The Service Line Development

At present time, there are many areas that are in high demand for patients in the service line area for completely new service lines. When following the strategic plan of implementation of the cardiovascular, cancer and orthopedic centers it will help to analyze the demand for the development of three new service lines. Please see below the elements necessary to perform such evaluation.

How will position this three programs and centers (Cancer, Orthopedic and Cardio-Vascular), as an aggressive business competition for Trinity Community Hospital in the assigned market area.

By reviewing the existing Trinity Community Hospital programs and services offered, that could serve as complementary components of the three new service lines.

This will make accessible the most advanced medical approaches for diagnosing, treating and preventing disease elements that will end helping many people, we could say in the thousands.

How will this three programs and centers (Cancer, Orthopedic and Cardio-Vascular), strengthen the outreach to be able to compete for great care and value-driven customers (patients), in the assigned market area.

Most likely this will drive very strong increases in volume and at the same time will improved the financial performance.

By performing a competitive analysis of similar programs (Cancer, orthopedic and Cardiovascular programs) in the assigned market area.

To evaluate and analyzed the trends in the industry (healthcare, but specifically to Cancer, Orthopedic and Cardiovascular elements) and evaluate the demand in the defined market area for such specialty services.

The demand to expand the service line is essential to increase performance of the organization and its future depends on the success of implementation of these three service lines (Cancer, Orthopedic and Cardio-Vascular).

The demand for developing these service lines as a Regional Cancer Center, a Regional Orthopedic Center and finally a Regional Cardiovascular Center in the assigned market area is based in specialty services is as follows, by using information from the WGU case study, exactly from the five-years program strategic plan (PDF file):

Goal 1: Developing a Regional Cancer Center.

Strategy A: Offer Distinctive Clinical Programs and Services

• Multidisciplinary, disease-focused clinics: breast, GI, lung, prostate
• Comprehensive medical, surgical, radiation, support services
• Evidence-based treatment and access to leading clinical trials

Strategy B: Emphasize Cancer Prevention and Control

• Community education
• Screening and risk assessment
• Outreach to underserved communities
• Strategy C: Enhance Service Access
• Fast-track scheduling
• Patient navigation

Goal 2: Developing a Regional Orthopedic Center.

Strategy A: Offer Distinctive Clinical Programs and Services

• Spine, total joint, hand
• Comprehensive rehab and support programs
• Best practices and treatment protocols

Strategy B: Emphasize Prevention of Injury and Disease

• Community education
• Screening and risk assessment
• Outreach services to underserved communities
• Strategy C: Enhance Service Access
• Fast-track scheduling
• Coordination of services

Goal 3: Developing a Regional Cardiovascular Center.

Strategy A: Offer Distinctive Clinical Programs and Services

• Peripheral artery disease, heart failure, electrophysiology
• Cardiology for women
• Evidence-based treatment

Strategy B: Emphasize Prevention and Control of Cardiovascular Disease

• Community Education
• Screening and risk assessment
• Outreach services to underserved communities
• Strategy C: Enhance Service Access
• Fast-track scheduling
• Coordination of services

When looking at the above goals (three of them) and strategies, the demand for this three (Cancer, Orthopedic and Cardio-Vascular) service lines in the assigned market area will required to direct the focus on the following crucial elements:

To guarantee that Trinity Community Hospital operations are conducted in an effective and competent manner.

To help to differentiate the organization (Trinity Community Hospital), also to generate profits, and to improve the care of their patients, and document quality especially in this time of increased transparency. 

Establishing a positive learning environment for the Trinity Community Hospital and their medical staff emphasizing on achievement and innovative strategies, which usually are used in very successful hospital around the country.

To guarantee that patient care is consistently of high quality and that the Trinity Community Hospital environment is safe for patients, staff and visitors.

To guarantee a high priority of service excellence for Trinity Community Hospital patients and staff.

How to prioritize this three new service line strategies at Trinity Community Hospital.

