REAL EXAMPLES OF SERVICING THE CONTINUUM OF CARE MARISA FARABAUGH, WAKE FOREST BAPTIST HEALTH NANCY PAKIESER, TECSYS
LET S TALK AND SHARE! SMI2U sessions are intended to be: Informal and interactive Approx. half presentation/half group discussion Today, we will present high level overviews of three provider systems for servicing non-acute care customers. Then we will open the discussion.
S.C. SERVICING THE CONTINUUM OF CARE INITIATIVE Because things are changing! Why the SMI Initiative? Traditional supply chain programs have focused on servicing acute-care hospital campuses But changes in physician practices, reimbursement, and reform efforts are leading many supply chain programs to expand both their operations and their value proposition into new non-acute care settings that they never serviced before.
SMI INITIATIVE TEAM STATEMENTS Team Problem Statement The industry lacks a recognized efficient, best-in-class model for a Supply Chain program that serves the entire continuum of care, including ASCs, remote clinics, physician offices, Lab services, home care, etc. Team Vision Statement Where is the bestin-class model? The Team s vision is a future industry with omni-channel supply chain programs that incorporate a flexible structure to meet changing demands while efficiently serving all locations of patient care, including ASCs, remote clinics, physician offices, Lab services, home care, etc.
THREE SYSTEMS - OVERVIEWS
ADVOCATE HEALTH CARE Created a non-acute care supply chain strategy focused around: a streamlined inventory management and ordering system centrally-managed distribution center leveraged transportation infrastructure to disintermediate redundant shipping and related costs and remove practice staff from supply chain activities. This process re-design enabled a wide range of operational improvements that: lowered supply and distribution costs reduced the amount of labor expended on managing supplies improved purchase contract compliance provided the flexibility to order limited-use items in smaller units of measure.
CURRENT MANAGEMENT OF AMBULATORY PROCUREMENT BEFORE AFTER
ADVOCATE S LESSONS LEARNED/BEST PRACTICES Must have scale Communicate, communicate, communicate Collaborate Be lean Practice
OCHSNER HEALTH Leverage the focus of CQO to address the increasing need to support physician offices Goal to streamline and standardize the community physician distribution program
OCHSNER HEALTH PHYSICIAN PARTNER PROGRAM Motivation for change Selling the value proposition Aligning mutual incentives Facing challenges Benefits of the partnership relationship
YALE NEW HAVEN HEALTH Population health driving strategies that address margin pressures and economies of scale to deliver high quality care.
YALE NEW HAVEN HEALTH Distribution practices Ambulatory procurement Ambulatory purchased services Home Health practices Population Health practices Pharmacy distribution practices outside of facility
THREE SYSTEMS- THREE APPROACHES
COMMON FACTORS IN ALL 3 PROGRAMS Expanding geography Changing supply mix based on customer shifts Supply cost variation High delivery costs Engagement of trading partners CHANGE MANAGEMENT
DRIVERS Advocate Improve patient safety through integration, standardization and compliance Ochsner Focus on C,Q,O to strengthen partnerships with physicians Yale New Haven Supporting efficient, effective population health care delivery strategies
TRADING PARTNERS Advocate Owens & Minor MedSpeed Ochsner McKesson GPO Yale New Haven Owens & Minor McKesson
ADVOCATE HEALTH CARE KEY POINTS Advocate partnered with one of the largest medical practice groups to collaborate on improving integration, standardization and compliance management Advocate then collaborated with key industry partners to develop a centralized inventory and distribution system to efficiently order, pack, and transport inventory throughout their network A hardware component further improved efficiency with Kanban system and standardized bins Among the many lessons learned: Must have scale Communication and collaboration will get you farther down the path Use lean thinking with SMEs as much as possible Practice and pilot different models until you meet your needs
OCHSNER HEALTH KEY POINTS Sought to address inconsistencies within non-acute space and developed OPP to help drive standardization of process and formulary Success came with hard work, selling the idea, countless site visits, and a deep understanding of change management Value in their distributor contract came through off label brands, innovative pharmaceutical agreements, and analytics platform to manage compliance and pricing This conversion led to difficult, but productive, conversation between distributor and GPO ultimately resulting in a new mantra If a product is deemed clinically acceptable and has a lower total cost than the current formulary item, it should be added to the formulary and offered to all clinics.
YALE NEW HAVEN HEALTH KEY POINTS Currently working on an integrated distribution center Working to mirror strong supply chain formulary based on success of pharmacy formulary Utilizes different distributors for acute and non-acute supply chain Non-Acute care products are delivered direct to physician offices Pharmaceutical and non-acute distribution through same provider Future opportunities for growth include: DME, home infusion, ostomy and wound care, and specialty pharmacy
DISCUSSION QUESTIONS How are these supply chain programs: Like yours? Not like yours? How is your organization addressing the expansion of supply chain support across the continuum of care? How has your organization connected or integrated supply chain with the caregivers? How important is it to standardize supplies across acute and non-acute care sites? What changes are needed for supply chain staff to engage outside the acute care arena?