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Hello everyone. It seems like many of you have passed through the strategy planning section of the program so I thought it might be fun to take a very pertinent subject and run it though the process. Alternatives to in office patients visits must be employed to keep the revenue flowing. Medicare has loosen the rules for non in person E/M CPT codes. Telemedicine is clearly a valuable tool, at least in the short term. Implementing it as a long term solution is a strategic decision, which mean you need to work the problem.
First thing, this is not your decision to make. It should be a team based decision with team members from each stakeholder level of your practice. You won’t have patients in the room but their needs to be ever present at each step.
Problem: Revenue flow short and long term, maintain and improve.
Mission: Does distance care align with your practice mission and values?
Vision: How does distance care fit with your 5 year vision? Is it something you have to do or something you want to do long term.
Market assumptions: How will the market treat the tradition office visit (E/M codes) in 1 year, 5 years? What will the financial reimbursement structure look like? Will your patients embrace it?
SWOT – Hand out homework assignments to the team. You need to be informed to the best of what the internet has to offer and then come to the table as information sources, educators, and only then SWOT creators.
I won’t go over the whole thing but some considerations. Practice infrastructure, payer mix, practice culture (maybe a survey), patient culture ( current experience, maybe even a survey, benchmarks) capital availability, technology availability, timeline for implementation, contract commitments, human resources, timeline to decision making, alternative technology, alternative service lines. Usually going from S to W to O to T, and taking it one at a time will lead to a thoughtful situational assessment.
I suggest the anonymous contribution tool (brain writing) to be used here. Often times the doctors have a hard time hearing their practice isn’t where they thought it was in the S and W categories. An accurate assessment is essential. Starting with a perception instead of reality is a disaster.
Competitive Analysis
What are the other practices doing. This is not about following their lead. Their lead may be about spending a large amount of capital to implement a state of the art system when patient may prefer a zero cost face time appointment. Remember, it wasn’t too long ago we were shopping for the nicest desk tops computers and now we carry our computer in our pockets. Don’t forget, capital is a zero sum game. You only have a limited amount, the capital you use on telemedicine will take away from capital to support something else. If the capital will produce positive NPV (you will discover this major financial calculation in Course #4) then it is a no brainer and will be implemented.
Strategy formation – remember the problem is revenue flow. Telemedicine is one strategy. Others? Let your TOWS matrix organize your process. There may be new service lines, enhancement of existing service lines, new value based compensation models, or maybe some cool out of the box solutions waiting for your team to discover.
Strategy evaluation: EFE and IFE, and the quantitative matrix.
Good strategy process will protect you from a reactionary decisions that end up dragging down the practice once the crisis ends. When good process is employed you can at least say it was the best decision we could have made at the time.
I will see all of you in class. I think most of you already know, I keep a close eye out on everyone’s progress and reach out pretty much each time you come to class. After all that is what good teachers do.
Take Care and stay well,
Dr. JWe are getting a nearly mandated trial run of telemedicine now with COVID, and I think it will speed up a much needed platform to delivering care. We need to think about where it will add value after COVID and see if it’s worth implemented. I am excited about the possibility long-term . So much time and effort is spent bringing patients into the office, when there are a lot of disease states/ problem that can more efficiently be handled via telemedicine.
This is a good example of listening to our customers. I for one would love to have access to telemedicine. I never really loved going to the office.
It will take strategy and business planning to successfully integrate it into a practice. We need to make sure it is profitable otherwise it will just make everything else that much harder. We have a course on Value Based Care, that uses an activity based cost analysis to find value in a practice. Telemedicine will have to undergo that kind of scrutiny before I would allocate resources in that direction.
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