To aligned these three new service lines as an integrated group, to maximize the value across the continuum of care, decreasing internal organization competition, and improving the services performance and manageability as a whole. 

2. ANALYZE HOW CURRENT INTERNATIONAL HEALTHCARE TRENDS COULD BE INCORPORATED INTO THE DEVELOPMENT OF THE NEW SERVICE LINE.

There are many different international healthcare trends that can be incorporated into the development of the new service line. Some are listed below:

The seeking and the accessing of health information. Increasingly health information available is becoming more personalized at the individual level. The generalized information on disease and the typical treatment responses over the internet, are becoming irrelevant to the consumer. Diversity of individual specific sources should include personalized medicine, the use of social media (people being able to express their feelings, their emotions, especially when they are relevant to the treatment), also the access to their electronic health records. The use of self help groups, disease specific.

Following the trend that consumers are demanding more information transparency. We need to understand that the transparency of information in healthcare is becoming an ethical obligation. Some of them are: waiting list, cost, patient access, patient satisfaction measures, also patient safety measures (Hospital error rates, infection rates, etc).

Using trends in home base service delivery. In our case Cancer, Ortho and Cardiovascular programs. This can be also performed at the customer (patient) home. Especially for patients that cannot drive, or cannot be transported to their appointments (treatments, consultations, etc) to Trinity Community Hospital. It could as is used in Australia, as the care continuum, which usually is initiate with internet-based information. This is a great element, especially for patients who are motivated towards receiving self care. In our case, two of the new service lines, Ortho and Cardiovascular can be very easily implemented in the home based service delivery.

The use of advances in technology and also in medicine, as in many other different countries. When investing in the disease prevention element and treatment it can direct us to a better understanding of the disease. Today’s day there is a technological growth, in home care based products, especially diagnostic tools as: Telemedicine, remote monitoring blood pressure, heart rate, skin temperature, etc. Microscopy added to cell phones. Regardless of many challenges during the adoption of telemedicine at various levels, a crucial development can be seen worldwide towards adopting telemedicine applications, tools and techniques.  Telemedicine has become a powerful element and has brought never seen dimensions to healthcare, not only by rendering therapeutic healthcare but also preventive care, supportive and educational. 

Understand the changes in generational attitudes. We need to understand that the Baby Boomers, do think and behave differently from their children. The aging populations (Baby Boomers) will soon increased in the healthcare system and overwhelm it. When there are older generations involved, it can lead to increased number of individuals that suffer from chronic and very expensive diseases to treat, that will put pressure on the healthcare system in general. Presently, it has been identified that once healthcare reform takes effect, and everyone will have health coverage there will be a huge shortage of physicians to take care of the people. Focusing on preventatives and improving health before the aging population gets to this level, should be a vital element because the end result could be more cost effective, by not having so many members of the aging population with so many chronic diseases.

Medical Cost that continue to rise in healthcare are never ending. By using the state of the art technological advances, at the same time with the cost of the aging population, these two items will have a combined cost that can affect spending of the healthcare system, and the delivery of the healthcare at nationwide. Focusing on the preventatives and the best up to date technology advances that lead to cost effectiveness, should be one of the most important focus of the healthcare system today.

Follow the trend of the growth in complementary and alternative medicine. Usually this occurs without a high level of expending. One of the countries using this great and valuable methods, is Australia. The need for emotional support, the help with anxiety, with fear, the information and education, make the patients feel comfortable, with their medical problems and concerns.

Focus on medicine that is evidence based is vital, instead of the old fashion process of trial and error given what the patient and doctor decide to try. Using research information with standard studies and protocols for treating illness is the best approach. Having physicians with the most up to date information and treatment is vital in the healthcare business. Having physicians keeping their education, to be able to keep their medical skills and medical knowledge up to date, is also vital.

