A Systemic Apprach t better Health Systemic Calls fr Tender in the Healthcare Sectr May 2017 Published by:
Backgrund Infrastructure investments in the healthcare sectr ften face challenges that lead t insufficiently used ptential. The reasns are manifld; ranging frm incmpatibility f medical devices r systems, inadequate training f medical staff, t insufficient maintenance and service. Traditinal tenders ften lead t breaks between planning and executin, creating prblems in crdinating between individual suppliers. The study A Systemic Apprach t better Health, cnducted by BMZ, GIZ, KfW and GHP, ffers insights int the advantages f an integrated and hlistic apprach t tenders in the healthcare sectr. Abut GHP The German Healthcare Partnership (GHP) is the vice and advcate fr the German exprt-riented healthcare industry. GHP member cmpanies cver nearly the entire German healthcare value chain, thus creating a unique netwrk with excellent cntacts t adjacent federatins, academia and plitics bth dmestically and abrad. GHP prmtes sustainability in prcurement prcesses in the healthcare sectr and wrks twards efficient, adequate and feasible healthcare slutins wrldwide. Systemic Calls fr Tender can help t ensure greater sustainability in healthcare prjects, e.g. by cnsidering life-cycle csts, cmprehensive training f medical staff and all-encmpassing maintenance cntracts. A SYSTEMIC APPROACH TO BETTER HEALTH - SYSTEMIC CALLS FOR TENDER IN THE HEALTHCARE SECTOR
Differences between traditinal and systemic calls fr tender Traditinally, lts are tendered separately thrugh descriptive tenders. While this apprach might be easier fr the tendering agencies ffers are mainly cmpared by price it ften leads t less than ideal situatins in regard t cmpatibility and lng-term sustainability f the facility. Mre than ften, the plicy f awarding the cntract t the cheapest bidder leads t a hetergeneus system where medical devices are incmpatible up t the pint f uselessness, which, in fact, increases csts. Why systemic calls fr tender? The hlistic apprach leads t ecnmical and sustainable slutins. Althugh it might appear mre cstly at the pint f acquisitin, the investment is cst-effective in the medium- t lng-term. The cmpatibility f the devices within the system is ensured in the planning phase, medical and technical staff is adequately trained, and the highest pssible up-time is guaranteed by the supplier. Systemic calls fr tender ideally include the planning f the prject, supply and prvisin, installatin, maintenance cntracts, training and prvisin f cnsumables. Because pure acquisitin csts nly represent part f the ttal, systemic tenders shuld include a calculatin f lifecycle csts (LCC). Withut the calculatin f LCC, it is difficult t avid buying the initially lw-priced prduct and having it turn ut t have high energy cnsumptins and expensive cnsumables. A SYSTEMIC APPROACH TO BETTER HEALTH - SYSTEMIC CALLS FOR TENDER IN THE HEALTHCARE SECTOR
Training & Lcal Capacity Building Adequately trained persnnel ensures the ptimal functining f the facility as well as the best pssible patient treatment. The educatin level is being raised within the facility as well as in the regin/cuntry. In the lng run, this leads t imprved internatinal standing, which in turn results in a rise in demand fr the high quality diagnsis- and therapy pssibilities n ffer. LCC Lifecycle csts arise ver the entire serviceable life f a medical device. In additin t acquisitin and installatin csts, LCC includes the fllwing factrs: maintenance cnsumables training needs energy cnsumptin waste remval dispsal persnnel csts fr peratin therapy- and prcess csts ther Lifecycle csts have t be cnsidered fr a sund ecnmic decisin, as they can have a cnsiderable impact n the award f the cntract. The ttal amunt f up-time shuld be listed in the calculatin as well as the necessary time frames fr updates during which the devices are briefly unavailable. A SYSTEMIC APPROACH TO BETTER HEALTH - SYSTEMIC CALLS FOR TENDER IN THE HEALTHCARE SECTOR
Maintenance Preventive maintenance n a regular basis is especially imprtant fr tw reasns: 1) A well serviced device is a guarantee fr a high up-time, 2) In case f emergency, hspital staff and patients can rely n the device t functin flawlessly. All in all, preventive maintenance is ecnmically and scially beneficial. WIN WIN WIN Situatin WIN 1 Tendering party / Partner Cuntry After successfully cnducting a systemic call fr tender and awarding the cntract t a suitable bidder, the buyer acquires a high-quality health care facility. Due t cmprehensive maintenance, service and training cntracts, a lng-term partnership is funded between the awarded bidder and the buyer. Well-trained staff, functining equipment and smthly running peratins help the facility t raise standards and make a name fr themselves. Mre patients cme fr preventive prcedures and treatment, leading t ecnmic and scial benefits. WIN 2 Patients and Sciety A better healthcare system and well equipped medical facilities make therapeutic measures mre accessible. Diseases are easier t diagnse and can be treated with the help f reliable medical devices. Preventive measures help t keep the sciety healthy. Well-trained persnnel are capable f tending t patients, even in emergencies. With high-quality care like this, patients are able t leave the facility faster and re-integrate int scial, cultural and prfessinal life. Trained staff raises the educatinal standard f the regin. WIN 3 The awarded bidder Systemic calls fr tender raise the standard fr bidders. The demanded dcuments and qualificatins (LCC assessments, inter-natinal references etc.) ensure that bidders with lw price prducts have t adjust. Cmpetitive disadvantages fr bidders f high-quality prducts with hlistic appraches, e.g. as the German healthcare industry, are reduced. A SYSTEMIC APPROACH TO BETTER HEALTH - SYSTEMIC CALLS FOR TENDER IN THE HEALTHCARE SECTOR
