Health Tourism

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Health Tourism in Kayseri the RegionIBM
Corporate Service CorpsTurkey Team 6
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Table of Contents

• Project Objectives
• Executive Summary
• Approach consulting methodology
• Findings and action plan for the development of
  health tourism sector in Kayseri and the region
• What is health tourism?
• Global consumer behavior and market trends in
  health tourism
• Findings and Hypothesis
• Recommendations
• Action Plan
• Communications and Marketing Strategy for
  Promotion of Kayseri Tourism
• Web Portal
• Questions Answers

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Project Objectives

• Findings and action plan for the development of
  health tourism sector in Kayseri and the region
• Planning for the Development of Health Tourism in
  Kayseri and the Region which is under the
  responsibility of ORAN Development Agency
• Creation of an Action Plan for the Health Tourism
  Development Strategy to be implemented by the
  ORAN Development Agency and other stakeholders
• Communications and Marketing Strategy for
  Promotion of Kayseri Tourism
• High level framework for health tourism web
  portal

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Caveats

• This study does not include
• Analysis on international insurance and legal
  aspects, due to lack of data, and
• Health records management, identified as a
  challenge during hospital interviews, as it was
  out of scope of this projects objective.

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Team Introduction
Maxine Watts from Australia Security Privacy
Consultant
Veena Pureswaran from USA Engineering Manager
Monica Tatiana Torres Diaz from Colombia LA
Pricing Process Control
Tadashi Suzuki from Japan IT Architect
Shingo Kato from Japan Software Technical Sales
Changwoo Jung from Korea Solution Architect
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Executive Summary
Why Health Tourism?
Key Recommendations

• All studies forecast strong growth through 2015
  and beyond for Health tourism industry
• Increased demand for healthcare services from
  countries with aging population
• Increasing Medical Tourists to Turkey
• Kayseri has significantly invested in healthcare
  sector
• Kayseri has advantages to attract Cappadocia
  tourists for elective treatments

• Establish Kayseri Health Tourism Council (KHTC)
• Obtain JCI accreditation and international
  affiliation
• Improve awareness of Kayseris medical treatment
  areas
• Focus on Internal Marketing Buzz Marketing
• Create a Kayseri Health Tourism Portal
• Continue to keep cost of treatment competitive
• Invest in hiring specialized doctors
• Offer customized packages for international
  patients
• Develop multi-lingual environment in Kayseri
• Invest in elective treatment facilities
• Improve connectivity of Kayseri with more direct
  flights to target regions
• Invest in hotel infrastructure
• Invest in international food, entertainment,
  shopping options

Key Findings

• Kayseri has well funded hospitals but lacks clear
  ownership and a strategic plan for development of
  health tourism industry
• Kayseri has advantages (cost and specialized
  doctors) in some areas of medical treatments but
  lacks specialization in some areas
• Kayseri lacks infrastructure (hotels, direct
  flights, multilingual staff etc) to support
  international patients effectively
• Kayseri lacks awareness of its health services in
  the target regions

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People we interviewed
April, 4th - Secretary General of the Kayseri
Chamber of Commerce
April, 7th - Mr. Kemal Tekden, the owner of
Tekden hospital
April, 7th - Mr. Memduh Keskinkiliç, the owner of
Alto Tour, a prominent tour operator in Kayseri
April, 9th Mr. MUAMMER SAK, ARGEUS TURIZM, HEAD
OF CAPPADOCIA AREA / TURSAB (ASSOCIATION OF
TURKISH TRAVEL AGENCIES)
April, 8th - Kayseri branch of Acibadem Hospitals
April, 19th - Mr. Mevlut Bilici, Kayseri Province
Governor
April, 13th - Maya Eye Hospital in Central
Kayseri and met with the Hospital Manager
April, 12th - Private dental health clinic called
Modern Dis.
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Table of Contents

• Project Objectives
• Executive Summary
• Approach consulting methodology
• Findings and action plan for the development of
  health tourism sector in Kayseri and the region
• What is health tourism?
• Global consumer behavior and market trends in
  health tourism
• Findings and Hypothesis
• Recommendations
• Action Plan
• Communications and Marketing Strategy for
  Promotion of Kayseri Tourism
• Web Portal
• Questions Answers

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Approach Issue based consulting

• Issue based consulting is a particular consulting
  technique used for solving problems, and consists
  of 5 stages
• In the Definition stage the consultant helps the
  client
• Clarify the symptoms causing dissonance
• Define the clients objective
• Define the barriers that keep the objective from
  being realized
• Articulate a vision for what a satisfying
  solution might be
• Help scope what that envisioned solution might
  entail
• In the Structure stage, the detailed work plan is
  developed and the initial storyboard is drafted.
  This stage involves a focused review of the
  engagement issues, the development of hypotheses
  about those issues, and the creation of key
  questions to test the hypotheses.
• In the Data Gathering stage, the consultant
  determines
• What data are needed and why,
• When to keep collecting and when to stop, and
• How to extract the datas important messages for
  the client.
• In the Synthesis stage, the final deliverable is
  produced and presented. Facts, findings,
  conclusions, and recommendations can be used to
  verify the accuracy and efficacy of a compelling
  story

OBJECTIVE
Definition Stage
ISSUE
Structure Stage
HYPOTHESIS
Data Gathering Stage
FACT
FINDING
Synthesis Stage
CONCLUSION
Engagement Objective
Engagement Objective
RECOMMENDATION
Recommendation
Issue
Issue
Conclusion
Conclusion
Hypo
Hypo
Hypo
Hypo
Buy-in Stage
OBJECTIVE
Finding
Finding
Finding
Finding
KQ
KQ
KQ
KQ
KQ
KQ
KQ
KQ
Fact
Fact
Fact
Fact
Fact
Fact
Fact
Fact
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Issue Diagram

