Standardization of advanced energy devices leads to cost savings, better patient outcomes

By Cathy Klinehoffer, Vizient Consulting Director
Angela Rogers, Vizient Consulting Director
Elizabeth Shoaf, Vizient Consulting Director

Advanced energy has emerged as a popular category with versatile solutions that produce cost savings, make surgery more efficient and precise, and lead to positive patient outcomes.

But there are challenges. While the advanced energy market includes a surplus of device options that offer surgeon flexibility, this variety can mean a convoluted inventory and considerations around balancing features with finances.

Surgical residents are typically trained on a specific advanced energy device during their specialty training, which carries into their attending surgeon practice preferences. These ingrained preferences can cause this category to have significant variability within a healthcare system, making standardization difficult to achieve due to change aversion.

By addressing variation and exploring the unique characteristics of each device, you can successfully overcome barriers within advanced energy. Start with the following strategies:

Standardize to achieve cost savings: By standardizing advanced energy usage, healthcare facilities can negotiate bulk purchasing agreements with suppliers that lead to cost savings. And on the cost savings (and most importantly, patient care) front, don't forget that reduced complications and improved outcomes translate to lower healthcare expenditures associated with post-operative care.

Bundling: Bundling contracts is often financially advantageous, but changing a product category will throw you out of compliance — and price increases follow. To avoid this, assess the overall financials if you plan to move a product category from the bundle. Talk to the bundled supplier and try to negotiate carve outs of the product category that you're looking to remove.

Consider disposables connected to equipment: Determine if the involved equipment is owned, leased or on a placement agreement. If leased or loaned, consider replacements with comparative equipment from a different supplier. If replacing the involved equipment is not an option, associated disposables should be carved out of cost analysis.

Embrace reprocessing: Reprocessing or remanufacturing of single-use products is cost effective and environmentally friendly. The first step is to create transparency by ensuring all stakeholders, from leadership to clinical staff, are on the same page and aware of the reprocessing strategy and its benefits. The second step is to research and understand the market in terms of the companies that reprocess, pricing and the products for which they have 510(k) clearance. It's also important to review contracts that you are considering for reprocessing.

If tier placement is based on volume or spend, existing tier placement may be negatively impacted by the purchase of reprocessed items. But if the savings from reprocessing is greater than the negative impact on tier placement, move forward with reprocessing. It's a common misconception that reprocessed products are inferior to original equipment manufacturer (OEM) products. Each reprocessed product is tested for quality assurance, whereas OEM products are sample tested. 

Implement a trial: By planning and overseeing a device evaluation, surgeons can evaluate the similarities and differences between products. These evaluations are vital to enhance overall surgeon satisfaction for a market share change. A successful trial simplifies the decision-making process for surgeons, leading to an efficient conversion timeline. Ensure trial terms are negotiated prior to the start of the evaluation, which includes the delivery location of trial products, the plan for unused trial products, the identification of responsible parties from each department participating in the trial and making sure evaluation forms are approved by the provider. For increased success:

• Have a surgeon leader/champion and surgical leadership involved in all evaluations.
• Give each supplier a week on site to educate about and promote their product prior to the evaluation. Make sure surgeons are aware of the evaluation and the opportunity to review the products prior to the evaluation time.
• Stop all communication between suppliers and surgeons prior to the evaluation ("quiet period").  Only the suppliers evaluating at each hospital are allowed as an audience.
• Obtain trial product from vendors. Aim for the product to be provided at no cost in specific quantities or at a discounted rate during the trial period. Ensure that enough quantities are allocated to each facility participating in the trial.

Education/training/in-service: Standardization and education help mitigate change fears by promoting the utilization of a new device with on-site vendor resources. Providers should share the weekly surgical schedule with their supplier and set supplier expectations, including:

• Providing in-service and training for surgeons and staff on products and equipment involved, if needed.
• When appropriate, ensure the sales rep is available to address questions and concerns during the evaluation.

Though many surgeons may resist change, especially if they have established preferences for certain devices, these strategies can help them see that standardization will allow for the highest quality of care to their patients, fostering trust and confidence in the product and procedure.