For the hospital it is important to be cost efficient, the suppliers wants to achieve growth in profits. The hospital must strive for independent solutions and investigations in this area. New innovations will change the scenario.

When Fresenius — purchased a rival dialysis provider — it had to sell outpatient kidney dialysis clinics otherwise it would violate federal antitrust laws. “Competition lowers costs and increases choices for consumers,” … “It’s especially important that consumers Reconditioned Hospital Equipment have choices when it comes to life-saving medical treatments… The rising cost of health care services is a significant concern (1)

The providers of dialysis clinics and services are not exactly the same as the providers of the dialysis equipment. Frenesius and Gambro offer both (the product and the service) but B.Braun and Baxter do not. Besides Frenesius and Gambro four other centers (Independent, Davita and Dialysis Clinic Inc, offer 80% of the Dialysis centers in the US. The data is from 2006, source: (2)

globaldialysis.com/usproviders.asp.

Besides the organizational solutions: Buy (new equipment) or sourcing by a service center) it is also possible to purchase “reconditioned equipment from various brands (FMC, Baxter, etc.”

Flexibility is often a business requirement that also in this area influences the form of the organization (buy or source from third parties, etc). One reason to be flexible is the constant innovation in the medical world. One producer may offer the best solution today, but in the near future a new provider may offer a more efficient solution. Also in the dialysis environment there are constant innovations.

“Gambro enters the emerging field of regenerative medicine, using adult stem cells for restoring the functionality of damaged kidneys. As a first step, Gambro will invest … during a three-year period for research purposes.” (Annual report Gambro 2005).

Other providers talk about the possibility of (external) artificial kidneys that would make the dialysis process easier…

Hospitals themselves will have to actively follow the market developments if they are not themselves already involved in research, Academic hospitals normally will be.

The last element if this dialisis case is information management. As mentioned in a previous article, the patient information must be updated during the treatment. But there are also clinical databases.

“Clinical databases such as EuCliD (European Clinical Database) are an important instrument for ensuring the quality of dialysis treatment. … EuCliD allows us to efficiently compare the treatment quality of individual dialysis clinics. Potential weak points can be more readily identified and … counteractive measures can be applied instantly. EuCliD is therefore a significant component of our integrated quality management system and also assists nephrologists in providing comprehensive patient care.” (3)