• Definition of Major Issues
• Strategy Ownership and Strategic plan for
  Kayseri to be a Health Tourism city
• Offering Competitive advantage in medical
  services offered by the city of Kayseri
• Infrastructure Infrastructure development for
  the city of Kayseri to support a health tourism
  industry
• Marketing Promotion and Marketing of Kayseri as
  a Health Tourism Destination

Client Objective
Engagement Objective
Issue
1. Strategy
2. Offering
3. Infrastructure
4. Marketing
Hypotheses
1.1 Hospitals are well funded
1.3
2.2 Elective treatments are available in Kayseri
2.4
3.1 Easy access to Kayseri for international
patients
3.4
4.1 Neighboring countries are good candidate for
target audience
4.4
Kayseri is a medical city
Kayseri is a medical city








Key Questions
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Table of Contents

• Project Objectives
• Executive Summary
• Approach consulting methodology
• Findings and action plan for the development of
  health tourism sector in Kayseri and the region
• What is health tourism?
• Global consumer behavior and market trends in
  health tourism
• Findings and Hypothesis
• Recommendations
• Action Plan
• Communications and Marketing Strategy for
  Promotion of Kayseri Tourism
• Web Portal
• Questions Answers

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Health tourism, medical tourism - What it is,
what it is not
Term initially developed by travel agencies and
the mass media to describe the rapidly-growing
practice of traveling across international
borders to obtain healthcare

• Health Tourism is traveling abroad for healthcare
  services.
• Health Tourism is usually not emergency or
  critical care travels
• While out of country
• Expatriate care
• Occasionally the medical procedure needed is
  urgent, but more often it is an elective
  treatment such as cosmetic surgery or dental
  care.
• Reasons health tourists go abroad
• Real or perceived lack of services at home
• Limitations imposed by payers or regulatory
  agencies, certain specialists and/or procedures
• Treatment protocols, equipment, or services
• Prolonged waiting periods
• Lower costs of care
• Personal reasons

Projected 15 increase in 2011

• In broader sense, health tourism (versus medical
  travel) includes the leisure aspects typically
  associated with travel and tourism.
  Mini-vacation options for patients and their
  friends and/or families are provided at reduced
  rates through arrangements with travel agencies
  and airlines.

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Strategy
Client Objective
Engagement Objective
Strategy
Infrastructure
Marketing
Offering
Issue
Hypotheses
Key Question and Data Gathering
Are top 5 hospitals internationally competitive?
(statistics on investors)
Stakeholder mapping and interviews
Data requests Interviews Internet research
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Hospitals are well funded ?
Kayseri has significantly invested in the
healthcare sector

• The Kayseri Health Campus Project
• The Kayseri Health Campus project is the first of
  an ambitious list of PPP (Public Private
  Partnership) projects and represents the first
  PPP program adopted for the healthcare sector in
  Turkey.
• Location Kayseri Province 2,800,000 people
• Beds No. 1548 of which
• 1,048 general hospital
• 200 physiotherapy and rehabilitation
• 200 psychiatric hospital
• 100 high security forensic psychiatric hospitals
• Capacity Expected access to healthcare services
  by 10,000 people by day
• Estimated cost of investment 278M USD

Source http//www.scribd.com/doc/33737968/PPP-Hea
lth-Campus-Projects
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Stakeholder Relationship Map
Kayseri Chamber of commerce
Sightseeing Spot/Market/Hotel
Associated Stakeholders
Other Institutions
Travel Operator
Transportation
Government Agency (ORAN)
Patients and relatives
Health Tourism
Advertising Company
Primary Stakeholders
Pharmacy
Investor
Insurance Company
Hospital
Many Stakeholders and Complex relations
Distributor
University
Pharmaceutical Company
Medical Equipment Company
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There is clear ownership for health tourism in
Kayseri ?
We are looking to develop new business
Health Tourism in Kayseri has huge potential
Quote from Interview with Semih Demirtoka, ORAN,
Quote from Interview with Alto Tur travel agency,
Memduh Keskinkilic
Travel Agency
ORAN
Who has ownership??
Health Tourism
Hospital
Quote from Interview with Cemalettin Yilmaz,
ACIBADEM,
We have an original channel such as
International Patient Center. This Center
performs the promotional activities abroad
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Kayseri maintains accurate health statistics ?
Kayseri is now developing statistics about
health

• The following institutions have some statistics
  about health tourism in Kayseri
• The ministry of health of Turkey
  (http//www.saglik.gov.tr/)
• Turkish statistical institute (http//www.turkstat
  .gov.tr/)
• We found that the data provided by these agencies
  are either incomplete or out of date
• Kayseri has also some statistics about health
• Statistics Dept. Kayseri Provincial Health
  Administration(http//www.ksm.gov.tr/)
• Administration Of Health
• Although relatively new, we found that the data
  is incomplete
• ORAN has recognized the importance of statistics
  and lack of data.

