Meet 3 men and 3 women circumventing the supply chain status quo

But it can be a challenge to peg a maverick in healthcare, an industry stereotyped for being risk-averse, with the supply chain management segment largely toeing the line. However, that didn’t thwart Healthcare Purchasing News from searching for those beacons of independent, non-conformist thinking.

We asked readers to nominate colleagues, competitors, customers, peers and supervisors by answering the following questions:

1. What makes this person a maverick – his or her overall philosophy and thinking or something he or she did?

2. What was it they did that was so innovative?

3. How did their colleagues, superiors, customers and facility react?

From the list of nominations, we selected six to profile. Following are those six in alphabetical order by last name. What they say, do and have done may be controversial. They may surprise you. They may inspire you. Read on to know them through this ever-so-brief glimpse into their worlds.

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Colleen Adrian, R.N., Director, Materials Management, Trinity Medical Center, Rock Island, IL

In theater circles, breaking the fourth wall indicates when the actors and players move their performance off the stage and into the audience, engaging them as part of the production.

Colleen Adrian, R.N., like a growing number of forward-thinking supply chain managers, is applying that concept to healthcare facilities with contract administrator positions. The noteworthy difference? She was doing it a decade ago before it became operationally fashionable.

Adrian placed contract administrators in all key clinical departments who are responsible for contracting, inventory management and customer support, essentially granting these areas an active materials management presence. Such a dedicated strategy and tactic far exceeded calls for materials management merely to reach out to the operating room and recruit clinicians to participate in cost savings and consumption management initiatives.

What helped was Adrian’s clinical background because she clearly understood the needs of the OR and other clinical departments, contributing to her credibility once she migrated from her peers to the business side.

Pivotal maverick moment: The pivotal moment that started my official supply management career was during the consolidation of two acute care hospitals when I was approached by Afshin Fatholahi, director of materials management at Genesis Health System, Davenport, IA, to be the Purchasing Manager of the new organization. My responsibilities included centralizing the purchasing function, managing the supply contracts and consolidating central processing.

Claim to fame: My claim to fame is my 20 years of operating room experience and the impact it has on managing the supply chain process. As a result of the positive influence, I integrated experienced clinicians into the role of contract specialists responsible for their area of expertise, OR, cath lab, clinical nursing, but reporting to materials. Skilled clinicians make for ‘better’ materials specialists because they have credibility with the nursing staff and physicians. They can ‘talk the talk.’

Unlikely source of inspiration: And that would be a very close friend who is the ultimate risk taker in all aspects of her life. She is wild and crazy. She taught me to ask, ‘What is the worst that can happen? If you can accept that, then do it.’

Biggest influence: This can be summed up in the word: Boss. I have learned from the best of them! From the first one to the latest!

Two adjectives to describe yourself that also could be applied to a medical device: Innovative, reliable

Your closest brush with career immolation: This would have been when I was with a former director and we challenged the CFO and CEO in front of the GPO. The details associated with this encounter remain sensitive. We were surprised to discover that privileged information, that we had obtained, had been sent to the GPO. The GPO then used this information to build its ‘case.’

A project that turned out differently than you thought it would: I attempted to put a networking group together with peers across other organizations within my network, in the hopes to share operational benchmarks, supply management processes, FTEs, staffing patterns, new ideas, etc. The effort was one that was not received in the manner I had intended, and it never made it to fruition.

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Brooke Berson, R.N., Director, Clinical Resource Management, Procurement & Supply Chain Management, Duke University/Duke University Health System, Durham, NC

Back in February 2000, Brooke Berson, R.N., decided to take a chance and become the first clinical professional hired in purchasing at Duke University Health System, specializing in value analysis. Her position was so new, in fact, she was asked to define it for herself.

Berson began researching value analysis in a variety of clinical and trade publications. Admittedly, she found it relatively easy to reach out to some of the other professionals in similar positions featured in the articles. So she would call them. Those calls would become so routine that she set up an e-mail exchange/listserv to continue the discussions about value analysis.

After three years, some in the listserv started thinking about taking these meetings to the next level. What started as a group of six morphed into a grass roots effort of more than 100 participants. By the fall of 2003, a steering committee was formed, along with the structure and bylaws that codified the mission and purpose of this new organization, the Association of Healthcare Value Analysis Professionals (AHVAP).

From there, AHVAP grew to nearly 300 clinicians and professionals involved in the procurement and management of supplies and equipment.

