Product Evaluation GPS

New service helps hospitals and vendors track product evaluations as they make their way through the system. Vendors have to pay ‘nominal fee,’ but developer says the ROI makes it worthwhile.

Whether your IDN has two acute-care facilities, like Mary Washington Healthcare in Fredericksburg, Va., or 13, like BJC HealthCare in St. Louis Mo., contracting executives know the trials of trying to evaluate the volume of new products that come through their doors. Which products need to be looked at first? Who’s shouting the loudest (either from the vendor side or from within your own facilities) about getting his or her product vetted first? What can the IDN afford to bring in this year?

Contracting executives feel a lot of the pressure. So do their vendors. A new service promises to help take some of the stress out of value analysis for both of them.

Tedious process
As a sales rep – and then sales manager – for a medical device company, Tim Hopkins recalls the tedious process of trying to shepherd a new product through his customers’ supply chains and onto their shelves.

“You never know if you’re talking to the right person,” he says. “And nine out of ten times, you’re not. So you spend a lot of time trying to sift through who the various people are, and how to get to the decision-maker.” The problem is compounded when one rep leaves and another joins the company. “A lot of times, they have no idea who to talk to,” he says.

Even after enlisting a clinical “champion” or “sponsor,” the sales rep’s job is far from done, says Hopkins. “When I would finally get up to the director of materials or supply chain, I would notice stacks of product files on the floor of their office.” Those files contained white papers, FDA documentation, marketing materials, price sheets – “all the documents I had sent in to the hospital over a period of months.”

Out of this chaos, Hopkins and his partners saw opportunity. “We felt if we could automate [the product evaluation process], we could [allow] the vendor to send in one submission all the documentation the hospital needed, and to answer all the questions vendors inevitably get asked.” The result was MedApproved.

Launched in February of this year, Cleveland, Ohio-based MedApproved is a Web-based service whose goal is to connect all hospital stakeholders involved in evaluating the myriad of products that come through their doors each year. Hopkins and his partners believe MedApproved can shorten the approval process time and make the process more “transparent” to vendors, so they know at all times at what stage in the evaluation process their product is.
Vendors pay a “small fee” for every new product they want to submit for a hospital’s consideration, says Hopkins.

One IDN that has contracted with MedApproved as part of an initiative to improve its product evaluation process is BJC HealthCare in St. Louis, Mo. Every year, Barnes-Jewish Hospital (the IDN’s largest facility) puts as many as 100 new-product requests through a formal evaluation process, says Garrett Jackson, value analysis manager, BJC HealthCare. Across all BJC facilities, probably an additional 20 are evaluated every year.

For the past year, BJC has been fine-tuning its internal product evaluation process in the perioperative area at Barnes-Jewish. “With the process flow fairly well established, we have now taken that evaluation process and expanded it to the ORs across the system,” explains Jackson, who began his career at BJC as perioperative business manager at Missouri Baptist Medical Center, BJC’s second largest facility. “In conjunction with that rollout, we began integrating our internal process into the MedApproved system.”

BJC’s product evaluation process, like that of many hospitals and IDNs, “was very much a process that was individually managed, and which really only leveraged a basic [Microsoft] Excel program…to keep track of what was going through the system,” says Jackson.

BJC recognized that automation could help the IDN track the evaluation process in real time, to “try to prevent what we termed the ‘fragment and conquer’ mentality of some vendors,” he says. “They knew that if they were able to get in the door at one of our facilities and get their item added to our item master, it essentially cleared the way for that product into another facility.”

MedApproved provides the automated tracking that BJC sought. It also helps BJC gather supporting documentation in one place, then disseminate it electronically to all the business managers and subject matter experts who need to see it, explains Jackson. “This way, we don’t double up on the financial and trial work.

“We’re trying to provide [managers and clinicians] much more information on the financial impact [of new technologies], their clinical efficacy, and information on how [the technologies] will be used and how they will affect their inventory – that is, will it replace something they already use,” says Jackson. “The advantage [with MedApproved] is that a lot of these analyses will be centralized. The individual facilities will still be able to judge whether they want the product introduced or not, but a lot of the pre-work will be pulled off the table.”

One of the biggest pluses of better automation is its ability to facilitate communication among decision-makers spread across the BJC system, says Jackson. “Traditionally, any communication between a front-end nurse and a manager has been through an e-mail string,” he says. “In order to aggregate any information that bounced back and forth, it had to be printed out, or else only one person had the full picture at any given time.