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Offering
Client Objective
Engagement Objective
Strategy
Offering
Infrastructure
Marketing
Issue
Hypotheses
Kayseri is in a good location to attract
Cappadocia tourist to Kayseri for health
Kayseri provides minimal waiting lists for
treatments
Sufficient capacity to introduce additional
patients
Key Question and Data Gathering
Dental examination Thermal treatments (Personal
opinion, interviews)
From statistics, interviews, expertise, success
rates, number of operations, time of recovery,
aftercare conditions
Current waiting lists in UK and Europe
Capacity of hospitals in Kayseri
Seasonal occupancy/rates
Current waiting lists in Kayseri
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Kayseri is in a good location to attract
Cappadocia tourists to Kayseri for health ?
Kayseris geographical location and airport
are advantageous to attract (for health)
international tourists visiting Cappadocia

• Kayseri is the easiest way to get to Cappadocia
• Has the closest airport, Turkish Airlines
  operate 5 flights a day from/to Istanbul to/from
  Kayseri.
• Kayseri to Cappadocia 75 kms, only 1
  hour, compared to 300km from Ankara

300 Km

• Cappadocias international tourist ? number is
  increasing every year
• Turkey tourists 28.6 million (international
  without citizen visitors )
• Tourist visiting Cappadocia 2.18 million, 1.49
  million foreigners
• Increased by 30 percent in 2010

75 Km

• Cappadocias tourist ?possible target for Health
  Tourism in Kayseri
• Tour groups, from Europe and most of them above
  50 years old (Source Group Observation)
• Tourist stays in Kayseri aprox. 1.6 days (Source
  Interviews)

(Source gototurkey.com, Turkishpress.com)
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Treatment Segmentation
The following diagram describes the
segmentation that was used for the benchmark
treatment analysis
Necessary (Medical Treatment)
Elective (Leisure)
Comparing Cities
Orthopaedics Oncology Cardiology Eye Dental
Medical Spa Thermals
Comparison
New Delhi
World
Istanbul
Kayseri
Kayseri Region
Bangkok
Turkey
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Thermal Spas in Turkey

• 1800 thermal springs in Anatolia
• 190 thermal resorts in 46 cities Bed capacity is
  almost 15,000
• 7th richest country in the world when it comes to
  thermal resources
• 10 million domestic guests and over 300,000
  foreign guests in 2009 and 1 Million forecast
  for 2012

Main Turkish Thermals Spas In Turkey
Yalova
Bolu
Canakkale
Ankara
Bursa
Balikesir
Eskisehir
Sivas
Bingol
Kutahya
Nevsehir
Afyon
KAYSERI
Izmir
Van
Konya
Aydin
Denizli
Mugla
Source Presentation health tourism
destinationfrom Turkish Healthcare
TourismDevelopment Council Spas Turkey
http//www.allaboutturkey.com/spa.htm Spa Summit
2010
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Dr. Fish as an attraction to International
Tourists
Dr. Fish treatment has become popular
around the world. It is a unique treatment that
can attract tourists since Turkey has the
original one

• Open in 2010
• 8 Spas 17 New openings, Franchises
• Services foot treatment
• Price 10 Euros, 15 min
• Testimonials

• In Turkey since 1950
• Services Psoriasis Fishy Treatment (21-14 days)
• Packages Treatment, accommodation, transfers,
  Catering, Local Excursions
• Prices 21 days USD 3392
• Testimonials

UK
Turkey
Wellness industry cluster market USD 2 trillion
USD 216 Billion
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Elective treatments are available in Kayseri
region ?

• Kayseri has the natural resources but needs
  to improve thermal infrastructure and awareness

• BAYRAMHACI THERMAL SPRING 65km west of Kayseri,
  two pools for men, and two for women.
• ..Small Place, frequented by people from the
  Village, there is infrastructure but not for
  International tourist..
• TEKGOZ THERMAL SPRINGS Yemliha district 33km
  from Kayseri, One pool for men, and one for
  women.
• There is not any hotel or building
• CIFTGOZ THERMAL SPRINGS 35 km from the city
  center. Two pools for men, and two for women.
• Drinking water available
• YESILHISAR MINERAL SPRING Yesilhisar Town 82 km
  from the city center.
• ZILE THERMAL Visited by Develi and Yahyali
  people.
• There is mud, can be an attractive for
  tourists, is more active than the others

April, 2011, Mr. Memduh Keskinkiliç, owner of
Alto Tour, a prominent tour operator in Kayseri
Lack of infrastructure
Source Kayseri City Guide/Mr. Memduh Keskinkiliç,
http//www.travelshopturkey.com/hotels.asp?id301
dest384
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Treatment Segmentation
The following diagram describes the
segmentation that was used for the benchmark
treatment analysis
Necessary (Medical Treatment)
Elective (Leisure)
Comparing Cities
Orthopaedics Oncology Cardiology Eye Dental
Medical Spa Thermals
Comparison
New Delhi
World
Istanbul
Kayseri
Kayseri Region
Bangkok
Turkey
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Necessary (Medical Treatment) Benchmarking
Criteria
The following approach was used to perform
the treatment benchmark treatment analysis
For each city, a major hospital was chosen
to perform the comparative analysis.
Treatment comparative analysis is based on the
following categories in each city/hospital
Cost Prices of major treatments were compared within each city
Specialization The number of specialist doctors for the chosen hospital and number of JCI accredited hospitals in the city
Capacity The number of facilities and the patients that the hospital can support
Awareness Google trends search and amount of information found on that hospitals website
International Patients Whether the hospital already has international patients and if there are facilities to support them
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Summary of benchmark analysis of Necessary
Treatment in Kayseri

Based on this analysis Bangkok is the
leader in eye treatment and New Delhi is the
leader in all the other treatments
Rating Definitions
High
0
5
Low
Orthopaedics
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Findings on Medical treatments available in
Kayseri
Necessary medical treatments are available in
Kayseri ?
Kayseri has potential in Cardiology and
Oncology treatments but has areas for improvement
?