To allow the use of what is called the international private medical insurance (IPMI). Method extremely popular in many countries around the world (Specially in European countries). By doing this, it will allow Trinity Community Hospital to treat patients from another countries for any medical reason. Especially if we can offer them treatments for various medical problems, that would not exist in their countries, or it would be very expensive there too. Also it is extremely essential for people traveling to the USA, and suddenly finding themselves in situations requiring medical attention.

Provide care to patients is not just for medical doctors anymore. There are many other types of healthcare practitioners that have college degrees to practice medicine that are not physicians, such as nurse practitioners, physician assistants, etc. Since there is already a shortage of physicians in the healthcare business, by using these other type of practitioners as the ones listed above, this will help tremendously with the elevated cost of medicine, to focus on protocol standardization and latest technology, which will bring huge differences for the changes of healthcare not only for the present time, but for the coming future.

Another trend it has to do with having influence of the payer over treatment of medical decisions. Due to the rising cost of healthcare the decisions need to be made by the payer, instead of the healthcare physician based upon ability to pay. Trinity Community Hospital is focusing on financials, regarding patient stay per day and making future decisions, based upon the lack of funding to invest. This already is taking direction towards the global trend of payers making the decisions of care based upon lack of stay or hospital admissions.

Strengthening prevention and wellness. Our present health system, needs to put more emphasis on helping people to stay healthy. Our healthcare system requires stronger investment in wellness, as is done in many European countries. A great element for prevention is to put emphasis on vaccines and other serious health issues. This would help to decrease the cost of healthcare and chronic conditions in the future. We need to understand, that early detection and appropriate intervention, will maintain the people in an optimal health possible. When focusing on preventatives this in turn will decrease the amounts of expenditures needed for treatment in the future. When increasing services such as orthopedics, cardiovascular, and oncology this will help tremendously with prevention of diseases that are extremely costly during their treatment.

Going to another countries for medical reasons, is very popular for many individuals around the world. As costs get cheaper for medical care in other countries people will travel for the cost savings benefit. Cost pressure forces people to seek healthcare treatment outside of our country, for the purpose of cost reduction that fits their finances. In that case by finding ways of bringing such services locally, this will promote business and looks for ways of cost effectiveness in the Trinity Community Hospital organization.

3. DISCUSS THE EXISTING PROGRAMS AND SERVICE LINES IN THE HEALTHCARE ORGANIZATION, THAT COULD SERVE AS COMPLEMENTARY COMPONENTS OF THE NEW SERVICE LINE.

Presently the existing programs and service lines for Trinity Community Hospital are aligned as complimentary components of the new service line and will enhance the success of the new service lines for all three specialty areas. They are outlined below:

The offering of another very important services as: Pulmonary medicine, internal medicine, neurology, thoracic surgery, gynecology, general surgery, otolaryngology and urology.

Making sure that patient care is of a great quality and that the hospital environment is safe for patients, staff and visitors.

The hospital reputation is considered very good. Keep offering excellence in service to patients and the staff.

Making sure that hospital functioning is conducted in a competent, productive and successful approach.

One of the greatest strength is the very competent, dedicated nursing staff, committed to outstanding patient care.

An intensive care unit, with 14 beds. 20 operating rooms and a very good emergency department.

Developing a positive learning environment for medical staff and non-medical staff, with attention on modernization and accomplishment.

Having all the basic support services as physical therapy, laboratory, respiratory therapy, pharmacy and radiology. In addition to the usual and basic X-ray, the radiology department has one MRI scanner and two CT scanners. Also offers ultrasound services and nuclear medicine. Finally a PET scanner that is used twice a week.

When analyzing the board members professions, personalities, and the involvement in the community, are also vital elements to success as complementary components for the new service line (Cancer, Ortho and Cardiovascular programs). The information below is from the WGU case study, exactly from the Trinity Community Hospital board profiles (PDF file):

Dr. David Joint is an orthopedic surgeon, native of the community. He is planning to open a branch office near the hospital campus. from the description, it tells us that he is very known in the community, and it has a lot to say. In another words his position and opinion really counts in the community.

