EXPO /16/2011. Clinical Advisory Committees and Value Analysis Teams. Clinical Technology Assessment

Transcription

1 Clinical Advisory Committees and Value Analysis Teams Pat Klancer, Senior Director, Diagnostix Supply Chain, Amerinet Tim Hopkins, President and CEO, MedApproved Brent Johnson, Vice President of Supply Chain, CPO, Intermountain Healthcare Clinical Advisory Committees and Value Analysis Teams EXPO 2011 Clinical Technology Assessment This is NOT the old Product Evaluation Committee NOT focused on commodities C-Suite and Physician Leadership Engagement Integration with Quality / Six Sigma programs Recognition of high cost implications Impact on Patient Outcomes, Market Position, Physician Satisfaction 1

2 Physician The Challenge of Technology Assessment Seminars 4 The Challenge of Clinical Technology Assessment Efficacy & Marketing Issues Clinical Outcomes Competition: Other Devices Competition: Other MD's Market Position 5 The Challenge of Clinical Technology Assessment Safety Issues Patient Impact: risks; side effects Smoke, Fumes, Radiation or other exposures Equipment Issues: Electrical Check-in; PM; CM SPD Issues: Disassembly, Cleaning, Sterilization, Parts Vendor Certification: HIPAA, TB and HBv Testing 2

3 The Challenge of Clinical Technology Assessment CDC FDA DPH CMMS OIG Regulatory Issues Regulatory Agencies OSHA Joint Commission Fire Dept CLIA NRC The Challenge of Clinical Technology Assessment Training and Competency Use of Device: Basic Handling and Application Training: MD s, Procedure Staff; Recovery Staff; Unit Staff Use of Device: Assessing Competency MD Staff Credentialing Process Education for the Patient and Family The Challenge of Clinical Technology Assessment Reimbursement Issues 9 CDM: Charge Description Master ICD-10 & C Codes Out Patient Reimbursement: Variable Zero or Fractional In Patient Reimbursement 3

4 The Challenge of Clinical Technology Assessment Cost Issues $ No Contract Undermines Existing Commitment Not in Item File ROI?? 10 The Crises of No Technology Process The device was used by Dr. X today what is my PO #? Purchasing ordered the new device at Surgery s request ** How do I charge, clean, inspect, use, care for, or return? Risks for the lack of an effective process: Errors in using new technology can result in. 11 The Challenge of Clinical Technology Assessment dangers to patients and staff, and liability to you Technology Control Process Find out what the Facility s process requires Be prepared to go through the process Provide all supporting documentation; answer all questions Ensure all affected parties have full knowledge and skills to utilize your products safely and effectively 12 The Challenge of Clinical Technology Assessment 4

5 Software Bridging Gaps in the Value Analysis Process Tim Hopkins, MedApproved LLC. MedApproved, LLC Tim Hopkins, President First independent web-based supply chain solution for new product review Developed by team of healthcare professionals Streamline and standardize value analysis process New product introduction process Enhances workflow, documentation, communications, interaction with desired suppliers, etc. How can software assist the VA process? Increase overall efficiency What is the current process? Manual, disjointed, cumbersome, etc. Single platform/repository notifications Transparency in the process Organize stakeholders and teams/committees Gatekeeper(s): Identify undesired product requests Use in committee meetings 5

6 How can software assist the VA process? (continued) Communication How does communication from VA and front-line stakeholders currently operate? Single platform where all stakeholders can communicate regarding a particular project Send tasks/assignments Eliminate/reduce duplicate efforts How can software assist the VA process? (continued) Documentation How is all this information documented presently? Single repository for documents History of stakeholder communications Who/why did we approved this? Voting and survey summaries Cost projections Reporting capabilities How can software assist the supplier? What is the process for a rep? Anticipate the standard info needed for approval Control and deliver a consistent message to your customers Ensure your information is being viewed by the appropriate people High level transparency into the process Business planning/forecasts 6

7 Software Bridging Gaps in the Value Analysis Process: Benefit Summary Efficiency Coordinated communications Documentation Automation Transparency Cost savings Physical costs Time savings- opportunity costs Questions? Tim Hopkins, MedApproved LLC Value Analysis at Intermountain Healthcare Brent Johnson VP Supply Chain 7

8 Intermountain Healthcare Overview Largest company in the state of Utah 31,000 employees Created in 1975 as LDS Church gifts it s hospitals to the community Rated the #1 or #2 hospital organizations in the nation each year during the past decade $4.0 billion in Net Patient Services Revenue $5.0 billion in Assets 24 hospitals, 160 clinics, 800 employed Health plans (Select Health) has 550,000 members 1 Worst Cost Best 1 Worst Source: americashealthranking.org and statehealthfacts.org Health Status Best If all doctors practiced to the standardof Intermountain Healthcare in Salt Lake City, Medicare would cost 40% less. Picture courtesy of: Dartmouthatlas.org 1 8

