Season 2 Episode 2: Reshaping healthcare supply chain operations

Driving healthcare excellence

As a leading academic medical center, Nebraska Medicine combines innovation, efficiency, and strong supplier partnerships to deliver exceptional care across their healthcare system.

“Procurement is necessary to get the right supplies to the right people, at the right time to provide extraordinary care,” says Dr. Ash, President and COO of Nebraska Medicine.

In this episode of the Smart Business Buying Podcast, Dr. Ash shares how the organization manages operations across multiple facilities while advancing medical care and research. From leveraging AI to streamlining procurement and building resilient supply chains, he highlights the strategies that keep their system running smoothly. As Dr. Ash puts it, “You probably don't realize how strategic supplies are until you run out. So you have to make sure that you have a partner that's not only meeting the needs of today, but constantly innovating and working with you to make you better.“

Dr. Ash focuses on three key areas:

• Enhancing operations and patient care
• Strengthening procurement and supply chain resilience
• Collaborating with suppliers to meet critical needs

Transcript:

This has been lightly edited for clarity. 

[00:00:07 - 00:00:48]
Kelly:
Welcome to the Smart Business Buying Podcast. I'm your host, Kelly Rogers, for today's Inside Scoop. Today I'm joined by Dr. Ash, president and chief operating officer of Nebraska Medicine. Dr. Ash leads operations across hospitals, clinics and more and brings a unique perspective on purchasing as both a health care executive and a physician. In today's episode, we'll explore how supplier partnerships, smart sourcing, and operational excellence are helping Nebraska Medicine deliver consistent, high quality care across their large health care system.

Welcome, Dr. Ash. To start us off, can you share more about your role and what you oversee at Nebraska Medicine? Tell us more about your day to day.

[00:00:48 - 00:01:00]
Dr. Ash:
I'm the president and chief operating officer, so I'm over health system administration. So the day in and day out operations across not only the hospital but the clinics and elsewhere.

[00:01:00 - 00:01:09]
Kelly:
That is a lot to manage as both a physician and a chief operating officer and president. How do these two different perspectives and influence your approach to health care?

[00:01:09 - 00:01:43]
Dr. Ash:
My role in Nebraska Medicine is president and chief operating officer with a clinical background. I'm constantly focusing on how do we improve quality, make it safer, improve the experience for everyone involved. The person is what is most important to us. So we focus on improving quality, safety, providing a wonderful experience for not only our patients, but our care providers and our team. And then we focus on operational excellence. And so it is always our goal to put the person first and do it in a way that benefits everyone is part of that experience.

[00:01:43 - 00:01:51]
Kelly:
Tell us more about Nebraska Medicine and what makes you unique. What are some of the core values and mission that guide the work at Nebraska Medicine?

[00:01:51 - 00:02:18]
Dr. Ash:
Nebraska Medicine is an academic medical center, a partner with UMC, and we share the same mission, and that is to advance clinical care through research and education and to transform lives providing services that aren't available anywhere else. Our values really are based in the acronym I teach, and it's innovation, teamwork, excellence, accountability, courage and healing.

[00:02:18 - 00:02:31]
Kelly:
That's interesting. I want to touch on the innovation piece as that is core to Amazon business as well. What does innovation look like in a system level for Nebraska Medicine, especially during periods of change or uncertainty, which we've certainly had a lot of lately?

[00:02:31 - 00:03:27]
Dr. Ash:
Nebraska Medicine is an incredibly innovative health system, and we're known internationally for our work in highly infectious disease and our advanced biocontainment center. We've treated patients with Ebola. So American physicians that were, treated with this highly infectious, tragic disease came back to the US, and we were also one of the leaders in our national response to Covid.

Other areas is we are known for internationally for our solid tumor as well as bone marrow transplantation, vascular disease, and a number of other clinical services. We're also highly regarded and digital transformation, the first place in the US to do ambient listening to make it easier for our physicians to connect with their patients, as well as an early adopter of artificial intelligence for operational excellence. Just to comment on a few.

[00:03:27 - 00:03:33]
Kelly:
Doctor Ash, that is amazing to hear about. How did those experiences shape how you approach your operational readiness?

[00:03:33 - 00:03:57]
Dr. Ash:
We have to fulfill our tripartite mission, which is care, research and education, and we provide advanced clinical care services not available anywhere else. To do that, we have to be at the cutting edge. Early adopters of technology, digital health, constantly focusing on operational excellence to be able to make sure that we're providing and meeting the needs for our region.