Berson, who served as the charter president, defers the credit of AHVAP’s founding and successful launch, as well as its ongoing growth.

"This took off because of the forward-thinking people in the group," Berson said. "Who knew there was a need?" With the growing trend of nurses being recruited into materials management, along with heightened interest in value analysis during a steady stream of budgetary belt tightening, someone with the foresight to spot a confluence of events and earn a spot in the annals of healthcare supply chain management history by helping to create a new association.

Pivotal maverick moment: I quickly understood shortly after being hired in purchasing how little I knew about value analysis and all of the tenets of utilization and cost savings. Necessity dictated that I reach out to other clinicians in purchasing and materials management to ensure my success in my new role! The small group grew and AHVAP was born about 1.5 years later.

Claim to fame: Humbled by winning the Presidential Award at Duke for my work on recalls, which served to validate that the organization I work for values clinical individuals like me who are committed to create a safer supply chain for our patients.

Unlikely source of inspiration: Absolutely a blank page for a job description!

Biggest influence: Many of the wonderful people I’ve met through AHVAP who have maintained professionalism, humor and who have been teachers to me in an endless learning environment. As hokey as it sounds, my boss is also an inspiration as she has been a terrific and supportive mentor.

Two adjectives to describe yourself that also could be applied to a medical device: Innovative and always working!

Your closest brush with career immolation: Still searching Friday at midnight and finding a recalled contaminated tissue that was scheduled to be implanted the next day.

A project that turned out differently than you thought it would: We redesigned our recall system and at my boss’ suggestion, centralized and took accountability for the leadership and oversight. This design and infrastructure, while unique to Duke, has become a best practice in the healthcare industry.

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Denyce Campo, C.P.M., Director, Supply Chain Management, Legacy Health System, Portland, OR

Denyce Campo, C.P.M., a Vietnam-era veteran of the United States Air Force, simply wasn’t content with the status quo and traditional ways of managing the supply chain when she entered the healthcare industry from the high technology manufacturing sector.

Instead, she brought along some non-traditional approaches from outside the industry to integrate different perspectives into healthcare. That included hiring a quality engineer to oversee the technical side of equipment issues and recruiting buyers with non-healthcare backgrounds.

Because the competition and margin pressure in technology companies can be extreme, the supply chain and spend management processes tend to be more advanced and developed to handle the constant financial pressure. Such a philosophy, typically foreign to healthcare organizations didn’t win her friends overnight. In fact, some accepted and embraced the new ways of thinking while others resented and resisted the changes. Still, Campo’s department earned some well-deserved recognition and respect within Legacy Health System.

Pivotal maverick moment: I declared my intent to terminate a committed contract on a sole-sourced product based on statistically supported quality issues without first having another source identified. Based on the strength of our data, we successfully engaged the supplier for support during our search, selection and transition period.

Claim to fame: Creating an internal Supply Chain Quality Assurance function modeled after those used in high technology manufacturing and incorporating technical product assessments and comprehensive on site manufacturing process audits into our product and supplier selection process. In addition this function acts as the system wide product quality champion by performing root cause failure analysis on failed products and provides that data to the engineering and quality departments of our supplier organizations – some of which resulted in actual product design changes that ultimately benefited the entire industry.

Unlikely source of inspiration: My first walk through the NICU

Biggest influence: My Air Force experience, quality gurus such as Joseph Juran and W. Edwards Deming and Susan Jorgensen, a most excellent nurse who not only embraced the new concepts I introduced but who taught me so much of what I needed to know to apply it successfully in healthcare.

Two adjectives to describe yourself that also could be applied to a medical device: Trustworthy, revolutionary

Your closest brush with career immolation: I have had several, and they all involve staking my job on doing and expecting the right thing from a quality, cost and service standpoint. Although we have had to make some difficult contractual and operational decisions as a result, I am very proud that my employer shares my passion, so thankfully I am still employed.

A project that turned out differently than you thought it would: I would have to say the project that turned out differently than I thought was the early re-engineering and reorganization of the supply chain department to incorporate long-standing and proven quality, contracting and supply chain management techniques from outside the industry. What I didn’t expect was the extent to which Legacy Health System employees would embrace this way of doing business and help me raise the bar twice as high as I thought possible.

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Fred Crans, Area Vice President, North, ECRI Institute, Plymouth Meeting, PA

Aside from beingthe author of HPN’s popular "Baseline" column, where he reflects on his career to date, sharing observations of the
industry and the personalities that drive it with verve and wit, Fred Crans has never looked at failure in the eyes with dread or success in the eyes with envy.

