Dr. Jimmy Chung leads the clinical integration for Advantus Health Partners to reduce waste and variability.
By Daniel Beaird
June 2023 – The Journal of Healthcare Contracting
Advantus Health Partners works to ensure clinical validation of key products and services, waste reduction and standardization of major product categories as solutions beyond traditional supply chain GPO management. Launched in 2021 by Cincinnati-based Bon Secours Mercy Health, one of the 20 largest health systems in the U.S., Advantus is led by healthcare professionals and providers with an aim to modernize and create more efficient operations between the supply chain and clinical sides.
Dr. Jimmy Chung is its chief medical officer.
“The big crisis in healthcare is that current spending is unsustainable,” Dr. Chung said. “The U.S. spends twice what similar countries spend on healthcare, and much of that has to do with waste and variability in how we practice in the U.S. and the resources we utilize in supply chain.”
Reducing variability
To help address this crisis, one business model for Advantus reduces the unnecessary variability in clinical care delivery.
As Dr. Chung puts it, if there are 20 different vendors for orthopedic implants at a hospital, then that’s 20 different ways of doing the surgery, and that leads to mistakes and errors that could harm the patient, while creating operational inefficiency and waste.
He has studied data over the past 10 years that suggests there are opportunities to standardize healthcare purchasing to reduce this variability, and patient risk and supply chain can become a strategic driver in it, playing a critical role in patient outcomes.
Advantus delivers products that have been vetted for quality and value, but physician preference isn’t a part of the equation. Clear expectations are set with physicians that their feedback will be used when procuring products, but not on a preference basis.
“We don’t have 20 different brands we’re offering through our contracting or GPO portfolio,” Dr. Chung said. “We want to vet what we believe delivers the highest value in patient outcomes and cost. That’s how we want to engage clinicians into our supply chain model.”
Dr. Chung added that they don’t believe physician preference adds value.
“Variability should only be accepted in cases where a necessary need must be considered like a unique patient or research,” he said. “A true clinical need has to be demonstrated before we go off contract.”
Standardization tools in supply chain operations
Dr. Chung says health systems are steering conversations more toward standardization and best patient outcomes. But supply chains still struggle to be heard as strategic drivers in a lot of hospitals.
“We’re thankful for organizations like AHRMM and SMI that are focusing on reducing waste and variability. There are huge clinical integration components at work with those organizations,” Dr. Chung added. “It’s about spreading the message to hospital executives and C-suites that supply chain needs to be at the table, and in order to do that, it needs to gain legitimacy.”
For example, SMI, a nonprofit community of providers and industry partner organizations, has released a new tool to measure the criticality of products to help create a more resilient supply chain. It’s an enhancement to SMI’s Resilience Maturity Model that was released in 2022.
The Critical Product Attributes Framework provides a common structure and language for healthcare organizations to identify the criticality of products they need in times of crisis. It aims to standardize the process of defining product critically and ultimately aid in providing better patient care. SMI’s Physician Advisory Council provided intelligence and insights included in the tool. The new tool:
- Provides a structure for identifying the criticality of products using a common language.
- Allows trading partners to have clear conversations about product criticality.
- Supports the broad use of the Resilience Maturity Model to drive a more resilient supply chain designed to meet future demands.
Teaming up with physicians
The COVID-19 pandemic brought supply chain to the forefront of healthcare. Physicians never had to worry about allocating masks before the pandemic, for example, but they helped administer protocols and appropriate utilizations for N95 masks during the crisis.
“Hospitals realized that bringing in physicians could be useful for supply chains as a whole, so you see roles like medical director of supply chain becoming more popular,” Dr. Chung said. “Many of the hospitals with strong supply chains now have a medical director or physician advisor in place.”
Those medical directors like Dr. Chung must communicate clearly with physicians about product changes and variability reductions. Most physicians easily adjust, but a small percentage might have genuine concerns.
“They might not be convinced it’s a better product, or they aren’t comfortable with it,” he said. “And there aren’t any incentives for surgeons to seek ways for surgeries to be done the same way.”
Standardization in surgeries would reduce errors and inefficiencies.
“There’s a lot of opportunity in the medical profession to have these conversations, but it’s not happening at that level because physicians aren’t trained in that area,” he said. “We’re still using an apprenticeship type of model. Being unique and doing things your own way is still valued in surgical circles.”
Avoiding unnecessary risks for patients
But patients are at risk for different outcomes if the same surgery is done in different ways. Some will have worse outcomes than others or some might have a longer length of stay. Hospital leadership is seeking better standardizations to solve these problems so outcomes can become more predictable.
“And if physicians aren’t driving that conversation, supply chain can start the dialogue,” Dr. Chung said. “We’re all aligned on the social determinants of health, sustainability, and the current healthcare crisis. Let’s start with that.”
Then, Dr. Chung says, supply chain and physicians can work on a common plane together. Reducing variability, for example, can be done if it’s demonstrated that a pared down number of vendors provide more value to physicians and patients downstream.
“There’s so much variability that it’s impossible for a patient to feel like they’re making an informed decision when they’re facing surgery. They have to put their faith in word of mouth and assume that it will lead to a good outcome,”
Dr. Chung said.