What You Should Know:

• Three years after COVID-19 was declared a public health emergency, many healthcare supply chain leaders and frontline professionals are operating in survival mode, according to new industry research from Deloitte Consulting LLP.
• Ongoing challenges include economic pressures, multiple resource shortages, data visibility and labor issues.

Key Findings

To gain greater insight into these impacts, Deloitte expanded its study by conducting site visits to healthcare facilities, interviewing frontline professionals and re-interviewing supply chain leaders in private and public sectors across government, healthcare, academic institutions, and humanitarian non-governmental organizations (NGOs) from November 2022 to March 2023.

Key findings include:

• 70% of interviewees cited data visibility as a concern.
• 73% of those interviewed indicated that disruption is the expectation, impacting their ability to focus on strategic initiatives, such as health equity.
• 60% of post-pandemic interviewees believe that healthcare supply chain will remain a focus for their organizations.

3 Recommendations to Increase Healthcare Supply Chain Resilience

To increase healthcare supply chain resilience and enable healthcare organizations to focus more on implementing long-term strategic initiatives, Deloitte recommends:

1. Developing a robust risk management framework and continuously monitoring supply networks to prepare for possible disruptions.
2. Focusing first on supplier relationship management for critical products.
3. Leveraging a Human-Centered Design approach to identify opportunities for improvement.

What You Should Know:

– Today GHX announced its acquisition of Syft, a leading provider of AI-enhanced inventory control and end-to-end supply chain management software and services. 

– As a wholly-owned subsidiary of GHX, Syft joins GHX’s value-based care division’s growing portfolio of solutions that help modernize the supply chain.

Modernizing Healthcare Supply Chain to Overcome COVID-19 Related Challenges

As health systems shift to value-based care as well as overcome COVID-19-related challenges, it’s vital to modernize the supply chain with the technology, processes and people needed for data-driven decision-making, end-to-end visibility, automation and collaboration. – Syft helps health systems remove complexity and optimize the supply chain from dock-to-doc – from warehousing and distribution to the clinical point of use. Combining Syft’s approach to automation-driven supply chain management with GHX’s extensive network and collection of data will help healthcare leaders transform the supply chain to better meet the demands of a value-based future.  

Syft represents the third acquisition GHX has made in the last two years that is focused on advancing healthcare’s movement to value-based care. In October 2021, GHX added Explorer Surgical, operator of a comprehensive digital and remote case support platform, and Lumere, provider of evidence-based data and analytics, in January 2020. Financial terms of the acquisition were not disclosed. Cleary Gottlieb Steen & Hamilton LLP acted as legal advisor to GHX. McDermott Will & Emery acted as legal advisor to Syft. 

“To combat these challenges and accelerate the shift to value-based care, health systems need to transform the supply chain from a cost center to a value-driver,” said Bruce Johnson, president and CEO, GHX. “Forward-thinking leaders are investing in the digital transformation of the supply chain with the technology, data and processes required for greater collaboration, automation, visibility and data-driven decision-making. Syft provides the data and insight health systems need to reduce costs, improve efficiency and support care transformation.”

In December 2019, the Assistant Secretary for Preparedness and Response told a House committee that “supply chain issues were among the most significant challenges to preparing for an influenza pandemic as well as other infectious diseases.”  A few months later, healthcare systems across the country and around the world are face-to-face with that harsh reality, as many of the largest healthcare suppliers are unable to fully meet the growing global demand for personal protective equipment (PPE) for healthcare workers and ventilators and other supplies needed to care for patients.  

Supply chain professionals are collaborating and innovating with clinicians and communities in ways that are not only addressing the immediate crisis but also will likely reshape the future of the healthcare supply chain. As the COVID-19 pandemic progresses, with some communities at or near the apex, the lessons learned to date can be shared in real-time with those still in its path.  

The work being done by Yale New Haven Health, as well as Mercy, BJC Healthcare, and SSM Health in the St. Louis area, serve as examples other health systems can follow as organizations work diligently to establish best practices to help serve their communities in the days and weeks ahead. 

Collaborate and Communicate with Clinicians

Supply chain professionals emphasize the importance of making sure healthcare workers feel safe in order to perform at the level demanded by the disease. This is challenging when the supplies they are accustomed to are no longer available and short supplies of alternatives warrant protocol changes, such as wearing the same mask for longer periods of time or even re-using equipment. Implementing these changes must be done in close collaboration with clinical leadership and constant communication with front line staff, so that they not only understand the changes but also the supporting evidence.  

