Opportunities and Threats
The topic at hand is improving the emergency room services of Newport News General Hospital. The PESTLE analysis conducted above has revealed several challenges and opportunities that may impact the hospital’s efforts to improve its emergency room services.
Political challenges, such as changing government rules and regulations, may make it difficult for the hospital to develop a stable pricing strategy. Economic challenges such as market collapse, inflation, high unemployment rates, and interest rate variations may also affect the hospital’s pricing decisions, affecting consumer purchasing power (Patel & Sinha, 2022). The hospital must also consider changing sociocultural factors such as demographics, an increasingly aging population, and consumer preferences. These factors may challenge the hospital in developing a competitive pricing strategy that meets the community’s changing needs.
On the other hand, the PESTLE analysis also revealed opportunities for the hospital. Technological advancements can be leveraged to improve emergency room services, such as adopting electronic health records and mobile applications. Additionally, the hospital can leverage its social reputation to gain a competitive advantage, especially by understanding consumer beliefs and values. Legal considerations, such as compliance with HIPAA rules, can allow the hospital to establish trust and credibility with patients.
Customers
Patients from various demographics in and around Newport News are the primary customers of our hospital. With new technology, patients can receive improved quality care and avoid being transferred to other referral facilities. Our competitors, such as Riverside Regional Medical Center, Sentara Hampton General, and Mary Immaculate, offer specialized inpatient care and advanced diagnostics, but our new project proposal could provide us with a competitive advantage.
External Supply Chain
External supply chain factors, such as suppliers, logistics, customers, and environmental influences, impact the hospital’s structure and success. The PESTLE model components (Political, Economic, Sociocultural, Technological, Legal, and Environmental) all affect the revenue model and shape the hospital’s operations. Competitors, government agencies, nonprofits, health departments, health plans, and local hospitals can serve as external strategic partners and improve patient care through coordinated efforts. (Carlton et al., 2018).
External World’s Impact on the Revenue Model
The various components of the PESTLE model influence the revenue model in healthcare. Changes in customer trends, environmental laws, economic fluctuations, technological innovations, and new regulations and laws affect a hospital’s supply chain and pricing structure, ultimately impacting the organization’s revenue model. The external environment significantly impacts an organization’s marketing strategy, customer engagement, pricing structure, vendor contracts, and logistical strategies, which all affect the organization’s revenue model and daily operations. These factors can negatively affect the revenue model and shape an organization’s operations.
Competitor
The major competitors of our hospital are Mary Immaculate, Riverside Regional Medical Center, and Sentara Hampton General. Among them, Riverside Regional Medical Center is the largest competitor that offers specialized inpatient care, including advanced diagnostics. As a result, these larger and more complex hospitals have an advantage in providing advanced care and treatment options. However, our proposed new project could give us a competitive edge and help us capture a larger market share (Carlton et al., 2018).
External Partners
Strategic partners outside the community health center, such as local and federal governments, nonprofit organizations, health departments, and health plans, can support providing patients with more comprehensive and affordable care. By collaborating with local government agencies and community-based organizations, our community health center can expand its range of services. The federal government’s increased spending on primary care can aid in this expansion. Collaboration between health departments and community health centers can also enhance clinical services and improve community health. Fee transparency can be ensured by partnering with healthcare plans through value-based payment and care contracts. Partnering with a larger hospital can provide coordinated care, data sharing, more staff funding, and grants from the hospital’s community benefit programs, increasing funding opportunities for patient care. Grants provide funding flexibility and can enhance opportunities for patient care (Coleman et al., 2018).
Relevant Laws and Regulations Impacting the Organization
The hospital is subject to several federal and state healthcare regulations, which will affect its operations. To protect the security of patient information, the hospital must follow the HIPAA Privacy and Security Regulations. The HITECH Act incentivizes hospitals to use patient health information constructively while simultaneously penalizing data breaches or the publication of insecure patient information (Konnoth, 2020). Medicare, Medicaid, and other insurance carriers have restrictions that regulate coverage for medical services. If therapy is considered medically unnecessary, insurance will not pay the expenses, increasing financial pressure on providers and patients.
