Friday, October 13, 2017
Friday, September 29, 2017
Animal Services & Welfare Community Development
Dental Services & Care
Disability & Low Income Services Educational Programs
Homeless Support Services
Maternal Health & Infant Care
Medical Clinics & Hospitals
To improve the delivery of healthcare worldwide by gathering, processing and distributing surplus medical and health supplies to charities at home and abroad.
Doctor Nathan Kwablah is one of these school-trained doctors. Born in Ghana, he left his native land to pursue a degree in medicine from St. George’s University in Grenada. He is now a medical officer practicing in Accra, Ghana’s capital city. He has a great love for Ghana and desires to be involved in its development, medically and otherwise. In addition to his career pursuits, Dr. Kwablah is the president of XTAN Medical Aid, a Christian medical mission non-profit that provides care in rural areas of Ghana where it is needed most. Using gloves and other items obtained from Globus Relief on a regular basis, Dr. Kwablah and his associates provide medical and dental care through their rural outreach programs. Excess items are donated by XTAN to needy local medical institutions. Dr. Kwablah is an apt demonstration that even just one man, or one donation, can make a difference.
Monday, September 25, 2017
The Joint Commission’s recently published study on how no industry consensus exists on what a “high-performing” healthcare delivery system means induces laborious thoughts of a Christopher Nolan film.
Standards and standard definitions remain incognito.
Evaluating, adopting and implementing potential solutions to this leaves many with insomnia.
Regulating, governing and discerning bodies remain incorrigibly incommunicado.
It should leave us with some sense of indignation.
Is there an exception? Only in your MMIS or ERP Supply Chain module field codes.
We really need an inception.
The Joint Commission’s review of a decade’s worth of literature (2005-2015 to be precise) found no consistent definition of the “high-performing” nebulous and non-descript epaulet when applied to such dimensions as cost, quality, access, equity and patient experience and safety or any combination.
No evidence apparently shielded it from variability.
The Joint Commission deserves accolades for shining a black light on this white sheet of branding, marketing and promotional hubris — even if many of us suspected unbridled hyperbole with a Dwayne Johnson eyebrow raise.
What’s the first step in those 12-step programs? Admit you have a problem.
But “high-performing” as a jingoistic appellation isn’t the only fuzzy ingredient in our fizzy water.
In an industry that prides itself in pursuing the need for standards, the players could strive to accept and adopt standard definitions and parameters in a variety of areas.
To wit: Here are a few that have haunted readers of Healthcare Purchasing News for at least four decades (had to work in a shameless plug for HPN’s 40th anniversary this year).
- Annual purchasing volume (APV) of group purchasing organizations (GPOs)
- Descriptions and descriptive categories of product attributes for more efficient comparison (branding differentiators can be customer service)
- Validated instructions for use (IFU) for effective sterile processing of devices
- CPT and ICD-10 codes that allow very little or virtually no level of human interpretation rooted in subjectivity (thwarting the “gaming of the system” to maximize reimbursement)
- Key performance indicators
- Functional job descriptions for Supply Chain professionals — even the ones hovering around vaporous strategic objectives
- Causal factors of a variety of hospital-acquired infections with reasonably detailed traceability factors
- Total cost of ownership
- Value-based purchasing — centered on the application of insurance
- Value analysis and management via evidence-based planning and outcomes
Back in the Clintonian healthcare reforming 1990s, doctors bristled at the notion of clinical pathways as “cookbook medicine” because it left virtually no room for variability and the individuality of the patient. Noted. You should find little motivation to dismantle the logic behind the need for standard definitions for financial management and operations. Call it “cookbook management and operations” if you want, but that measure should lead to effectiveness and hopefully efficiency down the road, which should trump complaints long-term.
Which ones have we missed? Let me know at email@example.com.
Rick Dana Barlow
Tuesday, September 5, 2017
Thursday, August 24, 2017
Presence debuted in November 2011 from the merger of Resurrection Health Care and Provena Health. At that time, Resurrection had been a member of Premier Inc. for a decade. Five months later, Presence decided to renew with Premier and join Premier’s Catholic Contracting Group (CCG), which formed in 2005 around committed supply and service contracts involving $2.4 billion in annual purchasing volume at that time.
