Integral to Improvement

Sentara Healthcare’s dedicated non-acute program, “DOCxdirect,” enhances relationships with community physicians

Servicing non-acute physicians is no afterthought for the materials management department at Sentara Healthcare, Norfolk, Va. Rather, it is an integral part of the IDN’s expansion strategy, as well as its desire to help doctors manage their practices better and improve care for patients. It is also a way to solidify the bond between those doctors and Sentara.

In order to better serve their non-acute-care providers, members of the Sentara materials management team have increased their knowledge of the specific supply- and equipment-related needs within that market. They’ve also identified ways for the individual physicians to have a voice. These initiatives have helped improve the team’s service to – and promote standardization among – Sentara-owned physician practices and the physicians who remain independent, but leverage Sentara’s resources through DOCxdirect.

Sentara launched DOCxdirect – the purchasing program for community physicians – in 2001 as a way to help doctors lower their non-labor costs by leveraging Sentara’s buying power. Today, approximately 260 practices participate.

Sentara’s non-acute supply partner, Henry Schein Medical, has been an integral part of the program since 2008. “We decided Henry Schein was the best fit for us,” says Cindy Saeger, program manager for DOCxdirect. “Their customer service team and representation are outstanding. It made good sense.”

Indeed, the non-acute setting comes with its own unique set of challenges. Products often vary from acute to non-acute settings, so ensuring physicians have access to the products that they require is critical in DOCxdirect member and patient satisfaction. Henry Schein has the full breadth of products that is appropriate for physician offices.

How DOCxdirect works
DOCxdirect members can purchase med/surg products, medical equipment, office supplies, pharmaceuticals, even services, such as red-bag-waste removal, document shredding and storage, and instrument sharpening. DOCxdirect delivers additional savings by supplying many of the products on which Sentara Healthcare has standardized – no easy feat among acute and non-acute supply needs. The IDN has several active value analysis committees in such areas as general surgery, orthopedics and spine. “You can’t drive down cost if everyone is using something different,” says Saeger. “These committees address issues such as standardization and utilization.”

Saeger and her staff’s focus to incorporate the non-acute physicians and their product/equipment requirements into the overall strategy has proven valuable to the IDN. The DOCxdirect staff now actively manage both Sentara owned sites, as well as the DOCxdirect program and serve as a resource to the rest of the materials team, who may be well-versed in acute-care products and services, but less so in non-acute ones. For example, during an ongoing initiative to standardize products among Sentara’s urgent-care facilities, Saeger and her team have been able to shed light on the necessity of some of the equipment and supplies used in those facilities.

Physicians part of the team
Another benefit for the non-acute physicians has been that DOCxdirect members are encouraged to be part of the standardization process, she continues. “When we’re evaluating something [in the IDN], we send samples to our DOCxdirect members for their evaluation and input.

Working with physicians across the system in this manner has worked. Sentara practices have standardized on many commodity items, and with Saeger’s help and encouragement, they also have standardized to products that are appropriate for the non-acute setting (but may be different from the acute sites of care). This has supported overall cost savings and standardization in the system as a whole, still reducing number of SKUs, and variation, while improving quality.

It is important that physicians know they have a voice within the health system and that they understand they can impact overall profitability and quality as part of this process, Saeger says. As a non-acute expert, Saeger is able to ensure their voice is heard and that it influences decisions.

DOCxdirect members enjoy personalized service from Saeger and her team, as well as the Henry Schein rep who services DOCxdirect members. Henry Schein and Saeger collaborate on strategies related to DOCxdirect to maximize value.

“Our representative brings a lot of knowledge to our customers,” she continues. “He has been doing this for years, and he can tell our members what has worked well for other customers, and what hasn’t.” But each member decides how frequently they want to engage with Saeger or a representative. “Some say, ‘I can order online; I don’t need you to call on me,’ while others want to see you once a week or once a month,” she says.

While DOCxdirect members reap benefits from the program, so does Sentara, says Saeger. Increased purchasing volume and hence, better negotiating leverage, is one way. But the benefits extend beyond that.

“It leads to better relationships between Sentara and the physicians,” says Saeger. “And that was the whole premise – to build better relationships with physicians in the community who are sending patients to our hospitals, using our reference labs, etc.”

A program such as DOCxdirect or any non-acute program won’t work without unique commitment, she says. “You have to be committed to doing everything that needs to be done for your physicians, or they will lose faith in you and the program.” That’s through good times and bad. “If something goes wrong, at the end of the day, the DOCxdirect member is going to call [the health system] and say, ‘You screwed up,’” she says. “We take it very personally, and we work hard to make sure it doesn’t happen again.” It’s an ongoing process, and it helps to have strong partners who understand the mission, vision and unique needs of the physician to ensure success.