Uncertainties or Barriers
The median household income in the Newport News region is $51,082, which is nearly 26% less than the state average for Virginia and 16% less than the national average (Keisler-Starkey & Bunch, 2020). Additionally, the unemployment and poverty rates are higher than the national average. Notwithstanding these problems, 88.1% of the population has some health insurance, which is comparable to the national average of 89.5% (Keisler-Starkey & Bunch, 2020). Introducing a new project may need help since residents of this region might not be able to purchase the offered services due to the lower household income and greater poverty rate. However, the fact that a sizable portion of the population has access to health insurance is encouraging. Although the program’s goals may initially be hampered by the aging population and rising poverty rate, this should differ. In an environment where healthcare expenses are growing, the program attempts to provide high-quality treatment while being reasonably priced. By raising the cost of services and prompting patients to avoid the hospital or seek care elsewhere, the cost of the program could potentially harm the neighborhood’s economy. The initiative, however, supports the hospital’s objective of giving the community it serves access to inexpensive healthcare. The initiative may require finance, but overcoming these challenges and giving affordable care to the community will be the final aim.
Market Data Analysis
Healthcare Data Supporting Effectiveness of the Program
Various studies have demonstrated the effectiveness of Electronic Health Records (EHRs) in improving healthcare quality, patient satisfaction, and financial outcomes. A national survey found that 94% of doctors reported easy accessibility of patient records, 88% reported clinical benefits, and 75% reported improved patient care due to EHR systems (Uslu et al., 2021). A community hospital in Vermont reported a 60% reduction in near-miss medication events, a 25% decrease in chart-pulling, a 10% increase in case mix, an average billable gain of $26 per patient, and increased revenue by more than $100,000 over two years. Patients’ satisfaction with EHRs was also high, with 92% happy with e-prescribing, 90% reporting rarely going to the pharmacy, 63% reporting fewer medication errors, and 76% finding it easier to obtain medication (Alexander et al., 2020). The results show that EHRs provide healthcare providers with the tools to make informed clinical decisions that benefit the hospital and create value for the patient.
Obtaining Data and Integrating Data
Various data sources are available for the healthcare industry, including the American Hospital Directory, Health Forum, U.S. Department of Health and Human Services, Agency for Healthcare Research and Quality, and World Health Organization. Yet, combining data from multiple views and disciplines can be challenging, making it overwhelming and of little use. The healthcare system can benefit from integrated data, especially in interpreting a patient’s EHR, which can be exchanged immediately upon arrival. Cloud-based solutions may simplify and enhance efficiency in integrating data from many sources, and standardizing data across numerous sources can further assist in this process. Using cloud-based I.T. infrastructure and standardizing data can facilitate the integration of healthcare information.
Analyzing Data to Identify Opportunities
Electronic Health Record (EHR) systems are vital in increasing the quality of care while decreasing costs. Clinical Decision Support (CDS) tools, Computerized Physician Order Entry (CPOE) systems, and Health Information Exchange (HIE) systems are the three fundamental features they offer. These capabilities help clinicians to make educated clinical choices and provide patients with quick access to their medical information. The most recent drug information is made available to doctors through CDS tools, which also cross-reference a patient’s medical history for potentially harmful drug interactions. Meanwhile, CPOE systems enable doctors to order prescriptions, lab tests, x-rays, and other medical services.
Organizations that have integrated EHR systems with CDS and CPOE components have experienced a decrease in the number of diagnostic tests ordered every visit by 14.3% and a decrease in the cost for diagnostic tests by 12.9%. This suggests that people do not have to pay for the same services twice and that physicians may work more effectively by reducing the number of pointless tests. Additionally, studies have indicated that a CPOE system led to a 55% drop in medication mistakes, whereas EHR systems combining CPOE and CDS features led to an 86% decrease in medication errors.
