OR Manager - June 2020 - 16

Cost savings achieved through sharing equipment
OR business
t's been said we live in a sharing
economy: We share our homes
through companies like Airbnb, and
we share our cars through companies
like Uber and Lyft. So it's not surprising
that organizations are now sharing
equipment, including OR equipment,
with positive results. For example, Kaiser
Permanente Southern California
(KP-SC) saved the purchase price of a
lithotripsy machine in 1 year by sharing
it with other facilities, says Ronald Loo,
MD, physician co-lead for the health innovation
team at KP-SC.
I
Dr Loo initiated the sharing program
in 2010, with his organization's purchase
of a lithotripsy machine that was
then shared among five hospitals. The
pilot program has since expanded to
include more than 100 types of equipment
used by 10 service lines in 27
facilities throughout KP-SC.
" The nice thing is that we aren't asking
any of our stakeholders, including
doctors and nurses, to sacrifice to save
money, " says Dr Loo. " And at the same
time, we're offering better technology to
our patients. "
Here is how equipment sharing can
benefit healthcare organizations, which
continue to face financial pressures.
Costs of ownership
" There's essentially an arms race
for the latest technology, " says Todd
Rothenhaus, MD, chief executive officer
of Cohealo, Inc, based in Boston.
Cohealo manages equipment-sharing
programs for health systems, including
KP-SC. As OR leaders know well, when
surgeons return from conferences with
requests for new equipment at the capital
purchase level, many health systems
try to accommodate these requests by
investing significant sums of money.
In addition, systems often end up purchasing
multiple pieces of equipment
so multiple sites can provide a needed
service. Financial outlay doesn't end
with the purchase. Other expenses include
upgrades, training, maintenance,
repairs, and service contracts.
16
OR Manager | June 2020
New technology
can be trialed with
limited investment.
Unfortunately, these costs make it
difficult for health systems to maintain
their razor-thin margins, particularly
when equipment is underutilized.
Benefits of sharing
Sharing can reduce the costs of ownership
through financial savings, better
patient care, and enhanced market
share.
Financial savings are achieved by
reducing equipment rentals and total
fleet size, and improving utilization of
existing assets. Rentals may be needed
because of damaged equipment or because
a hospital doesn't have enough
volume to justify a purchase. Dr Loo
says that KP-SC was able to reduce
laser rentals by more than half by sharing
equipment.
Underutilization equals lost money
because capital dollars are invested
in equipment that is not providing revenue,
yet still requires significant operational
expenses, like maintenance and
storage. Sharing a device at multiple
sites can decrease the overall inventory
of equipment needed to address the
same case volume, and at the same
time, improve utilization of existing assets.
A
related problem is equipment
hoarding. Dr Loo cites the example of
colonoscopes. " Historically, every site
keeps a couple of extras in the closet
in case one breaks. Multiply that by 20
sites, and it adds up, " he says. " When
people know they will receive a replacement
scope right away if they need it,
they don't have to stockpile and the
organization doesn't have to buy extra
scopes that sit idle. "
Sharing provides that reassurance,
leading to financial savings that can be
reinvested in the organization. " Every
penny we save means more money we
can invest in our members [patients]
and our people, " Dr Loo says.
Better patient care is achieved by
avoiding equipment-related case delays
and cancellations. Sharing also enables
surgeons and organizations to trial new
technology with limited investment,
making it available sooner to patients
and protecting the financial health of
the organization.
" Many times a new technology
sounds really good, and you project you
will use it a lot, but in a couple of years
it doesn't pan out, " Dr Loo says. " Sharing
allows surgeon pioneers to evaluate
technology early on, so we aren't shortchanging
our members. "
An organization can either defer a
capital purchase entirely, or purchase
fewer devices that can be shared. For
example, one of Cohealo's clients initially
had a request to purchase six devices
for different sites, but sharing cut
the number to three, making the purchase
feasible. " The organization could
then say 'yes' to a surgeon instead
of having to say 'no,' " Dr Rothenhaus
says.
Should I share?
Not all equipment should be shared.
These questions help determine how
easy it would be to move a piece of
equipment.
➤ What is the size and weight of the
equipment?
➤ Does the equipment have wheels?
➤ How susceptible is the equipment
to damage from movement and/or
vibration?
➤ Does the equipment require
calibration when moved?
➤ Does equipment contain personal
healthcare information on the device?
➤ Does the equipment contain any
hazardous or volatile substances (eg,
nuclear material that can't be moved
without additional paperwork)?
Source: Cohealo, Inc, Boston.
The ultimate guide to sharing equipment.
www.ormanager.com
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OR Manager - June 2020

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