Does your staff receive the right support to increase productivity and reduce costs?

Transcription

1 NewYork-Presbyterian has moved aggressively to succeed in the era of healthcare reform. The health system has recently expanded by acquiring three community hospitals in and near New York City. Ranked Number One in the New York metropolitan areas by U.S. News & World Report, NewYork-Presbyterian is a widely respected teaching hospital and a pioneer in healthcare innovation. A key current initiative is development of an in-house service organization in diagnostic imaging to align with the health system s biomedical service program. To that end the diagnostic imaging department is creating a service team that will enable full clinical operations to serve all patients 24/7. It is expected to be complete within the next five years. A critical element of this initiative is a collaboration with for maintenance and repair of imaging devices at affordable cost. In place of a full-service contract, NewYork Presbyterian's in-house service team takes primary responsibility for the equipment, while calling on OEM experts for escalated service, technical support, parts and training. The team has access to an online asset management system, remote device monitoring, and advanced diagnostic tools and repair technologies. The shared service agreement is saving and is expected to continue saving several hundred thousand dollars while maintaining fully compliant planned maintenance and supporting increased device uptime. Over recent years, we have worked collaboratively and progressively with the GE team, led by Joe Janovsky, to develop and fine-tune a mutually beneficial shared service arrangement," says Chris Schaefer, The Duke University Health System Clinical Engineering team includes 15 members who service some 950 diagnostic imaging assets worth about half a billion dollars, across three hospitals and more than 100 other care locations. For years, the in-house team had received support from under a service contract covering more than 200 GE imaging devices and related equipment. In 2014, as the service contract came up for renewal, Director of Clinical Engineering Grant Smith saw a critical need to reduce service costs. Responding to Duke s needs, developed a new 5-year, $20 million agreement that yields $400,000 in annual savings, achieved largely through parts pool arrangements that have reduced parts costs by 35 percent. Meanwhile, GE continues to provide technical support to the in-house team under a labor pool at a discounted hourly rate. We moved forward with the new contract because of the strong relationship our in-house staff already had with GE, says Smith. Their willingness to listen and their flexibility in offering viable options to meet our objectives justified our decision to continue with them as a key supporter. Addressing parts costs Care providers today routinely seek service cost reductions, and Duke was no exception. Specifically, Smith wanted to cap annual parts costs while ensuring fast parts availability for all GE devices, which make up the largest share of the system s installed base. Does your staff receive the right support to increase productivity and reduce costs? Service provides flexible support options for your patients to provide seamless workflow and reduced cost. The following healthcare providers demonstrate two examples: Shared service agreement helps NewYork-Presbyterian prosper in a new era of care Shared service agreement helps NewYork-Presbyterian prosper in a new era of care NewYork-Presbyterian s key initiative is to develop an in-house service organization in diagnostic imaging to enable a full clinical operation to service patients 24/7. This collaboration resulted in a shared service agreement, where the in-house team assumes responsibility for equipment while calling on OEM experts for escalated service, technical support, parts and training. Benefits to NewYork-Presbyterian include an estimated $650,000 savings through: Conversion from full to shared service offering Reduced outside contract labor costs Avoidance of travel costs Standardized overtime labor Read full case study A service contract renewal brings substantial cost reduction and strengthens teamwork between Duke in-house team and GE engineers A service contract renewal brings substantial cost reduction and strengthens teamwork between Duke in-house team and GE engineers Duke University Health System has contracted with to support their clinical engineering team for over 200 GE imaging devices. Both sides worked on a new agreement that would reduce annual parts costs while ensuring fast parts availability for a larger share of the system s installed base. continues to support the in-house team under a new labor pool structured at a discounted hourly rate. The nearly $400,000 annual contract savings was reached through: Reduced parts expense by 35% from pool arrangements Savings of $225,000 through customization of matching coverage to specific equipment for PET/CT, CT, Nuclear Medicaine and Mammography Improved device repair turnaround times based on part availability and on-site technical support Read full case study

2 Shared service agreement helps NewYork-Presbyterian in a new era of care prosper NewYork-Presbyterian has moved aggressively to succeed in the era of healthcare reform. The health system has recently expanded by acquiring three community hospitals in and near New York City. Ranked Number One in the New York metropolitan areas by U.S. News & World Report, NewYork-Presbyterian is a widely respected teaching hospital and a pioneer in healthcare innovation. A key current initiative is development of an in-house service organization in diagnostic imaging to align with the health system s biomedical service program. To that end the diagnostic imaging department is creating a service team that will enable full clinical operations to serve all patients 24/7. It is expected to be complete within the next five years. A critical element of this initiative is a collaboration with for maintenance and repair of imaging devices at affordable cost. support, parts and training. The team has access to an online asset management system, remote device monitoring, and advanced diagnostic tools and repair technologies. The shared service agreement is saving and is expected to continue saving several hundred thousand dollars while maintaining fully compliant planned maintenance and supporting increased device uptime. In place of a full-service contract, NewYork Presbyterian's in-house service team takes primary responsibility for the equipment, while calling on OEM experts for escalated service, technical Over recent years, we have worked collaboratively and progressively with the GE team, led by Joe Janovsky, to develop and fine-tune a mutually beneficial shared service arrangement," says Chris Schaefer,

