Do you know exactly what XYZ implant costs? Probably not. But Kermit might be able to help…and they have now started using the Mendix platform. According to the March 15, 2016 news release, “Mendix, a Platform-as-a-Service (aPaaS) provider, has announced that innovative healthcare startup Kermit has utilized the Mendix platform to custom-build an analytics platform that provides hospitals with greater insight into, and control over, PPI spend, resulting in millions in cost savings and enhanced patient outcomes.”
Kermit Using Mendix, Helping Hospitals Save Millions

“While hospitals spend a significant amount on Physician Preference Items (PPI), such as artificial knees and hips, and cardiac defibrillators, leads and stents, they often lack the visibility required to manage and optimize these costs. Kermit addresses this issue by providing surgeons, supply chain managers and executives with real-time data on implantable medical device transactions. The cloud-based application captures and centralizes billing info, running automated contract compliance and price audits to ensure vendor agreements are being followed. As a result, hospitals are able to save millions of dollars.”
“The costs of medical device implants are out of control, and the market was ripe for a solution that would fix a broken model, ” said Richard Palarea, CEO and Co-founder of Kermit, in the news release. “Kermit is the most disruptive business intelligence application in the segment in the last decade. If we had used traditional development methods, we never could have built an application with the speed, cost-effectiveness and breadth of features we did using Mendix.”
“In today’s digital business environment, the companies that lead are the ones that make bold moves to disrupt their markets, ” said Derek Rook, CEO and Co-Founder of Mendix. “Using the Mendix platform, Kermit’s leaders turned their vision for more accountable PPI spend management into reality with unprecedented speed and agility.”
Palarea told OTW, “Surgeons are being asked to reduce their costs to help shoulder the burden of the CMS [Centers for Medicare and Medicaid Services] bundled payment (CJR) initiative, but most surgeons, when asked what a particular implant costs, typically hazard an incorrect guess. Kermit dashboards, key performance indicators and mobile platforms show surgeons exactly where waste and overcharging occurred and maintain an accurate daily score of contribution to margin.
“Hospitals have attempted to paper clip and tape together their own homegrown systems to perform implant audit and compliance. These disparate systems require significant manual process and are fraught with error points. Others have attempted to cash in on the promise of their EMR [electronic medical records] or ERP [enterprise resources planning] systems, but are finding that the visibility required to accurately manage the category is not there. Kermit captures data at the point of use—in the operating room—and immediately classifies it. Pricing audit and contract compliance is managed in real time and vendors are not issued purchase orders if the price charged and the utilization instance is not approved. The automated process has not only been met with smiles from the hospitals who save money and time, but also by their suppliers who issue correct billing and are paid more quickly.”

Discussion
This is a fascinating development. In my practice we've seen similar outcomes with the revised protocol. The key differentiator seems to be patient selection criteria. Has anyone else noticed the correlation with BMI thresholds?
Great point. I'd push back slightly on the conclusion, the sample size in the cited study is too small to draw population-level inferences. That said, the directional signal is compelling and worth a larger RCT.
We implemented a similar approach last year. Early results are promising but we're still gathering 12-month follow-up data. Happy to share our protocol if anyone is interested.
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