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Telehealth services business model final proposal
- 1. INTERESTING FACT: the Rod of Asclepius (with one serpent), not a Caduceus (two serpents and wings) is a symbol of healthcare Katarzyna Trzópek
- 2. E-Health uses digital technologies and telecommunications, such as computers, the Internet, and mobile devices, to facilitate health improvement and health care services E-health users communicate with health care professionals by e-mail, to access medical records, to research health information, and to engage in a person-to-person exchange of text, audio & video, and other data. Interactive TV, also known as Polycom, provides both audio and visual transfer of a variety of information between two or more individuals at two or more locations in real time. Kiosks, which are freestanding devices (usually computers), are used in e-health to provide interactive information to the user. Most information is provided through a series of interactive prompts on a touchscreen (Encyclopedia Britannica). Telemedicine - a field within E-Health, in which telecommunication technologies and medicine interact to allow for the provision of healthcare remotely
- 3. Socio- Demographic • Aging Population -- health care needs associated with that change • Rural versus Urban -- problems with access • Projected shortage of healthcare professionals Technological • Convergence of Telecommunication Technology and Consumer Electronics • Trend within medical sector to make devices more portable Economic • The Rising Cost of Healthcare • Possible Cost Savings with remote vvisits scheduled via Provider or an Online Service • Time Poverty -- the idea that there's not enough time to do all the work we need to do. Especially in high-earning professions, time is money. Regulatory • Medicare Coverage of Telehealth Services • American Recovery and Reinvestment Act (2009) )and provisions of Health Information Technology for Economic and Clinical Health (HITECH) • Health Insurance Portability and Accountability Act (1998)
- 4. •Teladoc 2002 •MD Live 2006 •Doctor on Demand 2012 •CareClix 2006 “General Purpose” telehealth companies offering exclusively online services •VSEE •California Telehealth network •Global Partnership for Telehealth Private and Non-profit organizations offering telehealth platforms • Hospitals • Physician offices Healthcare providers (e.g. Kaiser 1. Concierge services for fee paying patients: 91% 2. Medication management/prescription renewal: 86 % 3. Minor urgent care (i.e. pink eye, fevers): 85 % 4. Birth Control counselling: 83 % 5. Home health care: 82 % 6. Chronic condition management: 80 % 7. Pediatric after-hours needs: 79 % 8. Behavioral health: 77 % 9. Post-hospital discharge: 73 % 10. Post-surgical follow-up: 59 % TOP 10 USES OF TELEMEDICINE ACCORDING TO PHYSICIANS (2015)
- 7. PRODUCT PRICING PROMOTIONS PLACEMENT TARGET MARKET VALUE OFFERING BENEFITS DIFFERENTIATION SERVICES MARKETING MIX Bhasin, 2017 PEOPLE PROCESS PHYSICAL EVIDENCE This Photo by Unknown Author is licensed under CC BY- HUB and SPOKE network model to deliver care in the clinical department
- 9. Business Type: Professional, Scientific, and Technical Services Product Type: Unsought, Specialty Services Primary SIC Code: 8748 - Business Consulting Services, not elsewhere classified Primary NAICS Code: 541618 - Other Management Consulting Services Products or Services: health and wellness support via video-conferencing, website and mobile platforms and related technologies; in-house visits (possibly) Proposed Areas of specialty: chronic health conditions: Alzheimer disease and dementia, Arthritis, Asthma, Cancer, COPD, Crohn disease, Cystic fibrosis, Diabetes, Epilepsy, Heart Disease, HIV/AIDS Mission: To promote advanced information technologies and services to improve access to high quality healthcare focusing on those suffering from chronic diseases. Business-Level Strategy: single business focus strategy aiming to dominate a segment of a population); long-term corporate/related diversification Organizational Structure types to consider: Boundaryless/network (HUB –and-SPOKE), learning, and matrix;
- 10. Bhasin, H., (2017, December 15). Service Marketing Mix – 7 P’s of marketing. Marketing91. Retrieved from https://www.marketing91.com/service- marketing-mix/ Dietsche, E., 2017 December 25) 82% of consumers do not use telehealth, survey says. Telemedicine Retrieved from https://medcitynews.com/2017/12/consumers-telehealth/ Funding. (2017). Telemedicine.com Your Single Resource for Telemedicine. Retrieved from https://www.telemedicine.com/resources/funding/ Fortenberry, J.L & James K. E (2017) The Hub and Spoke organizational design: an avenue for serrving patients well. BMC Health Services Research, 17(1): 457 https://doi.org/10.1186/s12913-017-2341-x Online Medical Groups. (2017). Telemedicine.com Your Single Resource for Telemedicine. Retrieved from https://www.telemedicine.com/see- doctor-online/ Pennic, J., (2015, August 13. 4 types of telehealth solutions. HIT Consultant. Retrieved from https://hitconsultant.net/2015/08/13/4-types-of- telehealth-solutions/ Porter, M.E., (1980) Competitive Strategy. The Free Press. Retrieved from https://play.google.com/books/reader?id=Hn1kNE0OcGsC&hl=en&pg=GBS.PT54.w.0.2.30 10 top uses for telemedicine, according to physicians (2015, June 23). Becker’s Health IT & CIO Report Retrieved from https://www.beckershospitalreview.com/healthcare-information-technology/10-top-uses-for-telemedicine-according-to-physicians.html Wicklund, E. (2018 August, 6) A Georgia Non-Profit Looks to Market Telehealth to Rural America. TELEHEALTH NEWS. Retrieved from https://mhealthintelligence.com/news/a-georgia-non-profit-looks-to-market-telehealth-to-rural-america
Editor's Notes
- In this presention I am going to describe a telehealth services model. First, I will give some definitions, then I will present some of the extenral factors shaping this industry’s environment with a SWOT analysis and the Five forces framework. After I will present the organizational famework and the value proposition it is supposed to deliver.