In fact, Crans chose to leave three "very good jobs" in his career because those organizations either lacked leadership, lacked quality leadership or lacked integrity that matched his own. Still, since the 1970s, Crans has left his imprint at six healthcare organizations, implementing a variety of concepts and programs that preceded the curve. Those included activating perpetual inventories for key clinical departments, such as the operating room and cardiac cath lab, distinguishing between official inventory numbers on the balance sheet from monthly expenses in the operating budget; developing a dedicated materials management information system administrator post; and putting into practice low-unit of measure for supply distribution, linen management, value analysis and procedure-based patient charging.

Crans contends that a true maverick "combines the vision of a Leonardo
da Vinci (to see the possibilities), the daring and courage of a Charles Lindbergh (to face the void and the possibility of failure), the romantic loyalty to a cause of Don Quixote de la Mancha, the desire to be in the fray as portrayed by Teddy Roosevelt, and the commitment of Davey Crockett.

"Real mavericks are called such because they don’t bend to the normal bell curve," Crans indicated. "They are often ridiculed and despised by their ‘peers.’ The mavericks are the folks who do what is right for themselves simply because it is right. They seek no fame or glory and seldom attain the coveted positions because they are not political animals.

"But ask them their opinion and you’ll get it straight and hard," he continued. "Ask them to fight with you and they will be there till their final breath. And when you take pause to think of them, you will always find a slight smile creeping across your lips."

Pivotal maverick moment: When I confronted the medical director of radiology at Baptist Hospital of Miami about service levels in patient transportation at the patient care committee meeting — telling him that (1) he was wrong about service levels and (2) since he had not deemed it appropriate to communicate directly to me about his issues (but instead, chose to talk only to the CEO), I didn’t feel he had any issues that I should be concerned about. The CEO supported me and directed the medical director to speak with me directly. We solved his issues quickly after that.

Claim to fame: Telling truth to power.

Unlikely source of inspiration: Davey Crockett: ‘If you think you’re right, go ahead.’

Biggest influence: Charles E. Housley

Two adjectives to describe yourself that also could be applied to a medical device: Dependable and controversial

Your closest brush with career immolation: When I told a system CEO that he was wrong three times during a single meeting — in front of senior leadership and representatives of an outside organization. In retrospect, I am amazed that nothing happened from it.

A project that turned out differently than you thought it would: Reorganization of the supply function at Timken Mercy in Canton, Ohio in 1986-88. Due to poor fiscal performance, the hospital mandated a cut in FTEs. By judicious planning and retraining, the operation was pared down by 25 percent with an increase in performance and customer satisfaction. Several people within the department acquired new skills and positions they never would have imagined themselves ready for — and we did it simply by retraining when someone left and ‘giving up’ open FTEs. In fact, we opened up the possibility thinking to such an extent that one of the senior buyers — Deb McCarty — and the Director — Brian Conklin — are both people who survived those difficult days.

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Randall Sparkman, Chief Information and Technology Officer, MedAssets Inc., Senior VP, MedAssets Supply Chain Systems, Cape Girardeau, MO

The computer whiz kids who conjured up Google and Yahoo may have garnered billions of dollars in revenue, millions in profits and scads of seemingly endless media publicity, but they weren’t so revolutionary as to qualify being classified as "the first." A piece of that honor is owned by someone who has flown under the techie radar for more than a decade. And he’s in healthcare.

Arguably, one of their forerunners staked his claim in healthcare all the way back to February 1992, barely a year after the World Wide Web debuted, granting Internet access to average joes without military or post-graduate education experience.

Thanks to the creative mind of Randy Sparkman, the group purchasing organization Health Services Corporation of America found a way to eliminate those thick three-ringed binders, crammed with GPO contractual and product information. HSCA’s CDQuick reduced those stacks to a compact disk that was updated monthly and mailed out to members. The CD catalog would open the flood gates to electronic order entry and redefine GPO operations.

By the late 1990s, Sparkman had built a powerful search engine that could automatically peruse complex data in less than a tenth of a second.

Sparkman and his efforts earned the watchful eye of MedAssets founder and CEO John Bardis. Calling Sparkman a "brilliant individual," Bardis cited his creations as one of the reasons MedAssets acquired HSCA. "I kid him all the time because he built one of the first search engines in the world," Bardis told HPN. "I said, ‘you’re really smart but if you were that smart you’d be a billionaire.’" In fact, Bardis said that he was thankful no one had really connected and understood what Sparkman had developed before he met him.

