ProcEx Solutions Ltd
Contributions
Type: Publication Only
Background
The Hemobiotherapy Department at Pitié Salpêtrière Hospital has been providing extracorporeal photopheresis (ECP) procedures for patients presenting with graft versus host disease (GvHD) and cutaneous T-cell lymphoma (CTCL) since November 2011 and for lung transplant rejection patients since June 2013. Initially, an “off-line” system was used for all procedures, and in the first 12 months we carried out a total of 225 treatments. At the end of 2012 we commenced a transition from the off-line system to a Therakos integrated photopheresis system. In 2013 we carried out a total of 527 ECP procedures with 397 using the integrated system. At the start of 2014, the unit was thought to be close to capacity so we participated in a ProcEx Solutions work-flow assessment where we successfully implemented improved ways of managing the increasing demand with the same number of nurses in the unit. Then, in 2014 we transitioned to performing all procedures using the integrated system and a total of 797 treatments were performed.
Aims
The aim of this study was to compare the cost and efficiency of performing ECP using the off-line system versus the Therakos integrated system.
Methods
An activity-based costing method was applied to provide an accurate and meaningful cost comparison between administration of ECP using the off-line method or the integrated system. This was important so as to not be misled by comparing the costs of off-line and integrated system procedural kits alone.
Results
The cost of performing ECP using the off-line system was more expensive than the Therakos integrated system (€1,429 vs €1,265) resulting in a cost avoidance of €131,242 for 2014 by performing all ECP treatments on the integrated system. Of note, the lymphocyte PHA and OKT3 inhibition tests mean scores were 99.2% (Integrated system) and 97.4% (off-line system), respectively.
| Off-line | Integrated (Therakos) |
Collection of leukocyte concentrate (PTC) | €173.75 | €1,009.20 |
Biologic analysis (patient) | €59.00 | €59.00 |
Biologic analysis (cell collection) | €31.05 | — |
Transportation of cells to CT area | €7.76 | — |
Irradiation of leukocyte concentrate | €616.55 | — |
Biologic analysis (irradiated cells) | €76.00 | — |
Transportation of cells to ward | €7.76 | — |
Injection (triple access) | €12.00 | — |
Personnel costs | €108.00 | €40.50 |
Bed retention cost/treatment (per hours used) | €337.50 | €156.00 |
Total cost | €1,429.37 | €1,264.70 |
| ||
Number of treatments in 2014 | 797 | |
Cost per treatment | €1,429.37 | €1,264.70 |
Total cost in 2014 | €1,139,208 | €1,007,966 |
Difference in cost (2014) | €131,242 | |
Summary
The transition from off-line to the Therakos integrated system proved beneficial in terms of cost and ease of implementation. The integrated system has resulted in efficiency gains in terms of the number of patients who can be treated in a day with the same number of nurses being employed. For hospitals considering a transition from off-line methods where cost is a barrier, activity-based costing should be applied to gain an accurate understanding of the true situation. Also, reimbursement factors should be considered when making a judgement; the off-line system allows significantly fewer treatments, so reimbursement levels received by the treatment center will be substantially reduced.
Session topic: Publication Only
Type: Publication Only
Background
The Hemobiotherapy Department at Pitié Salpêtrière Hospital has been providing extracorporeal photopheresis (ECP) procedures for patients presenting with graft versus host disease (GvHD) and cutaneous T-cell lymphoma (CTCL) since November 2011 and for lung transplant rejection patients since June 2013. Initially, an “off-line” system was used for all procedures, and in the first 12 months we carried out a total of 225 treatments. At the end of 2012 we commenced a transition from the off-line system to a Therakos integrated photopheresis system. In 2013 we carried out a total of 527 ECP procedures with 397 using the integrated system. At the start of 2014, the unit was thought to be close to capacity so we participated in a ProcEx Solutions work-flow assessment where we successfully implemented improved ways of managing the increasing demand with the same number of nurses in the unit. Then, in 2014 we transitioned to performing all procedures using the integrated system and a total of 797 treatments were performed.
Aims
The aim of this study was to compare the cost and efficiency of performing ECP using the off-line system versus the Therakos integrated system.
Methods
An activity-based costing method was applied to provide an accurate and meaningful cost comparison between administration of ECP using the off-line method or the integrated system. This was important so as to not be misled by comparing the costs of off-line and integrated system procedural kits alone.
Results
The cost of performing ECP using the off-line system was more expensive than the Therakos integrated system (€1,429 vs €1,265) resulting in a cost avoidance of €131,242 for 2014 by performing all ECP treatments on the integrated system. Of note, the lymphocyte PHA and OKT3 inhibition tests mean scores were 99.2% (Integrated system) and 97.4% (off-line system), respectively.
| Off-line | Integrated (Therakos) |
Collection of leukocyte concentrate (PTC) | €173.75 | €1,009.20 |
Biologic analysis (patient) | €59.00 | €59.00 |
Biologic analysis (cell collection) | €31.05 | — |
Transportation of cells to CT area | €7.76 | — |
Irradiation of leukocyte concentrate | €616.55 | — |
Biologic analysis (irradiated cells) | €76.00 | — |
Transportation of cells to ward | €7.76 | — |
Injection (triple access) | €12.00 | — |
Personnel costs | €108.00 | €40.50 |
Bed retention cost/treatment (per hours used) | €337.50 | €156.00 |
Total cost | €1,429.37 | €1,264.70 |
| ||
Number of treatments in 2014 | 797 | |
Cost per treatment | €1,429.37 | €1,264.70 |
Total cost in 2014 | €1,139,208 | €1,007,966 |
Difference in cost (2014) | €131,242 | |
Summary
The transition from off-line to the Therakos integrated system proved beneficial in terms of cost and ease of implementation. The integrated system has resulted in efficiency gains in terms of the number of patients who can be treated in a day with the same number of nurses being employed. For hospitals considering a transition from off-line methods where cost is a barrier, activity-based costing should be applied to gain an accurate understanding of the true situation. Also, reimbursement factors should be considered when making a judgement; the off-line system allows significantly fewer treatments, so reimbursement levels received by the treatment center will be substantially reduced.
Session topic: Publication Only