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Value-Chain Analysis of a Rural Health Program

(A) Components of Porter’s Value Chain Analysis Model;

Porter’s value chain model has two components that form the basis of analysis of tele-medication services. (i)  Use of Tele radiography for Trauma care. In this system, a patient visits a chosen site hereunder referred to as spoke site, which is connected to another location known as a hub site where specialty medical personnel are available. The patient’s image is captured and transmitted to the hub region where it is studied, analyzed and then recommendations made to the spoke location that instructs the medical team on how to treat the said patient. The medication and actual treatment are then done to the patient without having to travel to areas with the expert medical staff. The image is saved at the hub site to act as a medical record of the patient.

(ii) The use of Tele-rehabilitation for wound care.

This approach consists of the specialists at the hub site studying the wounds of patients via videoconferencing and sharing data and information with health stations which collect and transmit medical information installed at spoke sites. The use of Videoconferencing and health care stations equipment which collect and transmit information about patients allow the experts to vaguely communicate and share with patients and healthcare experts to examine patients’ injuries and other useful symptoms in the real sense. Another technique is to capture the patient’s images, transmit them to the hub site for further consultation by use of the store and forward styles. This is referred to as non-real time tele-consulting (Wilson, 1999).

(B) A summary of key points raised from the case

Two techniques discussed above relate to costs of running the systems. Structural cost drivers are reasonably relevant. To capture and relay medical data, it requires capital investments in computers, procurement of a network and acquisition of the equipment and machinery for imaging. Other technologies are as well required for the system to effectively function. These programs would also be availed with power to run the equipment and the appropriate capacity developed to run the machines. Whenever the equipment breaks down or requires repair, there should be adequate personnel to attend to the machines for running of the systems.

There are  executional cost drivers.   Walz  & Brill ( 2000) notes that the functioning of tele-radiography systems requires that rural hospitals be available to capture and transmit digital images concerning patients as deemed necessary. The introduction of the system of capturing and relaying of patients’ images to the hub calls for extra charges on patients who use the service. Extra manpower is needed to carry out the duty of charging and collecting the extra fees from tele-radiography. This means that more administrative costs are incurred by the two sites to efficiently run the facility. According to Tyler (2001) The effective functioning of real-time tele-rehabilitation for wound care cases requires the services of a physician, nurse or physician assistant at the spoke site to facilitate the efficient examination of patients with a remote specialist.

The functioning of the telemedicine examinations and prescriptions requires other system support facilities and activities to guarantee that the necessary equipment remains connected prior to the consultation and during the consultation uninterrupted( Hakansson & Gavelin 2000). The scheduling and planning for the consultations are supposed to be adhered to with minimal disruptions. Where either party from both centers or one fails to honor an appointment or consultation, the administrative costs associated with this, runs wasted. This presents a non-sustainable system given that future operations do not promise recovery of the costs from the fees charged.

(C) How Porter’s model was used to evaluate the cost-effectiveness of implementing Telemedicine in rural health practice;

Porter’s model analyses the cost effectiveness of the service by considering the provision of the service against non-provision so as to gauge the viability of either system. He observes that the costs of transporting physicians to rural hospitals or transporting of the necessary equipment like x-rays to areas where they are required would present high costs. Therefore to save on such costs, he notes that the use of technology to examine patients, offers a better system since it is cost effective. The productivity of the specialty professions is said to be impeded by the travels when they are to attend to patients. Therefore, the system offers an appropriate way that does not require any travelling but rather examine and administer medication to patients far away via technological advancements.

The greatest beneficiaries of real-time video consultations are said to be patients. Where urgent attention is needed e.g. from burns or some other accident, immediate care is made available therefore timely response to the needs of those in need. This also saves the direct costs that could have been incurred on transportation to the location with the specialty services. Therefore, saving on funds and time.

(D) The value of using the model in strategic planning

The model provides an analysis where costs against revenue is  generated from the scheme. It provides that projects whose benefits outweigh the costs should be implemented. By studying its sustainability also, it offers that the project should be able to sustain itself from the revenue it generates. By complying with these principles, any schemes that are proposed would be successful since they are able to sustain themselves through the incomes that they generate. Therefore it is an ideal model towards strategic planning.

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