Physicians Play Key Roles in Supply Chain at Novant Health

Novant Health physicians play formal supply chain roles in reducing clinical variation and managing the adoption of new products.

Physicians play formal and informal roles in supply chain at Winston-Salem, North Carolina-based Novant Health.

Formal supply chain roles for physicians include serving on value analysis teams and participating in quality assurance processes. Informal supply chain roles for physicians include alerting supply chain departments when products go out of stock and when there are problems with products.

At Novant, physicians serve on a pair of formal supply chain groups, says John Mann, MD, senior vice president of Novant Health Institutes, and president and chief operating officer of Novant Health Clemmons Medical Center in Clemmons, North Carolina.

"We have a Clinical Variation Reduction Team. The CVRT was established in 2012. That is a group that includes the supply chain team combined with physicians who represent most of our institutes—the clinical delivery side of the organization including some of our chief clinical officers. Together, we partner with the sourcing team around recurring contracts for products that we use in our acute facilities. That spans a wide variety of specialties, including orthopedics, vascular, cardiac, neurology—any specialty that uses a product in our hospitals can be involved in clinical variation," he says.

The physicians who serve on the CVRT provide clinical input and clinical guidance that is useful in negotiations with vendors, Mann says. "We have found that this relationship brings more power to the conversation. Historically, vendors have used physician relationships to influence hospital administration. We have turned the tables on them. Our sourcing team partners with physicians and they go to the vendor and say, 'This is what the physicians want for their patients. This is what we need for Novant Health.' We have turned the dynamic around, so the vendors cannot undermine the efforts of the health system to drive value and savings for our patients."

The health system also has a formal supply chain group that includes physicians to manage the adoption of new products, he says. "If a physician wants a new product, whether it is clinically better, drives better outcomes, or drives a competitive advantage, those decisions are done in collaboration between physicians and the sourcing team, so we are driving the conversation with the vendors. Having doctors involved ensures that we keep the patient front-and-center in all of our conversations, and it disarms the vendors. When vendors approach our sourcing team, they may say, 'A doctor wants this product.' But we are going to make that decision ourselves and draw value to the health system and our patients."

Physicians participate in supply chain beyond formal roles

Building relationships between the supply chain staff and physicians has educated the sourcing team, says Mark Welch, MHA, senior vice president of supply chain at Novant.

"The relationship between the supply chain team and physicians has evolved over the years. When we first started out, we focused on clinical variation to understand why we had clinical variation. What we found out was that having a relationship between supply chain and physicians to talk about those things has been more valuable than just addressing variation. Physicians have a scientific background, and most of them love to teach—they have taught my sourcing team many things about different procedures that we probably would have never known if we had not built a relationship," he says.

Both new physicians and physician leaders play informal roles in Novant's supply chain, Welch says. "When we recruit new physicians, part of the recruiting process is our physician leaders talk about supply chain and how we approach supply chain along with expectations for physicians to participate. At our institutes and service lines such as neurology, orthopedics, vascular, and surgical services, the leaders are involved in sourcing from Day 1 when they come onboard. We get them up to speed on where our contracts are, listen to any concerns they might have, and many times they bring a different perspective."

Novant physicians are often engaged to influence supply chain decisions, Mann says. "If we have a product that is in a three-year cycle and is coming up for renewal, we will engage with many physicians to gain their input. We want to know their experience with the product over the past three years. We may need to look at a change. It can be challenging to engage with dozens of physicians across the organization, but we have found that investment of time gives us a better result at the end of the process."

Certain qualities help physicians play formal or informal roles in supply chain, Welch says. "They must have curiosity. They need to be innovative. They need to be somebody who wants to learn the business side of healthcare. Physicians are curious about a lot of things, and as they get deeper into their careers, they get interested in where the money is going and where the money is coming from. Healthcare is complicated, but most physicians are intrigued by how it works."