“We want to turn that paradigm on its head and provide a full set of information and communication to anyone in the system who needs to research a particular product,” says Jackson. The automated system allows BJC to “roll e-mail responses into the internal discussion. We can centralize the communication piece and get everything on record of how we dealt with that product.”

Mary Washington Healthcare
For the past year, executives at Mary Washington Healthcare in Fredericksburg, Va., have worked to improve the system’s value analysis process, says Robert Gidcumb, director of supply chain management. The IDN is one of four VHA health systems comprising Virginia Alliance LLC.

Last year, Virginia Alliance members made a decision to align its members’ value analysis processes, an objective that dovetailed with Mary Washington’s desire to improve its internal process. So each of the Virginia Alliance members contracted with VHA to implement its Clinical Quality Value Analysis program in their respective systems.

CQVA is a formal approach for making decisions about supplies and services. It calls for decision-makers from multiple disciplines within the healthcare facility – e.g., clinicians, physicians, finance, supply chain, infection control and others – to work together to consider all aspects of the technology or service under consideration, explains Gidcumb. “We look at value in its totality, not just from a financial standpoint.”

Despite the improvement that CQVA brought, Mary Washington still sought a way to streamline the value analysis process. MedApproved appeared to be such a way. “It gave us the opportunity to ‘electron-icize’ – if I may use that term – the process,” says Gidcumb. “We can manage it for our benefit and that of our vendors, so we don’t lose track of any vendor initiatives.

“We can identify where a product request is, who has it, and who has responded back with their subject matter expertise,” he says. Subject-matter experts can go online and vote “yes” or “no” on a technology. Then, when core team members meet to reach a final decision, “we actually go to the MedApproved site and display the initiatives on a projector for the team members to review,” explains Gidcumb.

“Does this mean every product will get looked at? No. But [MedApproved] enables us to make a decision and respond to vendors promptly, so they don’t have to make repeated calls.” In fact, the nominal fee that MedApproved charges vendors is more than offset by the savings they realize by avoiding the trip to Mary Washington (which lies halfway between Washington, D.C. and Richmond, Va.) to make unnecessary calls, he believes.

What do vendors think?
At first glance, suppliers may see MedApproved as yet another roadblock in the selling process. But Hopkins says that isn’t the case.

“We’re not suggesting vendors not have face-to-face meetings” with clinicians, he says. “It is still the rep’s responsibility to meet with the physicians or clinicians who will drive their product.” Rather, the system is designed to speed up the evaluation process once a clinician has decided to back a new product.

“Hospitals see hundreds and sometimes thousands of new products each year,” says Hopkins. “You have hundreds of physicians, hundreds of different clinicians, providing input, in addition to all the people in the supply chain. In many cases, they are at different physical locations, and there’s no central platform for them to look at and communicate with each other about new products.”

Vendors with new products log on to the MedApproved vendor portal and create a product profile. This is basic information, including a description of the product, the specialties that might use it, information regarding FDA clearance, and pricing and reimbursement information. Vendors can also upload supporting documents, such as white papers, studies or marketing materials. They may be asked to answer an additional set of hospital-specific questions.

The request for evaluation is routed to the appropriate department head or product-evaluation-committee member. E.g., cardio-related products are routed to those people on the hospital committee looking at cardio products.

Based on a customized flow chart of the evaluation process, the system “knows” when one phase of the evaluation process has been completed and the next has begun. “Our system allows [the vendor] to watch the process as it moves through the hospital,” he says. “The hospital can give you an estimated decision date, and you can sit with your manager and forecast when certain products will be approved.”

Hopkins emphasizes that MedApproved has nothing in common with vendor credentialing. “Vendor credentialing companies are addressing the reps who are physically walking in the building,” he points out. “That’s where it stops for them. Our service helps them more effectively sell their products.”

Assist vendors too
“I think having a better, more coordinated approval process will assist vendors almost as much as us,” says Jackson. “They won’t have to spend all their human capital making multiple product introductions. Instead, they know they have one area to approach, which will then get the word out to all our facilities.

“Often, the perception is that it’s vendor-against-hospital. But so many products really do offer clinical advantages and cost reduction, or a very distinct clinical advantage. Our desire isn’t to thwart the process for vendors, but to get the word out to all our facilities. We really see this as a way to coordinate those efforts.”