- History : the idea of telehealth can be traced to the time when medical needs arose onboard of ships where no doctors where available. The first mention of using telephone to reduce unnecessary office visit was found in peer reviewed general medical journal Lancet in 1879 (Nesbitt, 2012).
- Market Analysis Telehealth involves both clinical and nonclinical services such as health education services, remote consultation between physicians or between physicians and patients. The driving aspect of health informatics in general, occurs at the convergence of telecommunication technology, intelligent home technology, and current healthcare information infrastructure technology. The rising costs of healthcare, the acuteness of healthcare costs in emergency situations and the predicted shortage of physicians in the aging society are important factors in driving efficiency, which technology integration can help achieve. In addition, the differences in healthcare coverage between rural and urban areas and the increasing prevalence of chronic diseases make a good case for a telehealth business model to deal with chronic diseases. It can also provide a real cost savings both the hospitals and the patients in a rural setting. The current ragulatory framework is also favorable. In 2009, the American Recovery and Reinvestment Act established the Health Information Technology for Economic and Clinical Health program, increasing funding to Federal programs such as Medicare to stimulate electronic health records adoption and the expansion of common data network. Also, the Interstate Medical Licensure Compact Commission is now expediating licensing permit to Physicians to practice telemedicine across state borders (before physicians were required to be licensed in each state where a patient was seen). Currently 19 states are participating in Compact program (Stewart, 2017). but likely more will join as time passes.
- „According to a survery conducted by Becker’s Health IT. 80 percent of physcians thought that chronic conditions can be managed successfully with telehealth. On the right, you can see the three busness models for telehealth. The biggest ones on the market such as Teladoc (2002), Doctor on Demand (2012), MdLive (2006), and CareClix offer a full online solution. The second group of non-profts and private companies provide a plaftorm for individual doctors to offer such services. Finally the hospitals themselves look for solutions to integrate the technology into their systems. Telehealth Solutions The survey, conducted in collaboration with QuantiaMD, gathered responses from more than 2,000 primary care physicians regarding their perceptions of video consultations (one of 10 top uses for telemedicine, according to physicians (2015, June 23). Telemeidicine.com a consulting gr that designs and installs programs in hospitals and clinics worldwide. On their website I found a link to the Online Medical Group who offer online services as well (Online Medical Groups, 2017). 2nd group – Private and non-profit companies offering platforms Non for profits can apply for grants from privately funded foundations such the Aetna foundation, the Blue –Shield foundation and the Hearst foundation, or Federal government. Examples : Global Telehealth built in house- platform designed for a small and resource thin healthcare providers (Wicklund, 2018). 3rd group Healthcare providers currently either offer or plan to offer telemedicine services (76 percent) , the rate of the adoption has been steady increasing over the years. Interestingly enough the providers did not expect that most of their patients would use telemedicine (Landi, 2017). And in fact 82 percent of consumers do not use telehealth services (Dietsche, 2017). It is the younger generation of millennials, 60 percent, that is most interested in using telehealth options (Pennic, 2015). Healthcare providers adopting telehealth solutions are finding themselves in one of the following three stages along their respective telehealth transformation journeys: – Stage 1, an ad-hoc solution often cobbled together to support the narrow, urgent need of a small group of clinicians and patients – Stage 2, a rationalized, departmental telehealth strategy that is more standardized and programmatic – Stage 3, a clinically integrated telehealth solution that enables advanced data exchange between healthcare providers, patients, labs, pharmacies and family caregivers.
