Health Care Value Chain

Professor William Wan

‘Value’ in Health Care

Value = Health outcomes/Costs of delivering the outcomes

Firm Value Chain(Swayne et al)

Pre-Service*marketing/marketing research*services offered/branding*pricing*distribution/logistics*promotion

Point-of-Service*clinical operations - quality - process innovation*marketing - patient satisfaction

After-Service*follow-up - clinical - marketing*billing*follow-on -clinical -marketing

Organization Culture*shared assumptions *shared values * behavioral norms

Organizational Structure*function * division * matrix

Strategic Resources* Financial * human *information * technology

PrimaryActivities

SupportActivities

AddValue

Firm Value Chain

Pre-Service Point-of-Service

*clinical operations

- high efficiency (20 minutes turnaround time) - no meal (gives beverage/snack ) - no seating assignment (pick your spot)

After-Service

Organization Culture

Organizational Structure

Strategic Resources

PrimaryActivities

SupportActivities

AddValue

Firm Value Chain

Pre-Service Point-of-Service

*clinical operations

- high efficiency (20 minutes turnaround time) - no meal (gives beverage/snack ) - no seating assignment (pick your spot)

After-Service

Organization Culture

Organizational Structure

Strategic Resources

PrimaryActivities

SupportActivities

AddValue

1. What are the resources/capabilities for the activities?

2. To what extent are they valuable, rare, inimitable, and nonsubstitutable?

Care Delivery Value Chain(Porter)

Monitoring/Preventing

Diagnosing

Preparing Intervening

Recovering/Rehabilitating

Monitoring/Managing

Knowledge Management

Informing

Measuring

Accessing Patie

ntValue

Primary Activities

Support Activities

Care Delivery Value Chain for Glaucoma(Buhlmann, 2009)

*life style counseling*diet counseling

*explanation of the diagnosis & implications

*education on procedures*life counseling

*medication counseling

*medication counseling*lifestyle counseling

*medication compliance follow-up*lifestyle counseling

*IOP, tonometry

*IOP, tonometry*visual field test*Ocular fundus*Nerve fiber scan

*procedure-specific pretesting

*Procedure-specific measurements

*IOP, tonometry

*IOP, tonometryRetinal nerve fiber layer thickness

*office visits*lab visits

*office visits*lab visits

*various *office visits*hospital visits

*office/lab visits*Telephone/internet interaction

*office visits*Lab visitsTelephone/internet interaction

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

*procedure-specific preparation*tight IOP control

*pharmaceutical: IOP lowering drugs/eye drops

*procedures: trabeculectomy/micro plugs

*fine-tuning of the drug regimen*determining supporting nutritional modifications

*managing IOP*monitoring visual field*managing aqueous fluid production

Knowledge Management

Informing

Measuring

Accessing

PatientValue