Episode 4: Driving VA Transformation

In Episode 4, special guests Michael Cordi and Taygan Yilmaz from Sturdy Health join us to discuss how to drive transformation of your Value Analysis program from a transactional purchasing function into a strategic, data-driven process that improves clinical outcomes, reduces costs, and strengthens stakeholder engagement. Join us for valuable insights and practical strategies for aligning clinicians, supply chain teams, and executives to drive sustainable value across the organization.

Want to learn more about Blue.Point? Contact us today for a free product demo! More information at www.bluepointscs.com or email jdoty@bluepointscs.com.

Data Slayer Podcast

Through this podcast, our subject matter experts will cover in-depth conversations on healthcare data, clinical research, industry trends, real-world stories, and more. 

Blue.Point provides health systems with a specialized data analysis platform designed to optimize clinical product utilization. Our technology identifies savings opportunities and delivers non-bias insights on product best practices, standardization, and utilization-driven impact across hospital systems.

Interested in learning more? Visit www.bluepointscs.com

Transcript

SPEAKER_01 0:04

Hello and welcome to the Data Slayer podcast where insight meets impact, brought to you by the team at Blue Point Supply Chain Solutions. Blue Point is a data intelligence platform with a focus on clinical product utilization. And in today's episode, we are going to discuss how to initialize the transformation of your value analysis program or process. And if you're new to our podcast, our first three episodes explained our platform and how data and value analysis all work together, which perfectly leads up to the subject we will be discussing today with real-world examples. I'm your host, Jennifer Dodi, and joining me from Blue Point are Anne-Marie Orlando, the vice president of clinical services, and Keegan Smith, the senior manager of analytics and product development. And we are fortunate enough to also have two special guests joining us. We have Michael Cordy and Ty Yomaz, both from Sturdy Health, an independent nonprofit community health system based in Attaborough, Mass. Welcome, guys. Nice to have you here.

SPEAKER_00 1:03

Thank you for having us.

SPEAKER_01 1:04

Yeah. So, Michael, I'll start with you. If you wouldn't mind sharing a brief introduction of yourself, your role, and how long you've been in this role.

SPEAKER_04 1:12

So my name is Michael Cordy. Uh, I'm the director of supply chain at Sturdy Health. I've been at Sturdy just over a year, but I've been in healthcare supply chain, believe it or not, since 2002. Started uh my career at Bay State Health, which is um level one teaching hospital out in western Massachusetts. I spent uh the better part of my career there doing various roles within the supply chain. Um, started off with warehousing logistics, moved into inventory control, um, actually spent four and a half years in a heart and vascular OR, so got a little bit of a clinical background there. Um, then I moved into procurement. I was a lab buyer at one point, and then I moved into uh a value analysis coordinator. And then from there I went into capital procurement of so all hospital building projects. So I've been exposed to a lot. I left Bay State back in 2021 and went into healthcare uh consulting. I worked for an advisory firm that gave me the opportunity to travel all across the United States helping large and small size health systems make their supply chains more efficient. And like I said, I landed at Sturdy about a year ago. Um now I'm in the director of supply chain role.

SPEAKER_01 2:26

Awesome. Well, thank you for joining us. All right, Ty, and I'll have you also introduce yourself for us.

SPEAKER_00 2:32

Thank you, Jennifer. My name is Ty Ilmaz. I am the business manager for the perioperative services division here at Sturdy Health. I've been in this position for about a year and four months. My background is in various clinical settings, academic medicine and surgical services. In my role here at Sturdy, I oversee the perioperative business operations, charge capture, and perioperative specific materials management. Um, I've spent about two years more recently as a program administrator in the um academic side with brown urology. And before that, I was in ophthalmology operations, where I worked on workflow optimization, revenue cycle improvement, and various care access initiatives. Um, I also come from a little bit of a clinical background. I was an ophthalmic photographer, which is an allied nurse type of professional. Um, I've also been in clinical research, so most of my 20s was involved with publishing various forms of clinical research papers. And uh over time I sort of navigated into healthcare administration and very eager to continue my learning of supply chain management and couldn't be more grateful to have Mike in the partnership.