Mr. Robert Holland holds a CPA degree. Has lived in the community for (5) five years. He is quite interested in national healthcare policy and legislation, especially when is related to healthcare finance.

Mrs. Cathy Promo she holds an undergraduate degree in marketing. Lived in the community for about (7) seven years. She is quite involved with the local chamber of commerce and recognizes the importance of good healthcare services in attracting new business and industry to the area. Mrs. Promo strongly believes that an extensive marketing and advertising, could reverse Trinity Community Hospital declining utilization trend.

Dr. Randy Sharp is a general surgeon. He has lived in the community for (15) fifteen years. His main interest is in cancer services. His group is planning to recruit a subspecialty-trained oncologic surgeon. Very similar situation as with Dr. David Joint. Dr. Sharps position and opinion really counts in the community too.

Mrs. Maria Lopez holds an undergraduate degree in journalism. She has lived in the community for (9) nine years. She also owns an small newspaper that is quite popular within the Latino community. One of hers priorities, is to ensure that adequate healthcare services are available to all minority groups.

Below we can also see some more complementary components, by using information from the WGU case study, exactly from the Trinity Community Hospital brochure (PDF file), page 1:

Trinity’s Commitment. We are committed to serving the community in a capacity that permits every patient to receive the care and support that they require.

Quality and Safety. At Trinity Community Hospital we endeavor to provide high quality services while ensuring the safety of patients, visitors, and staff.

Service Excellence. We will continue to strive to exceed the service expectations of our patients, visitors, employees, and physicians.

Staff Achievement. We will provide opportunities for the enhancement of the skills and expertise of all staff members.

Growth and Profitability. Striving to grow service volume, to operate efficiently, and generate sufficient capital for investment.

The information below about more complementary components also comes from the WGU case study, exactly from the Trinity Community Hospital brochure (PDF file), pages 2 and 3:

WHAT SETS US APART FROM THE REST OF THE MEDICAL COMMUNITY

Trinity Community Hospital is a 150-bed, not-for-profit hospital offering:

• A broad range of medical, surgical, and support services to the community.
• Patient-friendly, pleasant environment that truly sets us apart.
• Facilitate a soothing environment, by using large windows, natural woods and tranquil views of an expansive landscape.
• Nourishing and delectable cuisine prepared and directed by a world renowned Russian dietitian.
• Providing exceptional care and services, through outstanding employees and medical staff members.
• Modern, high-tech laboratory, radiology, pharmacy, physical and respiratory departments.
• Surgery and endoscopy suites, with the newest digital equipment. Robotic surgery.
• Newly renovated patient rooms, with homelike ambience.
• Physician locater service, to help finding the right physician for your needs.

4. ANALYZE THE FINANCIAL AND OPERATING DATA TO DETERMINE THE FINANCIAL FEASIBILITY OF INSTITUTING THE NEW SERVICE LINE.

The first three tables below, are the current utilization trend and revenue of the current year data, also shows the previous data for a year and two years prior; As we can see in every column (top to bottom) has decreased in every single hospital category. Under table two, the AR (accounts receivable), instead of decreasing, they also increased, making the hospital to wait longer to collect the ending balance.

Anytime that the time increases above 50 days, this indicates a serious collection problem, which at the same time causes a significant pressure on the hospital cash flows (each one of the years, starting with the current to two years prior, are over 50 days. The only visible exceptions are Medicare, Medicaid, and Self Pay (See table three). The last table is predicted data with the new service lines being implemented within the organization and increase in utilization and revenue.

When looking and paying attention, to the predicted increases based on the new service line in every column (with the exception of ALOS- Average length of stay, which by the way is a positive result, not a negative) there is a significant increase. And the revenue section shows that will help the organization to get out of the negative margin, to a nearly $30000000- million dollars positive margin.

