by Donna Colby and Neil Horton
Clinical Advisory Solutions
08/05/20

This blog post is one of a five-part series on clinical-supply integration, a process for informed business decisions that engage clinicians, preserve quality and safety and lead to greater patient satisfaction.

Traditional value analysis committees have been making decisions on the purchase of clinical products and services for years. Typically residing in the supply chain department, these value analysis programs have not always been efficient. While they have historically been good at benchmarking pricing and anticipating the financial impact of a new product request, many have struggled with:

1) Gathering and summarizing clinical evidence

2) Executing meaningful practice research

3) Managing in-house product evaluations

Clinical-supply integration (CSI) is the next phase of value analysis and no longer resides in the supply chain department. Instead, CSI is truly interdisciplinary.

This blog will explain how one key performance domain of CSI – knowledge – can help health care organizations approach research and analysis differently to make better decisions. To put it another way, how you know what you know, can be the difference between a good decision and a regrettable one.

A more robust approach to knowledge

Knowledge refers to the process used for gathering and using clinical data (including in-house product evaluations), as well as practice research findings. CSI differs from traditional value analysis programs in its more robust approach to knowledge and the way it enhances decision-making. 

Not every clinical product or service decision will require an elaborate process to gather and summarize research findings. A request for a commodity item that doesn’t come into contact with the patient, has been declared safe by the FDA for the last 30 years and is currently in use by 50 percent of hospitals may not require an in-depth literature search, the use of weighted criteria and an in-house product evaluation.

At the other end of the continuum, a new technology request that involves new equipment and a new treatment modality, with a lack of high-quality clinical evidence and unclear reimbursement, may require more comprehensive research and analysis. As part of CSI, organizations need to be able to answer the following questions:

How do you know what the evidence says?

With CSI, gone are the days when a claim of superiority in the supplier’s brochure sufficed as evidence. 

What constitutes clinical evidence in your process? Is it subjective? Opinion? How does your process incorporate a ranking of clinical evidence, weakest to strongest? 

A solid clinical evidence process needs to articulate the direction, strength and quality of the evidence. Additionally, your committee needs a robust, transparent way of incorporating clinical evidence into its decision-making.

Making decisions on assessment requests for invasive new products or new technology without a process in place for the research and review of clinical evidence may result in unanticipated financial, quality or safety outcomes.

How do you know what your peers are doing?

Some decisions will need to incorporate an understanding of what other clinicians are doing. Are you being asked to embrace a new technology as an early adopter? Are you sitting on a time-sensitive marketing opportunity to enhance your reputation for offering innovative treatment options? Are you being told that you are the last academic medical center in the region to convert to the latest sports medicine miracle implant?

Understanding the clinical practice landscape, regionally and nationally, can help uncover the risks and opportunities with important decisions. 

How do you manage robust in-house product evaluations?

With CSI, gone too are the days when the outcome of an in-house product evaluation is the single use of an implant with a single surgeon who proclaims better intraoperative handling. When the body of evidence for a new product is not persuasive one way or the other, committees often agree to perform an in-house product evaluation.  With CSI, in-house product evaluations are handled with a scientific rigor similar to that found in published clinical evidence.  This will enhance the quality of the evidence and ultimately enhance the decision-making process.

Value analysis programs have not always been efficient.  Perhaps related to their supply chain history and a lack of truly meaningful clinical integration, many organizations have struggled with clinical evidence, practice research and in-house product evaluations.

CSI programs move beyond the four walls of supply chain and more fully integrate physicians and clinical interests. CSI’s more robust approach to knowledge can help your committee make informed, evidence-based supply decisions.

Clinical-supply integration is an ongoing, interdisciplinary strategy encompassing four performance domains — engagement, insights, process and knowledge — to inform decision making about products and services in order to eliminate harm, improve outcomes and lower costs. Read about the domains in the related articles below. Learn more about clinical-supply integration or contact Donna Colby or Neil Horton

 

About the authors.  With more than 30 years of experience in the health care industry, Donna Colby is a consulting director for clinical advisory solutions at Vizient. Working both as a registered nurse and as a clinical director within supply chain, she partners with members to develop and establish clinical supply integration between clinical delivery areas, physicians and supply chain.  She works with members to create overarching governance structures, including physicians, which provide a platform for leadership to make decisions based on quality, evidence and total financial value.

 

 

Neil Horton is consulting director for clinical advisory solutions at Vizient. As a registered nurse, he brings more than 30 years of experience to the role including clinical, value analysis, operational and sales.