Healthcare Jumpstart Course
Week 1
The healthcare industry works to promote health and prevent, diagnose, treat, and manage disease. The industry
delivers a complex array of preventive, remedial, and therapeutic services.
Healthcare spending has been on the rise, constituting over 17% of the US gross domestic product (GDP) and
over 11% of many European and other developed nations. The annual global expenditure for healthcare amounts
to over USD 6.5 trillion, or roughly 9% of the world’s GDP. Growth markets tend to have lower healthcare
spending as a percentage of their GDP and lower health expenditures per capita than mature markets. However,
this percentage will likely rise significantly in the next decade.
Technology is an enabler of this recent transformation. Many healthcare organizations are investing in electronic
medical records systems, new technologies, cloud, mobile, and social to digitally reinvent their programs and
processes in an effort to become more efficient and improve their quality of services.
Five Levels of Healthcare Needs: - 1) Environmental, 2) Basic, 3) Medically necessary, 4) Preventive care and
wellness services, 5) Health enhancements
Dominant Healthcare Financing Models – 1) Nationalized Healthcare Service, 2) Single payer, 3) Social
Insurance, 4) Private insurance, 5) Governmental entitlement programs
Key Segments –
1) Providers, 2) Payers, 3) Life Sciences
Providers maximize the provision of quality healthcare services for a given population while remaining within
budget and profitability constraints.
KPIs – 1) Hospital clinic and quality KPIs 2) Operational business performance 3) Joint Commission International
(JCI) accreditation, 4) Value-based KPIs
Challenges - Key issues for the healthcare industry are consistent across the globe: quality, cost, and access.
1) Healthcare costs rising, 2) Demand for care exploding, 3) Chronic illness growing, 4) Business
process inefficiencies, 5) Low investment in IT
Potential for positive change –
1) New medical technologies and treatments, 2) New consumer options and engagements, 3)
New payer options, 4) Overall industry restructuring
The World Health Organization (WHO) report, first published in 2010, indicated that non-communicable diseases
(NCDs) were responsible for more deaths than all other causes of death, combined in most middle- and high-
income countries. NCDs principally include cardiovascular diseases, diabetes, cancers and chronic respiratory
diseases.
As populations age, annual NCD deaths continue to rise. Given this high burden, the industry can no longer
afford to focus on acute care and its traditional delivery and business structures, while chronic care consumes
more and more of its resources.
Expectations from individuals and their families demanding more value from their healthcare dollars, and their
visibility into quality and performance, is pressuring healthcare organizations to [Link], regulators,
employers, and stakeholders all require greater levels of reporting and access to quality and price information to
support the choices they make.A rapidly expanding middle class, with the finances and desire to spend heavily
on premium health services, is stratifying healthcare in the growth markets. This trend is exacerbated by
government cost-containment efforts, an aging population and inadequacy of government-provided care, all of
which are driving health consumers to the private sector.
With the increase in social and other digital innovations empowering individuals, they expect more
personalization, convenience, and ready access to information for their healthcare needs. These two trends are
driving the emergence of mobile health, remote monitoring, and telemedicine initiatives, which are now
accelerating.
Digital Hospital Initiatives implications- 1) Patient centricity, 2) Healthcare analytics, 3) Cloud opportunities
Globally, the industry aspires to become a system focused on value—delivering better quality care and outcomes
at the most affordable cost. These changes require transparency into the costs and effectiveness of care, along
with gleaning greater insights from the exponentially expanding volume of health information available today and
in the future.
Common objectives – 1) Build sustainable healthcare systems, 2) Improve care and outcomes, 3) Promote
patient participation
To meet these objectives, stakeholders are adapting to transformational needs that include—
1) Individual needs, 2) Societal needs, 3) Payer needs, 4) Provider needs, 5) Government needs
Market share concentration of providers is generally low.
Market share concentration for payers is high with a few payers, typically the government and few private
organizations, dominating the segment
The emerging medical tourism segment looks set to introduce a new level of competition, and is of particular
concern to private hospitals, as they now compete for the global citizen patient
Barriers to entry in the industry are relatively high given the significant costs, level of education, and skills
required to provide relevant services that meet quality and regulatory compliance standards.
Key Success Factors – 1) Access to government funding, 2) Economies of scope, 3) Skilled workers, 4) Effective
cost controls, 5) Minimizing empty beds, 6) Health IT adoption
Organizational structure – 1)Administrative (Back office), 2) Support services, 3) Information Management, 4)
Clinical services, 5) Allied health,