Purchasing’s enduring pennant race

Recently, I was speaking to a group of Supply Chain professionals about healthcare today when I was asked an interesting question: “If this was a baseball game, what inning is it for Supply Chain?” I paused for a moment before responding.

“We’re just getting in the game really. Batting practice is over but it’s only the 2nd inning or so.”

That question was very timely since we’re now more than halfway through 2016, and Supply Chain is facing even more pressure to improve costs, quality, and outcomes. According to most of the leaders that I’ve spoken with, they’ve had some successes but still have substantial work to do.

More importantly though, many of these Supply Chain leaders had finally come to an important realization: Being effective in the world of value-based care requires more than just stepping up to that plate. It requires a new mindset and a willingness to embrace change. Further, we must understand that progress is more important than perfection.

Just like in baseball, every hit for Supply Chain won’t be a home run — and that shouldn’t even be the goal. However, we must acknowledge that we will strike out again and again if we use yesterday’s playbook for today’s vastly different game.

Here’s how to know if you’re at risk for striking out:

Strike 1: You’re still not using clinical evidence.

A Procured Health survey of more than 100 hospitals found that only 28 percent of respondents consistently reviewed critical safety information like adverse events and FDA or vendor product recalls prior to choosing medical devices. Similarly, only 25 percent of respondents evaluated comparable products to see if they provided superior clinical outcomes instead of just purchasing the product requested by the physician. Even more concerning is that 73 percent of survey respondents said that vendors are their primary source for clinical information.

That’s a dangerous way to operate — especially in the world of value-based care where poor outcomes are extremely costly. Arming your clinically-integrated Supply Chain team with much-needed product research, outcomes data and market landscape information elevates the conversation from being about just a device to being about delivering the best patient care.

Rather than relying on physicians’ experience alone, objective peer-reviewed clinical evidence fuels more meaningful conversations.

Strike 2: You’re still not engaging physicians.

For many health systems, physician engagement is a sore sport, an area where they have struck out in the past so they’re quite cautious now. However, not striking out with regard to physician engagement is critical because unlike in the past, when physician engagement was “nice to have” for a few projects per year, the need to engage physicians is now a constant. In this new type of physician engagement, physicians are central players, not merely passive observers of Supply Chain presentations or participants who simply request their prized physician preference items.

These efforts must be based on an understanding that everyone is there for the same reason — the patients. The conversations must be realigned around patients and value — not products or price. Engaging physicians and leveraging evidence ensures that your organization is managing clinical spend in a manner that is informed by outcomes and linked to overall clinical improvement efforts.

Further, our ability to engage physicians is perhaps the biggest shortcoming of Supply Chain as compared to device vendors. A Procured Health survey of 101 orthopedic surgeons and electrophysiologists shows that one-third of physicians rated their vendor as valuable while less than 10 percent said the same about Supply Chain leaders. Now, that’s a statistic that has to change.

The big differentiator is that vendors are continuously building relationships with physicians, whereas physicians complain that Supply Chain only approaches them when they’re asking them to make sacrifices. To create a partnership, Supply Chain must be proactive in aligning with physicians around value to help them identify opportunities to improve patient outcomes and eliminate wasteful expenditures. In practice, this means Supply Chain should not just pursue savings but also focus on bringing forward recommendations that are better for patients, even if it means adopting higher-priced devices.

Strike 3: You think device selection is the end.

Leveraging evidence, engaging physicians and taking an analytical approach to clinical spend management does not end with the product selection. Supply Chain must also begin tracking the financial and clinical outcomes associated with device selection. Tracking long-term results can help hospitals to monitor changes in their payer landscape, assess physician claims around their perceived productivity using certain products, and measure vendors’ claims around improved clinical outcomes. Modeling the before and after of device implementation is the key to addressing the many unknowns around any product implementation — and making even better decisions moving forward.

Now, back to baseball. Batters up! It’s Supply Chain’s turn — and it’s perfectly fine to hit a double this time. Just make sure to aim for a triple next inning and then that home run! All of this comes to you from a Kansas City Royal loyal.

Dee Donatelli, RN, CMRP, CVAHP, has 30-plus years of experience in the healthcare industry with expertise in supply chain cost reduction and value analysis. Donatelli, current President and CEO of Mid-America Service Solutions LLC, a Vizient collaborative, is an advisor to Procured Health, a member of the Bellwether League Class of 2015, and was the lead consultant at Navigant Inc. Also the former president of the Association of Healthcare Value Analysis Professionals, Donatelli is an active member and Fellow of the Association for Healthcare Resource and Materials Management and an HPN Editorial Advisory Board member. Reach her at [email protected].