Health Sector Supply Chain Research Consortium - Completed Research Projects
Completed Research Projects
- Revision Total Hip and Knee Arthroplasty Implant Identification Practices: Implications for Use of Unique Device Identification
Principal Investigator: Natalia Wilson MD, MPH
This project investigated implant identification practices by orthopedic surgeons prior to revision total hip or knee arthroplasty (THA/TKA) within the context of unique device identification. Considered was methods used, time taken, percentage of cases when the failed implant could not be identified and cost and clinical impact.
Survey results highlighted the inadequacy of current documentation process to comprehensively obtain device identification for failed implants in THA/TKA. Survey results also highlighted surgeon and staff inefficiency and perceived clinical and cost impact when components of the failed implant could not be identified during pre-operative planning. The UDI Rule presents this opportunity for UDI use in patient care settings, across specialties, as standard practice for documentation of implantable devices.
- The Value of Unique Device Identification (UDI) Across Healthcare
The White paper discusses the Unique Device Identification (UDI) System Proposed Rule that was published by the U.S. Food and Drug Administration (FDA) on July 10, 2012. The UDI rule sets the foundation for use of UDI across healthcare and establishes a common language for medical devices. The potential benefits of UDI are many, including greater accuracy and efficiency in the procurement process, improved charge capture, a standard for device documentation in clinical care and post-market surveillance, enhancement of post-market surveillance activities, greater efficiency and comprehensiveness in recalls, and the ability to track a device across its lifecycle. Achieving the full value of UDI across healthcare will require implementation and adoption of UDI in multiple areas, including supply chain, clinical care, and post-market surveillance, as well as integration between these areas. Research, key constituent involvement, and education efforts are ongoing to address implementation and adoption of UDI across the healthcare industry.
- Corporate Governance and the Adoption and Diffusion of Health Information Technology within Integrated Delivery Systems
Principal Investigator: Michael Furukawa
While several previous studies have found “system affiliation” to be a significant and positive predictor of health information technology (IT) adoption, little is known about the association between corporate governance practices and adoption and diffusion of IT within integrated delivery systems (IDSs). Rooted in agency theory and research in corporate governance, this study examines the relationship between corporate governance practices (centralized decision rights and strategic alignment between business and IT strategy) and IT adoption, standardization, and innovation diffusion within U.S. IDSs. The methodology included Cross-sectional, retrospective analyses using data from the 2011 Health Information and Management Systems Society (HIMSS) Analytics Database on adoption within IDSs (n=485) is used to analyze the association between two corporate governance constructs (centralized decision rights and strategic alignment) and three IT constructs (adoption, standardization, and innovation) within IDSs for clinical and supply-chain IT. Multivariate fractional logit, probit, and negative binomial regressions are applied.
Some of the practical implications of the study include that while IT adoption and standardization are likely to benefit from corporate governance practices within IDSs, innovation is likely to be delayed. Additionally, corporate governance is not one-size-fits all and contingencies are important considerations.
- Supply Chain and Revenue Cycle Integration: Asset Management in the U.S. Hospital Systems.
As healthcare reform continues to place an emphasis on margin management within provider organizations, creating synergy between the supply chain and revenue cycle has increased in importance. In most provider organizations supply chain management (SCM) and revenue cycle operations function in silos, occasionally responding to anecdotal evidence to make improvements in the processes linking the two areas. Hospitals and health care systems that become proficient in managing the revenue environment achieve strategic advantage by reaching their financial goals and assuring a stream of revenues to support their clinical efforts. While the supply chain function has not traditionally been perceived as extending to revenue capture, it is increasingly clear that a linkage between supply chain and those aspects of the hospital that recover money for products used is indispensable for accurate, efficient and consistent cost recovery . This paper and supplemental tool were developed through literature reviews of research pertaining to revenue management, and interviews conducted with three health care systems that vary in size, mission, technology implementation, and efforts to achieve integration of supply chain and revenue cycle operations. While it is clear that technology applications are indispensable to successfully manage “supplies as assets” from point of order to recovery of funds, it is increasingly clear that an organization’s comprehensive intent to strategically manage its supply chain, as a flow of materials, information and funds, is indispensable to success.
- Value for Money: Supply Chain Strategies and Potential Contributions.
As the US health care system is challenged by changes brought about by health care reform and the difficult economic climate, achievement of “Value for Money (VFM)” has become an increasingly important concept depicting a health care system that seeks to achieve maximum benefit and quality for the funds it expends for both clinical and administrative services. This white paper, based on the 2011 Dissemination Conference HSRC-ASU, discusses seven factors pertaining to achieving value for money. The importance of both vertical and horizontal collaboration is stressed across health care providers, suppliers and intermediaries in achieving savings as well as improved clinical outcomes.
- Repositioning Supply Chain in the Health Care System. The paper contributes to the growing awareness of the importance of strategically managing the supply chain function and building a competent and capable supply chain management workforce. The paper reports on interviews with fourteen senior supply chain managers and 7 senior system leaders regarding the repositioning of supply chain into the executive suite of their systems. Key aspects of this repositioning include recognition and validation of repositioning by outside advisors, the touting and dissemination of the value of the supply chain function by senior system leadership, and system readiness for such repositioning. Also discussed are the principal attributes associated with the new breed of supply chain leaders. Included are their attainment of advanced education in business and supply chain management and their considerable skills in relationship management with internal and external channel partners such as group purchasing organizations and distributors.
- Physician Preference Item Management (PPIM). This research evaluated innovative strategies utilized at hospital systems for their management of physician preference items. During the 2008 HSRC-ASU Dissemination Conference, representatives of these identified hospital systems, consortium board members and guests, and other leading experts were brought together for a day-long conference to share strategy, discuss best practices for PPIM, and provide a platform for conceptualization of a cross-disciplinary clinical strategic sourcing center model for PPIM. In follow-up of this conference, a white paper was developed and disseminated.
- Hospital-Physician Gainsharing in Cardiology. This was the first rigorous analysis of the value that gainsharing brings to the health sector as a strategy to align hospital and physicians via incentives for standardization, process improvement and efficiency. The research was published in Health Affairs in 2008.
- Centralization of the Supply Chain Function. A case study and consultation on centralization of supply chain function was carried out in conjunction with Catholic Health Initiatives. "Alignment of CHI Materials Management Leaders" was presented at the International Research Study of Public Procurement, 3rd Workshop, Paris, France, in September 2007.
- Strategic Sourcing & Outsourcing Practices. This project targeted best practices in strategic sourcing and outsourcing from non-health care industries for adoption in health care organizations.
- Supply Metrics. The HSRC-ASU provided the research funding for the genesis of SCMetrixTM, a benchmarking and performance measurement tool. SCMetrixTM was subsequently spun-off and is now a joint venture between Arizona State University and the Association for Health Care Resources and Materials Managers.