Should Ascension prioritize expanding its telemedicine services to reach more rural patients or focus on improving in-person care quality at existing hospitals?

Introduction

The trade-off we're examining today is whether Ascension should prioritize expanding telemedicine services to reach more rural patients or focus on improving in-person care quality at existing hospitals. This scenario touches on critical aspects of healthcare accessibility, resource allocation, and quality of care. I'll analyze this trade-off by examining the context, stakeholders, potential impacts, and metrics, then design an experiment to inform our decision-making process.

Step 1

Clarifying Questions (3 minutes)

• Context: I'm thinking about Ascension's current market position. Could you provide some insight into our market share in rural vs. urban areas?

Why it matters: Helps understand where growth opportunities lie Expected answer: Lower market share in rural areas Impact on approach: Would lean towards expanding telemedicine if rural market share is significantly lower

• Business Context: Based on industry trends, I assume telemedicine services have a different revenue model than in-person care. Can you confirm how our revenue streams differ between these two service types?

Why it matters: Influences financial implications of the trade-off Expected answer: Telemedicine has lower reimbursement rates but potentially higher volume Impact on approach: Would need to balance potential volume increase against revenue per patient

• User Impact: I'm curious about patient preferences. Do we have data on rural patients' willingness to adopt telemedicine versus traveling for in-person care?

Why it matters: Crucial for understanding potential adoption and impact Expected answer: Mixed preferences, with younger patients more open to telemedicine Impact on approach: Would influence targeting and rollout strategy for telemedicine expansion

• Technical: Regarding our current telemedicine infrastructure, what's our capacity for scaling? Are there any major technical hurdles we'd need to overcome?

Why it matters: Determines feasibility and timeline for expansion Expected answer: Some capacity to scale, but would require investment in servers and security Impact on approach: Would affect budget allocation and implementation timeline

• Resource: Thinking about our workforce, how does our staffing situation look for both telemedicine and in-person care improvement initiatives?

Why it matters: Impacts our ability to execute on either option Expected answer: Shortage of specialists for in-person care, easier to staff telemedicine Impact on approach: Might favor telemedicine expansion if staffing is a significant constraint for in-person care improvement