3 "Since the start of this agreement, we are running close to 99 percent uptime, especially on our most expensive assets." Chif Umejei, Director of Biomedical Engineering Biomedical Imaging Manager. "The shared service model works when both parties are committed to a true win-win relationship. Beyond cost savings, accomplishments to date include: Improved device service response time Upgrades of advanced imaging devices to current technology Streamlining of service after hospital acquisitions Strengthened engagement of the in-house service team. Embracing the new The impact of healthcare reform led NewYork-Presbyterian to target 24/7 clinical operations. In particular, says Schaefer, the Affordable Care Act means more patients with health insurance. To handle increased demand for imaging, it is imperative to expand hours of service rather than to add more high-end imaging equipment, he says. At a holistic view from Chif Umejei, Director of Biomedical Engineering, The business model is changing. I think it has been proven in different markets that there is a need to provide these services 24/7 as long as there are patients who require them, the services need to be available. Also, we re beginning to take in many more complex cases that have a significant need for imaging technologies. The hospitals that thrive will be those that can respond the fastest to the needs of patients, irrespective of what time of day it is. So we have to look at how biomedical engineering and diagnostic imaging can support that mission. We decided that to reduce our cost and reduce equipment downtime, it made sense to invest in our local talent. To develop that talent, we are implementing the shared service model. Faster response NewYork-Presbyterian sees more uptime largely because in-house engineers can respond faster than OEM service personnel dispatched from off-site. Response in 30 minutes or less can save valuable hours of waiting time. Since the start of this agreement, we are running close to 99 percent uptime, especially on our most expensive assets, Umejei says. With a capable in-house team backed by OEM engineers, We re not losing any of the benefits one would expect from a full service contract, he adds. We are actually gaining increased support through collaboration between both organizations. The agreement includes annual technical training to help NewYork-Presbyterian engineers advance their knowledge and sharpen their troubleshooting skills. They also benefit by observing OEM engineers called in for more complex repairs. The in-house team also gains productivity from both the technical service package license and remote technical support aspects of a shared service arrangement. Our in-house team now has access to much of the vast collective experience of the GE field engineer force, Schaefer says. In addition, the shared service arrangement provides annual days for TiP TM Lifecycle applications training. This continuous training supports troubleshooting, training for new technologists, refresher training, and instruction in new advanced clinical applications. The training helps ensure that all technologists remain fully up to date and can apply the full diagnostic power of imaging systems without any unnecessary service calls resulting from operator issues. Upgrading MR systems Implementation of the shared service agreement began with X-ray and ultrasound and has expanded into MRI. We are now targeting the high-end modalities because they tend not to have backups in place when one unit is not available, says Schaefer. Once we expand the hours of availability on those systems, we need to take the best possible advantage of them. A key component of the offering was the upgrade of three MR systems to improve throughput and increase service coverage. The upgrades were structured so that NewYork Presbyterian could pay for them as part of the shared service agreement instead of having to expend capital. A major benefit of the MR upgrades was standardization of systems to enable more efficient servicing for the in-house team. MR systems are among our most important tools, and maintaining them at optimal effectiveness across the

4 board is absolutely key, says Schaefer MR systems are also at the high end of the cost spectrum and difficult to substitute for when they are not available for any reason. The short-term benefit of having the same technology platform on all the MRs is standardization and reduced cost in building an effective in-house support team. If we have multiple MRs on all different platforms, then the support team needs to be knowledgeable in the differences between each unit. It is far easier for a team to focus on just one platform. In the long term, a single platform means that maintaining and upgrading our MRs to the state-of-the-art level, which this hospital always pursues, becomes a single decision instead of multiple decisions. Smoothing acquisitions The shared service agreement also simplified service and helped limit cost as NewYork-Presbyterian began acquiring community hospitals. As each hospital s imaging asset inventory comes on board, it is simply folded into our master service agreement. That makes it significantly easier when we acquire a new facility to leverage the terms we have already negotiated, says Umejei. It has been phenomenal for us. It significantly cuts down the paperwork, the legal conversations, and the overall stress of procurement by simply taking an asset list and adding it to our master service agreement. Most of the facilities we re acquiring are community hospitals that don t have the same bargaining leverage we do. They gain financial relief just by becoming part of our health system. In the long term, a single platform means that maintaining and upgrading our MRs to the stateof-the-art level, which this hospital always pursues, becomes a single decision instead of multiple decisions. Benefits to NewYork- Presbyterian Estimated $650,000 in recent savings through: Conversion to a shared service offering Outside-of-contract labor cost reduction Avoidance of travel charges Standardized overtime labor rates Service contract cost reductions for newly acquired hospitals 100 percent planned maintenance compliance Increasing in-house staff expertise Access to remote diagnostics/repair and advanced service tools Single point-of-contact for service support Chris Schaefer, Biomedical Imaging Manager

