AHVAP’s collaboration with ECRI Institute intended to promote the profession and the craft
Value analysis is not just about determining how one widget will work in one department, according to Barbara Strain, MA, SM(ASCP), director, value management, University of Virginia Health System; and Nila Getter, BSN, MS, RN, nursing product manager, Kettering Health Network, Miamisburg, Ohio. It’s about how technologies will perform in the entire hospital, and how they will do so while helping the healthcare organization improve safety, cost-effectiveness, clinical efficiencies and patient outcomes. And it’s about answering that question using an organized, fully formed knowledge base. Getter is the current president of Association of Healthcare
Value Analysis Professionals (AHVAP), and Strain is past president.
With over 220 members and counting, AHVAP is gaining a higher profile in the market. But the organization began with a listserv, when Brooke Berson, director of clinical resource management at Duke University, wanted to connect with other clinical people who were being asked to work with their supply chain counterparts to bring technologies into their facilities.
“It ended up being a large e-mail distribution list,” says Strain, referring to the listserv. As that list grew, some participants felt it was time to formalize the group. So they formed a steering committee, put together bylaws and formed AHVAP in 2004. Back then, the association was comprised primarily of clinical people, but today, it includes anyone involved in healthcare value analysis (with the exception of vendors).
AHVAP’s collaboration with ECRI Institute, announced in April 2012, is indicative of the direction in which AHVAP is headed, says Strain. It is part of the association’s Industry Business Partnership program, intended to further its mission to promote processes and information to assist value analysis professionals, she says.
The agreement calls for ECRI to provide AHVAP with programs related to evidence-based analysis of healthcare technologies, capital and supply procurement, and medical device safety and management. ECRI and AHVAP will offer co-sponsored educational events, quarterly newsletters, and white papers intended to help value analysis professionals apply evidence-based decision-making and clinical and quality indicators in their healthcare technology selection processes.
The ECRI relationship attracted publicity given the stature and size of ECRI in the market. But AHVAP has relationships with other organizations. That’s because vendors and healthcare providers both need help implementing value analysis programs, and are looking to AHVAP for assistance, says Strain.
That AHVAP, its mission and its members are becoming high profile should come as no surprise, particularly given the pressures of healthcare reform and declining reimbursement, according to Strain and Getter. “Every institution is trying to figure out how to remain viable, to take care not only of their current patients, but the [expected] influx of Baby Boomers,” says Strain. Senior executives recognize that by embracing the four principles that value analysis professionals espouse – safety, cost-effectiveness, clinical efficiencies and patient outcomes – they can thrive amidst the pressures facing them.
“[Value analysis is] all about looking at the entire DRG or length-of-stay, including everything from the minute the patient goes to the clinic or doctor’s office, all the way through admission to the hospital, to discharge home and follow-up care,” says Strain. Absent a fully formed knowledge base of value analysis, “you tend to focus on the widget or product or piece of equipment, and not in any organized fashion.”
Value analysis takes a big-picture view of how products and processes are used throughout the healthcare system, not just in one department, adds Getter. “There is so much crossover among departments,” she says. For example, the lab may be evaluating products for blood draws. But do they keep in mind that nurses in the emergency department are also drawing blood? Are they communicating with each other? The value analysis professional ensures that they are.
Says Strain, “Building relationships with key caregivers, whether they’re bedside nurses, lab techs, surgeons or physicians; and getting that network on the same page, moving in the same direction,” are important components of the value analysis professional’s job. “And you can’t do that without senior leadership,” she says.
Another necessary component of value analysis is data. “Data is king,” says Strain. “You need good, clean data; you have to know where to get it; and it has to be trustworthy, accurate, reproducible and accessible.” It also has to be transparent, so providers can answer questions such as, “Why is one patient’s length of stay or cost of care different than that of another with the same diagnosis?” She calls it “peeling the onion,” that is, identifying all the components of a patient’s stay, such as OR costs, blood costs, pharmaceutical costs, diagnostic imaging, etc.
With firm cost figures in hand, healthcare providers know which DRGs are profitable and which are not. That knowledge, in turn, can guide supply chain professionals as they negotiate contracts with suppliers of consumables, implants, pharmaceuticals and equipment.
Building the skill set
“AHVAP and ECRI Institute both understand and believe that value analysis as a profession is something that is much needed in healthcare today, with value-based purchasing, healthcare reform, accountable care and the alphabet soup of healthcare reform,” says Tom Skorup, FACHE, vice president, Applied Solutions, ECRI Institute. There is a need to build the skill set of value analysis professionals in areas such as comparative effectiveness research and quality measurement, and a need to further integrate value analysis with the supply chain and clinical quality improvement. “Medical products can have strong value implications,” he says.
ECRI may be in a unique position to help AHVAP with that integration. The company has been conducting technology assessment for years, and in 1997 became one of the original Evidence-Based Practice Centers, designated by the Agency for Healthcare Research and Quality, part of the Department of Health and Human Services. ECRI also became one of the first federally listed Patient Safety Organizations in 2008, and serves as a repository of reports about adverse events in the field.
“We have been assisting our members for years in the value analysis space,” says Tim Browne, director of ECRI Institute’s PriceGuide service, an advisory service for the procurement of med/surg supplies, implants and services. In addition to pricing and spend analytics, PriceGuide produces custom technology analyses for members. “We may test the product or research the available evidence, then provide our analysis back to the member, and those reports are typically used in their value analysis processes, so they can bring in an unbiased perspective,” he says.