By Gina Thomas, RN, MBA, Chief Nursing Advisor
Historically, most health systems developed value analysis teams to address the clinical and cost benefits of a specific product or groups of products. Over the years, however, these teams have been unable to fully analyze those benefits, making it difficult to determine if products should be adopted and what their guidelines for use should be.
This gap hasn’t been due to a lack of skill, but rather a lack of institutional support for an evidence-based, data-driven approach. Most value analysis teams do not have a staff of researchers who also understand the type of clinically oriented questions a physician may ask, nor do they have the bandwidth to methodically compile available research and map it to actual use to support clinical conversations. Additionally, these teams have often been inundated with contracting and sourcing projects that shift their focus away from a true understanding of value.
Without the integrated, consistent and broad application of evidence and data, hospitals and clinicians are left making decisions based on other available sources: vendor marketing materials and clinical expertise, confidence and experience with the medical device in question. While these sources should be considered in the clinical benefit and cost analysis, they can often be built on inherent biases and limitations.
To understand the importance of evidence, let’s look at three primary factors driving unnecessary variation.
- Incredibly complex care delivery: The sheer volume of medical devices on the market is nearly unquantifiable and more are being introduced every day.
- An explosion in scientific knowledge: A practicing physician would need to read 20 articles a day, 365 days a year to keep up.
- Healthcare fragmentation: Clinicians struggle to access the data they need; an average of only 15% of routine medical practice has a basis in research.
The ability to apply data from peer-reviewed literature, clinical trials and regulatory filings counters these factors and drives confident and informed decision making. The use of evidence fosters respectful debate amongst clinicians, provides greater transparency of information, and aligns healthcare leadership with clinicians to positively impact the care provided to patients.
Fortunately, over the last few years, progressive health systems have begun to rethink their approach. While value analysis is still recognized as a critical, strategic supply chain function, there is increased awareness that the rigorous and consistent application of clinical evidence is essential and should be integrated into the existing clinical governance as opposed to a separate value analysis infrastructure.
Using an evidence-based approach to evaluate new and existing medical devices substantially elevates the value analysis process. At Geisinger Health, for example, introducing evidence into the new product request process has had a profound effect. In a recent webinar, Geisinger’s Vice President of Enterprise Supply Chain Services Jun Amora said that he has seen a significant reduction in new product requests. “We’re still reviewing new product requests,” he said, “but since they’re coming in a lot more vetted now, we’re able to use that time for strategic sourcing initiatives.” Read more about how Geisinger used evidence to engage clinicians in the value analysis process.
A product-focused―or even new technology–focused―approach to value analysis has long out-lived its usefulness. The truly high-functioning value analysis team must prioritize larger issues related to pervasive clinical variation without improvements.
And it all starts with the evidence.