The need for effective clinical stakeholder engagement is a familiar supply chain concept. The longstanding relationship between materials management and value analysis professionals represents the most common interaction between clinical and supply stakeholders. It is possible, however, to better define what clinical-to-supply integration is and how to achieve it. Through interaction with health care organizations nationwide, Vizient defines the characteristics of clinical-to-supply integration as engagement, insights, knowledge and process.
Enhancing clinical quality through engagement
Supply chain partnerships take many forms, and success is measured in different ways. In collaboration with clinical stakeholders, enhancing clinical quality is an appropriate measure of success and should be a primary goal. Effective engagement frequently includes clinical-to-supply integration executive and clinical champions to highlight the strategic importance of the approach to the health system. Aligned goals and shared incentives are equally as important to the engagement’s success. If supply chain operations focus on cost reduction and clinical stakeholders on patient care, the opportunities for mutual success are relatively small. If the objective instead is delivering the highest quality of care at the most competitive total cost, success takes a broader form and can be formalized through governance.
Delivering actionable performance insights
A key distinction between a clinically integrated and a segregated supply chain is the ability to monitor and measure performance in a way that includes clinical measures of success and considers relative performance to peers. Understanding the total cost of care at the procedural level, how that cost compares to others and how outcomes vary across physicians are the types of actionable insights to distill from a clinically integrated supply chain.
Offering evidence-based product knowledge
If we hold supply chain stakeholders responsible for providing product information in support of a clinical decision, this should include supplier claims of product performance. If a supplier communicates that the benefits of a gender-specific knee outweigh the higher relative cost to the non-gender-specific knee, a clinically integrated supply chain will offer physicians the peer-reviewed evidence to determine if the claim is valid.
Driving engaged stakeholder involvement with process
This is reflected by organizations that intentionally add clinicians to processes that may have traditionally been considered exclusive to supply chain operations. The concept of a clinically integrated contracting process is an example where the criteria for consideration in contracting are well defined and scoped by clinical stakeholders, and balanced against the traditional financial measures of success. This approach can even extend all the way to inventory management, to ensure “trunk stock” is not flooding the OR, and to purchasing to help reduce the number of special or x-type orders.
What a clinically integrated supply chain can achieve
When Western Connecticut Health Network needed to find savings that were more significant, Vizient discovered untapped opportunities – and then helped put those ideas to work.
The challenge. Three hospitals in western Connecticut always worked individually to keep costs in check. After the hospitals united to form Western Connecticut Health Network (WCHN), it was time to reach for loftier goals.
WCHN focused on reducing supply acquisition costs, but now the system was seeking savings opportunities in the more complex areas of utilization, clinical operations and purchased services. With emerging payment models and shifting reimbursement measures, nothing was untouchable – from revenue cycle, pharmacy and physician preference items to clinical variation and outsourced services.
The solution. The powerful Vizient data and analytics, subject matter expertise and willingness to customize an engagement specifically for the health system were exactly what WCHN needed to reach its savings goals.
WCHN began a comprehensive financial improvement project with Vizient in December 2012. Initially focused on Danbury and New Milford hospitals, the project expanded to the system’s newly merged Norwalk Hospital.
The results. By combining proactive executive leadership, supportive physicians, and Vizient data and subject matter experts, WCHN saved $5.8 million in 15 months – exceeding its original $5 million goal. That’s just the beginning.
WCHN also implemented tools and processes to sustain its success. The health system worked with Vizient to establish value analysis teams for critical areas such as the OR, cardiac catheterization lab, interventional radiology and nursing care. The teams meet regularly to review new medical products, technologies and services, and ensure they are a good fit for patients, physicians and the organization.
This article was written by Martin Lucenti, MD, PhD, senior principal at Vizient and published in the July/August issue of Supply Chain Strategies & Solutions magazine.