• Affordable cost for treatments for eye and dental
  treatments compared with the cities included in
  the benchmark
• High level of specialization in Cardiology and
  Dental treatments compared to other areas of
  treatment in Kayseri
• Kayseris Hospitals have experience with
  international patients in Cardiology, Oncology
  and Orthopedics
• Overall Kayseri has a better ranking on
  Cardiology, Oncology treatments
• Kayseris lack of JCI accredited Hospitals or
  international affiliations (AHA etc)
• Number of specialized doctors are significantly
  low specially in Orthopedics and Eye treatments
• Low awareness of Kayseris treatments
• Lack of multi lingual staff in Kayseris
  hospitals
• Lack of International Patient facilities, for
  example, only Acibadem has an International
  Patient Center in Kayseri

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Kayseri provides minimal waiting lists for
treatments ?
Kayseri provides no waiting time, only
preparation time for treatment
Waiting lists are very long in the Western
Europe, such as UK. Meanwhile, most hospitals in
Kayseri have no waiting time.
Combined quote from interviews with ACIBADEM
hospital, TEKDEN hospital, Moderndis dental
clinic, and Governor of Kayseri Province
Source http//www.dh.gov.uk/en/Publicationsandsta
tistics/Statistics/Performancedataandstatistics/Ho
spitalWaitingTimesandListStatistics/index.htm
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Kayseri hospitals have sufficient capacity to
introduce additional international patients ?
Kayseri hospitals have sufficient capacity to
introduce additional international patients by
50 each year for 5 years
Typical occupancy rate is around 50
Bed count analysis
The total number of beds in Kayseri hospital 3595 (1)
Under conditions that occupancy rate is 50, the number of vacancy beds per day 1800
The number of vacancy beds per day each hospital ( 29 hospital ) 62

International patients analysis
The number of international patients at a hospital per year 3200 (2)
The number of international patients at a hospital per day 9
Under condition that the number of international patients increases 50 each year and the number of domestic patients remains the same each year, the number of international patients at a hospital per day in 5 years 60
Source YATAKLI TEDAVI KURUMLARI CALISMALARI
(1) http//www.acibadem.com.tr/(2)
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Infrastructure
Client Objective
Engagement Objective
Strategy
Marketing
Offering
Infrastructure
Issue
Hypotheses
Kayseri infrastructure can support international
health tourism
Kayseri is a medical city
Easy access to Kayseri for international patients
Food, shopping and entertainment options are
available
Key Question and Data Gathering
Number of hospital and doctors/specialists per
1000 people
Number of hospital and doctors/specialists per
1000 people
Hotel capacity
How many different cuisines available?How many
restaurants? Opening hours?
Multi-lingual staff How many shopping
centers? Entertainment options?
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Kayseri is a medical city ?
Kayseri has a higher number of hospitals when
compared to other cities in Turkey and any other
medical advanced cities in the world. Furthermore
in 2014, The Kayseri Health Campus will be
completed, number of beds per population will be
3rd in the world

• Specialists
• 2168 doctors, 1837 nurses, 454 midwifes

• Hospitals
• 15 public hospitals, 14 private hospitals, 3595
  hospital beds
• 7 hospitals have ISO-9001 certification

When the Health Campus is completed
4.47
Above Turkey average and same as the world
average even in 2007
3 growth YTY

• TURKISH HEALTHCARE INDUSTRY REPORT
• Statistics Dept. Kayseri Provincial Health
  Administration

2020? 7? 27? 31
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Easy access to Kayseri for international
patients ?
Turkey is a very attractive tourist destination
for European countries which is roughly half the
distance to travel compared to India but Kayseri
needs more direct flights for easier access

• Flight
• Very limited direct flights to Kayseri
  international airport
• Most travelers can get to Kayseri by taking
  transfer flight from Istanbul

• Visa requirements to Turkey
• Top 10 countries visiting Turkey dont require
  Visa or can get Visa at the border gates
• Out of about 200 countries,
• 45 without Visa, stay up to 90 days
• 23 can get Visa upon arrival at the Turkish
  border gates
• 32 requires Visa

• Get Visa at the border gates
• Visa Exempted

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?
?
?
Source http//www.mfa.gov.tr/visa-information-for
-foreigners.en.mfa
33
Kayseri infrastructure can support international
health tourism ?
Kayseri doesnt have enough multilingual staff or
information. Infrastructure of Kayseri is
adequate for domestic health tourism but lacking
for international health tourists

• Hotels
• 1450 rooms and 2796 beds in 21 hotels ( 2 five
  stars hotels, 4 four stars hotels, 10 three stars
  hotels)
• 3 international chain hotels and others are
  domestic

• Kayseri Multi-lingual
• Hospital Not enough multi-lingual staff
• Restaurant Menus only in Turkish and no
  multi-lingual staff
• Shopping Center No multi-lingual staff or
  announcements
• Railroad No multi-lingual staff or
  announcements
• Roads Only Turkish signage
• Hotels Only 2 of 21 hotels have multi-lingual
  staff
• Media Most of TV channels and radio stations in
  Turkish

Hilton
City One
Novotel
Grand Eras
Selcuk
Nüzhet

• Airport
• Erkilet Airport is 4km to the city center.

