1. 1. Value Analysis in the Hospital Laboratory Terry McIntire MT(ASCP) Value Analysis Coordinator JPS Health Network
2. 2. JPS Health Network 6000 employees Level 1 trauma center 537 beds Over 50 clinics > 4,500,000 laboratory tests per year
3. 3. Value Analysis Program Organized and Started by Owens and Minor in Oct 2012 o 6 Value Analysis Teams o 1st Full Year o $2.55 million annualized savings $0.46 million Laboratory o 113 Initiatives implemented 14 Laboratory Initiatives
4. 4. VAT Program Structure 4 Cardio/ Imaging VAT Peri- Op VAT Support Services VAT Patient Care VAT VASC Admin Services VAT SUPPLY CHAIN MANAGEMENT SUPPORT Lab VAT AD-HOC SUPPORT Bio-Med Infection Control Finance Risk Management Decision Support Facilities HR Performance Acceleration RX (P&T) IT
5. 5. Value Analysis Program Transitioned from O&M to JPS in October 2013 2 Value Analysis Coordinators growing to 3 in near future o 6 Value Analysis Teams have grown to 9 o 2nd Year to Date (year ends in September) o $7.58 million YTD annualized savings $2.44 million Laboratory o 132 Initiatives implemented YTD 21 Laboratory Initiatives implemented YTD
6. 6. VAT Program Structure 6 Cardiology Radiology VAT Peri-Op VAT Support Services VAT Patient Care VAT VASC Admin Services VAT VALUE ANALYSIS COORDINATORS - SUPPLY CHAIN MANAGEMENT SUPPORT Lab VAT AD-HOC SUPPORT Clinical Engineering Infection Control Finance Risk Management Decision Support Facilities HR Performance Acceleration RX (P&T) Service Contracts VAT IT VAT
7. 7. Look at Reference Laboratory Testing Quick savings Hot List Review often. Have new tests been added at non discounted prices? Are panels ordered when only individual test is needed? ANA test vs profile is good example Vitamin D There is more than one and more than one way to measure 25-OHD less expensive and ordered most frequently 1,25 OHD more expensive, frequently ordered in error JPS saved $84,000 per year by internalizing
8. 8. Quick savings continued Is that super accurate test really needed? If using a bucket gives the results needed, why spend for mass spectrometry?
9. 9. Quest by any other name. Hospitals frequently have multiple accounts all belonging to same Corporation Are all really needed? Are the charges different for the same test from the different divisions of the Corporation? $75 vs $15 for same test was discovered at JPS $290,000 annual savings for JPS Could switching to a different division of the same lab produce savings?
10. 10. Keep Looking at Reference Labs Labs will almost always bid below GPO pricing Better pricing may be obtained without changing labs JPS saved $400,000 per year by putting out RFP and changing labs another $200,000 might be possible Reference Lab RFP
11. 11. You use how many labs??? Do you really need 30+ reference labs? The major laboratories offer much of the testing done by secondary labs Get help from pathology with physician preference labs Prices are negotiable with secondary laboratories. begin by asking JPS obtained 25% discount from Prometheus just by asking
12. 12. Pathology Reference Labs Many tests formerly done by niche labs are now offered by bigger players at lower prices Consolidate to fewer labs Internalize testing
13. 13. Why send it out? Internalize high volume assays. Can your molecular lab do that assay? PCR testing has become simpler, but is still expensive if sent to a reference laboratory TB blood test save $30/test Vitamin D earlier slide
14. 14. Why Keep It In-house If the test is done infrequently Can a reference lab meet your turn around time need? Is it worth the reagent, QC material and tech time cost? Negotiate reference lab price before sending first specimen.
15. 15. Point of Care Control point of care testing Is there a real need for this test to done if it is 3-5 times more expensive than if done in-house? JPS limited the number of A1c tests done POCT Volumes and variety of assays keep increasing. More competitors in market JPS switched to better technology and still saved $90,000 for CLIA waived POCT Flu kits
16. 16. Butterflies Limit use of butterflies for phlebotomy $81,000 savings
17. 17. Courier Service Switched from contract couriers to JPS couriers Eliminated courier runs when testing not affected If testing only done once per day for a send out to another hospital, just send the specimens once per day $25,000 savings at JPS
18. 18. Blood Bank Quick and Easy Obtain credit from local blood bank for blood drives conducted at your hospital for JPS ~ $6,000 - $8,000/year
19. 19. Blood Bank Waste Reduction Process changes PAR reduction Return soon to expire units to Blood Bank vendor $150,000 savings for JPS
20. 20. Blood Bank Blood Utilization Reduction Work with Medical Staff on transfusion policies Set thresholds for transfusions Over $500,000 annual savings for JPS
21. 21. Whats next? Reagent deals for high volume assays Consolidation of satellite labs Look at national market for blood products Keep looking at Reference Laboratories Just keep working
22. 22. Questions Comments Suggestions When was the last time you did something for the first time?
23. 23. Terry McIntire MT (ASCP) Value Analysis Coordinator JPS Health Network 1500 S Main St Fort Worth, TX 76104 817-702-1452 tmcintire@jpshealth.org http://www.linkedin.com/in/tdmcintire www.twitter.com/tdmcintire