By John Bethune

For most biomed departments, one of the most cost-sensitive decisions they make is whether and when to take equipment service in-house. The larger the facilities served, the more complicated the equation becomes.

Figuring out the answer is a key part of the job for Andrew Ulvenes, the executive director for clinical technology for Kaiser Permanente’s northern region. His group supports 21 hospitals and 70 clinics serving some 3.4 million members, all with 275 clinical technology team members.

Like many of his peers across the nation, Ulvenes has been tasked with finding substantial savings from his operations. Over the last year, he says, his team has had to “figure out how to be more cost-effective and reduce our spend by 25%.” To undertake this substantial cost, he says, he’s worked closely with GE Healthcare to “help us look across our portfolio and figure out ways that we can get better leverage through scale.”

Scale is the right word for it. His organization has more than 540 vendors, supported by a mix of in-house service, full-service contracts, and à la carte service calls. While there is plenty of opportunity for savings, locating that opportunity is complicated.

“We look across our portfolio and see what our mix is,” Ulvenes says. “Where we have full-service contracts, we look at the amount of technology we have, and at our labor force and compatible skills.”

If he sees a good business case for moving service in-house, his next step is often to consult with GE Healthcare to see “how they might be able to support us, in terms of parts, repairs and preventive maintenance” as well as “technical support when we get into the technical troubleshooting and remote diagnostics.” Finally, he looks at how GEHC might support him “with training and development of our people.”

At that point, he says, his team steps back and looks at their projections “compared to what we are spending either with an OEM or a third-party service line, and figure out where we can save some money and deliver a higher quality of service with a lower cost point.”

As might be expected in today’s healthcare environment, finding savings by moving service in-house is an ongoing, high-priority activity. “We’re constantly assessing where our portfolio mix is,” Ulvenes says, “and where focusing a little more effort will have a better return.”

John Bethune is editorial director of 24×7. He can be reached at jbethune@allied360.com.