5 Economies of scale also benefit the acquired hospitals in other ways. For example, a small hospital that cannot justify an in-house service engineer for its one or two MRs or CTs suddenly, when acquired, gains access to the NewYork-Presbyterian team. Meanwhile, if a newly acquired hospital is geographically distant from most in-house service engineer talent, Umejei has the option to apply some of the cost savings from the shared service collaboration to call on OEM engineers to service that location. Multiple rewards Umejei and Schaefer have seen rewards from the service arrangement that transcend pure economics. Our technicians have a sense of ownership of the equipment, and when you own something you take care of it a little bit better, Umejei says. They feel more engaged and empowered because they have access to the best training. They are more confident because they are certified to the highest industry standards." He advises hospitals considering the shared service model to think long term: You will invest up front in training. You may not see costs reduced as low as you would like in the initial contract, but over time it begins to pay for itself. Creative relationships like this are the way to go. Vendors and hospitals willing to take creative approaches will be most likely to thrive in healthcare today. About NewYork-Presbyterian NewYork-Presbyterian is one of the nation s most comprehensive academic healthcare delivery systems, serving patients in the New York metropolitan area and from around the world. It collaborates with two medical schools, Weill Cornell Medicine and Columbia University College of Physicians & Surgeons. It includes the flagship NewYork-Presbyterian Hospital and three regional hospitals: NewYork-Presbyterian/Lawrence Hospital, NewYork-Presbyterian/Hudson Valley Hospital, and NewYork-Presbyterian/Queens. About provides transformational medical technologies and services that are shaping a new age of patient care. Our broad expertise in medical imaging and information technologies, medical diagnostics, patient monitoring systems, drug discovery, biopharmaceutical manufacturing technologies, performance improvement and performance solutions services help our customers to deliver better care to more people around the world at a lower cost. In addition, we partner with healthcare leaders, striving to leverage the global policy change necessary to implement a successful shift to sustainable healthcare systems. Our healthymagination vision for the future invites the world to join us on our journey as we continuously develop innovations focused on reducing costs, increasing access and improving quality and efficiency around the world. It s not business as usual. Find out how Services can help General Electric Company All rights reserved. General Electric Company reserves the right to make changes in specifications and features shown herein, or discontinue the product described at any time without notice or obligation. TiP is a trademark of General Electric Company. GE, the GE Monogram are trademarks of the General Electric Company., a division of General Electric Company W Innovation Drive Wauwatosa, WI JB3 US

6 A service contract renewal brings substantial cost reduction and strengthens teamwork between Duke in-house team and GE engineers The Duke University Health System Clinical Engineering team includes 15 members who service some 950 diagnostic imaging assets worth about half a billion dollars, across three hospitals and more than 100 other care locations. For years, the in-house team had received support from under a service contract covering more than 200 GE imaging devices and related equipment. In 2014, as the service contract came up for renewal, Director of Clinical Engineering Grant Smith saw a critical need to reduce service costs. Responding to Duke s needs, developed a new 5-year, $20 million agreement that yields $400,000 in annual savings, achieved largely through parts pool arrangements that have reduced parts costs by 35 percent. Meanwhile, GE continues to provide technical support to the in-house team under a labor pool at a discounted hourly rate. We moved forward with the new contract because of the strong relationship our in-house staff already had with GE, says Smith. Their willingness to listen and their flexibility in offering viable options to meet our objectives justified our decision to continue with them as a key supporter. Addressing parts costs Care providers today routinely seek service cost reductions, and Duke was no exception. Specifically, Smith wanted to cap annual parts costs while ensuring fast parts availability for all GE devices, which make up the largest share of the system s installed base.

