Cath Lab Digest talks with Anthony Orsini, Cath Lab Director, Ohio State University Medical Center, Columbus, Ohio, about his facility’s use of Owens & Minor's Clinical Supply Solutions (CSS). Powered by QSight technology, CSS is an inventory, order, contract management and revenue enhancement service enabled by a proprietary web-based technology platform.
Tell us about the cath lab at Ohio State University Medical Center.
We are a facility in a heart-only hospital, the Richard M. Ross Heart Hospital at the Ohio State University Medical Center. We have four cath labs, three of which are coronary rooms and one which is a combo room for vascular and coronary procedures. We have approximately 35 staff, 7 interventionalists and 10 cardiologists.
We are actively involved in several research protocols, mostly device protocols in the cath lab. The hospital has a great deal of research that goes on both in and around cardiology, but as it pertains to the cath lab, it’s mostly device-oriented.
Volume-wise, we do roughly 4,000 diagnostic procedures in a year and close to 2,000 interventions.
You are using CSS (formerly QSight), an internet-based clinical inventory management system from Owens & Minor (Mechanicsville, VA). Can you tell us more?
Our facility has been using it in various hospital departments, not just the cath lab, since 2003. I think the biggest advantage we noticed with CSS right off the bat is that it allows you to get a good view of your inventory. It allows you to get your arms around what you actually have. From that standpoint, it allows you to manage it better; most notably, to reduce the amount of inventory that you have on hand for procedures. Beyond that, it allows you to track your product, track expired products and easily find recalled products. We are able to generate supply charges for patients and also to order products directly through the system. It interfaces with our billing and patient accounting for the supply charges, and then also with our purchasing system and materials management (which is PeopleSoft).
All staff participates in generating encounters. During a patient procedure, a staff member creates an encounter for the patient in CSS, and then bar codes items as they are used. There are also additional procedural data that you can collect through CSS. The system allows you to look at your encounters from various data points. For example, you can look at the cost associated with a certain type of procedure. You can look at costs associated with a certain operator or a combination thereof. The reporting aspect is quite robust. We typically utilize usage reports, encounter details, and implant reports for implantable devices and implantable stents.
You have 7 interventionalists. How do you handle any varying preferences for products?
CSS does have a feature that we used to create preference cards. It would tell you what a physician uses for any particular procedure. Currently, however, we rarely use that feature, because our standardization is very high. We don’t have many differences between operators or between procedures. With only 7 interventionalists, there is not a tremendous amount of variability from one to the other.
What was your situation before CSS?
We had no system. Basically, I would have to describe it as a manual process. We had to inventory our shelves. We had an inventory sheet and would have to go around and count items. It led to problems like missed charge capture, overstocking, out of stock and expired products.
What about par levels?
CSS does help you determine par levels with a feature called QPar. It will do complete cycles on products. Since you are scanning products out and scanning them in when they are replenished, the system learns how long it takes to get certain products. It knows the rate at which you use them. It will then suggest par levels for all of your items. We use it as a guideline. There are some things you have to look at carefully, such as a very low-use item, for example, a particular size of a coronary stent. Since it doesn’t move that much, CSS will recommend that the par be “1,” and for some items, it’s not possible, because you could use two in a day or you could drop one, or something unexpected like that could happen. So we use it as a guideline. We usually focus on those items that are extremely high use, and we adjust the par based on what CSS suggests.
Were your two supply coordinators in place prior to adopting CSS?
We converted some positions that did inventory and other things, and had them focus more on the inventory aspect. Before that, we had clinical staff members that handled the inventory. At that point, with no system, and all the clinical knowledge, they were the ones you had to use for inventory management.
Does CSS facilitate your work with other departments?
To some extent, we do most of our cross-departmental work with our operating room. The OR has CSS in a limited capacity; they do maintain a separate database. CSS is used in a hybrid suite in which endovascular procedures are performed.
Is your staff utilized in the hybrid suite?
Yes, although it is a combination of staff. There are mostly OR staff. The cath lab provides an RT, present for x-ray support. The RT also does clinical documentation and runs parts of the equipment. Only peripheral vascular surgeons do endovascular procedures in the hybrid suite.
Have you noticed any financial advantages with the use of CSS?
Yes. We have not been able to quantify what the system has saved us, but I would estimate approximately $250,000 in the first year. It allowed us to reduce our on-hand inventory significantly.
What about charge capture?
Not only is it more accurate, it has allowed other departments to be more involved with what we are doing with our inventory. For example, the system allowed us to develop a one-to-one charge code for each and every item that we have. That took a lot of work in the beginning to make that happen. It helps immensely in terms of charge capture and revenue capture, reducing the amount of work that staff have to do now to maintain the system.
Any advice for cath labs considering this system? Do you find there are advantages to a web-based system?
The main advantage of the system is that it is a comprehensive application, meaning it has enough features and tools to make it a complete inventory solution. It is customizable, allowing labs to fit the system to their operation and not the other way around. The advantage of a web-based system is that capital costs are extremely low, requiring only a internet connection and bar code scanners. The subscription-based service keeps labs from being anchored to a system that could cost hundreds of thousands of dollars.
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