Increase your span of effectiveness: develop a clinical business plan through your PET

Healthcare Purchasing News, Feb, 2005 by Tony A. Hall, Thomas Nichols

Jupiter Medical Center's (JMC) Procedure Evaluation Team (PET) offers a glimpse of the evolution of value-based technology assessment. Unique in structure mid function, the PET program at JMC has been in existence for one year. The PET takes the traditional value analysis process to the next level by introducing policy and procedures, and requiring that a comprehensive evaluation be completed regarding new procedures and new products impacting existing procedures.

If a new product is used tot an existing procedure at JMC, then it moves to our Procedure Evaluation Team (PET) and becomes a new procedure proposal. This addresses the back door and/or golden-hand cuff approach of introducing new products used in an existing procedure. This entry point can mean the difference between service line success and failure.

The PET addresses the full impact of new procedures such as patient safety, risk, FDA documentation, financial proforma, physician technique and credentialing, medical executive committee, and board approvals. The PET also includes an advanced level of business expertise including healthcare administrators, government reimbursement analyst, managed care analyst, accountant, and educator. Meeting twice a month, the PET process allows the team to stay abreast of the process and provide critical inter departmental communications.

JMC's vendor access control system utilizes a photo ID system. We also offer each registered representative a set of documents that allow him or her to propose introduction of products and procedures to the organization. Representatives following our standards are guaranteed a value based analysis and response. Those choosing the more traditional marketing approach will meet significant resistance in placing their product or procedure into our supply chain. Physician support in this new partnership is mixed, but those that have participated have benefited directly from the process.

The process begins with a Product and Procedure Request Form (see example). A Healthcare Industry Representative, a Physician or Surgeon or a JMC associate can initiate this form. The form serves as a milestone for getting the request into the queue for analysis and is handled via e-mail only--an electronic record. This is the tool that allows the Clinical Resource Manager In begin a review of current requests.

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Guided by administrative policy, the program is also dynamic by design. Each request is dealt with as an individual project allowing the process to change depending on the nature of the request. The PET is a standing committee that is also supported by a reimbursement and analysis subcommittee. During the analysis and re view phase all the available internal expertise is enlisted including clinicians and physician representatives. All available external sources (such as ECRI, white papers, and the Internet) that help determine how much analysis will be required to make an informed decision on the request are also used.

The timeframe for the process ranges from days to months depending on the complexity of the request (is it a simple product request or an all new service line). Essentially, the PET process develops "Clinical Business Plans" for the organization. This innovative approach slows down the process of introducing new procedures just long enough to allow the organization to gather the objective data required for an educated decision.

It is still likely that many organizations allow product to move from an innocent demo in a physician's office directly in a procedure in the O.R. Those days should be numbered. The need to move to serious front-end analysis of new procedures has moved from being a non-entity to mission critical status.

New products and procedures are the lifeblood of innovation and quality care; they also represent the need at times to say "no" for the greater good of affordable quality care. This "closed loop" brings the business of healthcare full circle; it announces to physicians and healthcare industry representatives that we (hospitals) are to be included as partners in the evaluation processes.

We continuously look for ways to improve and hope this comes from a dialogue created by this article.

Tony A. Hall is the Director of Materials Resources at Jupiter Medical Center in Jupiter, FL. Hall has been in Materials for 25 years and has also served in other capacities including Information Systems director, a Marketing & Public Relations Director and a healthcare consultant. He has been a member of AHRMM since 1983.

Thomas Nichols, RN, C, is the Clinical Resource Manager at Jupiter Medical Center He has been a Registered Nurse for 11 years prior to joining Materials Resources in 2002. He is a member of AHRMM and Association of Healthcare Value Analysis Professionals (AHVAP).

Part 1 appeared in the January Issue of Healthcare Purchasing News.