Sustainable Healthcare Tourism in the Post COVID 19 Era

Abstract

Health tourism in India offers high-quality medical treatments to foreign tourists at affordable prices. The COVID-19 pandemic significantly impacted the industry, leading to a decline in the number of medical tourists. This chapter discusses the government’s response to the crisis and the opportunities for sustainable healthcare tourism in the post-pandemic era. The Indian government issued guidelines for health tourism operators, emphasizing sustainability. These guidelines aim to control the virus’s spread while ensuring the industry’s long-term sustainability. The article explores the potential for sustainable healthcare tourism in India post-COVID and how the industry can attract more foreign tourists by leveraging changing trends. The role of the government in managing the health tourism sector is to highlight and focus on sustainable practices. Measures to ensure the safety of foreign tourists seeking medical treatment in India are discussed, including sustainable infrastructure development, responsible waste management, and resource conservation. By incorporating sustainable practices, the health tourism industry can reduce its environmental impact and contribute to the well-being of local communities.

1. Introduction

Health tourism, also known as medical tourism, involves setting foot in another country to receive medical treatment, often at a lower cost than in one’s home country. In recent years, health tourism has become an important industry in India due to the country’s world-class healthcare facilities, skilled doctors, and cost- effective treatments. Health tourism brings in revenue for the country and helps boost its economy.

The growth of health tourism in India has been significant over the years. The medical tourism industry worldwide was valued at around US$16.761 million and is expected to reach US$27.247.6 million by 2024, with a compound annual growth rate [CAGR] of 8.5% during the period 2019–2023. According to reports from FICCI and IMS Health India, India holds approximately 18% of the global medical tourism market share [1]. India’s healthcare infrastructure has been steadily improving, and the country is now home to many world-class hospitals, clinics, and healthcare centers. In addition, the availability of skilled doctors and healthcare professionals in the country has also contributed to the growth of health tourism in India.

There are many reasons why India has become a popular destination for health tourism. Firstly, the cost of medical treatment in India is significantly lower than in countless other countries. Patients who travel to India for medical treatment can save money on their healthcare expenses [2]. Secondly, the quality of healthcare in India is excellent, with many hospitals and clinics equipped with state-of-the-art technology and facilities.

The government has introduced various policies and initiatives to make it easier for foreign patients to access medical treatment in India. For example, the government has simplified the visa process for medical tourists and introduced measures to ensure that healthcare providers in the country maintain high standards of quality and safety.

2. Impact of the pandemics on the healthcare tourism of India

In recent years, India has witnessed the impact of various pandemics on its healthcare tourism industry. The outbreaks of diseases like H1N1 influenza in 2009, Ebola virus during 2014–2016, and Zika virus in 2015–2016 have significantly affected the flow of medical tourists to the country, posing challenges to this crucial sector.

During these pandemics, healthcare tourism experienced a decline as potential travelers became increasingly concerned about the risk of contracting these diseases and the overall safety of medical facilities [3]. Governments worldwide issued travel advisories, urging their citizens to avoid non-essential travel to affected regions, including India, which reduced the number of international patients seeking medical treatment in the country.

The fear of infection and the uncertainty surrounding the pandemic resulted in many medical tourists canceling or postponing their scheduled treatments. The perceived risks associated with traveling for healthcare caused potential patients to rethink their decisions, opting to seek medical services locally rather than traveling abroad. This shift in patient behavior directly impacted the revenue generated from healthcare tourism in India.

Furthermore, during pandemics, healthcare providers and facilities were compelled to divert their attention and resources toward managing and containing the spread of diseases within their populations. The sudden influx of domestic patients suffering from pandemic-related illnesses strained the healthcare infrastructure, making it challenging to cater to medical tourists’ needs effectively. This diversion of resources further hampered the delivery of healthcare services to international patients.

The impact of these pandemics on healthcare tourism served as a wake-up call, highlighting the sector’s vulnerability to global health crises. It underscored the importance of implementing robust infection control measures and maintaining trust in the healthcare system. The ability to effectively communicate safety protocols and reassure potential medical tourists about the preparedness of healthcare facilities became critical.

As India gradually recovers from these pandemics, the healthcare tourism industry must rebuild trust and assure international patients of the safety and quality of healthcare services, achieved through a multi-faceted approach that encompasses enhanced safety protocols, stringent infection control measures, and transparent communication about the preparedness of healthcare facilities to handle any future health crises.