SPEAKER_01 3:51

Well, based between the both of you, we have a lot of experience here today. So this is going to be a great conversation. Um, so I guess to start with our first topic, Mike, I did want to talk about or have us all discuss um what processes did you bring or learn to enhance at Sturdy Health within the value analysis as we see it today.

SPEAKER_04 4:12

So I can start if you want.

SPEAKER_01 4:16

Okay.

SPEAKER_04 4:16

So, you know, when I got here, it was really kind of everybody doing something in a silo, right? There wasn't really uh any governance around the VA policy or structure or even, you know, the meetings themselves. So kind of first order of business that I did was I rewrote the policy, right? So from scratch, um, it was actually an iteration of multiple policies that I've you know curated over the years, but um we brought it here to Sturdy and you know, with the help of Ty um and other um nursing leadership and clinical leadership, we really tried to revise it to fit Sturdy's culture at this point. Obviously, it was a very comprehensive policy, and it was made to align with best practices. And what I tried to instill was this is out of a charity model scale, this is a five. What is written is a five. It doesn't mean that we're there right now, but this is what we need to strive towards. And but to have it kind of laid out, we can at least work from that, right? So we created a new policy, and then part of that was a charter, a one to two page charter that really um kind of is a truncated version of that policy with highlights of you know meeting cadences, you know, prep meetings and and outlining that, and then kind of you know, just additional supporting documents. So we had to actually look at our roster, right? Because we kind of had this broader committee, right, which with just like a million different stakeholders that didn't really belong. So what we did was we created two subcommittees, um, one for periop because you know it kind of ties the area, and the one the one for nursing, um lab, and then uh other ancillary support like respiratory and things like that. So we we we broke it out, broke down this huge large committee where there was way too many stakeholders, you know, they didn't really even need to be there. We created new rosters and uh new subcommittees, and then we created an executive committee as well because we put some thresholds into our policy. If it reaches X number of dollars, as you know, for an approval process, that would be an operational increase. We need further approval. Um, so you know, most of that is done and written and approved. We're still working out some of the kinks. Uh, we created a new product request form. We don't have a software report like system. Um, we're working on trying to get one of those to help us stay more centralized with our data. But current state is um, you know, we we have an electronic form that kind of, you know, that folks can submit, and then that drives the agenda. Um, so you know, we're working on all, you know, reaching best practice, software would enhance that. We're not quite there yet. So we're doing some things manually, but I think to go back to the original question, we really went back to the policy, the charter, and the people, and really took a deeper dive into that and revised that. So that was really step one.

SPEAKER_00 7:10

Um yeah, I Mike framed that really beautifully. And and he's right, you know, there was a lot of like work that once Mike joined on board, which was shortly after I was here, um, there was a lot of what I would say revival. You know, whatever existed prior to our time was sort of in a quiescent state at best. And I think being able to tap into Mike's you know, multiple multiple years uh of experience really helped kind of uh put a lot of meat on the skeleton of what was here. So um, you know, he certainly spoke to the the idea of the maturity model that we have with our value analysis committee, and and certainly we are on a trajectory. And I think having that policy charter, the right people in the right room at the right time, um, that's been really wonderful to really help have that framed out. I think one one thing I'll add on top of that is I the conversations are also happening. I think, you know, certainly Mike is leading one aspect of the value analysis committee um for the hospital system. He works in tandem with me to, you know, sort of as a mentor within the perioperative space as well. And I think uh both separately but in concert, we've really emphasized the importance, I think, on difficult conversations because for for folks in our role, uh, I think value analysis, it's it's intuitive, it makes sense, it's part of our experiences, but we also have to meet people where they are and also realize that that's not um they're they're not living and breathing our worlds, but being able to communicate the the why and the necessity behind activity like this is so important. And I think um certainly we've uh cut our teeth uh quite expansively uh in the in the time that we've worked together in aligning with providers, with nurses, with uh surgical techs, um, to just have them understand like what's the what's the underlying conceptual framework behind value analysis as a tool just for financial sustainability, but also making sure that we're all working towards that similar end of putting the patient at at the end of all of the activities that we're engaged in. And I think when we're framing it in that way, it's less an exercise of, well, you know what, the business manager is just saying we need to do this and the head of supply chain is saying this is this is a this is a necessity.