Pivotal maverick moment: Wanting to find ways to help providers better manage their supply contracts and wanting my IT department to contribute to the success of the company rather than simply be a cost center, led me to look for opportunities to improve processes through software. I recognized that there had to be a better alternative than binders and microfiche for our GPO to provide supply contract information to customers so the idea of CDQuick was born. CDQuick provides all contract information in a searchable format and even helps organizations manage our customers’ custom contracts. It’s helped MedAssets offer flexibility and ease of access to information to customers and has been a key differentiator for us.

Claim to fame: For CDQuick, I developed a search engine to help customers find the line items they needed because there was no workable technology available at the time to quickly search. This search engine development was pre-Google and Yahoo. So my claim to fame…I developed a search engine before those guys.

Unlikely source of inspiration: For me there is no thrill like developing software – I love creating leading edge systems, showing it to people, and watching their reaction.

Biggest influence: Working with the people at MedAssets has been a tremendous experience and has exposed me to really smart, innovative people. I feel privileged to work with the entire MedAssets management team, particularly John Bardis and Rand Ballard.

Two adjectives to describe yourself that also could be applied to a medical device: Precise and high quality. Medical devices must be precise in their functioning to improve a person’s quality of life. Developing software also requires precision and attention to detail to ensure it improves processes.

Your closest brush with career immolation: In 1989 I was offered the lead IT position with HSCA, now [part of] MedAssets. I passed on the offer repeatedly before finally accepting. Given the experiences I have had during my 19-year career with MedAssets, it would have been a huge mistake to have not accepted.

A project that turned out differently than you thought it would: I was part of the team that helped develop Crosswalk, a solution that links the supply chain to the revenue cycle. This is something that has never been done before, and it has been very interesting to watch how it changes the way our Crosswalk customers work and think about charging for supplies.

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David Zimba, Vice President, Corporate Contracting, West Penn Allegheny Health System, Pittsburgh, PA

David Zimba may have gained industry recognition and professional prestige for having implemented the "grocery store" merchandising model in healthcare supply chain management, but his maverick nature extends well beyond that.

HPN named him one of the "20 Healthcare Supply Chain Influencers to Watch" (July 2007) largely for upending the fundamentals of basic contracting and purchasing. In fact, his efforts were key contributors to the massive financial turnaround of his organization.

Zimba introduced a plethora of strategic sourcing initiatives and information technology-driven practices to gain control over supply chain operations, and to a certain extent, the buying process in vendor relations. He was one of the early adopters and passionate implementers of online reverse auctions at a time when healthcare providers, cynical and skeptical about online-motivated process improvements over profits, were turning sour on the Internet.

Pivotal maverick moment: In the supply chain, a few come to mind. Announcing in January 2001 to a senior leadership team of a Fortune 20 company that our health system was going to pursue a grocery-store model of supply distribution and replenishment and we would earn shelf-fees to do it, or in spite of significant industry resistance, convincing our chairman of orthopedics to utilize electronic sourcing to procure orthopedic supplies.

Claim to fame: Actually making the grocery-store model work as anticipated despite both internal and external pessimism. Proving that reverse auctions can work in healthcare and watching them bring almost $0.5 billion in savings.

Unlikely source of inspiration: My mother, Betty Zimba. When I was younger I would always try to convince her to let me do something by saying ‘everyone was doing it.’ In reply she often asked in a very forceful way, ‘if that’s so, what if all your friends were going to jump off a bridge, are you going to do that too?’ I guess I have since used that experience to question why everyone was doing it, doing it that way, and instead challenge the status quo.

Biggest influence: My high school wrestling coach, Leo Johnson. I learned several life lessons from him: Every individual has a higher responsibility to a team, you learn the most from your mistakes and that in order to learn you have to risk making a mistake, and that maintaining excellence is much harder than achieving excellence.

Two adjectives to describe yourself that also could be applied to a medical device: Resilient and durable

Your closest brush with career immolation: I have had too many that it makes my wife Patty, cringe. My personal analogy is that I am a lot like bad-tasting medicine. My supporters suffer through it, others just simply puke. As I was leaving Arthur Andersen to join WPAHS, a former partner said, ‘it’s not you, it’s the medicine.’ I carry on believing he really meant it.