[00:03:57 - 00:04:14]
Kelly:
Absolutely. And operational excellence is a perfect segue. So switching gears here, we know with so many different locations in your health system that there are many different supplies you need throughout the day. What role does procurement play in delivering consistent, high quality care for your patients?

[00:04:14 - 00:04:28]
Dr. Ash:
Procurement is necessary to get the right supplies to the right people, at the right time to provide extraordinary care. And anyone that lived through Covid and was in health care at that time realized how mission critical supplies were.

[00:04:28 - 00:04:48]
Kelly:
Yes, I know many of our Amazon Business customers, even beyond health care, felt the same way. The Covid era definitely forced a lot of us to think differently about our strategies and how we sought out, and how we use backup suppliers. Can you talk a little bit about the implications if products and supplies aren't there on time, or if you maybe run out of stock?

[00:04:48 - 00:05:10]
Dr. Ash:
If we think about the implications of not having the right supplies at the right time to care for patients, we have to spend a moment and acknowledge that most all of us during Covid had those moments where we may not have ran out, but we were definitely afraid that we could have ran out of supplies that would have had us delaying surgeries or not being able to provide them at that time.

[00:05:10 - 00:05:25]
Dr. Ash:
And that's really unthinkable. And so we have to have partners that are constantly working to make sure that we're as resilient as well as supplied as possible, so we can do what we do better than anyone else. And that's provide extraordinary care.

[00:05:25 - 00:05:37]
Kelly:
That's great. Dr. Ash, we know patient care is always the number one priority. So how does having confidence in your sourcing process help build a better experience for your employees, whether they're clinicians or physicians or other roles?

[00:05:37 - 00:05:57]
Dr. Ash:
These are hard jobs. These are stressful jobs. So anything that we can do for our staff or our employees that make it much easier to get their job done. And so with Amazon, we were able to introduce an easier, less friction way of ordering supplies, which makes their day better. Therefore it makes us happy.

[00:05:58 - 00:06:08]
Kelly:
Thanks, Doctor Ash, we love to hear that. With such a large health system like Nebraska medicine, give us a sense for how broad the scope is of what you're sourcing every single day.

[00:06:08 - 00:06:32]
Dr. Ash:
Supplies needed across the health system go from anywhere from the O.R. to the clinic space, as well as the back office, and they're all important. It's not just who's providing the care at that moment, but it's all the people behind the scenes that are supporting them. If they can't get their job done, it's going to show up in ways that we can't allow to happen. That's why we demand so much from our partners.

[00:06:32 - 00:06:43]
Kelly:
Thank you, Doctor Ash. Now we're moving on to supplier relationships. You've mentioned this a couple of times when you're evaluating new suppliers or long term partners. What are some of the most important things that you're looking for?

[00:06:43 - 00:07:06]
Dr. Ash:
When we're looking for strategic alliances. We have to look at those that are cultural fit. And do they provide a service in a way that is of higher quality, more efficient, and a better experience for our care team? And then we hold them accountable and make sure that they're doing what they said they would in a way that is cost effective. And we don't have to worry about.

[00:07:06 - 00:07:17]
Kelly:
Yeah, those are great criteria. From your perspective, can you share how some of these really strategic alliances have helped Nebraska Medicine adapt to the ever changing environment and help to serve patients better?

[00:07:17 - 00:07:44]
Dr. Ash:
So strategic engagements have helped us advance as an accident medical center. There's a number of examples of where where some of the first in the country to provide care, advancing services that wouldn't be available without these type of alliances. But we also need those partnerships and alliances in other ways, making sure that we have the right technology, the right supplies, and being able to do it in an efficient, cost effective way.

[00:07:44 - 00:07:53]
Kelly:
And how do you approach these areas and spend that fall outside of traditional contracts and alliances? So in procurement we often refer to this as tail spend.

[00:07:53 - 00:08:13]
Dr. Ash:
So in health care there are a lot of purchasing that is based on contracts. But there's many, many, many other things that there are different vendors, different choices and different price points. So by providing a easy to use front end that the team likes to use, but also helps us control cost and spend, that's a great partner.

[00:08:13 - 00:08:23]
Kelly:
I know a big topic for purchasing teams has always been cost. So what operational and financial challenges are you seeing right now across the healthcare industry?