Patrick Kenney, MD, medical director for supply chain at Yale New Haven Health, says it is especially disruptive for systems and clinicians who routinely seek to reduce variation to improve quality. When changes are a necessity, not an option, Dr. Kenney stresses “communication is essential, along with close interaction between supply chain, medical staff and nursing leadership.” Yale New Haven Health employs a multitude of communication channels, including videos, websites, and town halls, among others, to help clinicians with the transitions.  

Dr. Kenney says the guidance from the Centers for Disease Control (CDC) has been vital in providing as many alternative strategies as possible. He and his colleagues have conducted research on the reprocessing of N95 respirators and are implementing the practice to help minimize shortages of the higher filtration devices.  The research (currently undergoing peer review) is available on a pre-print service (https://www.medrxiv.org/content/10.1101/2020.03.24.20041087v1) to accelerate knowledge sharing.  The 1,000+ COVID-19 related articles already on the site are a testament to the wealth of knowledge that is being generated by researchers around the world.  

Community Coordination

In his daily briefings, New York Governor Andrew Cuomo has called on hospitals in the hard-hit New York City area and now the entire state to plan and function as if they were one system, to help ensure, among other things, that supplies are where they are needed most. Without such coordination, Governor Cuomo says individual hospitals and governments can create unnecessary competition leading to higher prices when they each seek to secure supplies from the same sources.   

In St. Louis, three major health systems, Mercy, BJC Healthcare, and SSM Health, are collaborating at the CEO level on testing, patient surge projections, and capacity planning.  BJC Chief Supply Chain Officer Tom Harvieux says it has been “a real community effort.”

Link the Patient and Supply Demand Planning

Yale New Haven Health has also created a dashboard of patients with confirmed or suspected cases to visualize where patients are coming from and to plan for upcoming demand. The System’s Corporate Supply Chain Lead Vin Matozzo says his team can predict with 70 percent accuracy the associated supply needs for those patients, helping ensure the product is where it is needed and to model the financial impact on a daily basis.  

Securing and Strengthening the Supply Chain

With the COVID-19 pandemic expected to last into the summer, and traditional suppliers likely unable to meet the full demand, the Association for Healthcare Resource and Materials Management (AHRMM), part of the American Hospital Association, has led an effort to identify and vet non-traditional suppliers to help broaden the supply base, while also minimizing the introduction of unscrupulous players. The vendors cleared through the process are listed on the AHRMM COVID-19 page.  Matozzo says the FBI and US FDA have also provided guidelines for how to recognize counterfeit products.  

Going forward, Yale New Haven Health’s Matozzo says it will be important for hospitals and healthcare systems to have better visibility into upstream supply risks, be it from natural disasters like Hurricane Maria, trade sanctions, labor strikes, or another pandemic that puts unprecedented demand on the global supply chain.  With a deeper understanding of how their supply partners are managing risk, providers can make sourcing and contracting decisions to minimize potential supply chain disruptions.  

Across the country, supply chain leaders credit relationships with trusted partners as foundational to meeting critical needs, beginning with the clinical, financial and operational leaders inside their own systems, and extending out into the community. This includes government, emergency responders, and public health agencies, as well as neighborhood resources. 

With many schools with medical training programs closing their on-campus operations, they can be a great source for supplies,  Instead of sourcing product from suppliers only, hospitals are calling on organizations that typically purchase those supplies, such as schools, construction companies, and hardware stores. In other cases, those with 3D printing capabilities are downloading open-source designs for products ranging from face shields to respirator parts and setting up production lines in their living rooms. As one hospital supply chain leader put it: “In healthcare, we get used to things working with certain players; in times of crisis your next-door neighbor might be your best supply chain.”

About Karen Conway

Karen Conway is Vice President, Healthcare Value with Global Healthcare Exchange (GHX). GHX is a healthcare business and data automation company that works with 4,100+ North American healthcare providers, and 600 manufacturers and distributors in North America to automate their business processes.

If we don’t learn from history, are we doomed to repeat it?  In 2009, as the H1N1 swine flu swept the globe, U.S. hospitals began to run out of test kits. Some had to set up tents to handle the rush of patients. Supplies of personal protective equipment including N95 respirator masks ran out in many places despite millions distributed from the national stockpile. 

Today’s coronavirus crisis is exponentially worse yet eerily familiar. Hospitals in New York, the pandemic’s epicenter, are already overwhelmed and running desperately short on supplies of PPE, ICU beds, ventilators, and other critical equipment. With the rate of infection still climbing across the country, it’s time to leverage lessons we learned from previous epidemics and supply shortages that could help hospital supply chain and clinical engineering (CE) teams respond to the challenges they face today – and prepare for the next epidemic tomorrow.

