Fontenelle Forest Nature Center Friday, March 25, 2005 7:30 a.m. – 3:00 p.m.

2005-2008 Strategic Planning Retreat Fontenelle Forest Nature Center Friday, March 25, 2005 7:30 a.m. – 3:00 p.m.

Staying Competitive in the Global Health Care Market Rubens J. Pamies, M.D., FACP Moderator Mr. Nizar MandaniExecutive director Sheila Ryan, PhD Professor, CON-Parent-Child, Admin Ed & Science Rodney S. Markin, M.D. Associate Dean, COM Mr. Joe B. Graham Chief Operating Officer Nebraska Medical Center Panelist

American International Health Alliance advancing global health through professional, volunteer, peer-to-peer partnerships Board of Directors Dennis P. Andrulis, MPH, PhD Research Professor Department of Preventive Medicine at the State University of New York Health Science Center/Brooklyn Sheila A. Ryan, PhD, RN Professor University of Nebraska Medical Center College of Nursing Donald W. Fisher, PhD Chairman President and CEO American Medical Group Association (AMGA) Roger J. Bulger, MD Secretary President and CEO Association of Academic Health Centers (AHC) Daniel P. Bourque, MBA Senior Vice President, System Operations VHA Inc. Louis W. Sullivan, MD President-Emeritus Morehouse School of Medicine Larry S. Gage, JD Past Chairman President National Association of Public Hospitals and Health Systems (NAPH),and a partner at Powell, Goldstein, Frazer & Murphy, LLP Henry A. Fernandez, JD Vice President and CEO New York State Historical Association & the Farmers' Museum in Cooperstown Alan Weinstein, MBA Consultant to healthcare companies

International Health Medical Education Consortium Sara E. Pirtle, MBA Update Co-EditorsInternational Studies and ProgramsUniversity of Nebraska Medical Center985735 Nebraska Medical CenterOmaha, NE 68198-5735 Tel: (402) 559-2924 / Fax: (402) 559-2923sepirtle@unmc.edu

GLOBAL INVOLVEMENT OF AHC’s AHC’s is Growing Rapidly Some recent examples include: And many more . . .

GLOBAL HEALTH/PARTNERSHIP UNMC , NMC, UNeMed, IMA 46 collaborative partnerships with medical institutions in 25 countries

Export Control Regulations Commerce Department Export Administration Regulation

Next Steps in our global presence… Where are we now? Where do we want to be in the future?

STAYING COMPETITIVE IN THE GLOBAL HEALTH CARE MARKET Mr. Nizar G. Mamdani Executive Director of International Healthcare Nebraska Medical Center

GLOBAL HEALTHCARE REALITIES 1. The revolution in communications technologies has raised our hopes that earth's current patchwork of countries may yet become a true global community. The growing globalization of businesses and enterprises has already begun 2. One major arena that stands to gain the greatest benefit from globalization is healthcare 3. Key components of understanding the dynamics of global health systems are: policy, financing, education, organization, leadership, and management 4. Regardless of the country, the health sector generally responds to the same political, social and financial pressures as other industries

US GOVERNMENT POSITION • The US Government, NIH, AHC, WHO, World Bank – all deliver the same message that the Global Health Care is vital to the growth and stability of the countries and that the developed nation have a social and sometimes a selfish reason to help in the promotion of decent healthcare • USAID Director Natsio’s speech in Spain this month reinforced US’s committed $16 billion to country stabilization programs

What Other US Medical Institutions Are Doing 1. Realizing the in inevitable progression and opportunities in the Global Healthcare Markets, most major medical institutions have substantial commitments to their international programs 2. Some institutions have also already taken their programs overseas in light of the post 9/11 situation about visa in the US: • John Hopkins in Singapore, Thailand, Panama, China • Harvard in India, United Arab Emirates, Japan • Cornell in Qatar • Emory University in India 3. GLOBAL-HEALTH is a reality today-UNMC needs to make a move now to secure a prominent position in this important market place and attain a long-term global presence

Current Handling of International Initiatives at UNMC 1. Several departments at UNMC are pursuing international activities in a variety of ways - there are no cohesive institutional policies or objectives 2. There is no ongoing sustainable follow up 3. Counter-productive to pursue international programs without adequate planning and follow up 4. International programs are discouraging because they take a longer time to mature - can only be effectively achieved through institutional commitment, persistence and support

Take Advantage of International Assets at UNMC • Partnerships with 76 medical institutions in 28 countries • Over 400 professional researchers/students from 40 countries • Provide training to 100s of international professionals • Hundreds of international patients have come to the Medical Center for their treatments • Have created a dynamic 2nd opinion consultation program, currently being utilized by over a dozen global institutions • Have signed significant cooperative agreements with key institutions in Japan, India and China for educational and research initiatives • Have people with great international contacts and network • Proven viability - have generated millions of dollars for the Medical Center in patient billings

