For instance, a study by the Harvard Team determined that fully 11 per cent of the lowest income group (with a monthly household income below U.S.$1,282) suffered from poor health compared with just 3 per cent of the highest income group (i.e., households with an income above U.S.$5,128) (Ramesh). As this author points out, the current approach to the delivery of healthcare services in Hong Kong has some definite strengths - as well as weaknesses -- that must be taken into account when formulating strategy for the future. In this regard, Ramesh emphasizes that, "Hong Kong's accessible and equitable health-care system has been achieved at a rather modest cost, and the concentration of public subsidies on in-patient care, which is expensive, has fostered a system that is both efficient and equitable. Centralized provision in public facilities reduces scope for supplier-induced demand and duplication of facilities, thus reducing overall costs" (p. 108).
Weaknesses. In reality, many of the same weaknesses that characterize the current healthcare delivery system in Hong Kong translate into strengths for the telemedicine enterprise envisioned herein. For example, Ramesh advises that, "The continuation of the privileged access enjoyed by civil servants and the superior ward classes available to them are inequitable and a blemish on an otherwise fair system. While lower-income households are more likely to use subsidized public facilities, even the top income group uses public facilities for both out-patient and in-patient services. The political implications of this are significant, as use of public facilities by upper-income groups ensures political support for the public system" (p. 107). Although not all residents in Hong Kong approve of the current approach to healthcare delivery, it is unlikely that any substantive changes will take place in the foreseeable future. As one authority notes, "There are, of course, some who prefer private provision and call for a reduction in the extensive role that the government plays in the health sector in Hong Kong. The reform efforts currently underway are unlikely to make a significant difference in the way health care is provided and financed in Hong Kong" (Ramesh, p. 108). These issues are particularly salient for the group targeted by telemedicine providers specializing in services for the elderly. For instance, Ramesh concludes, "Even if the proposed Health Protection Account is established, it is unlikely to make much of an impact except to mobilize some additional resources. Based on Singapore's experience with Medisave, one can surmise that the proposed contribution rate is too low to allow the accumulation of sufficient funds to pay for long-term care of the aged" (p. 108).
Opportunities. Taken together, the foregoing suggests that there is a significant opportunity available for telemedicine providers of all types in Hong Kong today, particularly those that specialize in the delivery of healthcare services for the elderly. According to the analysts at the Hong Kong Trade Development Council (HKTDC) in their report, "Industry Developments and Export Opportunities for Hong Kong Companies in Hong Kong," although the medical and healthcare product industry in Hong Kong is regarded as being in the early phases of development, there are some companies already manufacturing the equipment needed for a wide range of telemedicine applications. For example, the HKTDC reports that, "One company has attained worldwide leadership in electronic peak flow meters (for asthma management) and another in scales and weight sensors. There is also a leading contract manufacturer of disposable electro-surgical products. Meanwhile, telemedicine equipment has been developed by a local oxygen supply company" (Industry developments, p. 3).
Threats. According to Gauld (2005), although the healthcare system in Hong Kong is largely adequate for the vast majority of its residents, healthcare accessibility and quality continue to depend on class and even the most wealthy residents may be hard pressed to receive timely medical attention if a pandemic or other emergency situation occurs that strains the system as it did during the outbreaks of H5N1 avian flu and SARS in recent years, which Gauld suggests pushed the healthcare system in Hong Kong "close to the breaking point" (p. 176). In addition, as Barnes (2006) emphasizes, "The international nature of many telemedicine matters further complicates many telemedicine consultations.... Therefore, depending on the country in which the patient is located, telemedicine providers may be opening themselves up to insurmountable liability problems" (p. 492). In fact, as of February 2004, there have been no legal actions brought before a court anywhere in the world concerning the potential problems involved in the provision of telemedicine consults between unrelated entities and these issues remain unresolved (Barnes).
The objectives of the marketing plan were three-fold as follows: (a) to deliver a thoughtful and informed analysis of the existing opportunities and threats to new business in the healthcare industry competing in Hong Kong today; (b) to describe a new business venture that takes advantage of identified opportunities in the delivery of healthcare services; and - to provide a relevant strategic analysis and action program pursuant to the foregoing.
The enterprise envisioned herein intends to take advantage of the Internet to promote the telemedicine provider described above. This strategy is congruent with a number of industry observers who suggest that an increasing number of healthcare consumers will turn to the Internet in the future. In this regard, Eger (2006) reports that, "Internet usage statistics point to one billion users worldwide, with a growth rate of 15% per month. The World Wide Web, the Internet's most popular component, is being integrated into the marketing, information, and communications strategies of almost every major corporation, educational institution, charitable and political organization, community service agency, and government entity in the developed world. No previous communications advance has been adopted by the public so widely so rapidly" (p. 19). In this environment, it just makes good business sense to take advantage of the benefits that accrue to the use of the Internet for healthcare delivery in new ways that promise to improve the quality of healthcare for its recipients while generating a profit in the meantime.
6. Action Program.
According to Stone and Mccall (2004), "A marketing plan sets out to provide a framework for the proposed marketing to take place. It identifies the objectives of the plan together with the methods and resources to implement it" (p. 223). Typically, marketing plans cover the basic issues outlined in Table 1 below as they apply to the telemedicine enterprise envisioned herein.
Marketing plan for telemedicine provider in Hong Kong.
Marketing Plan Component
To become profitable as quickly as possible and assume a leadership position in the telemedicine industry by the end of the company's second year of operations.
To promote the level of healthcare services available to the residents of Hong Kong in general, and to the elderly and infirm in particular through the delivery of high-quality healthcare services through telemedicine channels.
Product: Telemedicine services
Approximately 75% of traditional face-to-face emergency room visit and treatment; comparable prices on routine treatment.
Promotion: Various means, including company newsletters, corporate Web site, billboards and televisions advertisements.
Funding assumed available.
Human Resources Requirements
Office and administrative staff; healthcare clinicians (two or three credentialed physicians; various nurse practitioners and geriatric nurses; office manager; technical support staff.
7. Financial Forecast.
Based on the statistical data developed concerning the number of current Hong Kong residents and the number of current Internet users, there are approximately 4 million residents in Hong Kong with the capability of subscribing to and receiving telemedicine services today. Based on this potential pool of patients, the company's financial forecast with use a 5-year strategic plan with the expectation of becoming profitable by the end of the second year of operation based on the following financing needs:
a. Projected firm sales.
b. Projected expenses.
c. Estimated levels of investment required to support projected sales.
d. Analysis of the firm's financing needs.
For this purpose, the percent-of-sales method would be used, a technique that is congruent with Shim and Siegel's (2001) guidance concerning financial forecasting.
Relevant quantifiable metrics will be used to monitor the financial performance of the enterprise envisioned herein on a regular basis in an effort to identify both opportunities for improvement and threats from competitors.
Barnes, J.K. (2006). Telemedicine: A conflict of laws problem waiting to happen. Houston Journal of International Law, 28(2), 491.