Market Assessment for Medical Practice Competition

For healthcare organizations, a competitive analysis is a means to assess who your competitors are, what value they provide, understanding their (and your) strengths and weaknesses, and where your practice fits in. A good competitive analysis is a scouting report of the actual market terrain that your practice must navigate in order to be successful. While analyzing the competition is an essential component of your strategy, most medical practices don’t conduct this type of analysis systematically enough. However, a thorough competitive analysis is indispensable.

  • First, begin by compiling a list of your practice’s competitors. Most of the time, such a list is comprised of who your practice considers to be its chief competitors. However, there may be other healthcare organizations that indirectly compete with yours, perhaps ones outside of your catchment area that offer services such as telemedicine or niche treatment modalities that are aiming for the same patients. You will also want to include information on healthcare entities that may be entering your market in the coming year. Once you have compiled the list, you can highlight those practices that will be the greatest challenge.
  • Second, analyze the competition’s services in terms of features, value, and target patients. How do they market them? How do patients see your competition? How do referring physicians view your competition? Take an honest look at their offerings. Is your quality commensurate? Do you have similar offerings? What is the unique value you provide that competitors don’t or can’t? Emphasize these benefits in your marketing.
  • Third, compile a list of competitor strengths and weaknesses and remember to be objective. You’ll do your practice no good if you allow bias toward your own physicians, staff, and services to cloud your judgment. Try to see the competition’s practice as though you were them. What makes their practice so great? If they are growing rapidly, what is it about their practice that’s promoting that growth?
  • Fourth, observe how your competitors market themselves through advertising, collateral material, and perhaps the use of physician liaisons. You will have to go to many different sources to get a complete picture. It takes practice and a little shrewdness on your part to piece together a complete picture of strategies and objectives, so the use of a qualified consultant may be to your benefit. Focus on the facts, be persistent, and trust your intuition to help you.
  • Fifth, what are the market demographics for your practice like now? Is it growing? If so, then there are likely quite a few patients left to go around. If on the other hand the market is flat, then the competition for patients is likely to be fierce. Your practice will find itself scrambling to win market share. The outlook portion of your analysis may seem like forecasting, but it’s really a measure of trends. By the time you’ve done most of your research, you’ll have enough information to determine what the outlook really is.

By evaluating yourself against your competition, you’ll likely find new ideas for your practice. While compiling a competitive analysis is an interesting piece of work, it can indeed be challenging. Consequently, you may want to seek the help of a healthcare consultant to guide you through this process. You’ll learn a lot about your market and in the process become a more valuable resource for your patients and referring physicians.


Contact ABISA for healthcare consultancy support or speaking engagements.

Outlook on Digital Health Data

Digital health tools can improve consumers’ direct visibility into and control over their vital health metrics and ongoing healthcare needs.  Millions of Americans report that smartphones and apps have changed the way they manage their health and wellness.  As Americans begin to use wearable devices to track and collect their personal health data, we will see more of a willingness to share that data with healthcare providers and intermediaries.  Consequently patients’ expectations for care and care delivery are changing, and will force the healthcare industry to change.  Providers, however, are having to tackle long-standing interoperability and data access challenges.  So, while many would agree that the future of digital health data is bright, there’s much work to be done.

The 2015 Digital Impact Survey surveyed 1,000 smartphone owners over the age of 18 and found a 70% increase (over its 2013 survey) in adoption of smartphone and apps to manage health and wellness.  Meanwhile another report has been published which analyzes consumer attitudes and preferences about making care choices and decisions and provides guidance to healthcare stakeholders regarding how to communicate and engage with consumers for self-care and support.  The report shows the increased adoption of connected health devices which includes items such as blood pressure meters, connected treadmills, digital fitness trackers, and networked weight scales.  Now, a research study conducted in the fourth quarter of 2016 reported results of its findings of patient evaluations on of technology.  The study polled over 12,000 adult patients and here is just a snapshot of some of the findings:

96% of respondents said they left their physician office visit with poorly communicated or miscommunicated instructions on patient portal use.

94% of patients with fitness trackers reported that their physician informed them the practice had no capability or interest in coordinating their outcomes currently via their electronic health record (EHR).

93% expressed concerns over the security of their personal financial information being used by healthcare providers; 70% of Americans reportedly distrust health technology.

91% of respondents noted feeling slighted by their providers who would not accommodate their personal data and believe their physician practice’s EHR should store any health-related data they request.

87% of patients are unwilling to comprehensively divulge all of their medical information.

84% of patients said their trust in their provider is influenced by how the provider used health technology; 69% of patients stated they believe their current primary care physician does not demonstrate enough technology prowess for them to trust divulging all their personal information.