When looking at the prediction, we can determine a financial feasibility, if we institute the new service lines. This will bring dramatic increases in volume and improved the financial operations and performance for Trinity Community Hospital. When reviewing the predicted results, we can see that there is a crucial positive effect on the hospital revenue, which it will allow to invest capital in the new service lines, which at the same time will increase the services and supports the community is demanding. At the end, the most important issue, element is that it will make available the most advance approaches for preventing, treating different disease processes and diagnosing, which will impact thousands of people in the community and surroundings.

5. DISCUSS THE TARGET AND MARKETING REFERRAL SERVICES FOR PHYSICIANS.

Describing below is a step by step plan, for marketing and referral services designed for the specialty physicians of Trinity Community Hospital. This will bring attention, and receive reputation at the same time from the community, specifically for services offered and rendered, which will increase their business, which creates an increase in revenue. This techniques will help to build name recognition and service awareness. Marketing referrals has many valuable advantages. it will bring patients (customer) at little or even not cost.

One single referral could generate a series of leads, because of satisfied customers passing the word-of-mouth to other people they know. Also, this kind of referrals are more trusting people, most likely not skeptical of the hospital, because they are usually confident in the person, friend that refereed them. the result is that this leads are much easier to bring to the hospital business, as potential patients.

An extremely important element in the healthcare business, is because is considered a very personal and private service, that from the beginning relies on trust, bonds and many times personal recommendations. Trinity Community Hospital must develop a planed and active approach that is based on many diverse marketing principles, as the ones described below.

Put emphasis on the foundation: A well-defined idea of the specialty practice vision and the elements that must be establish, for a profitable and successful practice. Explain and simplify the vision is key to the goal of a profitable and successful specialty practice, as the new service lines at Trinity Community Hospital.

To audit the current referral program for Trinity Community Hospital. make an inventory of the current referral system. We need to ask ourselves, how effective are the current means of creating referrals?. What percentage of our patients has been obtained through a referral?. What percent of increase we think we could reasonably achieve?. Do we know the current satisfaction level of our patients?. Such evaluation will allow us to have an inventory of the referral program’s weaknesses and strengths.

Developing and putting in place the marketing plan: Concentrate on a goal for medical marketing checklist and determine the medical specialty programs that will be offered, which in our case are Oncology, Ortho and Cardiovascular. Create a checklist for the chosen goals. The checklist will concentrate on direct marketing advantage to physicians, physician assistants, nurse practitioners in our community with faith and assurance. When creating this kind of marketing plan, this will make the specialty practices much effective, valuable, productive and profitable.

Attract referrals for the business: One of the most important elements in business is to stay in communication with the medical community. Marketing is all about selling the business, and in order to do that, we need to create presentations to other medical professionals in the community, in order to establish professionalism and credibility. Initially, we need to start with researching the needs of directing ourselves to other medical professionals, and finding out what are their expectations. It should be diverse, balance but powerful, with plenty of resources. People from all the aspects of the healthcare industry. Reach out to others by writing letters introducing the business practice and services offered, this information should included progress reports to be able to show the evidence to the medical community of the demand and service.

Making progress and connections with the medical community: Develop strategies for the hospital business, which include several types of presentations to the medical community to show the outreach of services that are available to the community. To know the most important people in this business, with whom discuss about our business and whom are the decision makers. When a connection is established, then setting up the patient care program, will be based upon the diagnosis. Then we begin with the word-of-mouth marketing element, which usually gets the business more and more referrals from other medical offices.

A very important, I will say crucial element, is to do not forget to thank them for sending the referrals. A thank you letter or a gift certificate will do. When using this method of marketing referral for specialty physicians, this plan will continue to do several things, first it will help patients with serious diagnosis and the treatment of serious medical conditions. Second, it will also help to meet the needs of diverse medical professionals. Third, it will build a long-lasting and trusting relationship. By the end, this strategy will be well worth the effort.