SPEAKER_03 9:47

Yeah, because when you're new to an organization like both of you were new, uh, while you bring in all of that type of experience, right, people are often thinking, oh my gosh, what are they changing? What are they gonna make us do now? And so sometimes you hit that wall of no, this is how we do it. And so getting them to embrace all of the changes, which are for the better, right? It can be a daunting task. So kudos to both of you for uh spearheading that and engaging with those stakeholders. So thanks.

SPEAKER_04 10:28

Thanks for the work's not done. And I'll say this process is is a fluid process, right? Throughout, right? This this will be revised and iterated on, you know, in a few months. Just and that's how it should be, because things change, times change, like how we act as an organization, it's always fluid and changing. So I think you know, a policy is not like a law, right? It's a guideline. So um, and sometimes folks will say they kind of look at it that way, and we try try to at least illustrate like, no, this is guidance, this is not set in stone. If we have a better way, let's do it. But we need to start from somewhere, and this is the starting point.

SPEAKER_00 11:06

So um yeah, absolutely. And and uh just to to make one last additive comment there, I think, you know, I see both Mike and uh my role and certainly for anybody who's engaged in the value analysis process is sort of uh a steward, right? That you know, whatever gets brought into any hospital system or really any any system that delivers some element of healthcare, that those items belong there for a reason. That there's not just the cost element to it, but there's also a you know a clinical value that's being brought with that. Um, and because at the end of the day, you know, are we do we want to expose our health systems needlessly to various forms of financial exposure and not have a just cause? We I don't think anybody would agree to that. And I think it's incumbent upon anybody involved in the value analysis process to be able to rest on those pillars of the the financial stewardship, the clinical justification. And if you can marry that towards the ultimate end with the patient there, then then I think you've done your job. And and certainly to Mike's point, you know, this is an iterative process. We have to look at it as uh as an ongoing journey, and it involves multiple elements of conversations. You know, Mike and his supply chain team or you know, me and my role saying this is just what has to happen, but really um engaging stakeholders to make sure that they feel like they have a voice in the matter. Um and and we're and us bringing that clarity to all of us.

SPEAKER_03 12:48

So part of that, have you provided, you know, those that are now sitting at the table and uh you're inviting them to have that lens, right? That you know, is it a people product? You know, is are the products that we're bringing in, is it to address a problem or is it just an ask, right? Are you are we before we even brought in a product, have we looked at the process? Have we looked at the people, right? Before we address that. And have you done any education on the with those stakeholders to help them see the lens that they should be looking at these products and these requests from?

SPEAKER_04 13:30

I think that's the end goal. You know, as we start to get more comfortable with the new process, I think that will come. I don't know that we're there yet if I'm answering that question honestly. I think the framework will allow for that, and that's the goal. Um, you know, I think for us it's getting it off the ground, kind of basically starting from scratch, like, all right, make sure the product request forms fill out completely, right? So if we have all the information that we're asking, we can help answer all those questions, right?

SPEAKER_03 13:57

Yeah.

SPEAKER_04 13:58

So um, and so you know, we're in the emphasis stages, but I think you know, we have the framework there. And as we as folks get more comfortable and as we have more meetings and the dialogue starts to, you know, become more robust, yeah. I think to that end, we'll we'll start to to check those boxes as well, Anne-Marie.