First and foremost, healthcare providers must prioritize implementing stringent infection control measures, including comprehensive training for healthcare personnel in handling contagious diseases and following strict hygiene protocols. Regular and thorough sanitization of medical facilities, proper waste management, and the availability of personal protective equipment [PPE] are crucial aspects of ensuring a safe healthcare environment.

Moreover, it is imperative to develop and enforce standardized guidelines and regulations specific to healthcare tourism, which address the challenges posed by pandemics. These guidelines should be regularly updated to align with international standards and cover areas such as patient screening, quarantine protocols, and emergency response mechanisms. By adopting and adhering to these guidelines, India can demonstrate its commitment to providing safe and reliable healthcare services to international patients.

Transparent and effective communication is pivotal in rebuilding trust and attracting medical tourists. Healthcare tourism stakeholders, including hospitals, clinics, and tourism boards, should actively engage in promotional activities highlighting safety measures, including showcasing the success stories of patients who received treatment in India during previous pandemics, emphasizing the high standards of care and the positive outcomes.

Public and private collaboration is essential to address the impact of pandemics on healthcare tourism effectively. Government agencies should work closely with healthcare providers and tourism authorities to develop strategies that mitigate risks and promote India as a safe and reliable destination for medical treatments, involving joint marketing campaigns, financial incentives for healthcare facilities, and the establishment of dedicated task forces to manage crises and support healthcare tourism.

3. Covid-19 impact on health tourism

Before the COVID-19 pandemic, the health tourism industry in India was booming. The country was a popular destination for medical tourists worldwide, particularly from the United States, the United Kingdom, and the Middle East [4]. India’s healthcare system has a reputation for providing high-quality medical treatments and procedures at a fraction of the cost in developed countries.

Several types of medical treatments and procedures were popular among foreign tourists in India. These included cardiac surgery, orthopedic surgery, cosmetic surgery, and cancer treatment. Patients chose India for these treatments because of the country’s skilled doctors and healthcare professionals, and affordable costs. In addition, India’s diverse culture, rich history, and warm hospitality made it an attractive destination for medical tourism (Figure 1).

Figure 1.

Market value with examples [3, 5].

The COVID-19 pandemic has significantly impacted the health tourism industry in India. The government has implemented travel restrictions, quarantine measures, and lockdowns. These measures have made it difficult for medical tourists to travel to India for treatment. In addition, the pandemic has led to a shortage of medical supplies, including drugs and vaccines, and a strain on the healthcare infrastructure (Figure 2) [6].

Figure 2.

Dimensions of medical tourism affected by the COVID-19 pandemic.

The government has taken various measures to control the spread of the virus and support the healthcare sector during the pandemic. These measures include increasing the production of medical supplies, providing financial support to healthcare workers, and launching a nationwide vaccination drive. The government has also introduced guidelines for health tourism operators to ensure the safety of domestic and foreign patients seeking medical treatment in the country.

The pandemic’s impact on India’s health tourism industry has been significant. The industry has experienced a sharp decline in revenue, with many hospitals and clinics reporting a drop in foreign patients. However, the industry has also adapted to the changing circumstances by offering telemedicine services and online consultations to patients who cannot travel to India for treatment.

4. Role of healthcare professionals in healthcare tourism during the pandemic

During the COVID-19 pandemic, healthcare professionals have played a vital role in reaching out to local and global patients, including those seeking healthcare services through medical tourism. Their expertise, dedication, and adaptability have been crucial in ensuring the safety and well-being of patients in these challenging times.

Locally, healthcare professionals have been at the forefront, having worked diligently to provide timely and accurate information about the virus, preventive measures, and treatment options to domestic and international patients. By staying updated with the latest research and guidelines, healthcare professionals have effectively addressed the concerns and queries of medical tourists.

In medical tourism, a crucial pillar was communicating with international patients and facilitating their healthcare needs. They have used various telemedicine technologies to provide virtual consultations, assess patient conditions, and offer medical advice [7]. This approach has allowed medical tourists to receive expert opinions and guidance from healthcare professionals without demanding physical travel, ensuring continuity of care.

