Brian Shoenfeld, BSME, MEng, Senior Vice President, Talon
Brian joined Talon in 2014 to bring his experience with product development, systems engineering, and continuous improvement to healthcare. He’s been in both staff and leadership positions in the defense and manufacturing industries. Brian is a lifelong learner who encourages questions and comments. You may contact Brian at email@example.com.
(VAMag) How did you get involved in the healthcare supply value chain?
Brian: On the surface, Talon is a medication management equipment vendor, which has given us the privilege of being exposed to a wide variety of hospital operating models. This experience has shown us that the impact of our products goes beyond product function and life-cycle costs. Over time, we evolved toward an inevitable alignment with the healthcare supply value chain, which caused a necessary shift for the Talon team to position themselves as trusted advisors first, equipment vendors second.
During this journey toward alignment with the healthcare supply value chain, we became a student of Lean to ensure we are recommending solutions that are best for the hospital instead of what’s best for a single stakeholder at the expense of another. For example, one product we were selling for years optimizes pharmacy operations, but it became apparent that this workflow directly contributed to nurses spending less time at the bedside and more time at the medication room. At the time, we were only collaborating with pharmacy directors, but we now know that downstream departments can also be affected and that we need to understand the impact to those stakeholders as well.
Lean emphasizes that value is defined by the customer (external or internal), the importance of discipline around continuous improvement, and focus on the overall effectiveness of each value stream. While we are new to the healthcare supply value chain community, there seems to be similarities between Value Analysis and Lean principles.
(VAMag) How do you see the clinical medical equipment world evolving in the current healthcare environment?
As hospitals become more aligned with Lean and Value Analysis principles, they will apply pressure on vendors to address product life-cycle and process deficiencies associated with clinical medical equipment. Hospitals will demand flexibility from vendors to the effect that equipment evolves in conjunction with clinical value stream improvement initiatives.
As a parallel example in the blood donation industry, phlebotomists at Gulf Coast Regional Blood Center were spending a significant amount of time manually moving protective cases, which contained equipment and supplies, from box trucks into buildings where they were hosting blood drives. The blood center decided to evaluate this process to see if high labor costs and workers compensation claims could be reduced. They realized that if they had the warehouse stock equipment and supplies in mobile storage carts, then their phlebotomists wouldn’t have to manually carry, unpack, and repack the heavy and bulky protective cases. There was no product on the market available that met their specific needs, so they collaborated with Talon to modify an existing medical cart design. As a result, this solution saved 74.5 minutes of setup and teardown time per blood drive, while virtually eliminating workers compensation claims. By evaluating a deficiency in the process (phlebotomists manually carrying and unpacking protective cases) and measuring the impact from a small pilot with carts, they were able to make an educated procurement decision about the value of current equipment (protective cases) versus alternatives (mobile storage carts).
Similar situations will arise in hospitals as value stream analysis and process improvement become more ingrained in organizational cultures.
(VAMag) The key facilitators of value analysis in the healthcare supply chain are the Value Analysis Coordinators, Directors, and Managers. Why should they take an interest in clinical medical equipment.
To fully comprehend the value of clinical medical equipment, it is imperative to know the functional impact to all affected stakeholders. This includes downstream stakeholders whose processes are affected by the equipment.
Returning to the pharmacy & nursing medication chain-of-custody example from earlier, nursing is a downstream stakeholder (pharmacy’s internal customer) who is impacted by a pharmacy director’s decision to buy equipment that works best for pharmacy. When the buying decision for equipment is made, the pharmacy director might not be thinking about nurses who line up at the automated medication dispensing cabinet at 9AM every morning waiting for their turn to dispense medications, and nurses might not think about there being any other way to get medications to the patient. Additionally, the pharmacy director might not think about nursing’s need to increase Direct Care Time at the patient’s bedside, yet they could make an equipment decision that directly results in nurses saving >10% of their time retrieving medications. The function and true value of medication cabinets and carts is not fully understood if evaluated from a pharmacy perspective without considering the downstream impact to nursing. This mindset is especially important for cross-departmental workflows.
(VAMag) Where do you see the key value points in clinical medical equipment today that value analysis professionals should be focusing on to gain the cost, quality, and outcomes advantage?
The key value points in clinical medical equipment are the functional requirements, as defined by the system or process, and the product’s total cost over time (non-recurring and recurring).
Does the equipment meet all functional requirements? Does the equipment offer more functions than required (i.e., buying a jetboat when a rowboat is sufficient)? What is the expected life of the product? What is the expected recurring cost for service contracts and maintenance? Does the vendor prevent flexibility by requiring a minimum term length in the contract?
There will always be premium and budget options for equipment, so it’s important to balance the functional needs of the application with cost to achieve the best value.