SPEAKER_00 14:16

I I agree wholeheartedly. And I think, you know, speaking to to the work Mike did out the outside when he started here, you know, he spoke about getting a proper VAC roster. And I think some people may view that as just a list of names. And I think it's it goes far far more than that. And the reason for that is understanding why is this person in this room? You know, what what opinion are they bringing to the table? Why should somebody uh who's a financial analyst be at this conversation? What about somebody who's an infection disease risk nurse? What about um uh, you know, X type of provider? And all these things, again, obvious to folks who are in value analysis, but in a committee like that where you're hearing the voices of multiple stakeholders, that's where you're gonna start to see, oh, okay, I didn't realize that I can't just say I want this particular product because it impacts this coder, for example. Yeah. Um and I think that's where, you know, uh the committee can help kind of provide those sparks of, okay, I'm understanding the the real meaning of uh an organization like this.

SPEAKER_03 15:26

I I always think about, you know, when you when you go and you represent your department in that value analysis committee, you don't realize sometimes your patients that you're seeing, you know, what what what do the nurses need to understand about the postcare of that new product you're asking in or what what are some of the, you know, maybe I'm asking for something from my department, but now I'm creating two standards of care at my facility, right? So so VA really helps you look at it from that, uh, not only at the micro view, but at the macro view and and really being able to help um, you know, the organization act as an organization and treat the patients as they should, uh, you know, with this with this standardization in mind and ensuring that we're we're there for the patients, but also uh training and education and all that that other stuff that that we need to make sure that we're uh being uh mindful of.

SPEAKER_01 16:29

So yeah. Yeah, I think you have all touched a little bit on the why behind value analysis and why you do what you do every day. I don't know if anyone wants to expand a little bit more on that, on the importance of this for those who don't might not understand.

SPEAKER_04 16:47

I mean, I I can add a little bit more. I I mean, I think you need so anything supply chain, it's really process driven, right? So I think in order to be successful, you need a system or a process in place, right? So I think value analysis is not only a governance structure, but it's a process that you know, if we adhere to, it's something we can lean on. It's not just, you know, we we don't want it to be just a yes committee or a no committee, right? We want it to have some depth, right? So, like for example, if a provider says, Well, I'm gonna, I want this new widget and it's going to save 35 minutes of OR time. Okay, that's great. But are we measuring that, right? It it's it's uh it's one thing to say it, and it's another thing to actually, you know, go through the process, do the look back. Um, so you know that we wanted to ensure that that was part of you know our process, right? Is to ensure that, you know, really we're we're hitting on multiple pillars when you build the VAT committee, right? It's not just new product requests, right? It's also the look back, it's also sourcing initiatives partnering with our GPO. Um, you know, the why, yeah, it is financial stewardship, but to Anne Marie's point, Ty's point, what is the clinical impact, right? Um, if you have two widgets that already do the same thing, that may be a different clinical nursing practice. We need to be able to recognize that and socialize that at those meetings so people understand. It's not meant to be a barrier, and so that's also something we're trying to illustrate. It's meant to be a conduit. Um, and I think with change and new things, people are resistant to that. So it's it's good, it's how you socialize it, it's how you roll it out, it's how you implement it, is key in this process. So I think, you know, to answer your question around the why, it's just it's to have something comprehensive that's systematic and valuable.

SPEAKER_02 18:36

So I have a question for you guys. You know, while you're moving through the VA process and working with your stakeholders, I come from that you got to tell the story and you got to have stuff to back it up, right? So the data. So what important data points do you guys focus on? Do you use, you know, scorecards, dashboards? What is it that you're constantly looking at? Like what's that metric being used mainly in your process?

