The Life Cycle of the Medical Equipment PURCHASING Heikki Teriö, Ph.D. Department of Clinical...
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Transcript of The Life Cycle of the Medical Equipment PURCHASING Heikki Teriö, Ph.D. Department of Clinical...
The Life Cycle of the Medical EquipmentPURCHASING
Heikki Teriö, Ph.D.Department of Clinical Engineering
Medical Technology Management
Need
Procurement
Management
Disposal
Market analysisNeed analysis
Technical specificationClinical testControl measurementExperience feedbackEvaluationDelivery controlEducationMaintenance planningRegistration
Preventive maintenanceCorrective maintenanceSafety assessmentEconomyDocumentationContinuing education
ReserveStorageSpare partsSale
Purchasing a function or a solution
From Vision
to Function
Vision
how will our work look like in 3, 5, 8 years
how will the medical methods be developed
how will the medical technology be developed
how will the economy of the health care system be developed
Purchasing a function or a solution
What we mean by purchasing a function or a solution
function of a piece of device
function of a system
function of an entire treatment room
Purchasing a function or a solution
We need a dialog between the different categories of staff from the very beginning.This is extremely IMPORTANT!
Purchasing a function or a solution
The dialog between the different categories of staff must include:
• how the equipment will be used• what special functions will be needed• what information is needed for the treatment – where can we
find this information• what availability is needed• what environmental demands we can state• how are we going to maintain the function/equipment• how are we going to finance the function/equipment
Purchasing a function or a solution
The new role of the Clinical Engineering
Internal consult• technical knowledge• economic knowledge• medical knowledge• good ability to co-operate
Purchasing a function or a solution
The Purchasing Process
Purchasing team Tender documents Announcement
Opening the tenders
Selection of supplier
Contract
Delivery control
Appeal time 10 daysAppeal
Qualification/evaluation
Delivery
Commission
Restart the process
Payment
Follow-up
The Annual Purchasing at Karolinska
• Total 237 M€21 % of turnover
• Material 128 M€
• Medical equipment 34 M€
• Services 76 M€
Decision to Purchase
A formal decision to allocate money must be made by authorised person.
Specify the type of goods/services required.
Specify the estimated cost.
Also a formal commission to start the purchasing process.
Commission to the Purchase Department
The commission is registered and given an unique ID-no.
The purchasers are assigned commissions by the Purchasing Manager
Larger and/or unusual commissions are discussed within the group and sometimes assigned to a pair of purchasers.
Investment number
On all investments over 1500 € are assigned with the number
Follow-up of the investment from budget to the inventory register
Who is responsible for what?
• Invitation to tender – Purchasing department
• Specifications – User/Clinical Engineering
• Contract terms – Purchasing department
Grupp
Underlag AnnonseringÖppning
Avtal
Besiktning
Remisstid (10) dagarÖverprövning
Utvärdering
Leverans
Uppdrag
Gör om upphandling
Uppföljning
Preparing the tender documentsThe Purchaser contacts the end users and clinical and technical experts.
Together the group prepare the tender documents:
- Invitation to tender
- Requirements specification (LCC)
- Contractual terms
The Purchaser has the overall responsibility for the quality of the documents
The demands on the product shall not be changed
Demands on the goods/servicein the invitation to tender • Explain all the demands that has to be full filled
(goods, services, time schedule etc.)• Explain the demands as a goal, function or result when ever it
is possible• Describe the demands so that they are measurable• Ask for the prise for all goods and services that will be
included (service, maintenance, new versions, updaters etc.)
Grupp
Underlag AnnonseringÖppning
Avtal
Besiktning
Remisstid (10) dagarÖverprövning
Utvärdering
Leverans
Uppdrag
Gör om upphandling
Uppföljning
Environmental demands of the purchasing
Environmental demands are part of the hospitals environmental control system
Relevant environmental demands in central purchasing
There is also national recommendations for different types of medical equipment
Making the purchase public
The invitation to tender is advertised in the bi-weekly ”Anbudsjournalen” and their homepage.
If open procedure advertisement is made in EGT S/TED i Luxemburg.
Open procedure >EUR 200.000.
Distribution of the documents
Companies who see the advertisement and are interested contact the purchaser and request the documents.
Sometimes we contact companies and ask if they are interested to ensure competition.
The purchaser distribute the documents via e-mail or regular mail.
In the future the documents will be made available on our external web.
Clarifications are distributed to the companies usually via e-mail
Opening the tenders
The tenders must be clearly marked
At least two (2) persons must be present at the opening and sign each page
Copies are distributed to end-users, experts etc.
Qualification and evaluation
The purchaser check the tending company and contractual terms.The purchaser make a price/cost evaluation.The end-users and experts check how the tender meets the requirements specification.The tenderer might be given a chance to clarify their tender.Evaluation is made – different methods
EvaluationLowest price
OREconomically most preferable
Ergonomics
Quality
Price
Functionality
Environment
Give the weight / share in the process
Grupp
Underlag AnnonseringÖppning
Avtal
Besiktning
Överprövning
Utvärdering
Leverans
Uppdrag
Gör om upphandling
Uppföljning
Selection of supplier(s)After evaluation we decide on one or more suppliers.
The reason for the selection must be documented and based on the requirements and criteria stated in the tender documents.
All tending companies are informed about which company was selected and why. They can appeal against the decision within 10 days.
Contract
Any open issues in the contract is discussed and final terms agreed.
The contract is sent to the supplier for signature.
We return a signed copy after the 10 days waiting period.
Copies of the contract are distributed to the clinic, Clinical Engineering Department and the Financial Department
Delivery of the goods
All deliveries are made to the goods receipt area.
The goods passed on to the Clinical Engineering department for delivery inspection.
After approved delivery inspection the equipment can be put to use and the warranty time starts.
Termination and follow-up
The contract is entered into a database for future follow-up.
All original documents are archived and kept for minimum 2 years. Decisions and contract for ever.
Follow-ups
Signing service contract after the warranty.
Price adjustments.
Prolonging the contract.
Checking the financial status of the supplier and how they perform.
Clockwork logistics
The users order through the database or by writing free text
Electronic authorizing
Buyer handles the free text order
Central creation of the orders to the distributor through EDI or automatic fax
The barcode is read at the delivery centre
Invoice control at the dept. of Economics.
Received - Payment Received at the clinic
Faktura
Current problems
• Lack of discipline – respect for the law.• Short planning horizon – no understanding for time consuming
process.• Purchases are getting more complex; technically, financially and
legally. Competence must be constantly improved.• The law, ”LOU” develops in the wrong direction – detailed
regulations instead of framework guidelines.• New, ”political” criteria, e.g. environment, equality, social justice • Acceptance for the e-purchase system - conservatism.
Smart Buy in the County Council, SMILIncrease the co-operation within the county council
Large volumes give better prizes and functionality
Better knowledge give better terms
Less suppliers give better terms
Guaranteed volumes give better terms
SMIL
Steering group with county and hospital directors
Project group with purchasing managers meets every 14th day
User engaged via reference groups
New way of purchasing
2 new analyzer positions to the county council
Thank youfor
your attention