Telestroke - a Telemedicine Opportunity or a Distraction

A Telemedicine Opportunity or a Distraction? - Case Analysis

Table of Contents

Executive Summary 3

Case Synopsis 4

Strategy Analysis 5

Business model and Business Goal 5

Major Business Strategies 5

IS Strategy 6

Problems Analysis 6

Firm-Based Value Chain Model 6

Model Application at PH Spoke Hospital 7

Implementation Needs Analysis 9

Problem Identification Table 9

Implementation Effectiveness 10

Summary of TeleStroke Implementation 10

Tangible and Intangible Costs Estimation 11

Tangible and Intangible Benefits Estimation 12

Conclusion 13

References 15

Executive Summary

This paper analyzes the implementation of TeleStroke, which is a form of Telemedicine service, in spoke hospitals. In order to analyze the opportunities and needs of TeleStroke implementation, Porter’s firm based value chain model is used to identify the primary and support activities of a spoke hospital. This way, the activities that are going to be affected from TeleStroke implementation can be determined. In order to determine the effectiveness of TeleStroke implementation, both the tangible and intangible costs and benefits were analyzed. From the analysis, it is concluded that TeleStroke is indeed more of an opportunity than it is a distraction.

Case Synopsis

It is estimated that 15 million people suffered from stroke worldwide and in the U.S. alone, around 795,000 people were diagnosed with stroke and 140,000 people died because of it, making it the third cause of death in the country (Gogan & Garfield, 2012). Acute ischemic stroke is caused when the blood flow to the brain is blocked by a clot (Gogan & Garfield, 2012). While administering tPA can greatly increase a patient’s chance to recover, tPA can also harm or worse, kill the patient when he/she instead suffers from other conditions such internal bleeding, which has similar symptoms to stroke (Gogan & Garfield, 2012). Therefore, a neurologist with expertise in acute stroke care is needed to determine if the patient should be administered tPA (Gogan & Garfield, 2012).

Telemedicine is a consultation system that is used in order to give medical services remotely (Gogan & Garfield, 2012). TeleStroke is an example of telemedicine. TeleStroke was successfully tested at Martha’s Vineyard Hospital back in 2000 (Gogan & Garfield, 2012). Soon after, the service was offered to hospitals that could not afford 24/7 stroke neurology coverage (Gogan & Garfield, 2012). The service was successful as Massachusetts General was able to form an alliance with Brigham and eventually TeleStroke was able to be extended to other hospitals in Massachusetts, Maine and New Hampshire (Gogan & Garfield, 2012).

Because TeleStroke has saved the lives of many stroke patients through the remote consultations it provided over the years, TeleStroke has become well known especially in Massachusetts area (Gogan & Garfield, 2012). After several talks with nurses from Falmouth Hospital, Shawn Farrell The Executive Director of the Partners TeleStroke Program considered providing telemedicine services to other medical domains. However, Dr. Lee Schwann, Vice Chairman of Neurology and Director Acute Stroke and TeleStroke Service thinks that it is not worth it to extend the service to other medical fields such as critical-care pediatrics because they already have too many things at hand (Gogan & Garfield, 2012).

As an IT consultant, it is important to analyze the implementation effectiveness of TeleStroke. This is done by identifying the activities in spoke hospitals that are in need of TeleStroke. Tangible and intangible costs and benefits must also be analyzed and if the benefits outweigh the costs, then it may be worth it to provide telemedicine consultation services similar to TeleStroke. 

Strategy Analysis

Business model and Business Goal

Recognized as a top tier hospital in the United States, Massachusetts General strives to “deliver the very best health care in a safe, compassionate environment; to advance that care through innovative research and education; and to improve the health and well-being of the diverse communities we serve “(Massachusetts General Hospital, 2017, p. 1). In order to achieve the highest quality in care and safety, Massachusetts General operates under the 6 tenets: safety, effectiveness, patient-centeredness, timeliness, efficiency and equity (Massachusetts General Hospital, 2017). Their six multidisciplinary care centers are world renowned for innovations in cancer, digestive disorders, heart disease, transplantation, vascular medicine and trauma (Massachusetts General Hospital, 2017). Renowned as a research powerhouse, Massachusetts General has discovered various medical breakthroughs from their research (Massachusetts General Hospital, 2017). As a top medical school, Massachusetts General has mentored their students in the field of science and medicine to put them in a path to become international leaders in their field of expertise (Massachusetts General Hospital, 2017). Having served the New England communities and the entire nation with its high class medical treatments for years, Massachusetts General is recognized for its excellence in community service where in 2015, it received Foster G. McGaw Prize (Massachusetts General Hospital, 2017).

Major Business Strategies

As a top healthcare service provider in the United States, Massachusetts General employs differentiation strategy across the industry as their business strategy and the TeleStroke service is no exception. TeleStroke service was started by Lee Schwamm of Massachusetts General after he successfully tested the system with Martha’s Vineyard Hospital back in 2000 (Gogan & Garfield, 2012). Schwamm and other twenty physicians in MGH neurology program offered TeleStroke service to numerous hospitals in Massachusetts (Gogan & Garfield, 2012). For several years, Massachusetts General was the sole provider of stroke telemedicine service.