SPEAKER_04 19:08

I mean, from a supply chain perspective, you know, we we look heavily on the financial, we partner with our GPO, right? So that's the huge part of this. A majority of our supplies are contracted through a GPO, whether it's a national GPO or a regional. So we try to align with them. And I think product categorizations, category management, if you will, is a big part of that on the supply chain end. So looking at financial impact. So, you know, we're looking at we use a lot of our our purchase order data. We also leverage some of our GPOs, spend dashboards, category management. Um, and then also our new product request form drives the process as well, right? So we're asking for um CPT codes, right? You know, um DRGs, right, if if those are there, and it's how we present it. So we basically have a two-slide process um for each request. So the first slide is the clinical, so it kind of addresses all the clinical questions, CPTs, you know, all the different data points that go there, reimbursement, et cetera. And the second slide is the financial, right? So if you're gonna go from widget A to widget B, what does that look like from an operational impact? And then hopefully, you know, with our decision support team, some people call that um differently, but I call decision support, they're looking at that kind of that cost of care, right? Like, is this case profitable? What are the direct costs? What are the indirect costs? And if we were to add this, what does that look like? Right. So I think we're pulling multiple data points, right? So it can be, you know, from revenue cycle to um implant record utilization to PO data to category management data out of off of our GPO. So we're pulling in multiple data points. Um, and I think that's why I would love a value analysis system that can integrate all those things into it. Um, right now we're doing it manually, but we are at least we are capturing all those different data points.

SPEAKER_02 21:11

Awesome. How do you guys define a project as being successful, right, with that data and those data points? Like what metrics hit it off as being a successful project? But then where do you see some potential gaps that you're gonna continue growing on? Because you guys, you know, are just starting.

SPEAKER_04 21:39

I'll answer then like go to Ty, because I think we have different needs. So for me, it's I have a supply chain savings goal, right? So my goal is to drive that. And obviously, you know, we funnel a lot of our you know conversion standardization initiatives through the VA, right? Because we need clinical buy-in to do this. So for me, it's measuring cost savings. So looking back year over year. So we said, you know, we brought this to VA, we said we're going to switch from this to this, and we're going to save this. So it's doing that look back over the course of the year and I would call it realize savings, right? Did we actually realize what we said we were going to do? And hopefully, you know, with that, the clinical piece of it, we brought in a product that was, you know, we standardized though on the nursing practice end. They're dealing with one item to do this type of clinical practice. So we've hopefully lessened the burden on all the things that they have to know. And hopefully that translates into better outcomes because it's it's it's one less task, or it's you know, it's it's it's one less product that may be the same. That why am I doing this differently if it does the same thing? And then, you know, realizing our financial savings targets at the end of the year. And I'll kind of pass it to Ty. I don't know if it's different clinically. I'm guessing there's a little bit different.

SPEAKER_00 22:58

Yeah, that well, you articulated that really well, Mike. I I agree with a lot of it. I think certainly in the world we're in with Periop, uh, we see a lot that does dovetail with what you just spoke about. I I think um sort of from that boots on the ground perspective, you know, you hear a lot from the nursing staff and the techs and materials coordinators of you know the impact of switching from one thing to the next. So it's a little bit of a qualitative measure, but I I certainly the less I hear in annoyance is is one element that is a is a good tracker for me. But in terms of the more quantitative piece, I think, you know, and and to what Mike spoke to having soft software to help measure uh a little bit more of this, we're we're looking at options within Periop to help us with this as well. But one piece that I'm hoping for is just uh being able to use the surgeon preference cards to understand a little bit more of our cost variants. Right now we're not ideally where we need to be in understanding those differentials, but those can be utilized as a tool for conversation with providers. And I think, you know, it helps bridge communication gaps when we're trying to uh just educate our providers on where the current state is versus where our hopeful state might be. Um, I think also looking at our denial rates is another piece that I have found success in, just to say, you know, we went through this with particularly our sports medicine arena, where there are a number of um items that fall in the category of allografts. I think if those can be well managed and we can switch those appropriately to alternatives, um, it helps us with the charge capture reconciliation process, but also ensuring that there's that clinical effectiveness that goes along with it. Um and certainly uh, you know, the overall clinical adoption that and and the outcomes that come from that, we always want to make sure that our patients are receiving the you know the most cost-effective, patient-centric, high value care possible. And a lot of that is driven by, you know, the the right choice in supplies. And, you know, it's never a race to the bottom. And you know, certainly Mike and I have um you know added a few grays to our to ourselves and all sorts of negotiations we've been a part of. Um but I think you know, one one exercise that's coming out of that and and take-home point is it's not always a race to the bottom, and it's important for us to to be conscious of that, but uh being able to standardize appropriately and realize those cost savings are going to be really important.

