Successful value analysis implementation relies on research
In part three of the yearlong exploration of HealthTrust’s Value Analysis Survival Guide, we learn to evaluate potential value analysis (VA) initiatives and how to shepherd them into a successful implementation.
Data and clinical evidence are the fuel that drives the value analysis process, say HealthTrust’s AVP, Clinical Resource Management, Domini Pelkey, BSN, MBA, RN, and Holly Moore, MSN, CCRN-K, Director, HealthTrust Clinical Services. “You have to have solid data that shows return on investment in order to even get people to the table to discuss whether or not they want to attempt a conversion,” shares Moore, “because it takes a lot of effort on the part of multiple stakeholders.”
When an opportunity develops, the Value Analysis team launches into research mode, explains Pelkey. What is the product? What information is available, and is there clinical evidence? What is currently in use? Who are the stakeholders involved?
There are three areas that Moore and Pelkey suggest Value Analysis teams consider:
1. Clinical evidence
When evaluating a product or device, the most important thing to define is how this product impacts patient care. Also ask if it improves outcomes, and define the problem you are trying to solve with the new product. Does the product enhance efficiencies or improve a process? Finally, look at the financial impact and whether there are cost savings or an increase.
Reviewing clinical evidence means checking the available studies about a product or device to help determine the product’s impact on patient care and quality outcomes.
When looking at studies, be aware of who funded the research to account for any potential biases that may have influenced the processes or the outcomes. Objective, non-industry-funded studies are ideal. Other sources to seek out are summaries from the Food and Drug Administration, peer reviews and studies that show efficacy and safety in large sample sizes.
A clinical evidence review should also include talking to your physicians and clinicians who may know about the product in question or its equivalents. Data isn’t limited to an Excel file—go to those who use the product firsthand or have exchanged information with their peers. It also includes getting verbal feedback from the physicians and clinicians and anyone else who is involved with that potential product initiative. These stakeholders can provide significant insights into standard of care and quality perspectives, as well as being able to interpret nuances that the nonclinical members of your team may not grasp.
Comparing your current costs to the potential costs of the new product is the tip of the iceberg when reviewing the financial aspects of considering a new product or device. You have to scrutinize everything and think things through. For example, a new technology requested by a physician may be more costly than what is currently in use. However, the new technology may include a positive change for reimbursement and increase revenue while improving patient outcomes.
Alternatively, reimbursement may be eroded by a new technology or medical device. It is important to thoroughly review all financial scenarios, including reimbursement, when considering the adoption of a new product.
To enhance the clinical and financial reviews, benchmarking is a useful tool. It peels back another level of opportunity to ask, “How is this facility achieving this?” Do a deep dive to understand the current mix of products. Comparing clinical data, cost per case and other metrics gives a richer understanding of how results are accomplished.
Once a thorough review is done, share with your stakeholders what you’ve discovered and the insights you’ve gleaned from the research. Present the information in a manner that is easily digestible by all stakeholders, keeping in mind their busy schedules. Putting this material together is more easily accomplished if you’ve been documenting throughout the process.
Expect hearty discussion, and be willing to listen. After everyone has weighed in and a decision is made to go ahead, then the focus of the Value Analysis team shifts to conducting an efficient and effective implementation.
Arguably, one of the most important aspects of any initiative implementation is communication. Pelkey shares, “Communication is key throughout the entire value analysis process but is imperative when it comes to executing an implementation.”
If you don’t communicate appropriately, an implementation can quickly go off the rails. To avoid such a scenario, Moore and Pelkey offer the following five steps to a successful implementation:
1. Identify and engage your key stakeholders from the beginning. Stakeholders include those at the leadership level and the decision-makers, but most importantly, all the people who will be impacted by the implementation—from physicians, clinicians, administrators and support staff to those who will be ordering and managing the product. These are the people who must be kept in the loop throughout the active implementation process as well as after.
2. Determine who will be your point person. This person will actively manage the implementation and be the point of contact for both stakeholders and the product vendor. Make sure everyone involved in the implementation knows how to reach this person.
3. Keep the channels of communication open. During the implementation and after, the point person should be on the ground on a regular basis. It’s best to meet in person for live interaction versus having to email, text or locate what phone number to call. Building those relationships is key, not only for that implementation, but also so those impacted know who is going to address any challenges or problems. Then when you come to them with additional opportunities, they are assured that you will maintain the relationship with that same level of customer service and continue to support them with each and every initiative.
4. Provide vendor support. The vendor/supplier needs to provide and coordinate education for those directly impacted by the implementation so everyone feels comfortable and confident about how to use the new product. The vendor also should designate a point of contact if more granular questions or concerns arise.
5. Track, measure and follow up. It’s important for all stakeholders who were involved in the initiative to know the outcome. Everyone needs to see if the implementation is working as expected and if it can be maintained. Collect direct feedback from the end users and pull data from financials and other metrics. Sharing that information with the decision-makers as well as the physicians lets them know that you are there to strive for and support a sustainable and high-quality healthcare environment.
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