In this interview, Lori Goucher, system clinical value analysis manager at Intermountain Healthcare, discusses best practices and success drivers in hospital vendor standardization.
The first step in reducing product variation and standardizing vendors is to define a strategy based on industry best practices and internal business intelligence. By pulling data from the organization’s multiple information systems such as EHR and ERP, leaders can gather actionable insights about products being purchased and device spend. Product utilization analysis of both commodity and high-priced physician preference items is necessary if organizations want to reduce or contain costs.
While data is important, it is only useful if a health system has the infrastructure in place to act. An engaged group of stakeholders actively collaborating and responding to a ‘single source of truth’ regarding product selection is the most important factor. Also, vendor standardization and reduced product variation are most effective when built on a patient-centered foundation.
To get insight on best practices and strategies implemented to achieve vendor standardization and reduce product variation, Clarivate recently spoke with Lori Goucher, system clinical value analysis manager at Intermountain Healthcare — a health system in Utah with 23 hospitals, 180 clinics and 2,400 physicians.
Among Ortho Trauma, Cardiac Rhythm Management, Interventional Radiology, and GI Station, in which service area has Intermountain Healthcare standardized its vendors?
We have achieved standardization in some of these areas like Ortho Trauma and Cardiac Rhythm Management. In Ortho Trauma, we were able to standardize this service area to a primary vendor two years ago during contracting. In our experience, contracting is a good time to standardize wherever possible and reduce product variation.
Within Cardiac Rhythm Management, a clinical need strategy helped to focus a primary vendor and identify situations that can fill gaps or indications for use to fill limitations or gaps of service. For effective implementation of standardization, we upgrade our formularies and Doctor Preference Cards — instruments, supplies and equipment required for any surgical procedure — and track compliance and vendor/product performance.
What challenges did you face during vendor standardization, and how were these mitigated?
“The key challenge during standardization is having strong physician preferences for products. To overcome such pushbacks, we have established a robust physician engagement hierarchy as part of our organizational structure.”
To give some background, Intermountain Healthcare had some organizational restructuring three to four years ago. We have since focused on high-value care principles, looking for the highest quality products along with affordability. The key challenge during standardization is navigating strong physician preferences for products. To encourage adoption, we have established a robust physician engagement hierarchy as part of our organizational structure.
At Intermountain Healthcare, we divide our clinical program groups into musculoskeletal, cardiac, general surgery groups and so on. Within these sub-groups, physician representatives work with their peers to bridge product preferences with a focus on empiric evidence for outcomes. It’s a waterfall team structure where specialty groups participate in clinical programs. We strongly encourage our physicians to be involved with their clinical program groups.
What strategies do you use to implement standardization and how do you select the best vendor for any service area?
One way to approach standardization is to be transparent with the physicians and conduct thorough clinical background on different products and performance. At Intermountain Healthcare, we have robust data collection tools that help us with our clinical research as well as to maintain records of how vendor standardization decisions were made in the past.
“One way to approach standardization is to be transparent with the physicians and conduct thorough clinical background on different products and performance.”
While standardizing vendors/products, we also look at patient risk management and out-of-pocket cost for products with new technologies. For instance, recently we had a request for 3D implants. Even though it was approved by our clinical program, when the product came through our formulary it was flagged for research as it required a prior authorization for use. To circumvent such situations going forward, we created a new standard for emerging technologies, such as 3D implants, to have a unique qualifier and prior authorization for medical use, so that the product cost is covered for the patient and they are not surprised by any cost variance.
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