Healthcare professionals have also been actively coordinating travel logistics and ensuring the seamless transfer of medical records and test results for international patients. By collaborating with healthcare tourism facilitators, they have helped streamline the process of accessing healthcare services in India, including assisting with visa arrangements, coordinating appointments, and providing the necessary documentation to facilitate medical treatments.

Moreover, stringent infection control protocols have been implemented to ensure the safety of international patients seeking medical care. They have followed international guidelines for hygiene practices, personal protective equipment [PPE] usage, and social distancing measures to create a safe healthcare environment.

These measures have protected patients and instilled confidence among medical tourists regarding the quality and safety of healthcare services in India (Figure 3).

Figure 3.

Roles and benefits during the pandemic.

Additionally, unique challenges of the medical tourists were recognized during the pandemic. They have provided personalized support and guidance to patients, addressing concerns related to travel restrictions, quarantine requirements, and changes in treatment plans. This level of care and attention has been crucial in maintaining a strong bond of trust between healthcare professionals and medical tourists.

Furthermore, vaccination drives have been instrumental in ensuring the safety and well-being of local communities and international patients. By actively promoting vaccination and providing accurate information about vaccine efficacy and safety, healthcare professionals have contributed to the resumption of healthcare tourism by instilling confidence in potential medical tourists.

5. Opportunities and measures taken post-Covid

With the availability of vaccines and the easing of travel restrictions, the health tourism industry has bounced back post-COVID. One of the changing trends in the health tourism industry post-COVID is the increased demand for wellness tourism. Wellness tourism involves traveling to a destination to maintain or improve one’s health and well-being. India, with its rich Ayurveda, yoga, and meditation history, is a natural destination for wellness tourism [8]. The Indian government can leverage this trend by promoting India as a destination for wellness tourism, highlighting the benefits of Ayurveda, yoga, and meditation, and supporting wellness tourism operators.

Another trend in the health tourism industry post-COVID is the increased use of technology. With the pandemic highlighting the importance of telemedicine and online consultations, health tourism operators can leverage technology to provide patients with remote consultations and follow-up care. The Indian government can support this trend by providing incentives and support to health tourism operators who adopt the technology.

The Indian government is crucial in managing the health tourism industry post- COVID. Various measures are in place for the safety of foreign tourists seeking medical treatment in India. These measures include issuing guidelines for health tourism operators, providing financial assistance to hospitals and clinics for upgrading their facilities, and launching a certification program for healthcare facilities to ensure compliance with international standards.

A Medical Value Travel Facilitation Portal in conjunction with the Heal in India and Heal by India Programs, is an online platform that provides information on healthcare facilities, medical treatments, and visa procedures to foreign tourists seeking medical treatment in India [9]. The government has also launched a marketing campaign to promote India as a destination for medical tourism, highlighting the benefits of the country’s healthcare system and its affordable costs.

Several health tourism operators in India have followed government guidelines to ensure the safety of foreign tourists seeking medical treatment in India. One example is the Manipal Hospitals, which has implemented strict safety protocols, including mandatory COVID-19 testing, social distancing measures, and contact tracing. Manipal Hospitals has also adopted technology, providing patients with online consultations and follow-up care (Figure 4) [10].

Figure 4.

Factors affecting the choice of destination for medical tourism.

Niti Aayog recognizes medical value travel as a key growth driver and significant forex earner [11]. Medical value travel benefits India by boosting the economy through foreign patient spending, enhancing healthcare reputation, promoting knowledge exchange, improving medical infrastructure, creating employment opportunities, and contributing to overall economic growth and global recognition.

6. Technology enabling during the pandemic for promoting health tourism

As countries recover from the pandemic and travel restrictions ease, technology has emerged as a crucial enabler for promoting health tourism in India in the post- pandemic era. With a focus on safety, convenience, and accessibility, technology solutions have transformed how medical travelers engage with healthcare providers and access healthcare services.

Telemedicine and virtual consultations have gained tremendous popularity during the pandemic. Through secure video conferencing platforms, patients can discuss their medical conditions, seek expert opinions, and even receive follow-up consultations from the comfort of their homes. This convenience not only saves time and costs for medical tourists but also allows them to receive timely medical advice and access specialized healthcare services in India.