Since doctors who use computer-based medical record systems are less likely to be sued for malpractice than those who do not, implementing EHR systems with CDS tools has also been linked to reducing these claims. According to a study done in Massachusetts, doctors who use an EHR system file malpractice claims at a rate of 6.1% as opposed to 10.8% for those who don’t (Rangarajan, 2020). According to healthcare data, the trend of using EHR systems is growing, with the percentage of doctors using these systems increasing from 46% to 88% since 2009 (Rangarajan, 2020). The trend is projected to continue, and we will see further changes in healthcare data as more clinics use this technology. EHR systems allow healthcare organizations to enhance clinical efficiency, patient care, safety, and effectiveness. The data in the graphic below illustrates increased care quality, patient contact with doctors, and support using EHR systems.
Evidence supports the usage of ehr systems, but there is also evidence against using this technology. When installing an EHR system, there are downsides, including financial considerations, privacy and security issues, early loss of worker productivity, and changes in patient care. Implementing a new system incurs implementation and maintenance expenses and the possibility of income loss owing to diminished productivity. Research indicated that workplace productivity declined by 20% in the first month, 10% in the second month, and 5% in the third month following adoption (Gibbs et al., 2021). There are obvious advantages to EHR systems but also obstacles, including usability and patient safety. If the program is poorly designed and has code errors, the interface might destroy or duplicate patient data. The graphic below demonstrates that some EHR systems may need more time to be ready for use in healthcare settings. For instance, if the information in a patient’s file is incorrect, the CDS tool may not function properly, resulting in disastrous patient care choices.
In a 2018 Stanford Medicine National Physician Survey, 60% of physicians stated that EHRs enhanced patient care, while 59% stated that EHRs require a functional overhaul. Another concern is patients’ access to their medical records (Garcia et al., 2022). A 2017 survey revealed that just 53% of the highest-rated hospitals provide patients the option to get their medical records, while other hospitals fee to release the information, and one hospital costs over $500 to disclose a patient’s medical record. There are political and legal forces external to hospitals that impact hospitals. The HITECH Act encourages healthcare providers to demonstrate meaningful usage of electronic health record systems in exchange for incentive payments. The statute mandates that people have the opportunity to access, download, and communicate their health information. Also, the hospital must furnish the patient with an electronic copy of their health records (Ngum, 2022). After analyzing both supporting and contradictory material from several viewpoints, judgments based on evidence might be proposed. While certain technologies may have or have had software flaws, the currently available technologies are more effective at giving clinical recommendations and focusing on patient safety.
Evidence-Based Strategies
A census is a wonderful tool for businesses to establish successful plans and obtain useful information about their target markets. The population of Newport News, Virginia, is 180,775, with an average household size of 2.51 persons and an annual median family income of $51,081. Sadly, the city’s poverty percentage exceeds the national average of 14.6%, reaching 16.4%. The population has stayed steady throughout the years, and the need for healthcare services has increased as it ages. Knowing the external environment is essential for firms to position themselves properly in the market. The PESTLE analysis provides an overview of external variables that affect operations, and analyzing demographic and economic trends assists us in understanding our position. Formulating and implementing a management plan is critical to a company’s success. Management plans guide a company’s internal and external activities within its environment. Collaborative management is a management model that allows the whole firm to participate in decision-making. This technique ensures that all physicians, nurses, administrators, and board members have a say in the decision before it is codified, which usually generates a sense of ownership within the business and results in productive work (Ngum, 2022). To properly position the business, Newport News General Hospital must build strategies that account for the multiple external variables and influences.
The demand for healthcare organizations to enhance patient treatment quality, safety, and efficacy persists. One of the evidence-based ways that can assist hospitals in executing programs focuses on the leadership position inside the institution. Research undertaken in the U.S. healthcare system has revealed that program implementation is more successful with good communication. Presidents and hospital board members who convey to middle managers that the programs are critical to organizational results and that financing will support their execution will have the support necessary to launch programs more efficiently. Collaboration connections between managers and clinicians are another crucial aspect of program implementation. According to studies, individuals participating in collaborative dialogue can sustain the momentum required to incorporate programs into the clinical context.
