1. Successful Collaboration Between Physicians and Supply Chain by Utilizing a Mobile Device Application: Pricing and Efficacy Tool for Value-Based Product Selections
Charlie Miceli, C.P.M. Vice President and Chief Supply Chain Officer, The University of Vermont Health Network
Georgiana D’Alessandro, Esq., Sr. Project Manager, The University of Vermont Health Network
rs:
This is the Title slide
Please do not alter the Track Name

2. FACULTY DISCLOSURE
The faculty reported the following financial relationships or relationships to products or devices they or their spouse/life partner have with commercial interests related to the content of this CE activity:
Georgiana D’Alessandro: Nothing to disclose
Charlie Miceli: Nothing to disclose
This slide is for internal use. Please do not alter.

3. How?

4. How?

5. How does supply-chain collaborate with physicians to make value-based product sections?
The University of Vermont Health Network implemented a mobile device application with relative costs and basic implantable device features.
The results were significant utilization savings, stronger physician alignment, and more thoughtful product selection for patient care.
How?

6. -WHO
1,325-licensed bed not-for-profit health system located in Vermont and northern New York with 6-hospitals, and the largest being an academic institution, University of Vermont Medical Center which is located in Burlington VT.

7. Cost Alone is Not Enough to Impact Physician Behavior -
“Finally, trying to make physicians focus strictly on cost may be off base as well. Some care, even more expensive care, is worth it. What we really should attend to is value — the quality and impact relative to the cost. It is certainly harder to determine value than price, but that metric might make more of a difference to physicians, and to their patients.”
There’s No Magical Savings in Showing Prices to Doctors, Aaron E. Carroll, New York Times JUNE 12, 2017.
- WHY?
- Recent article (opinion) in NY Times. Reviewed a lot of research including a recent study that showed drug prices to physicians. Did not influence their behavior at all compared to the control group.

8. Cardiac Rhythm Management Initiative
Goals of the RFP:
reduce cost
maintain product quality
preserve physician choice
provide physicians with information to asses device value and comparative effectiveness
- WHEN?
- In February 2016, UVM Health Network issued Request for Proposals to four suppliers of Cardiac Rhythm Management (CRM) devices (pacemakers, defibrillators) for new pricing agreements

9. Clinical Engagement Step 1: Asses Current State Physicians comments:
“…Major differentiator [between four major pacemaker/defibrillator companies] is largely price”
“Only a relatively small percentage of patients wind up requiring some distinguishing bell or whistle that may merit a higher price point.”
“…in most cases bias, habit and physician-vendor relationships determine usage.”
Gauge interests and relationship between supply-chain and physicians
Survey utilized to asses physician knowledge of costs: asymmetrical information when sales reps aware of costs, but not physicians
Refocus on Interests and Improving Relationship
Research component - Physician Administration Alignment Cost Savings Protocol (PACS - approved by IRB)
Develop white paper with consultant as proof-of-concept
Preserve choice - alternative scenario of dual or sole-vendor contract would limit choice and transparency

10. Collaborate: Physicians & Supply Chain
Step 2: Data Build
Device Cost, Comparables, and Technology Level:
For each vendor, and each modality (e.g. single chamber pacemakers) the high-end and lower-end technology was identified
This information was utilized to display device configurations based upon levels of technology for each system with leads, rather than line item cost
The average purchase price (net rebates) in previous calendar-year for each modality was the baseline for savings
Developing the mobile device application required collaboration between supply-chain and physicians

11. Implementation Step 3: Consistent Process for Device Selection
During the first six months of this initiative, it was agreed that Neptune PPA tool be used in 100% of CRM implants
Utilizing the tool in advance of the case to minimize pressure from the vendor to bias selection at the time of implant
Physician selects various options, and then the app displays device configurations/technology, net cost information, items in inventory (including bulk), competitive change out/rebate incentives, as well as info. manufacturers website: device features, size, and battery life
Developing the mobile device application required collaboration between supply-chain and physicians

12. CRM Initiative Savings Per Hospital
WHAT
At the same time as the RFP, implemented a physician phone app .

13. CRM Initiative Savings Per Hospital
WHAT
At the same time as the RFP, implemented a physician phone app .

14. Bulk Purchase Savings Trends
WHAT
At the same time as the RFP, implemented a physician phone app .

15. CRM Initiative Market Share Per Vendor
WHAT
At the same time as the RFP, implemented a physician phone app .

16. CRM Initiative Market Share Per Vendor
WHAT
At the same time as the RFP, implemented a physician phone app .

17. Continuous Monitoring
Calculated savings based upon product utilization on a bi-weekly basis per provider
Developed weekly progress reports to capture usage trends by modality, bulk purchases, competitive-change-out incentives, and missed savings opportunities
Progress reports shared with providers to understand clinical decision-making and collaboratively develop proactive future savings strategies
WHAT
At the same time as the RFP, implemented a physician phone app .

18. Cardiac Rhythm Management Initiative
CRM phone application
Physicians can select the
provides options based on functionality, size, and
CRM products based on specific patient needs
cost
WHAT
At the same time as the RFP, implemented a physician phone app .

19. Refocus on Value, Not Cost
Benefits of the Mobile Application:
Physicians see and understand pricing deltas among suppliers, product features and technology in a manner that is relevant to their clinical workflow
Utilization cost reduction by selecting higher-end more costly technology only when appropriate for clinical care

20. Q&A Slide