Observation Deck – Comparative effectiveness research: Big term, big opportunity

Comparative effectiveness research is a relatively new term in the healthcare lexicon, and one with which supply chain professionals should familiarize themselves. That’s what makes Strategic Marketplace Initiative’s Executive Briefing, “Comparative Effectiveness Research (CER) and the Healthcare Supply Chain” such good reading.

As SMI points out, comparative effectiveness research attempts to compare different diagnostic or treatment options for clinical conditions. These interventions may be procedures, devices, drugs, tests or behavioral interventions. The comparative information can be generated from reviews of published research, or from new studies that yield new evidence.

It truly is the part of the post-healthcare-reform landscape, and probably will be regardless of how the Supreme Court rules later this year. The question is, what role can supply chain executives play in it? That’s the question that SMI tackles in its Executive Briefing.

To date, efforts to maximize the value of comparative effectiveness research have been primarily focused on clinical systems, data management, and associated processes. Little attention has been paid to connecting it to the supply chain. But that’s changing.

SMI points out that “collaboration and understanding between clinical, operations and administration” is critical in today’s environment, and suggests a “cross-disciplinary effort surrounding [comparative effectiveness research including] clinicians, supply chain management representatives, and representatives from finance, risk, quality and senior leadership.”

Comparative effectiveness research will affect healthcare systems in a number of ways, SMI points out. For example, it may provide an opportunity to redesign existing committee structures, such as technology assessment committees and value analysis groups. But that’s not all. Such research may also stimulate the development of information technology systems that will facilitate the collection and analysis of data that includes the cost of product, of procedure and of hospitalization, not to mention clinical outcomes.

But if supply chain executives are to play any role in comparative effectiveness research, they may need to stretch their skill sets. As SMI says, “This new era of healthcare reform is revealing the need for [supply chain management] to expand its skills and leadership in areas such as partnership development, data analytics, clinical utilization, group facilitation, project management and change management.”

While supply chain executives have long tapped into clinical staff for help with utilization, product selection and value analysis, the new breed of executive will have an increased need to tap into clinical knowledge and experience if they hope to support physician interaction in product decision-making.

No one is suggesting that supply chain executives become clinical experts. “Physicians articulate the critical perspective on the factors impacting different treatment options, including medical practice standards, patient population variables, safety, cost and historical trends,” points out SMI. But the supply chain executive is in a position to deliver comparative product information to clinicians through newsletters, presentations, webinars and dedicated websites.

“Participation of physicians in [comparative effectiveness research] efforts with [supply chain management] establishes an atmosphere of patient-centeredness,” the authors point out. “Creating active communication between physicians and supply chain management allows available evidence to drive clinical and product decisions. For areas without solid evidence, this open collaboration allows discussion of the options available and ways that the hospital system could be involved in evidence generation.”

Comparative effectiveness research presents an opportunity not just to establish new and deeper relationships with the clinical staff, but with vendors as well, says SMI.

“Currently, product development activities are frequently driven by feedback from physicians (product user) and patients (the ultimate end user), with limited supply chain involvement,” says SMI. “A significant ‘disconnect’ exists between the common value analysis model that focuses on costs, efficiency and value for developed products, and the research and development model with costly investments to develop new products. Supply chain is often the driving force behind a provider’s value analysis process and culture, and thus is in the position to promote the necessary change that emphasizes quality patient outcomes with CER information.”

In other words, the authors suggest, healthcare providers can have a favorable impact and offer guidance to medical device developers as they conduct their research on new technologies. Communication before and during the R&D process might help prevent millions of dollars wasted on technologies that the market doesn’t want or can’t use.

Comparative effectiveness research offers a new opportunity for JHC readers willing to stretch themselves.

To download the free SMI Executive Briefing, go to www.smisupplychain.com and click on “Industry Tools.”

About the Author

Mark Thill
Mark Thill is the Editor of The Journal of Healthcare Contracting and has been reporting on healthcare supply chain issues since 1985. He is a graduate of Dominican University in River Forest, Ill., and he received a master's degree in journalism from Northwestern University in Evanston, Ill.