SPEAKER_03 25:46

I think I think transparency there is key, right? Uh because a lot of times we are not as transparent with physicians. Uh, you know, when they're performing the case, right? They're thinking about, you know, the operations of the case, right? The you know, the supplies they have, who's at who's sitting, who's standing next to them at that table, right? That that is a big deal to them. What is what are they putting in my hand? What do I have access to? And so they're not thinking about all those other things that help you keep the doors open and make sure that you can uh maintain the community health and access to healthcare and all the other operational things that go into that procedure. So transparency is great and um you know, building the culture that is open to looking at that transparency is important too. So it so you it sounds like you guys are well on your way uh to that position.

SPEAKER_04 26:48

Yeah, I would you know like to get deeper into scorecards, as you mentioned, Keegan. I think that hinges that correlates well with you know the stuff that you're doing at Blue Point, the clinical supply utilization management. I think that's one of the pillars of VA. And I think when you're a mature health system, that's what you're looking at. That's it that's integrated into your VA program. It's written in there right now for us to start doing that. Have we done it? Not to the level that we need to. Um, but I agree, like those are big things, not just looking at price at the pump, but clinical utilization, right? You're all doing the same case, you know, it's all the same DRG, the patient population. You know, I've always heard the argument, well, my patients are sicker than your patients, I have to see this. So I know, but we can we have enough data now to create all to make all things equal, right? Which is powerful. And say, no, why are you using all these advanced hemostats? And this provider B had the same patient, right, same age range, same cool morbidities, and they didn't use it at all, right? So, you know, I think the data is powerful, and and providers don't want to be called out, and you don't want to call them out because you know they are you know helping keep the lights on, right? So um it's a very delicate way that you have to socialize this information. Um, yeah, and it's a little bit of an art form that I have not yet perfected, but I'm working on it, you know.

SPEAKER_03 28:10

Right. That's what Ty is there for.

SPEAKER_04 28:12

Ty's there to smooth over, you know, before I open my big mouth and say something that I shouldn't.

SPEAKER_00 28:20

I I just wanted to add one item. So uh when Mike and I were convening about something uh earlier today, you know, he mentioned the the process improvement uh concept of swim lanes, and I think it's very relevant. And and to that end, um, you know, oftentimes you have multiple entities working on similar but distinct items that relate to value analysis. And, you know, I'll I'll give you one example where we've had conversations around certain items that stand a pretty low chance of making it through value analysis, not because there isn't the clinical efficacy there or because the hospital doesn't want to support the provider in the product's inclusion, but the payers have very specific coverage policies that just very clearly name this is experimental and investigational. And leaning into that conversation, and Anne, you spoke to the the culture of transparency. I think, you know, that's one element that maybe, you know, value analysis committees may not necessarily think of when trying to build out a larger scale program. But I I believe in that, um, and I certainly see through the dialogue that Mike and I have had in our separate but related uh conversations throughout the hospital system that being honest, being as transparent as possible of where, you know, person one who's working on one element of a of a product being being here versus other folks along that chain, just providing as much of the 30,000-foot view of all of that, that can do so much more than an email or just you know, communicating just your angle. Um being able to to name all of that, I think is has really helped us kind of help tighten our processes and helped with our efficiency. Are we there yet? Absolutely not, but I think with every month that we go through and have our value analysis committees, at least on the periop side, I just see the tenor and the tone of our dialogues changing.