Delivering care in a novel manner is a method that may be utilized to seek new possibilities and manage several external obstacles. Some patients visit the hospital multiple times in a short period, which can be challenging for the elderly. Outpatient advanced patient care is in great demand, and community hospitals need help meeting this need. Care coordination, patient education, and new technology have enabled Partners HealthCare in Massachusetts, which comprises smaller community hospitals and health clinics, to deliver treatment at home. Patients might send vital signs and symptoms to telemonitoring nurses, resulting in fewer hospital visits. This initiative saved the business $10 million and reduced hospital readmissions by 51%. The Veterans Health Administration, where patients may engage with their clinicians using webcams, provides additional support for this technique. This resulted in 14% fewer urgent care visits and 7% fewer hospital admissions than in hospitals without this technology (Caver et al., 2020).
Creating an ehr system employing an evidence-based strategy would assist in maximizing results and minimizing the negative impacts of inadequate training. Plan development must consider the consequences of failing to ensure patient safety and improve treatment quality. A training, activation, and support strategy based on empirical evidence facilitates problem resolution and ensures the organization’s responsiveness to technological developments. This strategy will use classroom and web-based courses to teach physicians about the new EHR program. Help will also be available 24 hours a day throughout and after training. By providing the personnel with adequate resources and comprehensive training, we can ensure that our patients receive excellent care and correct diagnoses. Future automated systems will meet problems, but with the proper training, processes may be improved and unanticipated impacts avoided.
References
Zawada, S. J. (2018). Telemedicine: The Promise and the Performance. Heritage Foundation Backgrounder, (3373), 2018-12.
Patel, C., & Sinha, K. (2022). Digitalization of Healthcare System in India—A Perspective and PESTLE Analysis. In Proceedings of Trends in Electronics and Health Informatics: TEHI 2021 (pp. 191-205). Singapore: Springer Nature Singapore.
Carlton, E. L., & Singh, S. R. (2018). Joint community health needs assessments as a path for coordinating community-wide health improvement efforts between hospitals and local health departments. American Journal of public health, 108(5), 676-682.
Konnoth, C. (2020). Regulatory De-Arbitrage in Twenty-First Century Cures Act’s Health Information Regulation. Annals Health L., 29, 135.
Keisler-Starkey, K., & Bunch, L. N. (2020). Health insurance coverage in the United States: 2019. Washington, DC: U.S. Census Bureau.
Uslu, A., & Stausberg, J. (2021). Value of the electronic medical record for hospital care: update from the literature—Journal of medical Internet research, 23(12), e26323.
Rangarajan, A. (2020). Technology Attributes, Organizational Learning Attributes, Service Attributes, and Electronic Health Record Implementation Success (Doctoral dissertation, Indiana State University).
Alexander, G. C., Weiner, J. P., & Kharrazi, H. (2020). Integrating E-Prescribing and Pharmacy Claims Data for Predictive Modeling: Comparing Costs and Utilization of Health Plan Members Who Fill Their Initial Medications with Those Who Do Not. JOURNAL OF MANAGED, 1282.
Gibbs, M., Mengel, F., & Siemroth, C. (2021). Work from home & productivity: Evidence from personnel & analytics data on I.T. professionals. The University of Chicago, Becker Friedman Institute for Economics Working Paper, (2021-56).
Caver, K. A., Shearer, E. M., Burks, D. J., Perry, K., De Paul, N. F., McGinn, M. M., & Felker, B. L. (2020). Telemental health training in the veteran’s administration puget sound health care system. Journal of Clinical Psychology, 76(6), 1108-1124.
Ngum, E. (2022). Exploration of the Impact of How Leadership Addresses Employee Psychological Workplace Violence on Registered Nurses (Doctoral dissertation, City University of Seattle).
Garcia, G., & Crenner, C. (2022). Comparing international experiences with electronic health records among emergency medicine physicians in the United States and Norway: Semistructured interview study. JMIR Human Factors, 9(1), e28762.
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