to UPMC s patient populations in Pittsburgh and Palermo. An incredible mutual respect and trust developed between the teams, explained Cheryl Brill, vice president of international clinical operations and quality at UPMC. We were able to have meaningful conversations about clinical outcomes, potential changes to practice approach and shared best practices, which enabled us to easily adapt to changing market conditions and demands for the best quality care possible.

10 8 UPMC SHARING BEST PRACTICES AND BUILDING OPPORTUNITIES AROUND THE WORLD Continuous learning and sharing best practices is core to UPMC s mission, and its work in Singapore was no exception. From the start of the collaboration, learning was taking place on both sides of the world. In terms of training, we were lacking doctors experienced in certain sophisticated treatments, like transplantation and oncology; expertise with procedures like robotic surgery; and nursing training, administration and management, Dr. Tan said. These were areas in which UPMC was very helpful. UPMC brought an excellent standard to all aspects of our work. I think we complemented each other very well, said Dr. Tan. Through our work with UPMC, we were able to bring a cancer center to Yangon, Myanmar, and establish a network of diagnostic centers with Russia. UPMC also enabled us to contract with best-in-class medical equipment suppliers, as well as third-party payers. On the other side of our relationship, UPMC wanted to further expand research and clinical development into Asia, Dr. Tan added. We offered our experience and relationships to UPMC as it continued to establish itself here. Additionally, the collaboration resulted in numerous business relationships and opportunities in Asia and Russia.

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12 10 UPMC PROMISES OF FURTHER GROWTH FROM A STEADFAST COMMITMENT TO ASIA Since entering into the collaboration, AAMG s partnership with UPMC remains strong. While the end-goal of enhancing the Centre and expanding its transplantation capabilities has remained constant, the teams have been able to adjust priorities to respond to the continually evolving health care market in Singapore. We are delighted with the collaboration with UPMC, as are our patients, community and shareholders. The relationship already has exceeded our expectations, Dr. Tan emphasized. UPMC brought the reputation, technology, equipment, clinical prowess and management leadership needed to help us elevate the Centre and distinguish ourselves in our markets. Through our collaboration and integration, we were pleased to be able to help AAMG expand its transplantation capabilities and deliver world-class health care truly focused on patients, Bogosta said. We are looking forward to continuing to work together to provide comprehensive care for patients where they live. Going forward, there is much more we plan to do, Dr. Tan said. We have no doubt that, as our partnership continues to get deeper, we will realize the vision of a comprehensive transplant center and have more and more measurable outcomes in Asia to talk about.

13 THEORY IN ACTION 11 UPMC brought the reputation, technology, equipment, clinical prowess and management leadership needed to help us elevate the Centre and distinguish ourselves in our markets. Dr. Tan Kai Chah, AAMG Executive Chairman

14 12 UPMC ABOUT UPMC UPMC s objective is to share our clinical, technological and managerial knowledge and expertise with partners around the world, customizing solutions so that patients and regions benefit and thrive. We believe everyone should have access to the best possible care, without having to leave their country or region. About Us UPMC, an academic medical center affiliated with the University of Pittsburgh, is a recognized leader in providing health care services in the United States and internationally. Through UPMC International Services, we are able to offer a full range of health consulting services. By collaborating with UPMC, our multi-disciplinary team can provide customized solutions, on-the-ground support and direct access to deep clinical expertise and operational knowledge. By working with UPMC to identify and implement customized solutions, our partners give patients in their area access to the best possible health care, become a magnet for patients from other regions and support growth of their local economies. You can learn more about the services we offer here: Our goal is to work side-by-side with our partners from start to finish, until we both agree that the work is done. We can assess needs, build the right hospital and infrastructure, provide education and design customized clinical programs. We can also work with our partners doctors and staff to ensure that entire team understands their roles in building and maintaining an excellent health care system.

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16 FOR MORE INFORMATION, PLEASE CONTACT: UPMC International Services UPMC