• Railroad
• 7 hours to Ankara, 6 hours to Adana
• Roads
• Well prepared inter-connect high-way
• Connects Bogazkopru, is 15 km to the city center,
  with several main highways which come from
  Ankara, Adana, Nigde
• 5 hours to Ankara, 1 hour to Cappadocia

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Food, shopping and entertainment options are
available ?
There are plenty of Turkish food options, however
there are limited international cuisine and
entertainment options for foreigners

• Food
• Kayseri is known for its rich Turkish cuisine
  culture
• One of the unforgeable tastes of Kayseri cuisine
  is pastrami
• Restaurants and cafes are generally open till
  about 10pm every night
• Lack of international cuisines such as Asian,
  Indian and European
• Shopping
• There is one major shopping Center Kayseri Park
  (10.00-22.00)
• Covered Bazaar (10.00-20.00)
• Street shops from carpets to clothes to fresh
  fish

Kayseri Pastrami

• Entertainment
• Erciyes Winter Sports Center during the Winter
  season variety of bars, cafes and restaurants
• Kayseri city there are no major entertainment
  facilities for foreigners no bars, pubs or live
  music
• Sightseeing
• Kayseri city has a number of places to visit
  including varies mosques, tombs and towers
• Cappadocia is within 1hour drive

Kayseri Park
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Marketing
Client Objective
Engagement Objective
Strategy
Infrastructure
Offering
Marketing
Issue
Hypotheses
Turkey is ranked within the Top 20 countries in
the Country Brand Index
How they are promoted? Hits in Google
What facilities they have in neighboring
countries?
Number of visitors from the neighboring countries.
Waiting list on their home countries, cost of
home countries?
What facilities they have in neighboring regions?
Number of visitors from the neighboring regions?
Demography of current Turkish workers
Number of visit from Turkish workers
Annual Country Brand Index ratings
Interviews and quotes for people
Key Questions and Data Gathering
36
Turkey is ranked within the Top 20 countries in
the Country Brand Index ?

• The worlds perception (brand) of Turkey is
  average when compared to benchmark countries
  India and Thailand.
• The Country Brand Index is an annual study that
  examines and ranks 110 country brands, based on
  Future Brands proprietary research methodology
  (in partnership with BBC World News)

Each country is measured in the following areas
Sources http//www.futurebrand.com/think/reports-
studies/cbi/2010/overview/ http//www.futurebrand.
com/think/reports-studies/cbi/2008/overview/
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Awareness about health tourism in Kayseri is high
for international patients ?
Awareness about health tourism in Kayseri is low

• Turkeys health tourism is generally well known
  compared to other countries
• Compared to other cities in Turkey, Kayseri needs
  to improve the awareness of the city in general
  and particularly in the area of health tourism
• Based on the web search hits result, Netherlands,
  Germany, France may be potential target customer
  for health tourism to Kayseri, Turkey

Source http//www.googlefight.com
Google Trends Comparison Istanbul, Ankara,
Izmir, Bursa, Kayseri
Countries who searched Kayseri
Health tourism awareness comparison between
Kayseri and Istanbul
Source http//www.google.com/trends
Source http//www.googlefight.com
2020? 7? 27? 37
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Neighboring countries are good candidate for
target audience ?
Elimination of visa requirements for neighboring
and nearby countries will ease the inflow of
medical tourists from these areas

• Talks underway for elimination of visas
• Greece, Portugal and Ukraine
• Countries that do not need visas
• Syria (as of 16.9.2009)
• Albania (as of 20.11.2009)
• Libya (as of 24.11.2009)
• Jordan (as of 2.12.2009)
• Tajikistan (as of 13.12.2009)
• Azerbaijan (as of 25.12.2009)
• Lebanon (as of 11.1.2010)
• Saudi Arabia (as of 10.1.2010, unilateral)
• Georgia, Pakistan, Bosnia and Herzegovina
• Croatia, Tajikistan, Serbia, Qatar
• Russia (as of 19.4.2011)
• Visas granted at border
• Belarus, Czech Republic, Estonia, Latvia,
  Lithuania, Hungary, Moldova, Norway, Uzbekistan,
  Poland, Slovakia, Tajikistan, and Turkmenistan
  can obtain sticker-type visas at border gates for
  stays up to one month.

Following the recent abolishment of visa
requirements between Turkey and Syria, Turkey has
seen a remarkable increase in the number of
patients from Syria, as well as from Lebanon,
Iraq and Iran, who seek to benefit from better
health services in Turkey. Private and public
hospitals and clinics are getting an increase in
the number of foreign patients. One private
clinic specializing in laser eye surgery in Hatay
is now getting 100 Syrian patients each month,
in addition to patients from Lebanon, Iraq and
Iran who cannot get such treatment at home
Source International Medical Travel Journal
39
Domestic patients from regions around Kayseri are
a target for medical treatment ?
Patients from neighboring regions of Sivas,
Yozgat, Nevsehir and Aksaray come to Kayseri
hospitals for Necessary medical treatment and
will continue to bring a significant inflow of
patients to Kayseri hospitals
.
.
.
.
.
However, concentration of specialized treatment
is in Kayseri. Most patients from these regions
come to Kayseri hospitals for necessary medical
treatment.
Kayseri hospitals also serve the neighboring
regions of Nevsehir and Aksaray
Most patients in these regions are referred to
specialized treatments by their physicians --
For example, family of heart surgery patient from
Aksaray We were referred to this Kayseri
hospital for cardiac surgery by our physician in
Aksaray due to the lack of same level of
specialized surgery in Aksaray. I can stay at
the hospital until the patient is able to travel
back to Aksaray
Source www.kayseri.gov.tr
40
Turkish workers in Europe are a good target
audience ?
Turkish workers from Germany, Bulgaria, France,
Netherlands and UK are a target audience for
necessary and elective medical treatments
Germany, Bulgaria, France, Netherlands and UK
have the top number of people of Turkish origin,
more than 75 of Turkish people living outside
Turkey
An average of 900,000 Turkish workers traveled
back to Turkey each year in 2008- 2010
Summer months and holiday season are very
popular for Turkish workers in Europe to travel
back to Turkey. Patients coming from these
countries are not only Turks but also people in
those countries that have heard about the medical
services in Turkey
Source OECD Study on Inflows of Turkish workers
to Europe Team Interviews
41
Foreign tourists already visiting Turkey are a
potential target for elective treatments ?
Countries that have significant tourist inflow to
Turkey are a good target for elective treatments
Germany, Russia, UK, Bulgaria and
Iran are consistently the top 5 countries with
tourist inflow to Turkey, constituting almost 50
of tourist inflow to Turkey
Source Turkey Ministry of Culture and Tourism
42
Countries with significant waiting list for
necessary medical treatment are a potential
target ?