Possible Areas of Global Opportunities for UNMC • UNMC's Research program expansion in key countries • Foster strong relationships for UNMC's Biotech initiatives/markets • Promote UNMC CON's RN to BSN programs internationally • Create a Telehealth Center of Excellence in collaboration with the Peter Kiewit Institute of Technology & UNMC's Allied Health Dept. • Take advantage of USAID’s new Country Stabilization programs, especially in Haiti, Somalia, Iraq and Afghanistan • Take advantage of professionals on our campus who have very valuable relationships and networks to help us achieve our goals

Benefits to UNMC • Make UNMC's global presence a REALITY • Research collaboration opportunities • Initiate BioMed programs to enhance international reputation and revenue • Strong international presence will enhance UNMC’s reputation, help attract top researchers/professionals to our institution • 6. Establish UNMC's Educational and TeleMed Programs globally • 7. Be a pioneer to take up the much needed standardization of the international medical education accreditation • 8. Opportunities for UNMC faculty, physicians, healthcare professionals, researchers and students to experience medical diversities in other countries • 9. Faculty and students exchange programs in over two dozen countries • 10. Build professional and personal international relationships • 11. Fulfilling a social commitment to help the less fortunate countries through training and assistance programs and participating in Federal programs • 12. Will be financially quite lucrative

CONCLUSION • Global healthcare has become a reality to reckon with • UNMC has the assets and the stature to have a positive impact in the Healthcare Globalization • Priority must be given to developing a viable infrastructure at UNMC that can follow through on international developments on a sustained basis • Important to embark on a coherent program to fulfill the social needs of helping the less fortunate nations – will also give us an opportunity to closely work with international NGO’s and Federal programs • The program will significantly raise UNMC’s standing and reputation in the US and Global healthcare arena • A well conceived international program will be self-sustaining, revenue generating and gratifying undertaking for UNMC

Global and International Healthcare Sheila Ryan, PhD Professor, CON-Parent-Child Administration Education & Science

The Globalization Of Society Places Increasing Demands On Us To Understand differing perspectives, traditions, religions, politics, cultures, health behaviors and health systems.

NURSING, as the largest health workforce, is essential to add value to global partnerships • Collaborate with international research to promote health and well being and better manage chronic care for all • Examine lessons of emerging and remerging threats to international health • Reduce burden of disease and disability

UNMC -CON asThe Global Leader in International Nursing Education • Leader in distance education • Leader in instructional technology • Leader in online course access • Leader with international “connections”

Mexico China Jordan India

Leader in Online Program Access • RN-BSN • BSN • MSN • 8 specialties, 2 with combined and integrated areas • CE models

Benefits to UNMC • Increase cultural sensitivity of faculty/students • Internationalize our curriculum • Increase faculty and student exchanges • Global classroom model for global outreach • Add to research site and samples • Multidisciplinary international doctoral program • Additional international students to all programs • -------------------------------------------------------------------------------------------------------------------------------------------------------------

Profitable and Cost-Effective Online Tele-education • By 2010 • Increase enrollment by 1500/year from five country • New financial models: Cost plus • High Revenue Product with Low Cost Risk • Partner with international societies and organizations

Leading Infectious Causes of Death Worldwide, 2001 SOURCE: WHO, 2002b

Global Partnershipsof dialogue, collaboration and shared planning can: • Decrease international nursing shortage • Increase professional standards and stature of nursing • Prepare nurse leaders for emerging healthcare roles

International BusinessStrategic Fit Mr. Joe B. Graham Chief Operating Officer Nebraska Medical Center

International Business Strategic Fit How does it advance our mission For Education? Research? Service? Outreach?

As positioned today International Business can advance the Mission(s) at the margin. If embraced more fully, it has the potential to be a separator in all of our missions.

However, it must produce cash.

High Winner Cash Cow Profit Houdini Keeper Low High Mission

High Cash cow Winner Profit Houdini Keeper Low High Mission

High Winner Cash Cow X Profit Houdini Keeper Low High Mission

High Good Risk Calculated Risk Profit or Mission Bad Risk Low Risk Low High Risk (legal, distraction, etc.)

High Calculated Risk Good Risk X Profit Low Risk Bad Risk Low High Risk (legal, distraction, etc)

High Mission X Low High Risk (legal, distraction, etc)

Requirements for Success • Sound Plan • Commitment • Time / Patience • Adaptability

Fontenelle Forest Nature Center Friday, March 25, 2005 7:30 a.m. – 3:00 p.m.