OR Manager - February 2020 - 7

OR business
Although capital expenditure processes
may vary among organizations,
providing clear expectations is essential.
OR leaders can keep committee
members (and vendors) on the same
page by ensuring they know the fiscal
year for the expense, the timeline for
forecasting capital expenses, and the
financial authority of the committee.
Standardize the process
Setting rules and standardizing the submission
process reduces conflict and
improves communication. " There is a
formal process for requesting to present
to the technology committee. The
project champion (generally a surgeon,
anesthesiologist, or nurse) initiates the
request by completing a project initiation
form, " McKenzie says (sidebar at right).
The form is reviewed for completeness
by McKenzie, the project champion,
and representatives from procurement,
IT, and finance; any pending
questions are resolved before presentation
to the committee. Champions use
a PowerPoint template to structure a
presentation that includes information
related to clinical benefits, evidencebased
outcomes, financial implications
(cost of ownership), and contribution
margin. " We want to understand why
the request is being made and its impact
on the patient and the organization, "
McKenzie says.
For the financial analysis, McKenzie
says, " we dig into volume, utilization,
and true cost savings versus shifting
costs to other cost centers. " The
committee considers not just the cost
of purchase, but also the cost of total
ownership over the next several years.
If costs are expected to increase, the
team looks for offsets such as reduced
length of stay. The goal is to establish
the ROI through a cost-benefit analysis.
For approved projects, a follow-up review
of the financial ROI at a later date determines
the accuracy of the projections.
Given the increased focus on cybersecurity,
one of the most detailed parts
www.ormanager.com
Game plan for presenting new technology
Those who wish to request a new technology at Duke University Hospital need to complete
a checklist before meeting with the committee. The checklist includes department
name and chair, service line vice president, name of technology, and manufacturer
name and contact information, with answers to the following questions:
➤ What is the clinical purpose? Where will the technology be used (hospital location)?
➤ Are there any individual, department, or institutional conflicts of interest related to the
device or technology? (For example, a surgeon working with the manufacturer and
serving on the review committee would need to abstain from voting.)
➤ Has the technology been approved by the Food and Drug Administration? (If not,
the requestor needs to go through the institutional review board instead of the
technology committee.)
➤ Is this request for investigational or research equipment? (If so, the requestor must
provide additional information such as the protocol number and whether the research
is part of a multicenter trial.)
➤ Have there been any documented adverse effects or recalls related to this technology?
➤ Is there a laptop or personal computer contained within or used in conjunction with
the technology? (If so, requestors have to provide additional information, as noted in
the main article.)
➤ Is there existing technology within the Duke University Hospital System that performs in
a similar way? (If so, the requestor needs to explain why the new technology is needed.)
➤ Is there another clinically proven approach for achieving similar clinical results? (If so,
the requestor has to provide details.)
of the submission is the IT analysis.
Requestors have to answer the following
questions:
* Will the manufacturer provide free
operating system upgrades and
patches to maintain system functionality?
*
Does the device store clinical data?
If so, requestors must state where
the data will be stored: Cloud, DUH
network, or an external or vendor
network. If an external or vendor network
will be used, additional questions
need to be answered, including
whether data are stored outside the
United States.
* Will the device require integration
with any DUH clinical system?
* Is there an existing interface with
the electronic health record?
* Does the device need data and/or
does it produce data or images?
* What type of personal health information
is included?
* Has Duke Health Technology Services
(IT team) reviewed the device?
* Will the manufacturer access DUH
systems remotely?
* Is any e-commerce being conducted?
" The
IT section can be the most
complicated part of the process, which
is why it's so important to have IT representation
on the committee, " McKenzie
says.
Decision time
The committee may request a product
evaluation before making a decision.
McKenzie says the evaluation period
should be long enough to yield sufficient
data. " It's not enough to do one or two
cases, " she notes. The evaluation logistics
may be based on total volume, and
the appropriate stakeholders must participate
in the process. DUH considers
Continued on page 8
OR Manager | February 2020 7

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OR Manager - February 2020

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