The Rest of the Story

Year in Review
Following up on some of the stories that made news in 2006.

Earlier this year, Ken Peterson, vice president of system logistics and management, Aurora Health Care, Milwaukee, Wis., told JHC that Aurora was getting ready to implement a new-product review process. This system would initially be paper-based, then automated.

At press time, Aurora was poised to roll out the new-product review system in a number of its acute-care facilities. (It has 12.) Clinicians will be required to fill out a new-item request form, answering questions about the product they would like to introduce into the hospital, such as: “How will this product improve patient care?” and “What item(s) will this product replace?” The request will be reviewed by the department supervisor and, if warranted, by the facility’s purchasing liaison and one of the IDN’s value analysis teams. (At any point in the process, the clinician’s request to bring in the product can be approved or denied.) Peterson hopes that the majority of requests can be reviewed and an answer returned to the requestor within 30 days after submission. Physician-preference products, or those that require an evaluation, will take longer. The process will allow for emergency or prior-approval use of the product when the IDN anticipates a longer review period, he says. At press time, Aurora was preparing to evaluate a system that would provide online processing of the entire process.

In May, ECRI asked a federal court to issue a ruling on the legality of price-sharing.

ECRI, a medical products testing organization based in Plymouth Meeting, Pa., asked the United States District Court in Philadelphia to declare that ECRI could continue to publish comparisons of prices paid by hospitals for Guidant Corp.’s cardiac rhythm devices. Guidant had begun inserting confidentiality clauses into its contracts and demanded that ECRI stop publishing information about its prices. ECRI argued that there is a pressing national interest in allowing healthcare providers to engage in comparative shopping for devices. The non-profit organization was backed by Public Citizen, a Washington, D.C.-based non-profit consumer advocacy organization. The case could come to trial by November 2007.

Chris Meyers Janda, vice president, materials supply chain, Fairview Health Services, told JHC earlier this year that the Minneapolis-based IDN had launched in January a new, physician-led technology assessment committee to review technology that costs $1,000 or more in incremental expense and capital greater than $100,000. In addition, she said she was looking forward to begin working with physicians leaders on technology that costs less than a thousand dollars.

Meyers Janda reports that the technology assessment committee declined the use of the Charite artificial spinal disc, as clinical evidence did not suggest improvements over the current standard of practice. “On a go-forward basis, we will be reviewing all artificial disc replacement devices as they come to the market and consider the clinical merits of each, based on evidence,” she says. In addition, Fairview has introduced a model for working with physicians on technology costing less than $1,000, but at press time, had yet to put a formalized process in place. “We are coordinating this with our Office of Clinical Affairs and physician leadership,” she reports.

Earlier this year, Brent Johnson, vice president of supply chain and chief purchasing officer for Intermountain Healthcare, Salt Lake City, told JHC that Intermountain was planning to implement a purchasing card system, which he expected to eliminate 30 percent of the IDN’s purchase orders.

Johnson reports that he and his staff have created a development team, which has chosen a bank, determined program controls and established program details. The team identified 100,000 annual purchase orders (for non-clinical, non-inventory, non-capital items) that could be eliminated by issuing purchasing cards to selected individuals in the IDN. What’s more, they found another 100,000 non-purchase-order transactions (e.g., employee reimbursements) that were candidates for elimination. At press time, Intermountain was beginning a pilot in eight areas, with full rollout expected to begin in February 2007. Johnson predicts that when the purchasing card program matures (in 12 to 18 months), 2,500 individuals will have cards, spending between $40 and $60 million annually. Intermountain will also roll out a travel card in 2007, which will be under the same umbrella program as the purchasing card. Johnson believes the purchasing card program will lead to employee satisfaction and reduced costs, and will help the purchasing department concentrate on larger, more strategic issues.

Last summer, Ed Robinson, system vice president of materials management for OhioHealth, Columbus, Ohio, reported that the IDN would be reviewing new med/surg distribution options available through Novation, and would upgrade to a smart-IV-pump platform that could be integrated into the IDN’s medication safety and clinical documentation system.

Robinson reports that OhioHealth completed an extensive due diligence process regarding med/surg distributors. (Its current incumbent relationships are with Cardinal Health in the Central Ohio Region, and Seneca Medical for most of the northern hospitals in the OhioHealth network.) Although a contract had not been finalized at press time, OhioHealth had made the decision to pursue exclusive negotiations with Cardinal Health for the Central Ohio Region. The Cardinal agreement would be extended to hospitals outside of Central Ohio, but those facilities could elect to continue working with Seneca Medical, which, according to Robinson, has a strong record of serving the regional market in Ohio.

Robinson also reports that the IDN is continuing to review “smart” IV pump options for the Central Ohio Region, and has formed an IV Pump Steering Committee (comprising pharmacy, nursing, information systems, clinical engineering, finance and the supply chain) to oversee the process. Baxter is the primary current incumbent for IV pumps, sets and solutions. The review process has been delayed by the FDA recall of the Baxter Colleague volumetric infusion pumps, says Robinson. In addition, the clinical integration component of large-volume infusion technology “is much more complicated than originally envisioned,” he says. The steering team determined that wireless connectivity is essential, and that the technology platform must be scalable to include two-way communication to and from the device as well as full integration into OhioHealth’s bedside medication administration bar-code verification process (McKesson’s AdminRX system). At press time, the suppliers under consideration were Baxter (pending a successful resolution of the FDA recall), Cardinal Health and Hospira. OhioHealth intends to make a vendor selection by March 2007.

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