Where the international patient is lost and how each leak is fixed
The travelling patient writes to several clinics at once. The one that answers first and builds trust wins. This is the method with which we measure, design and build International Patient Departments in hospitals and clinics across Latin America: eight dimensions that are scored, ten steps that are redesigned and five leaks that are closed in order.
The IPA Method in three phases
It is the same sequence the firm uses to build departments, both in a two-day workshop and in a twelve-month programme. The depth changes, not the order.
Measurement of the institution's current capacity to attract, receive, serve and follow up an international patient. Critical gaps are identified with evidence, not with perception. The instrument is the eight-dimension radar and the control-point checklist.
Design of the department: the patient journey from start to finish, roles, communication protocols, pricing, partnerships and the minimum technology required. It is approved before anything is built.
Implementation plan with priorities, owners and indicators. Every action originates in a finding from phase 1, and has a verifiable compliance indicator.
Four rules that order everything else
Every score in the diagnosis must rest on something that exists today and can be shown. If you cannot show it, it does not count. This one rule changes the result of almost every internal diagnosis we have seen: institutions score themselves high on what they believe they have and low on what they can effectively demonstrate.
We do not work with industry averages. We work with the enquiries your institution received, your ticket, your response time and your close rate. When a data point does not exist, it is estimated and marked as an estimate. An honest estimate is worth more than an invented data point.
We measure the same eight dimensions twice: as the institution sees them and as a real patient lived them. When the difference between the two readings exceeds two points, the valid score is the patient's. They are the one who decides which clinic to go to.
If no one holds the title, the scope and the authority over the international patient, there is no department: there are people helping when they can. It is the first dimension we correct, because none of the other seven holds without it.
This is the same principle that sustains 1,700 points of sale in 60 countries. Store number 300 cannot depend on its manager being exceptional. It depends on the system being replicable.
Eight dimensions. Each one is scored from 0 to 5.
The diagnosis does not deliver an overall rating. It delivers eight, because an institution can have excellent channels and non-existent follow-up, and that contrast is the data point management needs. The total is out of 40.
| Dimension | What it measures |
|---|---|
| Response | Speed and quality of the first contact. How long an international enquiry takes to receive a human response, in what language and with what content. |
| Owner | Whether an owner of the international patient exists with a title, scope and authority, or whether someone does it on top of their job. |
| Proposal | Whether a qualification script exists, whether tele-guidance is offered and whether the quotation is a formal document or a loose price by message. |
| Follow-up | The cadence after quoting. Whether follow-up is scheduled or only happens when the patient insists. |
| Channels | Whether markets, the proposal and the acquisition channels are defined and connected to the journey, or whether there is advertising with no process behind it. |
| Technology | Whether all leads live in a single record with templates and flows, or in personal chats. |
| KPIs | Whether a weekly dashboard exists with response in minutes, qualification, quotation, close and ticket, or whether only enquiries are counted. |
| Structure | Written roles, a weekly review ritual and international revenue separated in the income statement. |
Your score places you in one of four levels
- 0 to 10
No architecture
Demand is served by improvisation. No one owns it, there is no process and no measurement. Any investment in acquisition made today is lost.
- 11 to 20
Fragmented
Isolated efforts that are not connected and not repeated. It is the most common range of all.
- 21 to 30
Under construction
There is a base: a partial process, defined prices, someone in charge. Follow-up, measurement and consistency are missing.
- 31 to 40
Structured
A system exists that responds, qualifies, quotes and measures. The work is no longer to build, but to optimise and scale.
And after structured. The four levels of the radar measure whether your institution converts. There are two further levels that measure whether it has a business: Growth, when acquisition, retention and referral strategies exist with customer acquisition cost and lifetime value calculated from your own data, and International Centre of Excellence, when the department has its own income statement with positive contribution for twelve months and the capacity to replicate in another site or specialty. No one reaches the fifth level without passing through the third.
Ten steps. Most institutions measure two.
Almost every institution measures the entry, how many wrote, and the exit, how many were operated on. The space between those two figures is a black box. That is where the business happens.
- 01Demand
- 02ResponseSpeed
- 03ContactQualification
- 04Evaluation
- 05Tele-guidance
- 06ProposalPrice
- 07Follow-upFollow-up
- 08Decision
- 09Care
- 10Post-care
Four leaks occur at a specific step. The fifth, the absence of an owner and of measurement, runs through the entire journey and is the one that sustains the other four.
Five leaks. Each one is closed completely or not at all.
The operating rule of the method is this: close one whole leak before touching the next. An institution with four half-closed leaks performs worse than one with a single leak fully closed, because the patient falls anyway, just one step further along.
What causes it. There is no single entry channel, no assigned owner and no coverage outside local administrative hours.
The standard that closes it. Every international enquiry receives a human response in under 20 minutes, seven days a week, with a name, role and next step with a date, in the patient's language.
What causes it. No one distinguishes the patient who can travel and pay from the one comparing prices. The team exhausts itself on the one who was never going to travel and arrives with no energy for the one who was.
