Lana Smith
Corporate director, service lines, Adventist Health, Roseville, Calif.
Adventist Health consists of 19 acute-care hospitals; more than 2,700 beds; more than 220 rural health, physician and outpatient clinics; 14 home care agencies; seven hospice agencies; four joint-venture retirement centers; 20,500 employees, 4,500 medical staff physicians and 3,600 volunteers; more than $3 billion net revenue (2013) and over $419 million supply expenses (2013).
As Adventists Health’s corporate director of service lines, Lana Smith leads clinical initiatives that support Adventist Health’s Care Transformation Model to provide patient-centered, safe, reliable and evidence-based care across the system. With a focus on the orthopedic service line, she works with more than 45 clinicians and 14 orthopedic surgeons to reduce unwanted and unnecessary variability in the care of hip and knee replacement patients, toward a $4.4 million implant and supply cost reduction target.
The Journal of Healthcare Contracting: What has been the most challenging and rewarding project you have been involved in recently?
Lana Smith: In my new role, we have established a link between supply chain and care transformation. Looking at physician preference items, we have identified key physician leaders to drive change, which will transform care of our patients to achieve top-decile performance clinically and financially. With such aggressive targets, it has been apparent that a new approach is needed to achieve sustainable improvements. Working in supply chain for so many years and crossing over to the clinical side, has presented an entire new set of challenges, including examining supply costs and utilization, and ensuring an emphasis on patient experience and quality.
JHC: Please describe a project you look forward to implementing in the next year or two.
Smith: We have recognized that a collegial process is essential to engaging all stakeholders to align with a shared solution. Using two processes for improvement – the Institute for Healthcare Improvement Model for Rapid Change and the GE Change Acceleration Process – we have been successful in bringing together clinicians and surgeons to assist in developing our vision and clinical and financial strategies. Physicians have identified several key milestones: standardized clinical pathways, membership to the American Joint Replacement Registry, Joint Commission Disease-Specific Care Certification and CMS bundled payments. It is exciting to be a leader and part of such transformation within Adventist Health. It channels my expertise as a clinician, and my skills in contracting.
JHC: What is the most important quality you look for in a supplier partner?
Smith: As a long-time member of Premier’s Surgical Services Sourcing Committee, I have been fortunate to gain an increased awareness of contracting. Having gained such knowledge, I strongly believe suppliers must demonstrate vision, commitment and integrity in meeting the needs of the system as we raise the stakes by exposing both opportunity and risk.
JHC: What is the greatest change we can expect to see in healthcare contracting in the next five years?
Smith: Committed to a physician-led model to achieve our goals, we believe that with transparency and reliable data, we can execute contracting strategies based on what physicians and clinicians need to provide the best care at the lowest cost. In the future, I see more clinicians involved in contracting as they bring expertise to the table that speaks to evidence rather than preference. This will require suppliers to understand the system’s goals are not just about price, but also about a balance of quality, cost and value.