By joining Ascension, which is fusing Presence with its AMITA Health unit, Presence likely will shift its purchasing volume over time to Ascension’s own group purchasing organization The Resource Group. AMITA Health represents a Chicago-based joint venture between Ascension’s Alexian Brothers Health System and Adventist Midwest Health.
With the deal reported in a variety of media outlets, including Healthcare Purchasing News’ online Daily Update, HPN Senior Editor Rick Dana Barlow asked for general market insights from Munzoor Shaikh, Director, West Monroe’s healthcare practice.
HPN: Will Presence Health as a brand name go away, replaced by AMITA Health branding? Or will there be some kind of co-branding?
SHAIKH: It’s not clear whether Presence Health will take on the AMITA branding yet, though this will likely be answered as the deal closes. More broadly, adding Presence to the AMITA Health joint venture should allow Presence to take advantage of investments that AMITA has already made in back-office operations (e.g., technology), which would allow Presence to improve their balance sheet.
A joint venture versus a stock deal avoids the complex regulatory process, which could drag out for 18+ months. This allows providers and employees to focus on providing care versus wondering about the future of the organization. Presence has been busy with M&A activity and is already dealing with divesting two hospitals in Illinois. There will be a lot of complexity in Presence’s operations over the next several years as they untangle one set of units and integrate into another organization.
What about operational redundancies, in terms of Supply Chain? Or is it too early to talk about centralization and standardization efforts? I presume Presence facilities will be using Ascension’s GPO The Resource Group? What changes can we anticipate?
This is another acquisition in a long spree of acquisitions for Ascension, showing that Ascension is committed to size. However, like most hospitals, efficiency isn’t the top priority. In fact, efficiency can worsen due to size. Narrow integration of Presence Senior Care unit is interesting. This could potentially lead to accumulating dis-synergies. Ascension already faces – like many hospital systems – a proliferation of applications doing the same thing. Such dis-synergies can become a taxing problem for current and future acquisitions. This has an interesting impact on the Chicago and North Indiana hospital markets. Several others could be a target for absorption, especially if they exist in semi-remote markets, align on mission with the Catholic system or struggle to obtain favorable networks via the payers.
How do you see Ascension’s larger AMITA presence competing and faring with other systems in the Chicago metropolitan area, including Advocate, Northwestern, Rush and University of Chicago Medicine?
The acquisition of Presence’s 12 hospitals should be a good fit for Ascension as it seeks to advance the AMITA Health partnership and gain more ground in Illinois. Presence (formerly Resurrection) was the largest Catholic health system in the state, and this acquisition solidifies Ascension as the Catholic health leader in the state. Ascension brings profitability and scale to Presence. Their footprints complement each other with Presence mostly covering Chicago locations (plus downstate) and Ascension/AMITA having a mostly suburban footprint. The expansive footprint for Chicagoans who often work/live in both the city and suburbs could give them a leg up on other systems in the area that focus on either the city or the suburbs, such as University of Chicago Medicine and Northwestern. Ascension’s city/suburb approach helps them compete better with Advocate, which takes a similar approach, but they’ll need to invest in infrastructure and technology upgrades in Presence locations to do so.
How do you see this deal impacting Ascension’s efficiency and day-to-day operations, as well as AMITA’s, and the Illinois hospital market in general?
After this deal, Chicago hospitals should pay heed to being acquired – unless that is their desire – and build unique market presence around quality, patient experience or superior ability to conduct value-based care if they want to maintain their independence. Hospitals’ challenges in today’s world become how to have their mission inform competitive strength in a pragmatic way. For example, if the community is a large constituent of your mission, you could subsidize community efforts with profits from other business lines. However, that is becoming a more and more challenging route. More practically, you need to have mission be combined with innovation, such as working with the community in innovating care delivery models, such as mobile health, and social determinants of health that are empirically driven, etc.