Cancer treatment center director shares insights on supply chain patterns

But with oncology, imaging, IT and surgery all starting to converge in hospital and outpatient surgical, imaging and oncology suites, it only makes sense for supply chain managers to be exposed to insights and strategies on equipment evaluation and acquisition in these clinical areas – particularly in the outpatient side, which tends to be heavily clinician-driven.

Healthcare Purchasing News Senior Editor Rick Dana Barlow recently chatted with Karen McGraner, director of Memphis, TN-based Baptist Centers for Cancer Care’s Radiation Oncology Center (BCCC ROC), about her award-winning facility’s equipment acquisition patterns and professional relationship with supply chain management as a department (albeit a freestanding facility) of Baptist Memorial Health Care Corp.

McGraner: The motivation and strategy exists beyond our facility. We have multiple radiation oncology departments within our organization. The strategic planning accomplished by all teams adds benefits not only to a single department but also to others. When Diagnostic Radiology evaluated the needs of a new PET CT, radiation oncology team members participated in the evaluation. We requested the addition of respiratory gating, laser positioning systems, and an indexed couch top. We work well with the MRI, CT, and PET CT teams when our physicians order diagnostic tests, as the imaging will later be used for treatment planning purposes. Our medical physicists and technical team work to ensure accurate positioning, scanning geometry.

Another hospital within our organization will be soon installing a [Varian Medical Systems] Trilogy and duplicate the integrated environment that we currently use. As an organization we understand the difficulty in recruiting highly skilled/knowledge workers, such as medical physicists and dosimetrists. We hope that with integration of equipment across our system remote dosimetry will now be an option/solution for future staffing challenges and for patients moving across our system.

Consistency of equipment and programs throughout our organization allows for cost savings benefits when negotiating not only capital contracts, but also support contracts. Consistency of equipment and software programs throughout our organization allows for secure access of necessary patient data for patients transferring between our hospitals. Consistency of equipment and software programs throughout our organization allows for teams throughout our System such as contracts, information, and facilities to have experience with purchasing decisions, implementation, and ongoing support.

Our organization is committed to providing quality and excellence in healthcare, which is congruent with our mission. We would have to say that we choose "Best of Breed" when considering equipment. When considering equipment, we first discuss our objectives. It is necessary to define our goals and the needs of the internal and external customers we serve. We review the functionality of the individual equipment, whether it is accelerators or treatment planning systems. The clinical teams then review the objectives and functionality for their respective needs.

The radiation oncologists and radiation oncology team is fortunate to work in tandem with a committed procurement team, information systems team, and diagnostic teams. Our Capital and IT Contracting Group – Supply Chain Operations team works to analyze market analysis and GPO pricing as we negotiate our contracts. We work with vendors who become not just ‘vendors,’ but partners with us to provide the best for our patients. It is our strategy to offer the best equipment to care for our patients at the best price.

We have worked with many vendor teams during the last year, from sales, installations, education, consulting and applications teams. We have experienced a true partnership in every sense of the word. All too often after the sale has been made and long after the applications teams have gone, no one touches base with you.

Our organization prides itself on creating partnerships with vendors who support our mission and vision and continue to be engaged with us for the long run. In this day of competition, our patients have knowledge and can often choose where they will seek care. Also in this day of declining reimbursement and economy, we seek the same knowledge and seek to work with those who will provide us with leading-edge technology and an ongoing partnership. Whether it is a sales division or support division that we have had the need to communicate with, they have done so willingly and have been responsive to meet our needs. Our experience with moving to a single vendor’s integrated solution – Varian Medical Systems, has been exceptional and has been seamless.

We also considered the multi-vendor environment. As vendors release new or updated equipment or software systems, there are ongoing connectivity and associated expenses.

The decision to move to a single vendor and integrated environment provided benefit beyond quality, but also inherent operational efficiencies. We removed import and export of critical data used in the planning and treatment of our patients across the multi-vendor environment. We were committed to provide quality, safety and accuracy. By removing redundancies, manual entries, import/export of key elements within our systems for planning soon became evident and allowed us to achieve those goals.

BCCC is following our vision and commitment to provide the latest technology to our region to establish a center of excellence in oncology and cancer care. The reputation of our oncology program allows retention of our referral source. BCCC is committed to looking for new programs to introduce. Our Capital and I.T. Contracting Group [and] Supply Chain Operations team works to analyze market analysis and GPO pricing as we negotiate our contracts. Our Capital and I.T. Contracting Group [and] Supply Chain team is involved with clinical and support staff to negotiate and optimize the contractual agreements to ensure our ROI.

[We have] increased clinical efficiencies with an integrated environment, removed redundant processes, increasing productivity, eliminating waste – approximately 23 percent decrease in total expense – and demonstrated increase in contribution margin and revenue.

Ongoing reviews of our records are completed to ensure accurate documentation and appropriate medical necessity for services are well documented. Such reviews are in tandem with our financial reviews. Electronic forms for patient assessments, patient education, weekly treatment, simulations, brachytherapy, physics, medication, and patient discharge have been customized in our EMR. Our customization has allowed us to populate key data fields into our dynamic documents to experience increased operational efficiencies, increased productivity, and consistent method of information in all of our electronic documents.

With the implementation of ARIA [Varian’s EMR system], its design provides review and accountability of all staff for accurate charge capture and review. Staff members now have increased understanding of the impact of accurate charge entry. Everyone is engaged and accountable. A billing interface/export to our hospital’s billing system has been introduced with added efficiencies as well.

We analyze comparative pricing on MD Buyline with Novation as our GPO and Sysco distributing our supplies.