• United Kingdom, Ireland and Canada are countries
  with the longest waiting lists for availability
  of medical treatments and surgeries.
• Of these countries, patients on the United
  Kingdom waiting lists are prime candidates for
  treatment in Turkey because of the proximity to
  Europe and ease of travel to Turkey
• For example, average waiting time in UK

Source http//www.dh.gov.uk/en/Publicationsandsta
tistics/Statistics/Performancedataandstatistics/Ho
spitalWaitingTimesandListStatistics/index.htm
43
Countries where medical care is expensive are a
potential target for necessary medical treatment ?
Average of 50 savings for treatments in Turkey
compared to other European countries (80 savings
compared to treatment costs in US!)
Cost multiplier relative to Turkey
Source healthinturkey.org
44
Summary of Findings - Issue Diagram
Client Objective
Engagement Objective
Strategy
Infrastructure
Offering
Marketing
Issue
Hypotheses
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45
Table of Contents

• Project Objectives
• Executive Summary
• Approach consulting methodology
• Findings and action plan for the development of
  health tourism sector in Kayseri and the region
• What is health tourism?
• Global consumer behavior and market trends in
  health tourism
• Findings and Hypothesis
• Recommendations
• Action Plan
• Communications and Marketing Strategy for
  Promotion of Kayseri Tourism
• Web Portal
• Questions Answers

2020? 7? 27? 45
46
SWOT analysis of health tourism in Kayseri

• Opportunity
• Increased demand for healthcare services from
  countries with aging population
• Shortage of supply in National Health Systems in
  some countries
• Demand from countries with underdeveloped health
  systems
• Decreasing cost of international travel
• Being a EU Candidate (Patient immobility in EU)
• Numbers of uninsured in developed countries
• Increasing Medical Tourists to Turkey

• Strengths
• Affordable cost for treatments
• High level investments were already made and new
  project (PPP and Ski Center) is in progress
• Kayseri is a medical city
• Kayseri has advantages to attract Cappadocia
  tourist for health treatments
• Kayseri provides minimal waiting lists for
  treatments
• Kayseri hospitals have sufficient capacity to
  introduce additional international patients
• Neighboring countries do not require Visas
• Kayseri has more specialized doctors than the
  regions near by
• Kayseri has more specialized doctors compared
  with benchmark countries for Cardiology and
  Dental treatments

• Weakness
• Low coordination between the stakeholders in the
  industry. There is not clear ownership for health
  tourism in Kayseri
• Kayseri does not maintains accurate health
  statistics
• Kayseri doesn't have enough multilingual staff,
  information nor entertainment for International
  people
• Low awareness of Kayseri as an international
  medical destination
• Kayseri does not have JCI accredited hospitals
• Number of specialized doctors are significantly
  low especially in some treatment such as
  orthopedics and eye

• Threats
• Strong competition from countries like Thailand,
  India, etc.
• Some of the developing countries in the region
  want to attract medical tourists too
• Possible conflicts in neighboring countries

47
Recommendations

• Establish Kayseri Health Tourism Council (KHTC)
• Board members from hospitals, hotels, travel
  operators, ORAN, Ministry of Health and Ministry
  of Tourism, Kayseri province Governors office
  etc.
• Representation from Kayseri Council (KHTC) in
  Turkish Healthcare Tourism Development Council
  (THTDC)
• Responsible for collecting and maintaining
  accurate health statistics
• Own short/mid/long term action plan for health
  tourism in Kayseri with measurable checkpoints
• Hire subject matter experts with medical
  background to validate top treatment areas
• Hire subject matter experts in healthcare
  consulting to continuously asses and provide
  feedback on health tourism action plan
• Monitor PPP Health Campus project and alignment
  with health tourism roadmap for Kayseri
• Obtain membership with the health tourism
  Association (MTA http//www.medicaltourismassociat
  ion.com)
• Invest in a Common International Patient Center
  (CIPC) for small and medium size hospitals to
  network and promote treatments to patients
• Investigate training and hiring health tourism
  facilitators to coordinate between CIPC and
  patients

• Obtain JCI accreditation and international
  affiliations for leading hospitals in Kayseri
• Continue to keep cost of treatment competitive
• Offer tax support as needed to compete with
  benchmark countries
• Invest in hiring specialized doctors in areas
  where specialization is low, for example,
  orthopedics and eye
• Offer customized packages for international
  patients
• Investigate facilities in Kayseri that can be
  combined with tour programs in Cappadocia

