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Involving clinicians in procurement decisions

April 01, 2020
From the April 2020 issue of HealthCare Business News magazine

By Valerie Dimond

As the healthcare landscape continues to change, supply chain professionals will also need to change the way they conduct business.
Historically, supply chain’s main focus was on cost, negotiating contracts and getting the best deal. While those goals are still dominant when making purchasing decisions, success also requires the inclusion of a lot more people, namely clinicians. Clinical-supply integration is an end-to-end process focused on shared accountability for care delivery, alignment with the system’s mission and values, and patient outcomes. However, the process can stall and get complicated if parties are misaligned.

For example, surveys conducted last year by Nexera and Acurity asked senior healthcare management professionals if their clinicians are officially included in supply chain utilization and procurement decisions. Most said yes, yet the majority of clinical, operations, and materials professionals polled said no. Moreover, only 5% of administrators cited clinical integration as their supply chain’s current priority. Clearly, health systems have more work to do when it comes to engaging those on the front lines.

“Clinical integration is really saying what is supply’s role in the total equation of managing outcomes or managing the total episodic care; it’s taking a more intentional approach to the holistic view of connecting supplies to outcomes,” said Steve Kiewiet, CMRP, FARHMM, FACHE, chief commercial officer, Intalere, and former vice president of supply chain at BJC HealthCare in St. Louis. “I don’t mean supply chain is in charge. Some people feel that way, and I do not. Supply chain is a key contributor, a key integrator, and a key facilitator. Supply chain doesn’t make the strategy, but we enable strategy. There are all these other inputs that don’t involve supply chain that are part of the equation, too, which is around care pathways and patient compliance, procedure variation and stuff like that. It’s integrating supply chain into the total conversation, and supply chain playing its appropriate role in that conversation.”

Steve Kiewiet
Yet, for many, there still exists a sizeable gap between supply chain and clinical leaders if those conversations fail to deliver fresh awareness and knowledge that can be used to solve problems more effectively and sustainably. “We don’t have an understanding of the impact we’re having on the clinicians,” said Kiewiet. “One of my friends is a surgeon who talks all the time about how sick and tired he is of having supply chain conversations because all they ever want to do is switch a product, not understanding the impact constantly changing products had on clinician burnout, and then the impact clinician burnout has on the quality of care, and the impact on the patient. We don’t measure it from a holistic point of view. Is it worth saving $1 million if you have no positive result on patient outcomes, because any potential positivity is eaten up by more stress on the clinical team? I just think that, fundamentally, we’re asking the wrong questions when it comes to measuring the value of supply chain activity in the connection to the mission and strategy that comes from the C-suite, beyond just ‘pay less for stuff, use less stuff, use less suppliers’. What should we be answering that we aren’t? Maybe the product isn’t the focal point. Maybe the widget or the service is not the focal point.”

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