New regulations on social security, purchasing groups, affect hospitals.
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The advantages of bid purchasing to both buyer and supplier are described and an explanation of how an ABC classification of inventory helps to determine which items should be bid upon is provided. The cost savings that resulted from bid purchasing of drugs by one hospital using an ABC analysis is also described.
The Steiermärkische Krankenanstaltenges. m.b.H (KAGes) is a company, owned by the province of Styria in Austria, which operates 21 hospitals with about 8000 beds and 14000 employees, serving a population of ca. 1.2 million people. KAGes has purchased a new hospital information system (HIS) for its hospitals. Within the strategic IT plan and the 'system structure new' (SSN) project, a methodology was developed for making an effective HIS purchase. Several steps of this project are described in the paper, request for product information, evaluation of vendor proposals, product presentations, test site evaluation, reference site visits and selection of vendor finalists. The authors present the internal project management methodology, including the structure of the project team, project information management through intranet, criteria for different steps of the evaluation and evaluation site organization. Four major HIS vendors with leading HIS products qualified for this stage of the project (evaluation site). About 60 teams with 400 members (end users and IT-experts) have assessed all the products installed, during one or more, repeated test sessions. The decision on which new HIS to purchase were based on the recommendations derived from this evaluation. After completing SSN-project with the suggestion to KAGes-top-management for negotiations with two vendor finalists, the new project named MEDOCS was started mid-1999. Two pilot installations (one general hospital and one teaching hospital department) are nowadays in the pilot implementation and subsequent roll-out (including substitution of the legacy system) is scheduled until the year 2003.
The economic feasibility of implementing a prime vendor purchasing system for pharmaceuticals was evaluated in a midwestern university hospital. Inventory costs, personnel costs, and check processing costs under the current purchasing system were compared with costs estimated for a proposed prime vendor purchasing system. For each step in the purchasing process that would be changed under the proposed system, work measurement techniques were used to determine personnel costs. The total savings from reductions in inventory holding costs, personnel costs, and check processing costs under the proposed prime vendor system was +98,396.37, or 2.4% of the value of pharmaceuticals purchased. Since the pharmacy department could not negotiate a contract in which the prime vendor's service fee was 2.4% or less, implementing a prime vendor purchasing system would not have been cost effective. Therefore, the hospital retained its existing purchasing system. Through detailed analysis of the major costs involved in pharmaceutical purchasing, the hospital was able to determine that it was not cost effective for it to use prime vendor purchasing.
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Planning for purchase, implementation, and use of an automated hospital information system is critical to its success. The planning process involves assessing needs, evaluating alternatives, selecting a system, and implementation support. Although an evaluation of costs and benefits of alternative systems is useful in planning for and selecting a system, the assessment can be very complex, and the assumptions used in the analysis are critical. Most benefits of automated systems are the result of improved timeliness, accuracy, and access to information, and these are difficult to value in dollars.
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As resources shrink in every aspect of hospital operations, CFOs are looking for ways to cut costs. One area where the CFO can take steps to control costs and contribute to the bottom line in hospital revenue is equipment acquisition. Instead of sitting back and approving whatever equipment is requested, the CFO can take an active role in assessing the equipment's feasibility and negotiating a good price.