Inside Cleveland Clinic Connected, A New Collaborative Model

As healthcare challenges intensify, hospital administrators and clinicians are looking for ways to access practical expertise beyond their walls without relinquishing control of patient care or facility management.

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Cleveland Clinic Connected was developed to address those needs.

The program is a long-term, consultative relationship. It gives member hospitals access to Cleveland Clinic’s wealth of clinical and operational knowledge while leaving ownership, governance and patient care firmly in local hands.

Through offerings such as advisory services, assessments of clinical service lines, educational and training programs and strategic guidance, the program aims to help organizations improve their quality, patient experience and clinical and operational capabilities.

The program is available to domestic and international hospitals and healthcare systems. It draws on Cleveland Clinic’s decades of experience as a global healthcare provider, operating hospitals and healthcare facilities in North America, Europe and the Middle East.

“We're that at-the-elbow mentor to guide them and share lessons learned over Cleveland Clinic’s 105 years of operation,” says Joe Sweet, a Senior Director in International and Emerging Markets who oversees Cleveland Clinic Connected’s international members.

Origins and rationale

Cleveland Clinic Connected began in 2018.

It emerged from Cleveland Clinic’s broader strategy to expand its global presence and share its unique care model beyond the healthcare system’s own facilities, building a network of independent, like-minded, quality-focused organizations to improve patient care around the world.

The goals are multifaceted: extending Cleveland Clinic’s clinical expertise, supporting hospitals seeking to improve and differentiate their services, and building relationships in regions where the organization may expand further in the future.

Currently, the program has six international members and three in the United States, with plans for additional growth.

How membership works

Cleveland Clinic evaluates potential members based on criteria that include:

Alignment with Cleveland Clinic’s mission and values
The geopolitical stability of the member’s market
The institution’s and region’s economic condition
Whether Cleveland Clinic can provide benefit to the potential member

A membership’s duration is a minimum of five years, allowing time to build relationships and implement meaningful improvements.

The delivery of consultative services follows a hybrid model, combining virtual collaboration with in-person engagement. Cleveland Clinic teams travel to member sites, and member physicians and administrators visit Cleveland Clinic locations for observerships and training.

While several other American healthcare organizations offer consultation services, Cleveland Clinic Connected is distinct, Sweet says. “We provide much deeper connections and advisory support with a select few rather than spreading ourselves too thin with a lot of members around the world.”

A different approach

Relationships in healthcare can take many forms, from branding arrangements to management agreements. Cleveland Clinic Connected is structured differently.

Its members retain full command of their operations, using Cleveland Clinic as a collaborative resource. Cleveland Clinic does not manage member facilities, employ their physicians or assume governance roles. The member’s brand and identity is not erased or diluted.

“It's really about cultural integration rather than imposing our own culture on our members,” says neurologist Emad Estemalik, MD, MBA, a Cleveland Clinic Connected Medical Director. “We’re giving them guidance and access to our intellectual property — how we deliver care, how we approach quality and safety. What they do with this information is ultimately their decision.”

That distinction is central to the program’s design and to how it is presented to prospective members, some of whom might worry that the relationship could lead to acquisition or loss of autonomy.

“We make it very clear early on: That’s not our intention,” Sweet says. “Our role is to learn from your team and better understand your approach to care delivery.”

Each collaboration is customized, not one-size-fits-all. The scope varies by an individual member’s priorities, needs, market situation and goals.

Some members may be focused on existing operations; others on building programs — or even entire hospitals — from scratch.

For example, Croatia’s Radiochirurgia Zagreb hospital, which became a member in 2025, is concentrating on solidifying its position as a leader in oncology care in southern and eastern Europe.

Exterior of Radiochirurgia Zagreb — Croatia's Radiochirurgia Zagreb cancer hospital

Central Asian University, another 2025 addition to Cleveland Clinic Connected, will leverage the collaboration to create a new hospital on the university’s expanded medical campus in Tashkent, Uzbekistan. Cleveland Clinic will provide direction on facility design and management, development and validation of medical education and residency programs, establishment of a nursing school, physician recruitment, supply chain management and digital transformation.

“We're guiding them through processes we're familiar with, how we've established hospitals according to market needs and geographical and population differences,” Dr. Estemalik says.

Rendering of Central Asian University Hospital. Courtesy of Central Asian University and HKS Architects

Membership’s advantages

Through its relationships with member hospitals in key markets, Cleveland Clinic gains visibility, increased brand recognition and clinical connections between local physicians and Cleveland Clinic specialists.

Members, in turn, get extensive mentoring and support in a variety of areas including clinical and hospital operations; patient care; medical education; professional and leadership development; marketing; supply chain; architecture and design; safety, quality and patient experience; caregiver retention; and strategic planning and growth.

