At Bon Secours Mercy Health, clinicians serve on Clinical Transformation Committees and Physician Resource Optimization teams.
The supply chain subsidiary of Cincinnati-based Bon Secours Mercy Health has two formal ways for clinicians to participate in the supply chain function.
At health systems and hospitals, supply chain departments play a gatekeeper role in the acquisition of medical devices and supplies, particularly for new products. Physicians and nurses can play formal or informal roles in this decision-making.
At Bon Secours Mercy Health, the supply chain function is administered by a wholly owned subsidiary, Advantus Health Partners. Clinicians from the health system play two formal supply chain roles: Clinical Transformation Committees and Physician Resource Optimization (PRO) teams.
Clinical Transformation Committees
These committees meet to make supply chain decisions for specific specialties, says Jimmy Chung, MD, MBA, chief medical officer of Advantus Health Partners.
"These committees have voting members who are clinicians from each of our hospitals as well as operational leaders such as operating room directors and cath lab directors. These committees make decisions at a group setting at the system or ministry level. This is work that a lot of health systems would like to achieve because at many health systems decisions are made at the hospital level. If you have a health system that has 10 to 20 hospitals, you can imagine 10 to 20 different processes, and supply chain trying to listen to all of them. In terms of strategy, that situation is very difficult," he says.
Clinical Transformation Committee attendees can be as many as 200 people to participate in discussions, but the voting members are generally the key leaders and clinicians from the hospitals, which is usually less than 30 people. "We have created centralized Clinical Transformation Committees at the ministry level that make decisions where there is opportunity for standardization and reduction of unnecessary variation. This brings the best value for our patients," Chung says.
Physician Resource Optimization teams
PRO teams function under the clinical operational leadership at Bon Secours Mercy Health, Chung says.
"The function of the PRO teams is to look at specific initiatives that may be heavily influenced by the way physicians practice. They deal with physician preference items—these items are generally high-priced products such as orthopedic implants. The spend for these items can be in the tens of millions of dollars for an organization our size. The challenge with physician preference items is that there are many vendors in the industry; and with a health system such as ours with 50 hospitals, each hospital and its surgeons all like to do things their way. You end up with 30 or 40 different contracts with different vendors. That leads to a lot of waste, a lot of unnecessary variation, and potential safety issues," he says.
PRO teams, which are relatively new at Bon Secours Mercy Health, are ad hoc groups of clinicians, Chung says. So far, there have been several PRO teams in the cardiac area, there is one PRO team for orthopedic work, and one PRO team created for the spine category. A PRO team is being formed for vascular work. "They are mostly designed to be ad hoc, but they can continue to do initiatives as they come up in the same category or the same specialty," Chung says.
Typically, a PRO team will have eight to 10 physicians, he says. "They are generally meant to reflect each of our hospital markets."
PRO teams can be used to reduce the number of vendors for products such as implants, Chung says. "We may go to a PRO team with a situation in orthopedics where we are working with 40 vendors; but based on our use pattern, market shares, and clinical quality research, we think that we can reduce the number of vendors to five or six. We present this scenario to the PRO team physicians, who analyze the data. If they approve the move, we have a process for that standardization activity. If there are any specific clinical needs that are not met, the PRO team will let us know so that we can then get any outlier products."
Selecting physicians to play supply chain roles
The clinicians who serve on the PRO teams and the Clinical Transformation Committees tend to be physician leaders, Chung says.
"In general, the PRO teams have physicians who can serve as leaders and content experts. These physicians tend to have leadership responsibilities. They can be held accountable for initiatives at their local level. In the Clinical Transformation Committees, we have looked for physician leaders. We look for physicians who may not have the highest volume for a product but are aligned with the direction where we would like to go to provide the highest value to our patients. These physicians tend to be well known in the hospital markets—they are validated by the market chief clinical officers," he says.
Ideally, physicians who work in these supply chain roles have business savvy, but other qualities are also important, Chung says.
"We would love to have all physicians who work with the supply chain to have an understanding of how health systems work and how the business of healthcare works. But we can't ask for that. Every physician does not have those skillsets. We look for physicians who are open-minded and are open to the idea of teamwork. We look for physicians who are engaged and dynamic. We look for physicians who are willing to work with peers to work toward improvement in healthcare quality and value," he says.
Related: Physicians Can Play Formal, Informal Roles in Healthcare Supply Chain
Christopher Cheney is the senior clinical care editor at HealthLeaders.
Clinical Transformation Committees can have as many as 200 clinicians participate in discussions, but voting members are generally less than 30 people.
Physician Resource Optimization teams deal with physician preference items such as orthopedic implants.
Ideally, physicians who work in these supply chain roles have business savvy, but other qualities are important such as open-mindedness and teamwork skills.