In 2009 I had an up-close view of the impact of H1N1 as the CEO of the nation’s largest (at the time) group purchasing and supply analytics company. What I learned then and experienced in the years since as various supply shortages have hit the industry is that our healthcare system is not perfect but has the talent and tenacity to endure.  We will face some tough times, yes, but we will get through this.

It matters, though, just how we get through it. At this challenging time, it’s important that we embrace positive new patterns of behavior and activity. Here are five lessons from the past that can be applied today to speed improvements to the supply chain and minimize the loss of life: 

1. Create open communications between providers and suppliers

One of the biggest challenges we faced during the H1N1 epidemic – and again during the 2015 IV solutions shortage – was unmanageable spikes in demand across certain health systems. Many hospitals resorted to ordering more respirators and IV solution than they needed for fear there wouldn’t be any when their patient load spiked, as expected. This approach exacerbated shortages in other facilities that used just-in-time ordering.

To avoid fear-based stockpiling and ensure access to critical equipment, it’s important to build and maintain open communications between providers and suppliers. Suppliers can work with health systems to manage to their historical ordering patterns and avoid stocking up outside of the norm, including previous spikes in demand. During flu season at my previous company, we always assembled a team to help manage demand on flu items to ensure we had enough gowns, masks and other PPE. To inform the demand for the influenza vaccine, we surveyed our members every year prior to the flu season. 

Open communication also fosters supply chain transparency, helping to avoid the kind of wasteful churn we’ve seen during this pandemic as providers search desperately to locate needed equipment and supplies. However, achieving visibility into the location, quality and availability of inventory across various players in the supply chain requires more sophisticated automation and analytics, and ideally an online marketplace to consolidate the hundreds of supplier relationships that most providers maintain.  

2. Use analytics to predict demand and forward-buy appropriately.

You can’t manage or improve what you can’t measure. Without advanced analytics to guide purchasing decisions, it is virtually impossible to accurately predict demand and supply.  Analytics enables CE teams to monitor high-demand mission-critical items and anticipate which products might be a problem if they became unavailable. By reviewing historical purchasing patterns, both steady-state and in spike conditions, analytics lets CE teams forward-buy using predictive analytics and advanced strategies.

The technology can help by delivering just-in-time information to assure maintenance of optimum stock levels, avoid stock-outs and predict surges in ordering.

3. Evaluate alternatives or new utilization pathways for critical products.

Even the best-equipped most automated supply chain sometimes runs into shortages that can’t be fixed in the near term. When that happens, hospitals are forced to figure out the optimal use of short-supply products to lower demand.

During the IV fluid shortage of 2015-16, some hospitals leveraged alternative pathways for use of Lactated Ringer’s or LR solution, one of the most common intravenous fluids that are used when patients are dehydrated, having surgery, or receiving IV medications. These hospitals found that they didn’t have to use LR solution in every case during surgery and so lowered the overall demand for the fluid.

Similarly, hospitals on the front line of the coronavirus pandemic face critical shortages of ventilators to care for COVID-19 patients. Adjacency markets are jumping in to fulfill the need, and some hospitals are finding they can locate refurbished or rental ventilators.

4. Ensure uptime of mission-critical equipment.

As the current shortage of ventilators shows, it’s critical to have a supply of reliable, cost-effective medical equipment up and running for patients when they need it. Equipment downtime can be deadly during an epidemic.  But minimizing downtime requires CE teams to do something that few have the resources to do—continuously track the quality of the parts and services they purchase. 

Quality-tracking is virtually impossible when teams independently contract for hundreds of pieces of equipment and thousands of replacement parts—a process that is neither efficient nor their core competency. Instead, they could adopt industry solutions that ensure suppliers are selected based on objective, qualitative and quantitative measurements that are predictive of high quality. These measures include the suppliers’ return rate; their return-during-warranty rate; and indicators of the level of service required over time.

Besides ensuring only high-quality equipment and parts are being purchased, CE teams can expand their access to resources with on-demand equipment servicing options. If the team lacks service capabilities and field service engineers to keep equipment running and is relying on on-contract service, it may be time to consider another option. Some companies support on-demand onsite services provided by a network of independent, local service organizations. This approach ensures the clinical availability of equipment on extremely short notice with repairs by certified experts.

5. Share insights and best practices across your network.

As many have observed, healthcare is a lonely business. Health systems often tend to operate in isolation from their peers. Yet during difficult times like these, healthcare professionals want to know what practice adaptations others have successfully instituted. 

Fortunately, CE teams can join online communities that encourage innovation and knowledge-sharing among peers in health systems across the country. In some of these communities, members can access curated content comprised of the latest best practices, along with tools that support strategic initiatives such as Capital Planning, Alternative Equipment Maintenance, and key strategies for achieving high-performance HTM.