The standard that closes it. A script of six to eight questions covering procedure, urgency, medical history, dates, budget, companion, language and country. Each lead classified as viable, requires information or not viable. And tele-guidance offered to all viable cases.
What causes it. A price is sent by message. The patient cannot decide a trip abroad on a loose figure.
The standard that closes it. An international price list in dollars per procedure, three to five packages with what they include and what they do not, and a formal quotation document sent in under 24 hours, in the patient's language and with a payment plan and change or cancellation conditions.
What causes it. The international patient almost never says no. They stop replying. Without a scheduled cadence, that silence is read as a loss.
The standard that closes it. Follow-up scheduled at 3, 7 and 14 days after each quotation. A recorded reason when a lead does not advance. A reactivation message at 30 days. And post-care contact at 7 and 30 days, with a request for a testimonial.
What causes it. No one holds the title. Leads live scattered across personal chats. There is no dashboard, and international revenue is lost inside general revenue.
The standard that closes it. One person with the title and responsibility for the international patient. All leads in a single record. Weekly measurement of enquiries, response time in minutes, quotations and closes. International revenue reported separately in the income statement.
The full checklist has 20 control points
Four per leak. It is the instrument we audit with. We send it to your institutional email.
Request the checklistThe five layers of the blueprint
The diagnosis says where you are. The blueprint says what gets built. It has five layers and they are raised in this order.
- 01
Foundation
An international patient owner with a name and role, the team structure and a service standard signed by management. Without this layer, none of the other four holds.
- 02
Growth
A profile of the ideal institution and patient, and the first acquisition engine: one market by one procedure by one channel, with a measured indicator. One engine switched on and working is worth more than five simultaneous attempts.
- 03
Experience
Tele-guidance, a value proposition written in the market's language, and the trust assets visible where the patient sees them: accreditations, specialist credentials, procedure volume, documented cases, testimonials, complication protocols and price transparency.
- 04
Retention
A post-care contact plan at 30 and 90 days, identified referral sources and calculated patient lifetime value.
- 05
Economics
Acquisition cost, the ratio between lifetime value and acquisition cost, the break-even point in patients per month, and the department's own income statement.
If it is not measured, it is not architecture. It is decoration.
These are the indicators that stay installed on the dashboard. They are not all that exist: they are the ones that change decisions on a Monday morning.
| Group | Indicator | Operational definition |
|---|---|---|
| Speed | Time to first response | Minutes between lead entry and the first human response, by channel and by time slot |
| Volume | International enquiries | By market, by procedure and by entry channel |
| Conversion | Funnel by step | Enquiry to contact, contact to evaluation, evaluation to quotation, quotation to close |
| Economics | Ticket, CAC and LTV | Average ticket by procedure and market, acquisition cost and lifetime value, calculated with your own data |
| Retention | Referral rate | Patients who refer or leave a testimonial, over patients treated |
A rule on the relationship between lifetime value and acquisition cost: below 3, the department is not a business, it is a service subsidised by the rest of the institution. It can be a valid strategic decision, but it must be a decision, not a discovery.
Four horizons, with a verifiable milestone in each one
Owner and channel
An owner appointed and in function, a single entry channel active and a service standard communicated to the team.
Qualify and quote
Qualification, tele-guidance and quotation in under 24 hours working. An indicator dashboard with its first measurement.
Active acquisition
The first growth engine switched on and an international package on sale.
Own P&L
A department with its own income statement.
A verifiable milestone is not an intention. It is not "improve the response". It is "100 percent of enquiries answered in under 20 minutes for four consecutive weeks, with a record".
There is only one question: do we build the department or grow it?
It is answered with five criteria.
- There is a person holding the title of international patient officer
- All international leads are in a single record
- Response, quotations and closes are measured weekly
- International prices are published or in a price list
- There were more than 10 international patients in the last 12 months
Three or more checked: your route is to grow. Fewer than three: your route is to build.
An institution that believed it was ready and discovers in the radar that it is at the first level moves on to build. That is a finding, not a failure, and it saves you the money you were about to invest in demand generation.
It was not born in healthcare
It was born building and sustaining multi-unit operations: Burger King, Dunkin', Church's Texas Chicken, Focus Brands, Krystal and Keke's. More than twenty years, and 1,700 points of sale in 60 countries under his operational responsibility.
The problem of a multi-unit network is identical to that of a hospital that wants to internationalise, even though the product looks nothing alike: how to make the experience just as good when the founder is not in the room. The answer, in both cases, is the same. One owner, written processes, measured standards and a record of what happens.
The only thing that changed when moving it to healthcare was the level of demand. In a franchise, a mistake costs a customer. In an international hospital, a mistake costs the trust of a patient who travelled to another country and of everyone who asks them how it went.
The method starts by measuring
The International Readiness Assessment applies the eight-dimension radar to your institution, with evidence and not perception, contrasts your reading with that of a real patient and delivers your score out of 40, your level, your main leak quantified in dollars and the 30- and 90-day roadmap.