Technology has facilitated the digitization of medical records, making it easier for medical tourists to access and share their medical history with healthcare providers in India. EMRs enable seamless information exchange between healthcare professionals, ensuring continuity of care and reducing the risk of errors. With secure electronic platforms, medical tourists can securely store and access their medical records, ensuring that healthcare providers have comprehensive and accurate information for effective diagnosis and treatment.

Dedicated health tourism portals and mobile applications have emerged as centralized platforms, providing medical tourists with comprehensive information and resources. These platforms offer various services, including information on healthcare providers, treatments, costs, and patient testimonials. Medical tourists can browse through different providers, compare services, read reviews, and make informed decisions about their healthcare journey in India. These platforms also facilitate online appointment booking, visa assistance, and accommodation arrangements, streamlining the entire process for medical tourists.

One such platform is HealthTrip, which is an innovative medical tourism platform that leverages advanced technologies like artificial intelligence and virtual reality to provide personalized treatment options. It offers comprehensive packages that include medical consultations, treatment planning, concierge services, and post- treatment care, ensuring a seamless and hassle-free experience for patients traveling abroad for medical purposes [12].

Healthcare providers and medical tourism agencies leverage social media platforms, search engine optimization [SEO], and targeted online advertisements to reach potential medical tourists globally. They highlight their expertise, state-of-the-art facilities, and success stories to build trust and attract patients. Additionally, online reputation management ensures that positive patient experiences are shared through reviews and testimonials, further promoting India as a preferred destination for health tourism.

With the help of data analytics, healthcare providers can gather valuable insights into patient preferences, treatment outcomes, and satisfaction levels [13]. By analyzing data, healthcare facilities can tailor their services to meet the specific needs of medical tourists. Personalized care, customized treatment plans, and individualized patient experiences enhance the overall satisfaction of medical tourists and encourage them to recommend India as a destination for health tourism.

7. Future plan

One of the challenges to health tourism in India is the perception of the country’s healthcare system. While India has world-class healthcare facilities and skilled healthcare professionals, the perception of the country’s healthcare system is often negative due to poor sanitation and hygiene, lack of transparency in pricing, and delays in obtaining medical visas. The quality of healthcare services must be improved, and must address the concerns of foreign tourists, and provide transparent pricing and visa procedures.

Another challenge is the need for more awareness among foreign tourists about the availability and quality of healthcare services. Many foreign tourists need to be made aware of the medical treatments and procedures available in India or the affordable costs of these treatments. The Indian government and health tourism operators must launch marketing campaigns to promote India as a destination for health tourism, highlighting the benefits of the country’s healthcare system and providing information on medical treatments and procedures available in India.

The need for more infrastructure and facilities in some areas of India is another challenge. While major cities such as Delhi, Mumbai, and Bangalore have world-class healthcare facilities, many other regions need more infrastructure and facilities to attract foreign tourists. Financial and technical assistance must be provided to hospitals and clinics in these regions to upgrade their facilities and provide high- quality healthcare services.

The future of health tourism in India is bright, with several opportunities for growth in the coming years. One of the growth opportunities is medical tourism, which involves traveling to a destination for medical treatments and procedures. The Indian government and health tourism operators can leverage this opportunity by promoting India as a destination for medical tourism, highlighting the benefits of the country’s healthcare system, and providing high-quality healthcare services to foreign tourists. Another opportunity for growth in the health tourism industry in India is wellness tourism. India, with its rich Ayurveda, yoga, and meditation history, is a natural destination for wellness tourism.

The “Atithi Devo Bhava” principle forms the fundamental essence of Indian hospitality, encouraging hosts to treat guests with utmost respect akin to divinity. This ethos guides India’s tourism and hospitality sector to welcome global tourists and warmly offer them an unforgettable experience. With its vast landscapes, diverse culture, rich heritage, and significant historic sites, India is a remarkable destination for travelers worldwide. Furthermore, India’s reputation for producing exceptional doctors adds to its appeal as a medical tourism hotspot. This advantage makes India a preferred choice for individuals seeking medical treatments abroad.

Furthermore, four significant trends will shape the future of wellness tourism and India’s position in the industry. These include Ayurveda, robotic surgeries, surgical camps, and startups. These trends contribute to the growth and development of India’s medical tourism sector, offering unique and advanced healthcare solutions. Prime Minister Narendra Modi recently expressed his vision of India becoming a global medical tourism hub during the Global Investment in Ayush Summit. His passionate remarks highlighted the potential for India to save and serve millions of lives each year, earning it a prominent position in the evolving geopolitical landscape [14].