[00:08:23 - 00:08:51]
Dr. Ash:
If you continue to look at how health systems are performing across the country, a third of them are still losing money. Margins are measured in single digit and a few mistakes. A few inefficiencies can take an organization from a black to a red at a time that we can't allow that to happen. So we have to constantly focusing on not only how do we advance clinical care, but how do we do it in a way that is safer, more efficient, and a better experience for everyone involved?

[00:08:51 - 00:08:58]
Kelly:
Interesting. And how do you weigh the financial outcomes against the quality of care when you're making some of these trade offs?

[00:08:58 - 00:09:30]
Dr. Ash:
We focus on improving quality, safety, providing a wonderful experience for not only our patients, but our care providers and our team. And then we focus on operational excellence. How do we positively impact the financial bottom line? I'm not going to prioritize projects that save a dollar if it creates a less safe environment. So we're really prioritizing in our decision making, even as simple as making sure people have the right supplies, how can we do it in a way that improves quality, safety and makes their lives better?

[00:09:30 - 00:09:37]
Dr. Ash:
That is a good day. If I can do it with a partner that helps lower the cost and eliminate waste, that's a wonderful day.

[00:09:37 - 00:09:50]
Kelly:
And that is so important, especially in health care. So I want to get into how you enable that high quality patient experience, but also what makes purchasing and supply chain in health care different from other industries?

[00:09:50 - 00:10:19]
Dr. Ash:
Health care cannot go oh, in a day or two I'll have a supply. I need the supply at the moment to make sure that I'm providing extraordinary care. However, we also need to buy it as cheaply as possible so health systems continue the work in group purchasing organizations, where we try to do collective bargaining and using a larger buying group to recognize the cheapest, you know, the cheapest price, the most value possible.

[00:10:19 - 00:10:27]
Kelly:
So what shifts are you seeing and how healthcare systems are thinking about supply chain management? Or maybe working differently with these GPOs.

[00:10:27:12 - 00:10:42]
Dr. Ash:
We're really focusing on resiliency in the supply chain as well as cost and efficiency of getting those products. We don't want a warehouse filled with supplies. We want partners that are able to get us the right things at the right time to meet our needs.

[00:10:42 - 00:11:01]
Kelly:
Of course. And technology has really impacted organizations ability to create more resilient, adaptable supply chains to deal with the sort of ever changing nature of health care. So while we're on this topic, everyone's talking about AI. How are you thinking about the role of AI in procurement to help better predict your healthcare systems needs?

[00:11:01 - 00:11:41]
Dr. Ash
AI is really good at looking at patterns and behavior and predicting what you will need, and it does it in a way that you're often surprised. The benefit of doing that is it makes it easier for the people that previous had to do that work. It's not rewarding to look at a list of how many of these I need and go through a process.

So anything we can do to eliminate that will be seen as a good thing. Our goal in the use of AI is not to eliminate people, but to allow people that focus. And what's more beneficial in our organization. And at the end of the day, that's either providing care or supporting those that provide the care. So if I can allow us to do a better job. Wonderful.

[00:11:41 - 00:11:56]
Kelly:
We totally agree, Doctor Ash, and we're looking forward to seeing how I can enable us to meet that goal and more. To wrap up things on today's inside scoop. What advice would you give to other organizations, even beyond the healthcare industry, to improve their buying processes?

[00:11:57 - 00:12:19]
Dr. Ash:
The old way can't just be taken for granted. You constantly have to be looking at what are new, innovative ways and who are those partners that are, even if they're introduced into a space that you may not be as familiar with, how are they approaching? How are they introducing a new way of doing things? You have to look at strategic alliances that allow you to focus on your core business.

[00:12:19 - 00:12:34]
Dr. Ash:
You probably don't realize how strategic supplies are until you run out. So you have to make sure that you have a partner that's not only meeting the needs of today, but are constantly innovating and working with you. Understand what they can do to make you better.

[00:12:34 - 00:13:14]
Kelly:
Thank you to Doctor Ash from Nebraska Medicine for joining us today and sharing your insights. I think a key takeaway for me is that having a strong, resilient purchasing process allows your team to focus on what matters most, and in this case, that's taken care of. Patients, whether it's having reliable and easy access to supplies or building supplier relationships, like Doctor Ash mentioned, having a strategic procurement practice is crucial to being able to weather uncertainty.

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