Strategy
Offering
48
Recommendations

• Develop multi-lingual environment in Kayseri
• Short training courses with certifications and
  exams for conversational proficiency for doctors,
  nurses, travel agents
• Also staff in restaurants, shopping centers,
  hotels, airports, TV channels etc
• Signage in multiple languages, for example,
  Turkish with English translation
• Invest in elective treatment facilities
• Spas, Hamams, hot springs in the area need to be
  improved significantly to be attractive for
  international tourists
• Improve connectivity of Kayseri with more direct
  flights to target regions
• Must offer direct flights to cities in Germany,
  UK, France, Russia Bulgaria, Jordan, Azerbaijan,
  Syria
• Invest in hotel infrastructure to accommodate
  additional international patients and their
  families
• Invest in international food, entertainment,
  shopping options for families accompanying
  international patients

• Improve awareness of Kayseris medical treatment
  areas
• Advertise Kayseris hospitals in Cappadocia via
  stands offering free health checks, free eye
  checks, free information kits to make facilities
  visible to tourists
• Combine health checks and elective treatments in
  Kayseri with travel packages to Cappadocia
• Promote Kayseris hospitals in international
  forums, congress, fairs in target markets and
  create partnerships with healthcare services in
  those countries
• Include Kayseri in existing Turkey health tourism
  websites, for example, healthtourism-tr.com,
  healthinturkey.org
• Internal Marketing
• Educate doctors, travel operators, insurance
  companies etc about importance of health tourism
  and align their roles to grow health tourism in
  Kayseri
• Buzz Marketing
• Facilitate word-of-mouth discussions, reviews
  using online forums, social networking tools
• Create a Kayseri Health Tourism Portal to enhance
  awareness, establish a brand and provide
  international patients quick information on
  health tourism

Marketing
Infrastructure
49
5 Year Action Plan
Phase 3 Expansion
Phase 2 Stabilization
Phase 1 Initialization

• Continue to keep cost of treatment competitive
• Offer customized packages for international
  patients
• Develop multi-lingual environment in Kayseri
• Improve connectivity of Kayseri with more direct
  flights to target regions

Growth of Health Tourism Industry in Kayseri

• Invest in hiring specialized doctors in areas
  where specialization is low
• Invest in elective treatment facilities
• Invest in hotel infrastructure
• Invest in international food, entertainment,
  shopping options
• Buzz Marketing to facilitate online word of mouth
  information

• Establish Kayseri Health Tourism Council (KHTC)
• Obtain JCI accreditation and international
  affiliations for leading hospitals in Kayseri
• Improve awareness of Kayseris medical treatment
  areas using recommendations provided
• Internal Marketing to educate primary
  stakeholders
• Create a Kayseri Health Tourism Portal

2011 - 2012
2012 2014
2014 2016
50
Table of Contents

• Project Objectives
• Executive Summary
• Approach consulting methodology
• Findings and action plan for the development of
  health tourism sector in Kayseri and the region
• What is health tourism?
• Global consumer behavior and market trends in
  health tourism
• Findings and Hypothesis
• Recommendations
• Action Plan
• Communications and Marketing Strategy for
  Promotion of Kayseri Tourism
• Web Portal
• Questions Answers

2020? 7? 27? 50
51
Market Segmentation
S1 - Countries with large tourist inflow
Germany, Russia, UK, Iran, Bulgaria 50 of
tourist inflow to Turkey Market for wellness
tourism
New Markets
Not so new markets
Old Markets
S2 - Countries with high costs and waiting
lists UK, Germany Look for timely, quality
care This segment intersects with high number of
tourists and Turks
S3 - Countries with returning Turks Germany,
Bulgaria, France, Netherlands, UK Look for low
cost packages Large segment because of a lot
Turkish workers

• S4 - Domestic Market
• Sivas, Yozgat, Aksaray, Nevsehir
• Increasing spending power
• Increasing inclination to travel to Kayseri for
  better facilities

S5 - Neighboring Countries Jordan, Azerbaijan,
Syria, Georgia Look for low cost
packages Increasing inclination to travel to
Turkey for better facilities
52
Target market selection
Start from S2/P1 single segment approach and then
gradually move to selective specialization
approach on S1/P2, S5/P1 in 3 years
S1 - Countries with large tourist inflow S2 - Countries with high costs and waiting lists S3 - Countries with returning Turks S4 - Domestic Market S5 - Neighboring Countries
P1 -Necessary Treatment
P2 - Elective Treatment
Target market strategies
New Markets
Not so new markets
Old Markets
Short term target market Mid term target market Long term target market
Present
In 3 years
Source Marketing Management A Framework for
Marketing Management, Kotler Keller
53
Easy access to target audience with internet

• Internet is the fastest and easiest way for
  people to access information
• 5 countries of our target audience are in the
  top 20 Internet users Germany 65 Russia 60 UK 51
  France 45 Iran 33 (million people)
• Internet penetration as percentage of
  population Germany 79.1 , Russia 42.8 UK
  82.5 France 68.9 Iran 43.2

Top 20 countries of Internet users and their
penetrations in 2010
Source Internet World Stats
2020? 7? 27? 53
54
Health Tourism Portal - Introduction

• What is a health tourism portal?
• Provide one stop service for the stakeholders of
  health tourism
• Patients can retrieve medical information and
  book the logistics like treatment, flight,
  hotels, tour and insurance
• Service providers (hospitals, travel agency,
  insurance company) can provide their service and
  offering via this web portal
• Business need
• International patients prefer a complete medical
  service which includes logistics like flights
• World Trade Organization (WTO) data suggests that
  more than half of the tourist population uses the
  internet to plan their travel destinations and
  book their holidays directly online