SPEAKER_03 30:27

That's great. It all starts with the having the same goal, right? Yeah, good patient care, good high-quality patient care, good outcomes.

SPEAKER_00 30:35

So absolutely.

SPEAKER_01 30:38

Well, I think we did receive a lot of good advice already from you. Um, but is there any additional advice you would like to share with a value analysis team that's looking to mature in their process?

SPEAKER_04 30:51

I would say start with your policy, right? Like I said, it is a guideline, but you know, make it as comprehensive as possible, making sure you're you answer the questions that haven't been asked, right? And um, and that happens a lot. So that's why you know it was important for me. And they're like, why is your policy 15 pages? I'm like, well, it's I didn't want it to be that long, but like if if we're gonna answer all the questions from each angle, right? Not just supply chain, but the clinical, the rep cycle, you know, if we're gonna answer all those questions, because there's odd things that happen in supply chain every day, right? And I've been I've been fortunate to be exposed to those, both good and bad, things that make you want to never do this again, and things that make you come back, like today. I don't want to come back tomorrow, but you know, of contrast media. I don't know why it's on national allocation. I can't you know, but I have to solve for it, right? So, you know, um, I think starting at the policy, creating a robust charter and the stakeholders. That's I think that's a key piece, is finding people. It was I there's a lot of reluctance with leadership and wanting to chair these committees. And I said, Well, you're a clinician, right? You can't be, you know, we have to have people that have clinical background, but also are far enough removed where you know their their colleagues still respect them, but they're also going to respect your decisions. And it's and I think it starts there when you're kind of building your roster, writing your charter, writing your policy, being very careful about who you choose to be on that group. Because nobody wants another meeting. So I think that was the other piece. So if you kind of have all these elements and you have a good process, the meetings are actually pretty efficient, right? Like if you write that in your policy, it's written right in there. If you don't show up for the meeting, we don't talk about your request. And if you don't show up again, it comes off, right? So you basically get two chances, and you have to be that granular. So I'd say be granular in your policy and and setting expectations because that helps drive the process as well. So that would be a recommendation. Be granular and answering the questions that maybe are tough, but it's you're you're it's all for a greater good. So you're not doing it to be the bad person, you're doing it to be efficient and create an efficient process. So I wouldn't back away from that.

SPEAKER_01 33:22

Solid advice.

SPEAKER_00 33:24

Yeah, I mean, I I think it's difficult to move forward on anything if you don't have a policy in place, you know, as expansive or as diminutive as it may be. Um, so I think, you know, you have to start somewhere. I I think one thing I'll add to what Mike has said, and I'm certainly saying it from a little bit of a the perspective of um some bias is I think certainly incorporating a little bit more of the the revenue cycle reimbursement piece just for awareness is really important. Um, you know, certainly at the national level, it's becoming that much more difficult to get paid on cases, period. So that puts the onus on a host of folks within value analysis to source products that are as cost efficient and clinically safe as possible. So uh again, I and I certainly spoke to the the the notion of a race to the bottom. It should never be that, but at least having an awareness that um we we should be very conscious of the cost input. Um and and I'd say, you know, Mike also spoke to the fact that we don't have the software leverage to help guide us with these decisions. So, you know, some of the gentle nudging and pushback I've given to providers who are bringing products forward has been um, what's your clinical justification? And I say that from a place of bias as well. Most of my 20s and early 30s was pretty fairly involved with clinical research. So um, you know, I understand that sometimes based on certain clinical trial designs, you're you're not going to get a randomized control trial for everything, but we should at least be angling towards that because that is your highest level uh of evidence base. And, you know, certainly if there's systematic reviews or meta analyses out there as well, even better. Um, but to say that, you know, I'm presenting this product, there's nothing in the literature, there's no meeting abstract, then, you know, it makes it very difficult to present this to a host of committee members who are expecting that this is somehow, you know, something that has weight to it. But um I I've seen that conversation change a little bit, uh, which is great. But um that's certainly uh lots of lots of things to consider. Yeah.

