Business Architecture of Hospitals – Part 4

… Also important is the relation of these patient groups with other patient groups.

This has both an operational as a strategic impact. ESRD patients are a group of patients that have a chronic disease. These require a different kind of attention than other patient-groups. To organize a hospital efficiently, the management must know what types of businesses have to be "channeled by" the organization. Besides patients with a chronic disease, there are patients that require urgent treatment, a traumatic-oriented service or other that have a rare disease which treatment can be planned together with the other operations.

A hospital, like any other company, must make organizational choices that are linked to a certain business. In case of a hospital the choice could be to concentrate on specific cures or diseases (like cardio-vascular, oncology, etc) for which it offers the natural choice in the area. Thus, In the area of ​​ESRD, the choice to outsource this treatments to specific centres will be linked to the strategic orientation of the hospital (this orientation is limited by governmental policies that require a basic proposition for all types of patients …)

The strategic element requires market analysis. The growth rate was mentioned previously, but what about the number of patients? Previously mentioned company estimated approximately two million ESRD patients world-wide, others estimate 920,000 dialysis patients worldwide growing by around 7% -9% per year. Yet an other publication indicates a that the "growth rate is five times the world population growth (1.3%) and continues to grow beyond all early expectations, showing no sign of reaching a steady state within the next two decades." (1).
This growth rate must be related to other treatments so that a long-term plan can be made.

There are some main suppliers in this market that provide dialysis equipment:

  • Frenesius Medical Care (Germany)
  • Gambro (Sweden)
  • Baxter (US)
  • B.Braun (Germany)

Some of these offer both the dialysis service as well as the equipment. Such a combination gives the hospital more choice to select a certain provider. The advantage of a company offering both is that the hospital can start with own equipment and later outsource the activity and still not loose on knowledge. A common risk is supplier lock-in and this issue is open for any supplier that offers a broad palette of medical services and equipment.

Interesting in this area is the development of the health-care sector itself. Hospitals are dominating public owned and therefore non-profit organizations, whereas health-care suppliers are private owned and profit-centers.

For the hospital it is important to be cost efficient, the suppliers wants to achieve growth in profits. The hospital must strive for independent solutions and investigations in this area. New innovations will change the scenario.

To be continued

(1) – Http://

© 2008 Hans Bool