Meet today’s gatekeeper – not like yesterday’s

Edition: July 2012 - Vol 20 Number 07
Article#: 4025
Author: Repertoire

NASHVILLE, TENN–Cindy Christofanelli says she’s a gatekeeper. But she’s not like any gatekeeper you’ve seen before. She’s got a master’s in nursing, and she’s a certified materials and resource professional. She is also a value analysis professional.

Christofanelli and her value analysis colleagues – many of them registered nurses – are the clinical voice of the supply chain. “We translate the business and clinical side of healthcare to decision-makers across the healthcare organization,” says Christofanelli, who is corporate director of supply chain management, SSM Health Care, St. Louis, as well as central region director for the Association of Healthcare Value Analysis Professionals (AHVAP).

Christofanelli was a keynote speaker at the 2012 IMDA Annual Conference and Manufacturers Forum. IMDA is the association for specialty medical distributors.

‘We will do the math’

As a value analysis professional, Christofanelli can be the supplier’s best friend or worst enemy, she said. “If you have a product that is safer and whose clinical outcomes are better, and we can prove it, value analysis professionals will take those projects to the top of the heap.” But if the vendor can’t produce proof that his or her product produces superior outcomes at the same or lower cost than what the institution is currently using, then Christofanelli is less likely to support it. In either case, “We will do the math,” she said.

AHVAP began with seven nurses exchanging e-mails about the work they were doing in their hospitals. Today, the organization has about 200 members, of whom roughly 60 percent have a master’s degree of one sort or another. Many have dual master’s degrees, in nursing as well as business administration.

In a recent survey, 80 percent of AHVAP members indicated they had “strong” to “very strong” support from their senior leadership. “Value analysis is growing, it’s not retracting,” said Christofanelli.

What is value analysis?

Healthcare value analysis is a systematic process to review clinical products, equipment and technologies to evaluate their clinical efficacy, safety and impact on organizational resources, said Christofanelli. “We are data-driven, quality-driven and safety-driven,” she said, speaking of value analysts.

“In the past, you might have gone to purchasing, and worked with the materials [staff], who may or may not have understood the product you were carrying,” said Christofanelli. Many times, materials professionals had just one question: “How much does it cost?”

Value analysis looks at far more than purchase price, said Christofanelli. It takes into consideration the potential or expected clinical outcomes of any device or piece of equipment prior to its acquisition. To the dismay of some in the audience, Christofanelli said that she and her colleagues look with a skeptical eye on studies funded by manufacturers. IMDA members responded that oftentimes, the only clinical data on new technologies is that which has been compiled by the manufacturer.

The value analysis professional also explores how the cost of a new device or piece of equipment will affect the profitability (or lack thereof) of specific DRGs. Usage is another important factor. If a new product costs less, but the hospital or IDN must use more, then it might not be cost-effective. Then there’s the cost of training RNs and others on new devices. If clinical outcomes associated with a new device are the same as the incumbent product, but hundreds of nurses have to be inserviced, then it’s probably not going to happen, she said. In this case, the pain of converting outweighs the gain.

Value analysis professionals are also skeptical of claims that a new product or device may save the nurse or clinician 15 or 20 minutes per procedure. “If I can’t reduce FTEs, I can’t count it,” she said.

The next frontier for value analysis professionals – and one that suppliers need to be aware of – is evaluating the performance of a new device after it has been brought into the hospital or IDN, said Christofanelli. Questions IDNs are asking themselves include, “Did we really save the money we thought we would?” “Did our patients really have reduced lengths of stay?” “Did we get the results we thought, and were we able to document them?”

Value analysis professionals will continue to be out front in helping their organizations balance clinical and financial outcomes. Studies show that healthcare reform could lead to reduced inpatient Medicare payments by as much as 18 percent, said Christofanelli. “If you knew your income was going to go down 18 percent, would you keep doing business the same way? You’d start to evolve.” That’s what healthcare organizations are doing. Suppliers should do the same.