On the physician side of things, the study states that 94% of physicians find the volume of digital health data to be overwhelming, redundant, and unlikely to make a clinical difference.  Additionally, 85% of physicians reported that the addition of EHRs has made patient care too impersonal.


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Physician Employment ≠ Quality of Care

As previously mentioned regarding physician practice acquisitions, many hospitals around the country have sought in recent years to increase their number of employed physicians.  Their goal of doing so is to be better prepared with healthcare reform that reimburses based on quality of care, outcomes and cost control rather than the traditional fee-for-service system.  The belief by many hospitals has been that employment of physicians will lead to greater care coordination, more closely aligned incentives, and ultimately better patient care.  However, a new study in the Annals of Internal Medicine demonstrates that “no association was found between switching to an employment model and improvement in any of 4 primary composite quality metrics.”  Specifically, there were no resultant changes in mortality rates, 30-day readmissions, length of stay or patient satisfaction rates.  Researchers noted:

“Although some of these improvements certainly are taking place as hospitals increasingly employ physicians, on the basis of the hospital performance metrics we examined, we found no national-level evidence that these changes have translated into better patient care.”

In the study, 803 acute care hospitals in the U.S. that switched to an employee relationship with their physicians were compared with 2,085 hospitals that maintained unaffiliated or contractual relationships with their physicians.  The researchers’ summed up their study by stating:

“During the past decade, hospitals have increasingly become employers of physicians. The study’s findings suggest that physician employment alone probably is not a sufficient tool for improving hospital care.”

Consequently, the study recommends hospitals should instead focus on ways to boost clinical integration and improve patient care instead of hoping those goals will be accomplished solely by employing more physicians.  The study that was recently published in the Annals of Internal Medicine can be found here.

On a related noted, other data proving that financial integration between physicians and hospitals has been associated with higher commercial prices and spending for outpatient care, can be found in my Consolidation ≠ Efficiency article.


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Hacking Healthcare

Many businesses (including healthcare organizations) go through great lengths to secure consumer (patient) data.  And while that effort is noble and important, we should not go around with rose colored glasses believing that the efforts are failsafe.  Indeed, much has been written about data breaches over the past couple of years as this profitable trend of theft increases.  The healthcare industry is no stranger to this; in fact it has been reported that a patient’s healthcare data is worth at least twice as much on the black market as regular consumer data.

The Institute for Critical Infrastructure Technology (ICIT) recently released a report showing that healthcare is an ideal target for hackers.  The report notes that healthcare organizations have actually been quite lucky (thus far) that more serious attacks haven’t disrupted patient care or placed patients at risk for harm.  As with other industries, connected devices are becoming more and more prevalent (e.g. pacemakers, treatment delivery software, MRIs, etc.).  And this trend continues to consumer items such as blood pressure meters, connected treadmills, digital fitness trackers, and networked weight scales.  The Director of Health and Mobile Product Research at Parks Associates, Henry Wang, commented on the growing demand from Baby Boomers:

 “These consumers face a variety of health and mobility challenges, so there is tremendous potential for accelerated adoption, improved outcomes, and ultimately significant cost savings for both companies and consumers. Interoperability and standards compliance will be the primary challenges as companies look to expand the connected health market and engage this demographic.”

The ICIT report recommends healthcare organizations:

  • consider the long-term consequences of existing cybersecurity tactics
  • improve organizational security controls
  • develop actionable incident response plans to prepare for distributed denial of service attacks.


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State of the U.S. Healthcare Industry

Healthcare leaders in the U.S. are preparing for more changes to the industry in 2017.  The pace of change in healthcare is extremely rapid as the pressure continues to mount on physician shortage issues, quality focus, cost containment, payment reform, etc.  Managed Healthcare Executive recently released its annual State of the Industry Survey results which reveal the top 2017 challenges, priorities, initiatives, and opportunities for the U.S. healthcare industry.  Here are a few highlights:

Biggest Challenge:  36% of respondents stated the biggest challenge facing healthcare organizations is complying with new government requirements and mandates; 25% stated it was implementing value-based reimbursement; 19% stated it was technology acquisitions/investments/implementations.

Revenue Predictions:  When asked to forecast 2017 revenues compared to 2016, 39% predicted it will be about the same; 35% predicted 2017 will be better; 26% predicted 2017 will be worse.

Expanding/Securing Market Share:  52% of those surveyed stated they are expanding customer improvement initiatives in order to expand and secure market share; 43% are focused on cost/quality transparency; 42% claimed to be focusing on increasing consumer outreach.