Moreover, India’s healthcare system has gained recognition, with numerous politicians and government officials from Africa and Asia expressing gratitude for Indian healthcare providers who have rescued the lives of their loved ones, forming a valuable asset for India in the dynamic realm of international politics.

Additionally, insurance presents a significant opportunity for growth. Indian insurance companies should actively explore avenues to offer health insurance to foreigners, tapping into the potential of this market segment.

8. Conclusion

Health tourism, also known as medical tourism, has emerged as a significant industry in India, driven by the country’s world-class healthcare facilities, skilled doctors, and cost-effective treatments. India’s healthcare industry has experienced substantial growth over the years, with the country’s healthcare infrastructure improving. The availability of affordable medical treatment in India has made it a popular destination for patients seeking high-quality healthcare at lower costs compared to their home countries.

However, the health tourism industry in India has faced challenges due to various pandemics, including the H1N1 influenza, Ebola virus, Zika virus, and, most recently, the COVID-19 pandemic. These outbreaks have resulted in a decline in the number of medical tourists traveling to India, as concerns about the risk of infection and the overall safety of medical facilities increased. Travel advisories and government restrictions have further impacted international patients flow.

The COVID-19 pandemic, in particular, has significantly impacted the health tourism industry in India. Travel restrictions, quarantine measures, and lockdowns have made it difficult for medical tourists to access healthcare services in the country.

The diversion of resources toward managing the pandemic within the domestic population has strained the healthcare infrastructure, making it challenging to cater to international patients’ needs effectively. As a result, the industry has witnessed a decline in revenue and a shift in patient behavior, with many opting for local healthcare services instead.

Healthcare professionals have played a crucial role in communicating with international patients and providing virtual consultations. Telemedicine and online platforms have become essential tools in delivering healthcare services remotely, ensuring continuity of care, and minimizing the risk of exposure to the virus.

As countries recover from the pandemic and travel restrictions ease, technology has emerged as a vital enabler for promoting health tourism in India during the post- pandemic era. Telemedicine and virtual consultations have gained popularity, offering convenience and timely access to specialized healthcare services for medical tourists. The digitization of medical records has facilitated seamless information exchange, ensuring continuity of care and accurate diagnosis. Dedicated health tourism portals and mobile applications have centralized resources and streamlined the healthcare journey for patients. Platforms like HealthTrip leverages advanced technologies to provide personalized treatment options and comprehensive packages for medical tourists.

To attract more international patients, healthcare providers and medical tourism agencies utilize social media, search engine optimization, and online advertisements to showcase their expertise and facilities. Online reputation management helps promote positive patient experiences and build trust. Data analytics plays a crucial role in gathering insights and tailoring services to meet the specific needs of medical tourists, enhancing overall satisfaction.

While the future of health tourism in India holds immense potential, there are challenges to overcome. Improving the perception of India’s healthcare system, creating awareness among foreign tourists, and enhancing infrastructure and facilities in certain regions is crucial. Transparent pricing, efficient visa procedures, marketing campaigns, and infrastructure development will contribute to India’s health tourism growth.

In this context, India’s hospitality ethos, “Atithi Devo Bhava,” which treats guests with the utmost respect, aligns with the country’s efforts to welcome and serve international patients. With its diverse culture, rich heritage, and world-class healthcare facilities, India is a remarkable medical and wellness tourism destination. As expressed by Prime Minister Narendra Modi, the vision of India becoming a global medical tourism hub underscores the country’s commitment to serving and saving lives, further solidifying its position in the evolving geopolitical landscape.

Looking ahead, the health tourism industry in India has a promising future. Medical tourism can leverage India’s advanced healthcare services and attract international patients seeking affordable, high-quality treatments. Additionally, India’s heritage in Ayurveda, yoga, and meditation positions it as a natural destination for wellness tourism. By leveraging technology, improving perceptions, raising awareness, and enhancing infrastructure, India can cement its position as a preferred destination for health tourism and contribute to the country’s economic growth and global recognition.

Conflict of interest

The authors declare no conflict of interest.