- --As I have mentioned, the current competitve environment is favorable to the telehealth industry. There is an existing knowledge base, human capital and resources and the need for quality, afforbale healthcare is always there. The strengths of both healthcare and tech industries make it possible to take advantage of this opportunity, to expand to underserved domestic and international markets, and create unique branding opportunites. Perhaps even allow telehealth companies to co-brand with indurance companies and create a community of people who would not be connected otherwise if it wasn’t for technology and social media. That will likely bring an extra dimension to what corporate social responsability is about. - Healthcare professional and employers are in support of telehealth services. Nearly three-quarters of providers (73 percent) said they were satisfied with their organizations’ telemedicine platforms. More than 60 percent said improved patient access and scheduling flexibility were key factors in delivering that satisfaction, with program software and compensation rates also scoring high marks. And, a third of respondents said 50 percent or more of patients continued to use telemedicine after an initial visit, demonstrating growing patient satisfaction with the service. Looking at financial returns, while only 46 percent of organizations track return on investment, of those that do track, 60 percent reported savings of 10 percent or more. Twenty-nine percent of organizations reported cost savings of 20 percent or more from the use of telemedicine services. The survey also found that a next wave of opportunity for providers may lie in using telemedicine services to enter lucrative foreign markets. While just 22 percent currently offer international telemedicine services, 32 percent said they are interested in doing so. And, of that group, more than 80 percent plan to roll out international telemedicine programs within three years. Yet, a consequence of operating in foreign jurisdictions in this expedited fashion is becoming entangled in the various local laws and regulations that govern health care technology around the world, the report authors note.
- 5 Forces The essence of formulating competitive strategy is relating a company to its environment. As we learned in unit 2, the external environment can be very broad. The forces driving an industry’s competitive environment have been laid out in the Competitive Strategy book by Michael Porter in 1980. The collective strength of the forces and their configuration has an impact on the industry’s profitability as a whole. Here, I’ve made an attempt to identify suppliers, buyers, and potential entrants. On the left, are the suppliers of software solutions who charge per usage and they have a considerable power. Larger organizations are theoretically less dependent because they have a way to mobilize resources internally but often times they are also less flexible. This is the issue of management though and not a good reason for buying software out of a box. There is however a comprehensive solution on the market offfered by Vsee. On the plus side, they take care of the tech part of a telehelath business incuding technical support but in the same time, one is stuck with they software which is also costly. In the middle, the industry. The working definition of an industry is that of a the group of firms producing products that are close substitutes for each other (Porter, 1980 p36). Threat of Entry: The sources of funding for telehealth have increased and opportunities are out there to get funding from venture capital, however, given the complexity of the business, which requires highly specialized groups software developers and advanced healthcare professionals means that the barriers to entry are high and are likely to remain that way. The barriers to entry include economies of scale, favorable to the new entrants. Scaling the business is difficult and does not happen without increasing labor in the same time. Telehealth services complement traditional healthcare services, but they can also be excluded completely if they don’t provide quality. Service buyers are the key to adoption and the evidence clearly points to strong support on that area. “Health care providers, entrepreneurs, and patients alike have realized the potential to improve the quality of care in a more convenient, cost-effective manner which, in turn, has put pressure on the payer community to evolve their reimbursement strategies.” (Landi, 2017)
- This company’s focus is on patients with chronic care conditions and payers who are willing to pay for their coverage. Payers will be allowed to negotiatie their prices which are going to be per member per month ( pmpm ). The case fees are also going to be negotiated. The more members covered, the lower the case fees. The OFFERING can be tailored to the type of persona that is expected to use the service. This is difficul to accomplish because the lifestyle of people differ based on their occupation, age, their comfot with technology and the type of a chronic care condition. In some cases, like with aizheimers and cancer, the service might need to be extended to caregivers. The BENEFITS are going to include comprehensive healthcare support available 24 hours 7 days a week, non-healthcare related psychological, financial and logistical informational services, general information on related healthcare topics, ability to communicate with other patients in a private save environment, while staying anonymous, in time xyz company would plan to offer in house vists and montior patients via portable devices, and run tests which results could be instantly communicated to their onsite doctors via secure electronic health records. This company will differentiatate itself by delivering comprehensive and customizable programs for any chronic care condition. Staffing will include first level health consultants operating inside a call center, speciality Nurses and Physicans, and program managers who will collaborate with internal and external experts to inform and shape the offered programs. Recruitment of healthcare professionals will be ongoing and based on the needs of the supported programs. First level health consultants will be drawn from a student population and will serve as a pipeline for more advanced jobs later. For this service I see a staff of counsellors, nurses and practictinairs, who are dedicated to their work and the idea of helping people, and who are committed to continous learning. Learning and collaborating with technical staff on the service platform is a critical part of the company growth. Based onhttps://www.marketing91.com/service-marketing-mix/
- „The healthcare industry is characterized by intensive, never-ending change occurring on a multitude of fronts. Success in such tumultuous environments requires healthcare providers to be proficient in a myriad of areas, including the manner in which they organize and deliver services. Less efficient designs drain precious resources and hamper efforts to deliver the best care possible to patients, making it imperative that optimal pathways are identified and pursued. One particular avenue that offers great potential for serving patients efficiently and effectively is known as the hub-and-spoke organization design (Elrod & Fortenberry, 2017).” I think the hub and spoke architecture has the best chance to deliver the services value in the clinical department which will be run as one of the departments in this matrix project organization. You can review the detail summary of the company xyz on the next slide. Thank you.