Thailand health tourism web site(http//www.thail
andmedtourism.com/)
India health tourism web site(http//www.medicali
ndiatourism.com/)
2020? 7? 27? 54
55
Existing portals Bangkok (http//www.bumrungrad.
com/)
Multi-lingual
FAQ section and Contact details
Information on accreditations, pricing and doctors
Insurance companies
2020? 7? 27? 55
56
Kayseri Health Tourism Portal High Level
Requirement
Allow potential clients to easily access
information regarding their packages and products
Determine the situation of health tourism at
present and gather data for reliable statistics
Travel Operator
Patients and Relatives
Government Agency
Kayseri Health Tourism Portal
Obtain and easily access information relating to
medical treatment internationally
Accept more international patients and enhance
health tourism awareness
Provide better service by providing their clients
with additional international medical treatment
options
Insurance Company
Hospital
2020? 7? 27? 56
57
Sample portal feature for Travel Operator
Allow potential clients to easily access
information regarding their packages and products
Travel Operator
Offering tour package Register and promote new or
special tour package
Patient Search Search the patients to be
potential customer based on the buying history
Quote creation Create a quote based on the
request from patients (they may use their own
system)
Request forum Answer the question from patients
2020? 7? 27? 57
58
Sample portal feature for patients and relatives
Obtain and easily access information relating to
medical treatment internationally
Patients and Relatives
Multi-lingualEnglish is mandatory, other
European languages are preferred
Insurance application Links to major insurance
company website and online application
Frequently asked questions (FAQ) How much money
can I save by choosing World Eye Centre for eye
treatments? When are payments due? How do I make
a payment? How do I know that the quality of care
is excellent? Will I experience language
difficulties or translation problems?
Hotel and Flight Reservation Links to all major
hotel website showing the details of the
facilities and rates
List of hospitals and treatments
available General information on accreditation
and specialization for each hospital Specialist
doctor information their experience in their
respective field Prices for treatments
City information Taxi service, Public
Transportation, Restaurant, Entertainment and so
on.
Request form Request detailed information and get
a quote
Hospital Appointment list Book upcoming and view
past appointments for treatment
Forum (Blog) Allow past patients to post comments
about their treatment experience
59
Sample portal feature for insurance company
Insurance Company
Provide better service by providing their clients
with additional international medical treatment
options
Offering insurance package Register new or
special insurance packages and promotions
Contact form Answer the question from patients
Online contract confirmation Confirm the contract
from patients and contact with the patient
Reimburse process Payment process for reimburse
from hospitals
2020? 7? 27? 59
60
Sample portal feature for Hospital
Accept more international patients and enhance
health tourism awareness
Hospital
Patient Search Search for patients by name, age,
gender
Appointment information Confirm the contract from
patients and contact with the patient
Specialists management Arrange shifts of doctors
and medical staff
Contact form Answer questions from patients
2020? 7? 27? 60
61
Sample portal feature for Government Agency
Determine the situation of health tourism at
present and gather data for reliable statistics
Government Agency
Data gathering How many patients are interested
in health tourism in Kayseri ? How much is the
revenue?
Data analysis Compare to previous year Number of
patients and their treatments
2020? 7? 27? 61
62
Kayseri Health Tourism Portal Phased Approach
M1 M2 M3 M4 M5 M6
Resource recruiting and project planning
Requirement definition
Architecture design
Function specification and prototype
System development
System test and assessment
System deploying and maintenance

• Phase I - Basic Portal-
• Develop basic Portal
• Hospital, travel operator, insurance web site
  links
• Online booking for treatment, hotel, flight
• Small start and gradually adding features is
  best practice

MMonth
Project period will be changed based on
requirements

• Phase II Advanced Portal-
• Enhance communication features
• Patients Rating for hospital, travel agency,
  insurance
• Communication between patients like social
  networking services
• Automatically updating information

2020? 7? 27? 62
63
Kayseri Health Tourism Portal Resources

• The following resources are required to develop
  the web portal

Roles Responsibility
Project Manager Initiate and plan the project, execute the project plan and control the scope, schedule, costs and quality. Coordinate the communication and manage stakeholders.
Data collector Collect, validate and organize the tourism information to be included into the portal and connect to all involved parties for their awareness of the project and comments and updates.
Architect Design the portal system including the layers, interfaces between components, data transfer protocol, and data storage strategy etc. with consideration of other non-functional requirements such as performance, scalability, and sustainability.
Programmer Develop function specification. Develop the functions based on the design, test and deploy the web portal.
Web designer Visual design for web pages, make sure the web interface is user-friendly and easy to use.
IT person Maintain the web portal after deployment, update the data and fix problems if any. Perform system check and analysis in a regular basis.
2020? 7? 27? 63
64
Acknowledgements

• IBM Corporate Service Corps (CSC) Program
• United Nations Development Program (UNDP), Turkey
• Digital Opportunity Trust (DOT), Turkey
• Middle Anatolia Development Agency (ORAN),
  Kayseri
• Secretary General of the Kayseri Chamber of
  Commerce
• Mr. Kemal Tekden, Tekden Hospital
• Mr. Memduh Keskinkiliç, Alto Tour
• Acibadem Hospital, Kayseri
• Mr. Muammer Sak, Argeus Turizm
• Modern Dis, Kayseri
• Maya Eye Hospital, Kayseri
• Mr. Mevlut Bilici, Kayseri Province Governor
• Special Thanks to our Field Assistants and
  Translators

65
Thank You!
Tesekkurler!
Gracias
Obrigado
Spanish
Hindi
Brazilian Portuguese
Danke
Russian
Korean
German
Grazie
Traditional Chinese
Thank You
Merci
Italian
French
Arabic
Tamil
Simplified Chinese
Japanese
2020? 7? 27? 65