Kjetil Istad

Kjetil Istad is the CEO of the Norwegian Hospital Procurement Trust (Sykehusinnkjøp HF), a national health enterprise that carries out procurement for Norwegian hospitals. He is Vice-president in charge of Value-Based Procurement for EHPPA. EHPPA is an alliance of public and non-profit Group Procurement Organisations which aims to pool expertise, leverage performance and provide its members with a strategic position in the European healthcare procurement market. Introduction of the value-based procurement is a key priority of the alliance, with the belief that this approach will benefit the hospitals we serve in the best possible way, and will translate to value that matters for patients.

Since he was hired as the Procurement Manager at then Aker University Hospital i 2005, Istad has been working in the field of public procurement in the Norwegian health sector.

Before joining the newly founded Norwegian Hospital Procurement Trust in 2016, Istad worked as a Procurement Manager and Director of Procurement and Logistics for the South-Eastern Norway Regional Health Authority.

Istad holds a five-year degree in economics from the Norwegian School of Economics (NHH). In addition, he has completed the Norwegian Health Authority’s Executive Management program.

Public procurement was established as a way of purchasing products that hospitals need. However, this one-dimensional view of procurement is changing very quickly. From humble beginnings as an obscure back-office function, I am pleased to say procurement is fast becoming a high-impact strategic partner for hospitals. What’s behind this shift? Traditionally, product price has been the key feature of a successful procurement process. A good price is important, but there are other elements to consider. The use of the most economically advantageous tender (MEAT) criteria offers scope to include quality and functionality of products and services. Of course, using criteria other than price increases the complexity of the tender, both for the customer as well as the supplier. So, is it worth it? At European Health Public Procurement Alliance (EHPPA), we believe the answer is ‘yes’. In my opinion focusing on price alone can obscure important value drivers. For instance, if you buy surgical gloves, and the focus is solely on price, you will get the lowest cost gloves. But is that a good deal for the hospital? It is not unreasonable to suggest that lower price means lower quality. If that means having to throw away gloves because they cannot be used, the cost of this should be part of the calculation. Using the MEAT criteria, quality can be calculated and incorporated into the decision on which glove to choose. Value-based procurement (VBP) goes one step further than MEAT. VBP is based on the idea that tenders should be evaluated based on what matters to patients. The introduction of VBP is a key priority of the EHPPA alliance. We would argue that this is also what matters to hospitals. This approach is rather difficult to apply if the starting point focuses on a particular product. VBP only works if...
This blog is part 3 of a series on the MEAT value-based procurement project, an initiative that advocates towards a shift from price-based procurement of medical technology towards value-based procurement. It does so by defining a Most Economically Advantageous Tendering (MEAT) framework that includes the value of medical technologies, services and solutions in procurement processes across Europe. Read part 1 and part 2 . If you would like to contribute please contact the MedTech Views editorial team at info@medtechviews.eu . As a public procurement professional, I have witnessed some welcome changes in how we select products for the public health service. However, to maximise the value we get from public spending, we must accelerate this shift in approach. It is futile to talk about innovation and change in the public sector without rethinking procurement. Leaders in the field of procurement must stand up and embrace change in our own processes, in how we approach the market – and in how we think . We need to put more focus on the effect of what we purchase rather than the cost of the items themselves – instead of buying inputs we should focus on buying outcomes. In Norway, we have an agreement with the medtech industry which allows us to test equipment as part of the tender process. This gives us an opportunity to see whether the product solves our problem and to observe how users – doctors, nurses and sometimes patients – view it. For example, when we ran a tender to purchase intravenous (IV) catheters we gave health professionals a chance to use it and sought feedback from patients. During this two-month testing period, we found that the cheapest catheter was not as sharp or flexible as the competing product, and health professionals often needed to try more than...