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Go Big or Go Home – Making Your IVF Center Achieve Optimum Excellence Kevin Doody MD

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Presentation on theme: "Go Big or Go Home – Making Your IVF Center Achieve Optimum Excellence Kevin Doody MD"— Presentation transcript:

1 Go Big or Go Home – Making Your IVF Center Achieve Optimum Excellence Kevin Doody MD

2 Goal Understand how to define your market space Discuss revenue generation strategies Develop a Quality Management / Business Process Approach Marketing Patient care Administrative Clinical Laboratory Accurate billing Manage expenses Information technology in REI

3 Go Big or Go Home???? Bigger not always better Sometimes less is more and more is less

4 Market Space Red Ocean Blue Ocean Blue Ocean Strategy, Kim and Mauborgne, Harvard Business School Press 2005

5 Red Ocean Industry boundaries are defined and accepted Competitive rules of the game are known Clinics try to outperform rivals to grab a greater share of existing demand As the market space gets crowded, prospects for profits and growth are reduced Products become commodities and cutthroat competition turns the ocean bloody

6 Red Ocean Good understanding exists with regard how to compete skillfully in red waters Analysis of underlying economic structure of an existing industry Choosing a strategic position of low cost or differentiation or focus Benchmarking the competition Active management Quality Management / Quality Assurance Efficiency Compliance with regulations

7 Blue Ocean Untapped market space Demand creation Opportunity for highly profitable growth Most blue oceans are created from within red oceans by expanding existing industry boundaries Competition is irrelevant because the rules of the game are waiting to be set

8 Revenue Generation in “Red Ocean”REI Practice- A Quality Management / Business Process Approach

9 Assumptions Delivery of REI services is a business Active management of business improves outcomes for customers (patients), employees, and stakeholders Quality management is essential for active management

10 Define Business Goals Recruit and retain patients Marketing Ease of treatment process Delivery of good patient care Administrative Clinical Laboratory Accurate billing Manage expenses

11 Define Scope of Patient Care Implementation is based often based on “local issues” Diagnostic testing Sonography HSG Andrology Endocrine Treatment IVF / IUI Gynecology Surgery Physician provider Facility provider (certified ASC) Laboratory services IVF Other

12 Definitions Quality Programs / Systems TQM Six Sigma ISO 9000

13 Definitions Process Mapping – Illustrated description of how things get done, which enables participants to visualize an entire process and identify areas of strength and weaknesses.

14 Definitions Control chart – Graphic representation of variance in a process over time

15 Definitions Statistical Process Control – The application of statistical methods to analyze data, study and monitor process capability and performance

16 Definitions Root Cause Analysis – Study of the original reason for non- conformance with a process

17 Six Sigma Sigma is a statistical term that is a measure of variance Processes are designed / developed to minimize variance such that one can be “six sigma” from perfection and the product is within specified tolerance from defect Six Sigma equates to no more than 3.4 defects per million opportunities (this number is relevant only to manufacturing)

18 Six Sigma- Definitions Defect – failure to deliver what the customer wants. Defects are considered to be sources of customer irritation They are also considered to be costly both to customers and to manufacturers or service providers. For IVF, failure to conceive should not be considered a defect. Incidents and deviations from protocols or expected outcomes are defects.

19 Six Sigma- Definitions Opportunity – the total number of chances to have a defect. Each opportunity must be independent of other opportunities, must be measurable and observable. The final requirement of an opportunity is that it directly relates to the customer perception of quality.

20 Six Sigma- Methodology DMAIC Define Business processes Opportunities Defects Measure Opportunities Defects Analyze Improve Control

21 Six Sigma- Methodology DMADV Design New product or process (e.g. egg freezing or IVM) Measure and identify Characteristics critical to quality Product capabilities Production process capability Risks Analyze Design Verify Pilot runs

22 Tools Document control system Error logs Complaint logs Indicators Audit mechanisms Objective measures of quality Graphical tools / statistical calculations Meetings / training Use of IT

23 Information Technology for REI Practices

24 Objective Detail the network requirements for IT systems in REI practice Detail the general requirements and desired specifications for practice management and EMR systems in REI practices Demonstrate the value of ART specific EMR for both patient care and Quality Management Describe the various interfaces / compatibilities available to enhance IT systems in REI practices

25 Disclosure Owner, CEO and Digital Medical Data Systems (aka – Digital MD Systems) Chief Software Architect of DOC (EMR for REI practices)

26 Background Microsoft Physician of the Year – 2004 Runner up other years Microsoft Clinic of the Year – 2006 Microsoft Ambulatory Record of the Year – 2006 Runner up other years Member HIMMS

27 Electronic Medical Records Point of care documentation (not a database) General considerations Security / access rights (permissions) Audit trail HL-7 communication with practice management software for scheduling, billing Encounter documentation Image archival (DICOM) Bidirectional laboratory interfaces (HL-7) Manage / reconcile medications, allergies, diagnoses (problem list) Prescriptions Printed Faxed Email (requires encryption) Provider choice

28 Electronic Medical Records General considerations Management of paper documents (scanning) Prior records Information sheets Consent forms Best practices advice / protocol management Algorithm driven Document management

29 Electronic Medical Records EASE OF USE



32 Electronic Medical Records ART specific issues Integrated Treatment of Male and Female Partner Radiology, laboratory, surgery and complex medical CDC Compliance FDA Compliance ART Lab Recordkeeping LIS Andrology / Endocrinology IVF and Andrology Laboratory Quality Management Flow sheet management









41 Conclusion Information Technology is an important aspect of any medical practice REI practices have both broad and very specific needs A well designed REI EMR should facilitate recordkeeping, patient management, workflow and QM

42 Blue Ocean Strategies for SREI Offer a “product” that your competitors aren’t offering Non-premium ART cycles Minimal stimulation Premium IVF PGS / embryo accumulation Multi-cycle plans Refund Donor egg bank Embryo morphokinetics Pharmaceutical, laboratory or device trials Note that what starts out as a blue ocean strategy quickly becomes red ocean

43 Summary REI is a business Many markets are saturated with providers Maximizing revenue requires active management Define business goals Evaluate services offered Define business processes QA Use IT to maximal advantage Look for opportunities to create demand

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