Top Disease States:  When asked to select the top three therapeutic categories and/or disease states their organization will be focused on in 2017, diabetes garnered 83%, cardiovascular 71%, obesity 49%, cancer 34%, and respiratory illness garnered 32%.

Value-Based Care:  46% of respondents stated their organization has started a few initiatives toward value-based care; 22% stated they have not yet started; 20% stated they have started many initiatives.

Value-Based Reimbursement:  37% of respondents claimed to be participating in commercial payer initiatives for value-based reimbursement; 35% claimed to be participating in a CMS/CMMI initiative; 33% stated they are not yet participating in any value-based reimbursement initiatives.

Big Data:  39% of those surveyed stated their organization uses big data “well” to improve healthcare quality and reduce healthcare costs; 34% stated they used it “not very well”.

Consumer Engagement:  36% of respondents believe that the most effective way to increase consumer engagement in managing their own health is through improved/more patient education; 29% believe it is accomplished through incentives/wellness programs.

More results from the State of the Industry survey can be found here.


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Strategic Planning Misused

Strategic planning is an essential business activity. However, several common mistakes must be understood so that practice administrators can guard against them. Pointing out these mistakes is not a criticism of the process but acknowledgement of improper implementation. Medical practice leaders must recognize both the benefits and the potential pitfalls of strategic planning, because it is their responsibility to ensure that strategic planning is conducted properly to achieve the desired goals. Here are four of the most-common planning mistakes we find:

Attempting to forecast and dictate events too far into the future.

In part, this may result from the natural desire to believe we can control the future. It is a natural tendency to plan on the assumption that the future will merely be a linear continuation of present conditions, and we often underestimate the scope of changes in direction that may occur. Because we cannot anticipate the unexpected, we tend to believe it will not occur. In fact, most strategic plans are overcome by events much sooner than anticipated by practice leaders.

Trying to plan in too much detail.

This is not a criticism of detailed strategic planning but of planning in more detail than the conditions warrant. This pitfall often stems from the natural desire to leave as little as possible to chance. In general, the less certain the situation, the less detail in which we can plan. However, the natural response to the anxiety of uncertainty is to plan in greater detail, to try to cover every possibility. This effort to plan in greater detail under conditions of uncertainty can generate even more detail. The result can be an extremely detailed strategic plan that does not survive the friction of the situation and that constricts effective action.

Tendency to use planning as a scripting process that tries to prescribe actions with precision.

When practice leaders fail to recognize the limits of foresight and control, the strategic plan can become a coercive and overly regulatory mechanism that restricts initiative and flexibility. The focus for staff members becomes meeting the requirements of the strategic plan rather than deciding and acting effectively.

Tendency for rigid planning methods to lead to inflexible thinking.

While strategic planning provides a disciplined framework for approaching problems, the danger is in taking that discipline to the extreme. It is natural to develop planning routines to streamline the strategic planning effort. In situations where planning activities must be performed repeatedly with little variation, it helps to have a well-rehearsed procedure already in place. However, there are two dangers. The first is in trying to reduce those aspects of strategic planning that require intuition and creativity to simple processes and procedures. Not only can these skills not be captured in procedures, but attempts to do so will necessarily restrict intuition and creativity. The second danger is that even where procedures are appropriate, they naturally tend to become rigid over time. This directly undermines the objective of strategic planning — enabling the organization to become more adaptable. This tendency toward rigidity is one of the gravest negative characteristics of strategic planning and of strategic plans.

Indeed, strategic planning is an essential part of practice management, helping practice leaders to decide and act more effectively. As such, strategic planning is one of the principal tools used to exercise operational control. Remember though, that strategic planning involves elements of both art and science, combining analysis and calculation with intuition, inspiration, and creativity. To plan well is to demonstrate imagination and not merely to apply mechanical procedures. Done well, strategic planning is an extremely valuable activity that greatly improves practice performance and is an effective use of time. Done poorly, it can be worse than irrelevant and a waste of valuable time. The fundamental challenge of strategic planning is to reconcile the tension between the desire for preparation and the need for flexibility in recognition of the uncertainty of the healthcare industry.


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2017 Second Tier Hospital HITs

It’s that time of year when many are making predictions for 2017 and the subject matter of health IT in the United States continues to be a hot topic for discussion.  As we continue to see an increased threat to patient data, many in the hospital IT world are looking at a myriad of security vulnerabilities and having to weigh those with other initiatives such as maintaining the EHR evolution or delving into interfaces with connected health devices.

HIMSS Analytics teamed up with Healthcare IT News to spotlight technologies that have the greatest predicted buying activity for U.S. hospitals in the coming year.  This post is the second-part summation of their findings.  Last week we looked at the top ten IT initiatives and today we will look at the second tier initiatives.  (Quotes below are from Matt Schuchardt, director of market intelligence solutions sales at HIMSS Analytics as noted in the research with Healthcare IT News.)

