Clinical laboratories can play a role in two of these ten cost-cutting opportunities
Everyone in healthcare expects significant across-the-board cuts to reimbursement as healthcare reform moves forward. High profile targets for cost-cutting are imaging technologies and physician preference items (PPIs), which include expensive supplies and implant products, including stents, wires, pacemakers, and knee/hip replacement prosthetics.
Hospitals and health systems, in recognition of this major shift in national health policy, are scrambling to stay ahead of these economic and regulatory pressures. It is causing them to closely scrutinize operational costs and implement cost-cutting measures.
Michael Snow, president/CEO of Kingsport, Tenn.-based Wellmont Health System, said in an interview with Modern Healthcare that physician preference items (PPIs) alone represent 15% to 16% of supply costs for his system’s eight hospitals. That translates to $26 million per year for these items. He says Wellmont will shave $2 million off PPI costs this year by using two strategies. First, clinical effectiveness research (CER) will help ensure the right device is provided to the right patient. Second, more competitive shopping for PPIs will result in lower prices at comparable or better quality.
Stepping in to help hospitals establish priorities for their cost-cutting efforts is the ECRI Institute of Plymouth Meeting, Pennsylvania. This not-for-profit organization pioneered clinical effectiveness research (CER). It recently released a report that identifies and discusses the top 10 technologies hospitals can utilize to reduce costs without sacrificing quality of care. This report also encourages hospital and health system administrators to involve physicians in the process.
The list of top ten technologies for cost reduction in hospitals takes into account the convergence of critical economic, patient safety, reimbursement, and regulatory pressures. In order of importance, and as titled by ECRI:
1) Electronic Medical Records: What Should You Be Doing Now?
2) Ultra-high, Field-Strength MRI and Premium Performance CT: Do You Really Need Them? Now?
3) Physician Preference Items: Do Your Docs Know the Costs?
4) Robotic-Assisted Systems for Surgery and Endovascular Catheterization: How Many Should You Have?
5) Radiation Oncology: Will Proton Centers Fulfill Their Promise?
6) Radio-Frequency Identification Technology: What Problems Can It Really Solve?
7) Alarm Integration Technologies: How Best to Monitor All Those Alarms?
8) Hybrid Operating Rooms: How Many of Your ORs Should Have Imaging Capability?
9) Therapeutic Hypothermia after Heart Attack, Stroke, Spinal Cord Injury:
Dawn of a New Era in Emergency Medicine?
10) Rapid Tests for Deadly Infections: Where Do They Fit in Infection Control Protocols?
For clinical laboratory managers and pathologists, the number one and number ten items on the list are significant. The number one item is electronic medical record (EMR) systems and how a hospital can deploy them for maximum benefit. This reinforces the need for clinical laboratories to have their own strategies for effective integration of the laboratory information system (LIS) with the EMRs of their parent organizations.
The number ten item on the list is a reminder that hospitals face substantial pressure to reduce nosocomial infections. The emphasis on rapid testing for infectious disease underlines that fact. It also confirms the importance for clinical laboratories to be proactive in supporting the infection control efforts of their hospital or health system. Among other things, that should include a willingness to introduce appropriate rapid molecular tests for infectious disease. It is an opportunity for the clinical lab to contribute additional value that benefits both the parent institution and its patients. —P. Kirk