Supplier Selection for Integrated Performance Solutions in Hospitals

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Supplier Selection for Integrated Performance
Solutions in Hospitals
Joseph van Orden University of Utah Gerhard
Plaschka DePaul University Rohit Verma Cornell
University
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The Context

• The health-care industry is evolving from being
  product-centric to patient-centric healthcare
• this requires enhanced collaboration among
  hospitals and their suppliers (IT, equipment
  manufacturers, )
• Focus of our studySupplier selection for
  integrated performance solutions within
  cardiology clinics

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Integrated performance solutions support the
cardiovascular clinical workflow by
providingphysician, technologist, cardiac
nurse, and other personnel withcomprehensive
access to a patients electronic medical
record together with compatible
workflow-oriented tools that support the
cardiovascular workflow.A strong focus is
placed on the data integration among various
cardiology modalities such as cath, nuclear
medicine, echocardiography, and other devices.
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Issues to consider in supplier selection (for
integrated performance solutions in
cardiovascular hospitals)

• Clinical performance (quality of care,
  diagnostics and therapeutics)
• Operational performance (e.g. capacity
  management, pharmacy, purchasing, facility
  management)
• Financial performance (dependent upon
  reimbursement, service mix, volumes, and
  operational and clinical performance)
• Preferences of multiple decision-makers
• Buyers Switching inertia

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Overcoming Switching Inertia
Customer will switch
Customer will not switch
Firm X Offering
Customer Inertia
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Overcoming Switching Inertia
Customer will switch
Customer will not switch
Firm X Offering
Customer Inertia
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Conceptual Framework

• The Science of Choice Modeling
• Sound theory, tested over 70 years
• Used to explore a large number of real, complex
  business, economic and social problems worldwide.
• Extremely high predictive accuracy
• Prof. McFadden received Nobel Prize in Economic
  Sciences, 2000

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The Choice Process
Product-Service Package
Decision Maker
Perceptions (beliefs)
Attribute evaluations
Overall evaluations
Choices
Attributes
Psychophysical judgments
McFadden (1986) Ben-Akiva and Lerman (1991)
Louviere, Hensher Swait (2001)
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The Choice Process
Medical Equipment Software Solutions
Decision Maker (Hospital Administrators,
Cardiologists, Technologists )
Perceptions (beliefs)
Attribute evaluations
Overall evaluations
Choices
Psychophysical judgments
Attributes
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The Method of Choice Modeling

• Implement choice theory by integrating it with
  experimental design, sampling modeling methods
• Identify potential drivers/hot buttons.
• Assign levels to drivers/hot buttons.
• Develop choice experiments
• Collect data from representative sample
• Estimate choice model(s)
• Conduct sensitivity analysis
• Develop decision support simulations

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Research Design
Qualitative Research Develop a concise set of
market drivers for integrated solutions in CV
services Literature review Interviews Focus
groups to identify and to build consensus on
key drivers of integrated performance solutions

• Quantitative Research
• Population of Interest Selection of US hospitals
  and clinics which might consider implementing
  Integrated performance solutions in the near
  future.
• 100 web-based choice interviews with
• Chief Operating/Administrative Officers
• Medical heads of CV Departments
• Administrative heads of CV Departments
• Cardiologists

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Qualitative Research Outcomes
Potential market drivers for Integrated
Performance Solutions in CV services

• Performance Improvement Guarantee
• Non-Obsolescence Guarantee
• Compliance Agreement
• Alliance Partner
• Outsourcing
• Reference Site
• Up-front Assessment of Baseline Performance
• Account Executive/Team
• Price

• Manufacturer (Brand)
• Level of Integration
• Improvement in Operational Performance
• Improvement in Clinical Performance
• Improvement in Financial Performance
• Accessibility of Patient Images
• Accessibility of Patient Information
• System Interoperability
• Ease of Use

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Quantitative Research

• 40-minute web-based choice survey with the
  following sequential sections
• Facility and respondent profile, including
  current level of integration
• Educational material regarding Integration
  Performance Solutions concept
• And perceived acceptance, credibility, benefits,
  problems, barriers re the concept
• Choice exercise 16 choices between customers
  current situation and hypothetical integration
  concepts
• Decision influencers on decision to implement
  such a concept
• Supplier perceptions rating Siemens, GE and
  Philips on 15 performance criteria
• Open comments
• 100 participants in total distributed as follows
• 30 Chief Operating and Administrative Officers
• 50 Administrative heads of CV Departments
• 20 Medical heads of CV Departments

This survey was very informative and asks
questions that were thought-provoking and well
thought out. Very interesting survey which I
think is relevant to todays care in
cardiovascular medicine. Interesting survey
would like to know more about different
companies approaches to full integration. Deci
sion charts (choice questions) were a little
difficult to follow but I tried to give my
objective answers for all scenarios.
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Participant Profile
Profession
Sampled facilities are within the upper echelon
with respect to fitting the cardiac cath lab
profile of opportunity for Integrated Performance
Solutions.
Corporate Business Exec Functions Administration
70 Operations 57 Strategic Planning 50 Program
Development 43 Finance 13 Information
Systems 13
Note Sums to gt100 because of multiple responses
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Facility ProfileBrand Penetration
Philips, GE and Siemens are the dominant players
with respect to installed base in CV services.
Brands Installed in CV
Siemens and Philips have higher penetration in
teaching hospitals (46 and 73 respectively)
while GE has higher penetration in community
hospitals (63).

Respondents could select all that apply half
selected one and half selected multiple brands.
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Current Integration and Expectations
Awareness of Integrated Solutions
High indicated awareness for integrated
solutions, even for solutions that enable
improved operational, financial and clinical
performance.
Facility managers awareness of integrated
solutions
that enable improved operational, clinical and
financial performance through integration of
modalities, networking and IT
aimed at improving workflow
Teaching hospitals have somewhat higher awareness
levels than community hospitals.
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Current Integration and ExpectationsMovement to
Greater Integration
Likelihood of moving in MAJOR way toward a more
integrated approach in next year or so
No significant differences between teaching and
community hospitals.
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Biggest Perceived Barriers to Advancement of IPS
Concept
Half of medical participants, including
Cardiologists, concur
Only 7 of Corporate Business Execs concur
9 of CV Department Heads concur
Integration of legacy systems
Note Respondents could select all that apply
average number selected was 2.3
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Biggest Potential Realistic Benefits of IPS
Concept
Note Respondents could select all that apply
average number selected was 7.0
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IPS Supplier SelectionChoice Modeling
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The Choice Process
Medical Equipment Software Solutions
Decision Maker (Hospital Administrators,
Cardiologists, Technologists )
Perceptions (beliefs)
Attribute evaluations
Overall evaluations
Choices
Psychophysical judgments
Attributes
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Choice ModelingInterview Snap-Shot
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Choice ModelingInterview Snap-Shot
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Relative Main Effects All Respondents
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Relative Main Effects Teaching vs. Non-Teaching
Hospitals
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Relative Main Effects Cardiologist vs. Managers
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Relative Main Effects Cardiologist vs. Managers
vs. Corporate Executives
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Intercept A Measure of Switching Inertia
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Relative Impacts
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SAMPLE Decision support simulation (DSS)
Desirability index plots for each competitor in
various segments
Numbers in GREEN cells can be changed to reflect
the corresponding levels for each value-element
Desirability index
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SAMPLE Decision support simulation (DSS)
Numbers in GREEN cells can be changed to reflect
the corresponding levels for each value-element
Willingness-to-pay
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