Questions Answered
The author of the OHS white paper, Mark Growcott, Ph.D., MBA, LSSBB, wasn’t available as of this writing. A SIGHT Medical manager, Doug Burnette, answered some of our questions:
- How and why seven trays when two were needed?
Burnette: The use of seven trays by ‘even the low-cost surgeons … is typically vendor driven,’ When using the [software], the low-cost surgeons were able to identify and have greater control, allowing the number of trays to be reduced.
- What’s in the seven trays which were not needed?
Burnette: Most vendors sent a universal set of instruments to manage every surgical technique possibility … Because the technology captures the exact instruments from the actual vendor being used, we can help hospitals understand what actually needs to be used and maintained on site.
- An OHS press release said that the ability to move TKAs from inpatient to outpatient was one of the key savings. How is that decision made?
Burnette: The technology allows the IDN (integrated delivery network) to scale surgical best practices at a clinically relevant level. This allows greater control of clinical parameters like LOS (length of stay) because the influence can occur at a very granular level at the point of care … SIGHT levels the playing field between [inpatient and outpatient], allowing the patient to be serviced in the setting that is best for them based on clinical factors rather than regulatory requirements, and allowing significant cost savings to payors.
- How does SIGHT improve upon typical hospital materials management or supply chain software?
Burnette: Logistics support in a surgical suite requires clinically relevant data to be available in managing pre-operative logistics (i.e., having the right thing in the right place at the right time, while minimizing waste and inventory carrying costs), which current software and hospital processes do not accommodate. They are traditionally able to handle commodities but not clinically-related parameters. Additionally, current systems do not provide any intra-operative support. SIGHT automation technology does.
- Can this approach and your software be used for other surgeries?
Burnette: Correct. Any device-related surgical procedure, from total joints to spine, to certain cardiovascular procedures, can be accommodated by the technology. SIGHT is already being used in total hip procedures and it expects to roll out ortho trauma by the end of 2018. Other procedures will be added in the coming months as well.”
Other Studies: Wide Variations in Device and Internal Costs Can Be Reduced
More bluntly than the OHS white paper, the Premier, Inc. study said that one cause of higher costs was that in many health care organizations, the purchasing process works this way: the individual surgeon, after being schmoozed by sales reps, makes a decision about which implant device to buy—and then and only then does the hospital purchasing department get to negotiate prices, from an obviously weakened position because the vendor sales rep knows the purchasing decision has already been made in that vendor’s favor.
“[H]ospitals that negotiated prices after surgeons had already made their selections of preferred vendors paid an average of 17 percent more for knee implants and 23 percent more for hip implants after controlling for other factors, compared to hospitals who collaborated with surgeons on their purchasing decisions,” the Premier paper said.
As an orthopedic implant representative for better than 30 years, I feel it necessary to reply to the above study, specifically; The Cost of Chewing the Fat with Sales People. After listing all the many functions the company representative performs, and then attempting to eliminate that one person, to me makes no sense. What appears to be completely ignored, is; most, if not all company reps are well trained professionals, providing an invaluable service to not only the surgeon, but also the hospital staff, whether it be in the operating room, central sterile supply, or wherever they are needed. Its then stated that the surgical techs, whom I’ve found to be excellent, are assigned some of the reps tasks. Its important to know; what training, and by whom? Most likely, not the in depth training provided by the implant companies to their reps, but I could be wrong, I believe this to be a serious omission. Now, I’m fully aware of the need to look at all costs associated with joint replacement, however in my opinion,value needs to be part of the equation also.