In order to be strategic about spend data, we must first understand the role of the researcher and analyst. So it is the responsibility of a supply chain professional to ensure that reporting and insights are drawn from reliable data. Cross-referencing data sources, especially purchase order (PO) and surgical case files, can be a great way to check a) if disparate data sources are in alignment or b) if your data needs to be vetted. If the data sources are not aligned, insights into procedure analytics can and will be overlooked – or may not even be possible. This leads to missed savings opportunities and a lack of alignment between clinicians and supply chain.
In this blog post, we’re going to discuss the differences between a purchase order (PO) file and case file, the issues that arise from them, and solutions for healthcare supply chain teams.
The Differences Between Case Files & PO Files
A case file is exported from a case file management system, e.g. Epic. The case file is a file in which all parts have a unique case identifier, and they have been used or implanted within a patient. In a surgical case, different parts can be from different vendors. Whereas, in a purchase order file, parts come from the same vendor. We often see other items – such as bone cement – and instruments included in these cases. These are sometimes provided by a different vendor than that of the metal or ceramic implants.
A PO file is different as it is the record of all of the parts and medical supplies that have been ordered by a facility. These are recorded by vendor, which oftentimes leaves out important information about a case. This is seen often in trauma, cardiology, and spinal procedures.
It’s a little different in orthopedics. A PO file for orthopedics procedures can be used for case analytics because oftentimes the parts implanted are from the same vendor and are included on the same PO.
Summary: A case file is a record of the procedure and parts that have been used on a patient. Whereas, a PO file is a record of items that have been purchased by a facility.
Potential Problems For Procedure Analytics
A common problem with PO files is that they do not provide case analytics for procedures other than arthroplasty. This is because arthroplasty is often recorded on the same PO file that is going to the patient. Whereas, other procedures are typically split across multiple POs. Other case types such as cardiovascular procedures, trauma, and spinal procedures cannot be derived from a purchase order file due to the fact that most of the parts used in these cases are not bought on the same PO. These parts are usually purchased separately or on bulk orders. For instance, trauma parts need to be kept in inventory at the hospital. This is also similar for bone cement used in arthroplasty cases, as cement is usually ordered separately from the implanted devices.
The PO file also lacks surgeon specific information. That’s because it was not intended for case analytics.
Without surgeon information, healthcare supply chain professionals will struggle to compare procedure data by physician.
Case files are great for getting to procedure analytics. However, we have come across many case files that were out of date and missing crucial items. These problems usually arise from Item Masters that are not properly updated, or from filters that omit non-stock items. This is a problem because out of date case files can skew spend amounts.
If crucial parts are missing, healthcare analysts cannot determine what type of procedure was performed.
Combining Case Files & PO Files
In your data system, congruence is the key to knowing case analytics – as well as understanding spend and where to save money. We often see case counts in the PO file that do not line up with case counts in the case file. This is problematic because the data lake needs to be congruent.
If items are missing from either file, it will miss many spend analytics opportunities.
Best Practice for Reconciling Case File & PO File
A quick litmus test is to compare the counts of arthroplasty cases in your PO file versus the arthroplasty cases in your case file, for the same time period. This is a good first pass in determining whether or not items are being accurately recorded – and recorded on time.
Once you have determined that the case counts lineup, you can go into the cases themselves and see if any parts show up in the case file that do not show up in the PO file or vice versa. This issue can often be traced back to an item master list. Often, we will see missing parts that do not have a record in an item master list. This could also be a filtering issue where non-stock items are filtered out.
After determining if any items are missing from either file, you can go in and, using specialized software, work and see if the pricing is lining up between the PO and the case file. The Purchase Order file is often used as “source of truth” for pricing since it will have the correct pricing for the part. If a part does not have the correct pricing, we recommend assigning the correct price from the PO to the case file part.
It is preferable to continually update the pricing in your case file for more accurate data and faster turnaround times.
Strategic Impact of Reconciling the Files
By merging and/or reconciling your PO file and your case file, you can get to a better data lake where consistency and congruence are impact drivers. A better data lake can lead to better pricing and vendor consolidation – as well as seeing where the system is performing a majority of their procedures.
Now, more questions can be answered such as: are we doing mostly normal uncoated knees or coated knees? Are we performing more specialized surgeries such as revision or oncology needs? How much are we spending on these procedures?
If you don’t have a solution that can cross reference both files, Curvo can help. We have the software, the data skills, and the domain knowledge to better understand the depth of the differences between PO and case files. We work alongside data teams to identify areas in both PO and Case files where improvements can be made. Schedule a demo to see the difference reconciling those two files can make.