SPEAKER_04 35:42

And I think the landscape has changed for the folks that now support these committees. Before it was kind of a very totalitarian, the doctor gets what they want, don't question it. I said so. This is what I was trained on. And I think you know, when you instill a good governance and a policy, and then you actually have stakeholders that are equally engaged, that are bringing good data, right? It's it it takes kind of that element out of it, right? Um a lot more talented people, and I'm not saying they weren't talented people in the past, it just wasn't given kind of the proper like due respect that it was in the past, and that's just been the nature of healthcare supply chain, right? Um so I I think you know, we're also in a time period where we're having we're doing good analytics, right? We're bringing evidence-based data into our analyses, and then we're presenting these things. So it's not just like because I said so and because I'm the surgeon. So I think that also has a lot to do with this as well. So lean on that, I guess if I'm giving advice.

SPEAKER_01 36:44

Um that's why we are here. Any last points, Anne-Marie? Anything you'd like to add?

SPEAKER_03 36:54

Yeah, I was just gonna say, when you once you get that that process or that policy, you definitely need to uphold it. And and that's that sometimes can lead to those hard conversations that you had. You know, if they're if they're not willing to come in to you know, the meeting to discuss the product, well, I guess we don't need to have that product on on the agenda because really if you if it's your ask, only you can really speak to what the clinical benefits are going to be for that product. Uh, you know, I think I think that's just something that we need to have people be comfortable with is having those difficult conversations and then having, you know, and the on the other side is is making sure that everyone is educated on what that expectation is. You know, we're not here um just to say yes to everything, you know, we need to question. And it's not from a place of skepticism. It's just, you know, we want to make sure that we're doing right by the patient. What does the IFU say? Is the IFU, you know, three pages or 300 pages? Can my staff actually follow it? Right? You know, there's is is it uh is it very confusing? You know, is it going to lead to more issues than we're trying to solve for? You know, and so it's there's a lot to discuss there. And then site of care now is coming in into play. So especially tie in your space, right? You know, are we are you going to be, you know, is the hospital the best place for this? Is you know, how can we wrap in your ASCs, you know, develop that? I think that's something you guys are going through right now. So uh yeah, so there's it's uh it's really great, but that policy is gonna be uh, you know, your your for lack of a better word, your Bible. And and you just have to be able to, you know, speak for that, speak to that for some.

SPEAKER_04 38:47

Yeah, and I think I'll just one last thing is I remember when Lucy, our CFO came back to me because she didn't want to read it, because she said it was too long. She's like, Well, this isn't the academic medical center. And I go, Well, you're welcome. I go, because like we may not be an academic medical center, but we should be approaching you know our value analysis through that same lens, right? Absolutely. Um, so I took that as a backhanded compliment.

SPEAKER_01 39:16

Um, but yes, that was okay. We will take all the compliments we can get, right? Every day. All right. Well, I think that was a really nice episode. Thank you for joining us. Um, and thank you to everyone who was listening. Uh, we really appreciate everyone joining us today. Um, please, for those listening, please like and subscribe wherever you are enjoying this episode so that you'll be informed the next time we have an episode air. And for more information, you can visit our website at bluepoints.com or any of the links in the podcast or video description. And one last thing, remember best practice doesn't have to cost more when you slay your data with Bluepoint. Until next time. Thank you. Thanks, everyone.

SPEAKER_00 40:04

Thank you, everybody.

SPEAKER_01 40:05

Bye. Have a great day. I do go through and edit, so like this whole part right now is being recorded, but of course, we're not going to promise to swear. Okay. I'll do my best. I could probably figure out how to add a bleep.

SPEAKER_02 40:24

Just put censored right across the screen.