Tom O?Brien

Imaging professionals and hospital executives are always looking for ways to improve patient care, and reduce time spent on non-value-added, non-patient-centered activities. Having to work with multiple vendors to service devices can be time-consuming, and ultimately take time away from treating patients. We find that many radiology professionals are looking for ways to streamline the equipment service process, while maintaining quality and efficiency in both caring for patients and assisting referring physicians.

The concept of “multi-vendor” servicing is becoming well understood in our industry. It refers to a single vendor providing a program of planned and corrective maintenance on equipment from various original equipment manufacturers (OEMs). This service is for both sophisticated modalities like CT and MR and general radiology equipment such as x-ray and ultrasound. What may not be well understood is how to determine whether this type of arrangement will deliver desired benefits for a given organization.

When hospital executives ask about multi-vendor services, it says three things—1) the organization wants to save money; 2) they care about service quality; and 3) they are interested in simplifying the delivery of the service process. Multi-vendor service may not be appropriate for every organization; therefore, it is an option hospital executives must think through carefully before deciding to pursue it.

Perhaps the most important consideration in weighing such a move is value. The pricing for a multi-vendor service plan is generally based on the number of assets that will be covered: the more assets, the lower the per-asset service price that can be achieved. There may be occasions when contracting for service on an individual asset from a source other than the OEM does make sense. Generally speaking, multi-vendor service is worth exploring in situations where many of the imaging assets come from one vendor. It makes sense to see if that vendor can provide service on the other OEM assets as well. However, due diligence is required. Make sure the vendor has the experience necessary to meet your service expectations.

If you are considering multi-vendor service for your imaging assets as part of your overall asset management approach, be sure to ask hard questions. Three major considerations should be savings and value, quality, and ease of doing business.

Savings and Value

You should realize an overall savings compared with your current service model depending on how many assets will be covered. The amount saved on service agreements, time and materials, and hidden/internal costs can really add up. The cost of a multi-vendor service agreement program compared to the sum of all of individual or per-asset service agreements should be lowered. It is common to have a high degree of variability in service plans when the plans are established one at a time. The key is to examine the required levels of coverage and make the comparison based on all of the cost factors.

A complete review of all of your service contracts is an essential step to take. You may be surprised that some OEM contracts for the same types of modalities vary greatly in coverage and cost. A vendor consolidation analysis will help bring this to light.

Moreover, the internal cost savings resulting from having to deal with only one service provider are invaluable. The service provider must have the depth and experience to help you realize these savings.

Quality

Service quality is usually measured in uptime, the percentage of time that a system is fully capable of patient care. Uptime is the product of the vendor’s technical ability and responsiveness, so it’s important to probe both areas. The caliber of the service people can make or break most service situations. Get the names of the local multi-vendor field engineers. If coverage seems thin, ask about plans to add the appropriate number of staff.

Technology also must be evaluated. An OEM provides training for personnel and online assistance for field engineers, so these factors must be a requirement of your multi-vendor service provider as well to achieve the desired quality and responsiveness. Anything less than a 94% uptime commitment is probably not going to be acceptable. Most vendors will commit to a 96% to 98% uptime level. For many situations in critical modalities, this 2% to 4% difference translates to predictability in staff and patient scheduling. For example, if your staffed hours total 400 per month, you will notice a loss of 24 (6%) of those hours due to unplanned downtime.

You will periodically be relying on your multi-vendor service provider for audits and compliance matters. This is another dimension to the quality experience you need to address. Be sure to inquire about quality management systems and experience with both federal and state level requirements. Completion of planned maintenance and of image quality standards are two of the key specific criteria. It is acceptable to ask for references and the number of hospitals where the provider offers service. Check those references and ensure that quality metrics are consistently attained.

Ease of Doing Business

What will it be like to do business with the service provider? Payment terms and out-of-coverage policies should be well understood, negotiated, and acceptable to your organization. One of the key reasons to engage a multi-vendor service provider is to achieve the simplification that comes from doing business with one vendor versus three, four, or more. Be certain the administration of functions such as accounts payable will indeed be simpler. When one vendor provides service, it is much easier to stay up to date with procedures and personnel. They should be providing you with service history records that can satisfy regulatory agencies and give you peace of mind. Also, the familiarity and consistency are worth a great deal. This is a two-way street. Your multi-vendor service provider will get to know you too. Eventually, they will be able to anticipate your needs based on the amount of service experiences.

Where to Begin?

The first step is to understand the cost, coverage levels, and renewal terms of your current service contracts. It sounds simple enough, but with many different contracts renewing in just about every single month of the year, it can be a daunting task to compile the inventory of your service contracts. The multi-vendor service provider should be able to assist you in this vendor consolidation. It can be eye-opening to see coverage levels and cost variances for similar pieces of equipment. If the multi-vendor service provider can’t help with this analysis, then they will not be able to offer you the cost savings and quality realization you should expect.

One final thought. According to Stephen Covey, “Accountability breeds response-ability.” Multi-vendor service is an asset management solution that works when the provider is accountable for all of the assets at the facility. Even though multi-vendor may help you gain cost and time efficiencies through simplification, it should not be mistaken for a solution that requires no oversight on your part. For the vendor to be truly “response-able,” the hospital must be engaged and hold them accountable.


Tom O’Brien leads maintenance consulting and life cycle management consulting within the Asset Management practice of GE Healthcare Performance Solutions. He has over 23 years of health care finance experience and has helped clients with long-term technology strategic planning, operational and capital financial planning, and asset optimization.