Health Care Value Chain Professor William Wan Value

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Health Care Value Chain Professor William Wan

Health Care Value Chain Professor William Wan

‘Value’ in Health Care Value = Health outcomes/Costs of delivering the outcomes

‘Value’ in Health Care Value = Health outcomes/Costs of delivering the outcomes

Firm Value Chain (Swayne et al) Primary Activities Pre-Service Point-of-Service *marketing/marketing *clinical operations research

Firm Value Chain (Swayne et al) Primary Activities Pre-Service Point-of-Service *marketing/marketing *clinical operations research - quality *services - process offered/branding innovation *pricing *marketing *distribution/logistics - patient *promotion satisfaction After-Service *follow-up - clinical - marketing *billing *follow-on -clinical -marketing Organization Culture *shared assumptions *shared values * behavioral norms Support Activities Organizational Structure *function * division * matrix Strategic Resources * Financial * human *information * technology Add Value

Firm Value Chain Pre-Service Point-of-Service *clinical operations Primary Activities After-Service - high efficiency (20

Firm Value Chain Pre-Service Point-of-Service *clinical operations Primary Activities After-Service - high efficiency (20 minutes turnaround time) - no meal (gives beverage/snack ) - no seating assignment (pick your spot) Organization Culture Support Activities Organizational Structure Strategic Resources Add Value

Firm Value Chain 1. What are the resources/capabilities for the activities? Pre-Service Primary Activities

Firm Value Chain 1. What are the resources/capabilities for the activities? Pre-Service Primary Activities 2. To what extent are they valuable, rare, inimitable, and nonsubstitutable? Point-of-Service *clinical operations After-Service - high efficiency (20 minutes turnaround time) - no meal (gives beverage/snack ) - no seating assignment (pick your spot) Support Activities Organization Culture Organizational Structure Strategic Resources Add Value

Care Delivery Value Chain Support Activities (Porter) Knowledge Management Informing Measuring Accessing Monitoring/ Preventing

Care Delivery Value Chain Support Activities (Porter) Knowledge Management Informing Measuring Accessing Monitoring/ Preventing Diagnosing Primary Activities Preparing Intervening Recovering/ Rehabilitating Monitoring/ Managing Patient Value

Care Delivery Value Chain for Glaucoma (Buhlmann, 2009) Knowledge Management Informing *life style counseling

Care Delivery Value Chain for Glaucoma (Buhlmann, 2009) Knowledge Management Informing *life style counseling *diet counseling *explanation of the diagnosis & implications *education on procedures *life counseling *medication counseling *lifestyle counseling *medication compliance follow -up *lifestyle counseling *IOP, tonometry *visual field test *Ocular fundus *Nerve fiber scan *procedurespecific pretesting *Procedurespecific measurements *IOP, tonometry Retinal nerve fiber layer thickness *office visits *lab visits *various *office visits *hospital visits *office/lab visits *Telephone/ internet interaction *office visits *Lab visits Telephone/ internet interaction Measuring Accessing Monitoring/ Preventing Diagnosing Preparing Intervening Recovering/ Rehabilitating Monitoring/ Managing *monitoring IOP *monitoring & addressing risk factors *early specialist referral for abnormal IOP or ocular fundus *medical & family history *Dedicated advanced testing *consultation with other specialists *formal diagnosis *formulate a treatment plan *procedurespecific preparation *tight IOP control *pharmaceutical: IOP lowering drugs/eye drops *fine-tuning of the drug regimen *determining supporting nutritional modifications *managing IOP *monitoring visual field *managing aqueous fluid production *procedures: trabeculectomy/ micro plugs Patient Value