A marriage worth fighting for

Now that many – though not all – of the legal questions surrounding healthcare reform are behind us, at least for the time being, the real work continues – improving patient care while reducing costs. It’s that most difficult task of marrying clinical and supply chain realities, and it’s written all over this month’s issue of the Journal of Healthcare Contracting. Look at these comments from some of this year’s “Ten People to Watch in Healthcare Contracting.”

Alan Weintraub, Enloe Medical Center: “We installed a process that combined an ongoing, retrospective review of existing consumable technologies with evidence-based evaluation of new technology requests. It’s been exciting to watch the program grow and expand.”

Jim Olsen of Carolinas HealthCare System: “We are [just getting] information on the relative quality of the medical products we use, in terms of the patient outcomes they deliver. Using that information to make better purchasing decisions and to work with physicians and surgeons is something that I have been looking forward to for most of my career.”

Kathleen Krueger, ProMedica: “We also developed and launched the clinical value analysis department, which connects the clinical outcome value of product utilization with the business case of cost.”

LeAnn Born, Fairview Health Services: “New value will be created by using rich data that we have about clinical variation in the use of products, as well as by using data that helps us determine how the use of certain products drives different outcomes for patients.”

Joe Walsh, Intermountain Healthcare: “Intermountain Healthcare is committed to evidence-based medicine, and we have the unique potential to link products to care process models to outcomes.”

As Journal of Healthcare Contracting Publisher John Pritchard points out in his new book, Muddy Waters, “For IDN purchasing executives, the clinical trend toward comparative effectiveness has put new emphasis on the value of linking patient outcomes with product cost data.” And that’s changing the game for suppliers as well, he says. “Increasingly, the onus is on suppliers to … provide evidence-based data that their product is contributing to positive patient outcomes at lowest possible cost.”
JHC readers have always known that they can accomplish little without buy-in from the clinical staff. The successful contracting executives have always been those who are skilled at communicating with their physicians, nurses, respiratory therapists, etc. What’s more, contracting executives have always known that the best way to reach doctors is through data.

But a few things have changed today. First, the quality of data, in terms of its ability to demonstrative clinical effectiveness of products and procedures, has improved. Second, concern about the ever-increasing cost of delivering healthcare permeates our culture. Case in point: The American College of Physicians and the Alliance for Academic Internal Medicine have developed a free curriculum to help train internal medicine residents about how to avoid overuse and misuse of tests and treatments that do not improve outcomes and may cause harm. Do you think we would have seen something like that 10 years ago?

Marrying clinical and cost data won’t be easy. There will be missteps and misinformation. And specialty distributors, who carry new technologies to market, raise a good point: How can they prove the clinical effectiveness of technologies that have just been introduced to the market and lack a track record?
Good question. One that the industry will have to work through. But the direction seems clear. And it’s an exciting one.

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