Guideline fr systemic tender generatin T ensure efficient investments eliciting a sustainable impact n the quality f healthcare prvisin the tender is welladvised t shift away frm fcusing slely n investment csts. Placing life-cycle csts in the center f the prcurement prcedure culd cnsiderably cntribute t an imprvement in the quality f tender prcesses. Criteria that reflect quality, safety standards, and life-cycle cnsideratins must be accunted fr. Systemic prcurements secure a level playing field in internatinal tenders and enable the cntracting authrity t identify the mst ecnmically advantageus bid. The checklist belw is a practical tl fr develping standardized tender methds fr reliable and cmparable results. A. A.1 A.2 A.3 A.4 A.5 Cntract types Investment Maintenance Uptime (in cmbinatin with a service cntract) Pay Per Use (if available, eg. reductin f maintenance csts) Life-cycle cntracts (investment and full-service-cntract) B B.1 B.2 B.2.1 B.2.2 B.2.3 B.2.4 B.3 C C.1 C.1.1 C.1.2 C.2 C.2.1 C.2.2 C.3 C.3.1 C.3.2 C.3.3 C.3.4 Planning Checking the installed base at custmer site Wrkflw Patient thrughput Cnsumables and ther materials Persnnel fluctuatin (new emplyees) Data transfer and data strage Rm fitting Technical systems Prduct histry Market intrductin f the system Updates und Upgrades (safety and applicatin widening, spare parts availability) Certificates and Apprvals Declaratin f cnfrmity (CE-certificate) FDA apprval (512k apprval) Sustainability Prduct cmpatibility (cnnectivity, data and image transfer) with installed base and als future investments Updates: free-f-charge safety updates - including hardware and sftware (during whle life-time-cycle) Upgrades availability (n-site upgradeability f sftware and as well hardware cmpnents) DICOM-3 data and image transfer between Hspital Infrmatin System (HIS) and PACS system based n DICOM-3, HL7
D D.1 D.2 D.3 D.4 E E.1 E.1.1 E.1.2 E.1.3 E.1.4 E.2 F F.1 F.2 F.3 F.4 G G.1 G.2 G.2.1 G.2.2 G.3 G.4 H H.1 H.2 H.2.1 H.2.2 H.3 H.4 H.5 G G.1 G.1.1 G.1.2 G.1.3 G.1.4 G.2 G.2.1 G.2.2 G.2.3 G.2.4 G.3 Cmmissining/ Start-Up Installatin Technical dcumentatin Applicatin training (basic and advanced applicatin services) Dcumentatin f applicatin trainings (certified) Custmer training (at manufacturer site) Applicatin training Physicians Operatrs Hspital technicians (first-line-service t reduce service csts and dwn-time f the system) Training materials (presentatin, hands-n training, etc.) Educatinal trainings fr custmers (new applicatins, user cmmunities fr knwledge transfer) Warranty Start f warranty End f warranty Cnditins (a descriptin has t be prvided) What is included AND what is excluded Service (n call) Use f riginal spare parts (NO third-party parts) Persnnel Service engineers - n call center agents Respnse time fr n-site visits Cntact availability (perating times, via email, telephne) Safety-updates Maintenance (recmmended) Use f riginal spare parts (NO third-party parts) Persnnel Certified technicians (frm manufacturer) Respnse time fr n-site visits Maintenance intervals Maintenance cntracts (frm manufacturer) Cntact availability (perating times, via e-mail, telephne) References Reginal Number f installed systems Trainings Service Maintenance Internatinal (wrld-wide) Number f installed systems Trainings Service Maintenance Publicatins and custmer respnses
Imprint Publisher German Healthcare Partnership (GHP) Gertraudenstraße 20 10178 Berlin, Germany Tel. +49 (0) 30 2028 1699 inf@germanhealthcarepartnership.de www.germanhealthcarepartnership.de Kreditanstalt für Wiederaufbau (KfW) Bankengruppe Referat: LEc East Asia and Pacific Deutsche Gesellschaft für Internatinale Zusammenarbeit (GIZ) GmbH Headquarters Bnn und Eschbrn Sektrvrhaben Gesundheitssystemstärkung Gdesberger Allee 119 53175 Bnn, Germany Tel. +49 (0) 228 44 60-0 hss@giz.de www.giz.de Palmenstraße 5-9 60325 Frankfurt am Main, Germany Tel. +49 (0) 69 7431 1672 www.kfw.de Edited by German Healthcare Partnership (GHP) Gertraudenstraße 20 10178 Berlin, Germany Design Sagrss Design Office GmbH, Berlin Printed by Xerx GmbH Pht credits Cver: Getty Images As f May 2017 GHP, GIZ und KfW are respnsible fr the cntent f this publicatin. Cmmissined by: Federal Ministry fr Ecnmic Cperatin and Develpment (BMZ) Pstal Addresses f BMZ: BMZ Bnn Dahlmannstraße 4 53113 Bnn, Germany Phne +49 (0) 228 99 535-0 BMZ Berlin Stresemannstraße 94 10963 Berlin, Germany Tel. +49 (0) 30 18 535-0 pststelle@bmz.bund.de www.bmz.de