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									                                                                    Value Analysis Team (VAT)
                                                                       Surgical Services
                                                                          Meeting Notes
VAT Meeting Date:         Wednesday, November 26, 2008 - 12:00 - 1:00 p.m.                                                   Notes prepared by: Brenda Forbis
Attendees:                Ryan Grueber, Kevin Ray, Dr. Faizer, Allan Tallmage, Michelle Reynolds, Susie Wyatt, Amy Tinsley, Theresa Baker, Dr. Stewart, Dr. Choma, Glenn
Absent:                   Mark Jackson, Lynn McKinney, Dr. Calhoun, Keith Sublette, Dr. Brown

Introduction of New
Review of Minutes         Minutes of October 22, 2008 meeting were approved as presented.

I. Product Trial Review                                   Update/Results/Discussion                                                 Action

                          The approved trial of this product in six cases have been completed. Dr.'s Nichols and
                          Gardner now use talent stent grafts only. Dr. Faizer still has occaisons where he must
                          use the Zennith graft as not all sizes are currently available in the Talent Stent Graft. Dr.
Talent Stent Graft        Faizer will continue to use the Zennith graft until such time as all sizes are available in
Request by Dr. Faizer     the Talent graft.                                                                             Approved
#999                      One of the trial cases has been completed. As this product is best used on thin patients, Pended waiting completion of
Mesa Spinal System        they are awaiting the appropriate patient to conduct the final trial.                         last trial case.
Request by Dr. Kuhns
#1467                     This product was approved for three trials. Two trials have been completed. Doctor            Pended waiting completion of
CopiOs Bone Void Filler   response was that the product was okay, but not necessarily better than what we               last trial case.
Request by Dr. Crist      currently use.
#1856                     Dr. Bal has completed the trial of this product. Dr. Bal did indicate that he did approve     Denied.
Tri-Lock Bone             the product but also stated that he felt it was evenly matched with what we currently use.
Preservation System       He stated that he did not believe all of his patients would benefit from this new system.
Request by Dr. Bal        His final comment is if what we currently use has a lower price, then we should continue
                          use of the current product.
#1886                     The trial of this product has not started.                                                    Pended waiting completion of
Thermadrape                                                                                                             trial.
Request by UH OR
#1889                     The trial of this product has been completed. The product received very high ratings          Approved.
Artiss                    from doctors involved in the trial. They would like to be able to use this product as it is
Request by Burn           very benefical to burn patients.
OR/Dr. Meyer

#1660                     Trial has not started.                                                                        Pended waiting completion of
FitMore Hip                                                                                                             trial.

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    Agenda Items                                                 Discussion                                                  Action (Who? What?                Cost/Benefit
                                                                                                                                  By When?)
II. Old Business
                         Glenn Berkey is working with physicians to receive and review information on
Baxter Agreement         comparison products from Ethicon.
                                                                                                                   Dr. Choma recommends
                                                                                                                   approval of a trial case for doctor
Request #1467                                                                                                      that would like to try it. They
CopiOs Bone Void Filler Dr. Choma reported that he had investigated this product further. It consists of bovine    should then report back what
Paste                   collagen and synthetic products and that it is friendly to bones. There is no head to head their findings are with product
Request by Dr. Crist    study of Mastergraft vs Copios and both are good products.                                 use.

                         The Baxter Agreement has been renewed with the reported cost increase. Baxter did
                         suggent use of a product Gelfoam Plus instead of Surgifoam and Thrombin. The
Baxter Agreement         Gelfoam Plus would have an approximate cost of $300.00 which is higher than the cost           Will continue to use SurgiFoam
Gelfoam Plus             of the current product.                                                                        and Thrombin.

II. New Business
New Item Requests
Comparison of Ortho      Short discussion on the addition of some new orthos. The new packs have been in use
Packs.                   and proving to be beneficial                                                                   Approved

Disposable Bipolar       Reusable forceps are difficult to keep in supply and difficult to verify insulation coating.
Forceps - two sizes      The disposable forceps are currently being used in custom packs. They are single use                                            Cost increase of
Request by UH OR         and are currently being used by the ENT and spine doctors as back up.                          Approved                         approximately $3,150/yr.
Variax Distal Radius
Implant System
Request by UH                                                                                                           Pended per discussion with       $400 per procedure cost
OR/Plastic Surgery       Awaiting discussion with Dr. Gainor.                                                           doctors.                         increase.
Variax Hand Solutions
Request by UH            This product is similar to Synthes modular currently being used and would be a                 Pended per discussion with
OR/Plastic Surgery       consigment product.                                                                            doctors.                         Cost neutral.
                      This request is pending Dr. Zitsch's approval. This is used in procedures for obstructive
#1990                 sleep apnea - genioglossus advancement and stabilization; hyoid and myotomy and
Repose Bone Screw     suspension. We currently perform no surgeries of this type. This procedure would be
System                another option when CPAP and UPPP or other surgeries fail. Ryan reported that there Pended per discussion with Dr.
Request by UH OR/ Dr. are reimbursement problems. Medicaid/Medicare and Blue Cross do not currently             Zitsch and further review of
Chang                 reimburse for this procedure as they consider it experimental.                            reimbursement issues.

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Finess Sinue Treatment This request is also pending discussion with Dr. Zitsch. Cost would include $2,499 for a
Request by UH OR/ Dr. reusable flexible endoscope and $1,100 for each treatment kit. Current product cost is      Pended per discussion with Dr.
Chang                  $1,600.                                                                                    Zitsch.
                       This product has an inserter which guides and distracts interbody space and should                                          Less potential trauma to
Lucent PEEK Lumbar     allow placement of more appropriately sized interbody spacer. This product has been                                         patient's nerve roots and
Interbody Cages        trialed in one case and received excellent reviews from the physician using it. The cost                                    faster for surgeon to
Request by CRH - Dr. is $4,171 each with an estimated usage of 4 per month. Current product cost is $4,271                                         insert; will not need
Kuhns                  each.                                                                                      Approved                         external distractor.
#2024                   This product is packaged in blister packs. Current product is packaged in glass vials     Approved. Theresa Baker and
Cobalt G, HV High       which presents possible glass breakage and contamination of product. This cement is       Allan Tallmage will meet with
Contrast cement         blue and easily seen so that excess can be removed. There is a possible cost savings      doctors to try and consolidate
Request by Dr. Aleto    of $20 - $24/each savings over current product.                                           cement products.

Open discussion

Meeting Adjourned:      12:31 p.m.

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