9 Intermountain Healthcare A Learning Organization Investment in Clinical Programs Identify Key Process Measure Current Outcomes Identify Best Practices Define Pathway to Improve Implement New Processes Re-measure Outcomes Care process model implemented Intermountain Healthcare Clinical Programs Cardiovascular Women & Newborn Surgery Intensive Medicine Pediatrics Primary Care Behavior Health Oncology Patient Safety Value Analysis What is it? An effective process to determine optimal product and service choices Evaluating services for clinical quality and cost effectiveness Bridges the gap between clinical staff and the supply chain process Taking the personal preference out of the equation Product analysis that includes life cycle cost, clinical benefits and desirable patient outcomes 9

10 Strategic Sourcing Process at Intermountain Step 1 Step 2 Step 3 Step 4 Step 5 Step 6 Opportunity Category Market Strategy Supplier Implementation Assessment Analysis Analysis Development Selection Spend analysis Category analysis ID suppliers Reconfirm scope Supplier calls Goals and objectives Category profiling Finalize decision rights committee Launch crossfunctional sourcing team Team charters Project planning ID demand drivers As-is" specs As-is" service levels As-is processes Current TCO Benchmark TCO Define specs Define service levels Define processes Supplier communication RFI (optional) Supplier interviews Industry analysis Market analysis Benchmark best practices Initial supplier assessment Leverage analysis Reconfirm objectives Supplier evaluation model ID desired outcomes RFP/RFQ/Auction Brainstorm processes Score proposals Finalize business requirements Supplier presentations Supplier selection criteria Site visits Determine sourcing Other due diligence strategy Contract negotiations Finalize long list of Executive approval suppliers Award business Executive approval Supplier communication Supplier communication Launch implementation team Implementation project planning Communications planning Supplier performance management planning Implementation execution Transition to a Program Manager Value Analysis Activities 28 Goals of Product Standardization/Value Analysis at Intermountain Decrease Clinical Variation Products selected and consistently used for specific clinical applications Example: Central Line Removal Kit Increase Patient Safety Products selected with patient safety as the #1 priority Example: Oral syringes Reduce Supply Expenses Drive volumes to fewer items and improve overall pricing Drive compliance contracts that can be sold to others Prepare for Distribution Current State: 12,000 distinct Med/Surg items Future State: 6,000 distinct Med/Surg items Value Analysis is not part of traditional contracting Options: 1. Not done at IDN 2. Hospitals do Value Analysis alone 3. Suppliers help with product expertise 4. GPO help with tools & resources Traditional contracting GPOs & some self-contracting Analyze Spend Analyze Category Analyze Market Develop Strategy Manage Negotiations Award & Contract Implement Strategy Value analysis activities in strategic sourcing Strategic Sourcing 10

11 Value Analysis includes many total cost of ownership factors Total cost of ownership Purchase Costs Internal Business Costs Easier To See Harder To See Purchase price Expired Freight product Non-compliant utilization Patient Clinical outcomes Acceptance Payment Inventory terms carrying Transaction costs SCO administration Costs Joint Trading Partner Costs Physician preference/ specifications Damaged product Early access to new technology Expediting/ special delivery Greater opportunity for value -comes beyond price Time Spent Area of Focus Savings / Avoid Opportunity Examples 75% Price 3% - 18% Suture Gloves Med/Surg 10% Volume 0% - 5% Service line expansion, new physician 10% Utilization 25% - 50% Tubing Lengths SCD Length Drape Technique Generics 5% Technology Adoption 100% - 500% (cost avoidance) CRM Spine Ortho Pharma New Technology Review GPO Tools & Services Utilization Management Value Analysis Options Supplier Assistance Strategic Sourcing Process Value Analysis Teams 11

12 What products need value analysis? Surgical Mesh Sometimes it depends on the culture Culture eats strategy for lunch every day Healthcare reform impacts supply chain 12

13 Impacts on Healthcare Reform on Hospitals We will be expected to do more with less The Good & Bad of Healthcare Reform on Supply Chain The Good The Bad 1. Need for more cost reductions will require more supply chain expertise & strategy 2. GPO s also will be needed more than ever before 3. Physician preference will likely fade in ACO/Bundled payment scenarios 4. Alliance behavior with suppliers, to reduce total costs, will be enhanced 5. Improved patient outcomes, working with supplier solutions, will become more desirable 1. Supplier costs pressures will increase even more 2. Capital spending will be dramatically curtailed 3. New technology will be scrutinized more than ever before for real value 4. Utilization rates decrease through efficiency measures and patient volume reductions We are all part of the same team Sure Glad There s No Hole In This End! 13

14 Thank You 14