  1. Asset Tracking/Management. “This is really an IT function: Tracking the certificates on your Windows machines, is everything up-to-date, are all your updates in place, are you tracking the depreciation of your servers and things like that? Certainly, as you get more tablets and things like that, tracking where they are and that they’re secure is going to be important.”
  1. Population Health Management. This is the aggregation of patient data across multiple health information technology resources, the analysis of that data into a single, actionable patient record, and the actions through which care providers can improve both clinical and financial outcomes.  “About 1,200 hospitals currently have a population health management system in place,” said Schuchardt. “We expect that to grow. If you look at the top 10 vendors for population health right now, two of them are EMR vendors, but they’ve got about 40 percent of the installs. The majority of vendors that hospitals have engaged with are slide plays into population health – I think only about 20 percent of the market right now are purpose built population health vendors.”
  1. Laboratory – Outreach Services. “This is making sure people are getting the tests that they need,” said Schuchardt. “You see the see the TV ads for biologics all the time that may cause liver damage: Are these people coming back in and having their levels checked on their liver while they’re taking them? This technology manages the process – making sure people are being notified of the results, notified for follow-up work, and things like that.”
  1. Bed Management. “The value of beds, the types of patients who are in those beds, are you getting the most of them, what’s your census rate like, what’s your average number of patients to a bed. We suspect that, like all other BI and analytics tools, we’ll continue to see growth.”
  1. Data Warehousing/Mining. A lot of hospitals have data warehousing capabilities, but they’re often “some sort of cobbled-together, self-developed system,” said Schuchardt. “We expect there to be growth there. More and more organizations are looking to turn their data into an asset. Having the data is one thing, using it effectively is an entirely different animal. And I think organizations are beginning to grapple with those concerns.”
  1. Anesthesia Information Management System. “If you think about where risk is, hospitals really focus around surgery,” said Schuchardt. “Making sure they’re monitoring anesthesia is really important: It’s the most dangerous part of any hospital stay, other than staph infections. Hospitals are looking at that, and you can see the current adoption rate is under 2,000, but we expect that to grow pretty substantially.”
  1. Telemedicine. Telemedicine is the use of telecommunication and information technology to provide clinical health care from a distance. It helps eliminate distance barriers and can improve access to medical services that would often not be consistently available in distant rural communities.  “Voice over Internet, telemedicine, nurse communication – all of these sort of connect together,” said Schuchardt. “If you think about organizations sharing data among themselves, you need to then think about how do they share data even internally? How is the nurse getting the right order, how are patients being routed? Those things will be more important in the post-EMR world as organizations look to better understand patient throughput and outcomes, and communicating what’s going on internally and externally.”
  1. VOIP. Voice over Internet Protocol (VoIP), is a technology that allows you to make voice calls using a broadband Internet connection instead of a regular (or analog) phone line.  “Voice over Internet, telemedicine, nurse communication – all of these sort of connect together,” said Schuchardt. “If you think about organizations sharing data among themselves, you need to then think about how do they share data even internally? How is the nurse getting the right order, how are patients being routed? Those things will be more important in the post-EMR world as organizations look to better understand patient throughput and outcomes, and communicating what’s going on internally and externally.”
  1. Storage: Vendor Neutral Archive. “There’s a lot of vendors in this space who have re-branded their archive as vendor-neutral because it’s a hot-button topic,” said Schuchardt. “But is that actually vendor-neutral? That’s a question hospitals should be asking their vendors before they buy. Is it going to let me exchange data between Philips and GE? Or is it just your old product with a new name? It’s making the data move from your PACS system into your EMR – if you go to the ER when you break your arm, and then you go to the ortho for follow-up care, can she see the original image very easily, even if she’s not on the hospital EMR, or hospital PACS? It’s the ability to store images from one vendor and then reproduce them in places agnostic to the vendor where they’re being reproduced.”
  1. Cardiology 3D Image/Display. Similar to the radiology display but focused on cardiology, this are “will have less adoption, always, than radiology, as there are a number of hospitals that just don’t offer cardiology services,” he said. “But there’s a similar growth curve with a cap on it, in that not everyone is going to be offering cardiology.”

This concludes our two-part summation of the top twenty HIT hospital initiatives for 2017.  Many thanks to Healthcare IT News and HIMSS Analytics for looking into the technologies most on the radar for 5,461 hospitals across the U.S. in 2017.  (Go here for more research from HIMSS Analytics or Healthcare IT News.)


Contact ABISA for healthcare consultancy support or speaking engagements.