7 We moved forward with the new contract because of the strong relationship our in-house staff already had with GE, their willingness to listen and their flexibility in offering viable options to meet our objectives justified our decision to continue with them as a key supporter. Grant Smith, Director of Clinical Engineering Traditionally we would need a comprehensive service agreement to get attractive pricing on parts, Smith says. But in that scenario we ended up spending too much for parts per device. We had been trending parts usage long enough to know that our actual parts spend was significantly less than the cost to insure the entire GE imaging fleet. We wanted to arrive at something closer to our true cost to insure all of those devices and spread the risk between Duke and GE. They were very receptive to that type of model. The outcome of the discussion aligned exactly with our objectives. The new agreement took effect in December Pooling parts and labor Under the agreement, Duke contributes a fixed annual amount to a parts contract covering all GE MR, CT, general radiology, nuclear medicine and mammography equipment. We provide the labor, Smith says. If we need GE labor, that is covered in a separate prepaid pool. After each year of the agreement, the parties will re-evaluate the parts and labor costs and make adjustments as necessary. Service for Duke s nearly ultrasound systems is handled similarly. In place of service coverage for each individual unit, smaller systems (such as laptops) are sent to a depot for repair under a pool arrangement based on the health system s historic repair rate for the equipment. The same is true for ultrasound probes. Parts for the larger console ultrasound systems are covered under another general parts pool. Two more pools were set up under the agreement to reduce the cost of a full service contract. One is tied to the FlashPad TM detectors used with digital X-ray equipment and the other to X-ray tubes for the OEC TM C-arm surgical imaging systems. GE also helped Duke reduce costs by providing service contracts at lower usage tiers for PET/CT systems, based on the actual number of patients scanned in the past year. Dependable support Since the contract took effect, the in-house team has taken more responsibility for labor, while relying on GE field service engineers for help with complex issues. We don t see them as often as we used to, but they are always available to help with that 10 to 15 percent of cases that might be just above our threshold of expertise, Smith says. The Duke team also benefits from online assistance from GE remote technical specialists in resolving equipment issues where possible without field engineer visits. We also get remote service from our local field service engineers at times when they are not on site, Smith says. It s easier to reach out to somebody with whom we already have a rapport. They re always willing to assist and guide us in the right direction. Carrying more of the labor load means training is essential for the Duke staff. That includes sending personnel to training courses at the Institute when appropriate and taking GE online courses. Team members also receive on-the-job training by working side by side with GE engineers. Every time we bring in new technology, we commit training dollars to get our folks up to speed as quickly as possible, says Smith. Even during the warranty period, we work elbow-to-elbow with the GE team and gain as much experience on the equipment as possible. The GE field service engineers have helped us get up to speed quickly on rapidly changing technology. GE s approach essentially says, We re supporting you at every level and we re willing to share our expertise.

8 They appreciate that the more and the closer we work together, the stronger our business relationship will become. It s beneficial for both sides to have them adopt that posture. Key objectives met Smith sees the current agreement as supporting the financial, operational and clinical objectives of Duke University Health System. When we look at it from a budget standpoint, significant gains go with a 35 percent reduction in the parts cost by going to a parts pool. Financially, we have done very well in this arrangement. From an operational standpoint, with the availability of parts and technical support from the manufacturer, we can turn service events around very quickly. With parts there is a shipping component, but GE provides parts availability on site for key items. So we are able to minimize turnaround time for down units in many areas. Clinically speaking, if we can get equipment back into clinical use quickly, that bodes well for our ability to scan patients. Many patients come to us from around the state, around the country, and internationally. We can t afford to have down systems that force us to reschedule those patients. Overall, we are very happy with the agreement, and we believe GE is, as well. It has given all of us an opportunity to work more closely together. GE s approach essentially says, We re supporting you at every level and we re willing to share our expertise. They appreciate that the more and the closer we work together, the stronger our business relationship will become. The Organization Duke University Health System, founded in 1998, is a world-class network dedicated to patient care, education, and research to enhance healthcare throughout North Carolina and southern Virginia. It includes Duke University Medical Center and two other hospitals with a combined 1,512 beds, plus multiple clinics offering comprehensive health and wellness services. The Results Produced nearly $400,000 in total annual contact savings. Reduced parts expenses by 35 percent through pool arrangements. Saved $225,000 through customization matching the right coverage to specific equipment for PET/CT, CT, nuclear medicine and mammography. Improved turnaround times for device repairs through ready availability of parts and remote and on-site technical support. Grant Smith, Director of Clinical Engineering

9 About provides transformational medical technologies and services that are shaping a new age of patient care. Our broad expertise in medical imaging and information technologies, medical diagnostics, patient monitoring systems, drug discovery, biopharmaceutical manufacturing technologies, performance improvement and performance solutions services help our customers to deliver better care to more people around the world at a lower cost. In addition, we partner with healthcare leaders, striving to leverage the global policy change necessary to implement a successful shift to sustainable healthcare systems. Our healthymagination vision for the future invites the world to join us on our journey as we continuously develop innovations focused on reducing costs, increasing access and improving quality and efficiency around the world. It s not business as usual. Find out how Services can help General Electric Company All rights reserved. General Electric Company reserves the right to make changes in specifications and features shown herein, or discontinue the product described at any time without notice or obligation. GE, the GE Monogram are trademarks of the General Electric Company., a division of General Electric Company W Innovation Drive Wauwatosa, WI JB34144US