“Safety, quality, and patient experience remain at the core of all our engagements and drive the value of the relationship”, says Erick Vidmar, an Executive Director in International and Emerging Markets who oversees Cleveland Clinic Connected’s domestic members.

How that focus is translated into day-to-day practice — particularly across diverse healthcare systems — is a central part of the program’s work.

Strengthening SQPE

At the center of every Cleveland Clinic Connected engagement is a focus on helping member organizations elevate safety, quality and patient experience — not by imposing a rigid set of standards, but by translating Cleveland Clinic’s principles into each member’s local context.

“That is the cornerstone of the program,” says Michelle Medina, MD, Cleveland Clinic Connected’s Medical Director for the Asia region.

The process begins with sharing how Cleveland Clinic defines and approaches safety, quality and patient experience, then working with members to operationalize those ideas. Leaders and frontline caregivers are engaged in understanding what those principles mean in practice: what should be measured, how performance should be communicated and what tools are needed to support continuous improvement.

“We help them understand our guiding principles and then translate those into actual processes,” Dr. Medina says. “What does that look like for executive leadership? What does it look like for caregivers? What are the tools, and how can they be applied in a local setting?”

Rather than exporting Cleveland Clinic’s metrics, the program helps members develop measurement systems that reflect their own realities.

That approach extends to how improvement efforts evolve over time. As organizations gain experience with foundational tools and governance structures, Cleveland Clinic Connected helps them think about progression — from basic capabilities at the frontline level to systemwide integration.

“There’s a natural question: How do you move from having tools in place to actually maturing as an organization?” Dr. Medina says. “That’s where we’re focusing now — helping them see how they can improve over time.”

Importantly, the program is designed as a coaching relationship, not an auditing function.

That coaching often includes working with frontline caregiver teams, whose insights can drive meaningful change. In some cases, local adaptations of Cleveland Clinic practices have produced innovations tailored to specific environments.

Dr. Medina cites an example from Vietnam, where teams adapted the use of checklists — a common safety tool — not only to improve clinical reliability but also to better manage limited resources.

“They took the concept and applied it in a way that made sense for their setting,” she says. “That’s their context, not ours — and it works for them.”

The result is a model that blends Cleveland Clinic’s experience with local expertise, reinforcing a culture of continuous improvement rather than prescribing a single way of working.

Clinical consultations

Physician-to-physician consultations regarding complex patient care issues — known as eClinical Reviews — are an optional feature of Cleveland Clinic Connected.

Physicians at member hospitals can submit medical records, imaging, lab work and other information for review by Cleveland Clinic specialists. The specialists provide a detailed written assessment describing how they would approach the case.

The most common areas for consultation are cardiology, oncology and neurology — specialties that often involve difficult issues and complicated decisionmaking and that benefit from the multidisciplinary teamwork Cleveland Clinic is known for.

The consultation report is returned to the member hospital’s medical team, not directly to the patient. This preserves the local physician’s central role in care.

While not all members utilize eClinical Reviews, the consultations illustrate the program’s broader emphasis on collaboration and shared clinical insight.

Working across borders

A significant portion of Cleveland Clinic Connected’s activity takes place outside the United States, where healthcare systems, regulations and clinical practices can differ substantially.

Cleveland Clinic draws on its experience operating in international markets — including London and Abu Dhabi — as well as on local expertise.

“We don’t assume we know every market,” Sweet says. “We learn it alongside our members.”

That learning process includes collaboration with Cleveland Clinic’s in-country representatives, consultation with third-party experts and input from Cleveland Clinic physicians with ties to specific regions.

The organization also considers geographic relationships between members and its global hubs.

“We look at the proximity of our members from a flight radius into our key hubs,” Sweet says. “We make sure those integrations are in place early in the relationship. If a member has a challenging clinical case that they can’t support, we want them to have a direct connection to one of our hospitals so they can get their patient there quickly if needed.”

Looking ahead

Cleveland Clinic leaders expect the Connected program to continue expanding domestically and internationally, with potential growth in Europe and Latin America, as well as further development in Asia.

At the same time, they emphasize that growth will remain deliberate.

“We want to grow, but we’re going to grow in a smart way,” Sweet says.

The long-term vision centers on building a network of relationships — connecting local providers with Cleveland Clinic expertise while preserving the strengths of each organization.

For physicians and healthcare leaders evaluating the model, Dr. Estemalik offers a simple proposition:

“If you’re looking to expand your horizons, elevate patient care and connect with some of the best clinical teams in the world,” he says, “we're the organization you want to work with.”

Photo at top: A Cleveland Clinic Connected representative meets with officials from Barton Health, a not-for-profit community healthcare system serving California and Nevada. Barton Health became a Connected member in 2025.