While this epidemic is unprecedented by all measures, our industry has experienced and endured many epidemics and countless supply shortages over the decades. Leveraging our learnings from these, we have the experience to effectively manage the coronavirus pandemic, no matter how painful it might be today. It won’t be easy. But by following the strategies I’ve laid out, and by working together to abate fear, we will be in a much better position to manage the crisis. 

About Jody Hatcher

Jody Hatcher is the former president of supply chain services for Vizient and a current board member of PartsSource. Prior to that, he had responsibility for all operational businesses of the newly merged VHA/UHC/Novation organization prior to acquiring MedAssets. Before that, he was President and Chief Executive Officer of Novation, which became part of Vizient in 2015. Under his leadership, Novation achieved record-breaking member savings and consistently increased member participation in offerings.

Chances are good the face mask you’re wearing or have on hand (just in case) was made outside the United States, maybe in China.

In calmer times, that wouldn’t matter much. But when Chinese officials are trying to stem a global pandemic that started in a Chinese city, how likely is it that the country will continue to export face masks at the same rate?

This isn’t a hypothetical. With the spread of COVID-19, aka, coronavirus, we know the answer is not very, and that it impacts a great deal more than face masks.

This moment might be one of opportunity for Mike Bowen, executive vice president for one of the few companies that manufactures masks in the U.S., were it not for the overwhelming numbers—for the chasm that exists between supply and demand.

“I’ve got requests for maybe a billion and a half masks, if you add it up,” Bowen says, adding that since January he is averaging around 100 calls and emails a day. “Normally, I don’t get any.”

Of course, the challenge illustrated by Bowen’s predicament is far more expansive than the inability of one Texas-based manufacturer to keep up with a ridiculous, panic-driven spike in demand.

“Without secure supply chains, the risk to health care workers around the world is real,” said Dr. Tedros Adhanom Ghebreyesus, director-general of the World Health Organization. “Industry and governments must act quickly to boost supply, ease export restrictions and put measures in place to stop speculation and hoarding.”

And in the meantime, what can an individual hospital or health system do to try and ensure adequate supplies?

Focus on things at home. Keep it local. At a minimum, implement real-time supply chain management systems that provide timely, accurate reports so you know what you have and need.

How can a robust supply-chain management system help you in times like these?

First, by managing items across supply chain methodologies. Certainly, your hospital orders from different suppliers, and chances are those suppliers don’t all use the same methodology. With cross-stock methodology capabilities, it won’t matter whether suppliers use KANBAN, EOQ/ROP, PAR, MIN/MAX or Suppress Pick.

When the system can search without concern for methodology compatibility, your hospital can have more faith in the accuracy of current inventory, will save time previously spent contacting individual suppliers, and can more rapidly resupply as needed by quickly determining who has what and where. Need to replenish hand sanitizer and cotton swabs? Initiate one search that pulls in all existing suppliers and tells you who has what you need before placing an order.

Second, by tracking the supply of an item for both primary and secondary suppliers. As COVID-19 demonstrates, this ability to manage backorder situations is always useful and sometimes crucial. A useful, vibrant system will use a barcode to add an item to a primary provider pick list AND report on the same item to a secondary provider in the event the primary has none in stock. The need for guess work and manually retracing steps when the primary provider does not have the necessary stock is eliminated.

Finally, by comprehensively managing all items not controlled by the Drug Enforcement Administration. Controlled substances that fall under DEA jurisdiction are a complicating factor, but the system you use should monitor everything but controlled substances. Is your hospital having to manually track and order some essential items? Time to look for a new system.

Beyond these common-sense steps enabled by a functional supply-chain solution, hospital administrators may want to start looking for alternative suppliers. The disturbing truth is that the United States has become heavily reliant on China for certain products that slow to a trickle in situations like the one COVID-19 is creating.

“This is an opportunity for companies to look for different ways to do the supply chain,” said Stephanie Kennan of McGuireWoods Consulting. “I think it’s an issue that over the long term we need to grapple with because we can’t even manufacture a lot of the drugs inside the United States.”

And where China is the source of many drug-related components, India produces many of the finished drugs imported to the United States. With COVID-19, the Indian government has instructed manufacturers to get permission before exporting 26 different drugs, about two-thirds of which are antibiotics.

So, will COVID-19 be the catalyst for a whole new era of manufacturing essential products inside the United States? Perhaps it will be, and perhaps it should be. And perhaps your hospital can find a way to contribute to or benefit from such efforts.

In the meantime, however, the best thing you can do for your organization and patients is to stock up on necessary items as efficiently and rapidly as possible. With any luck, COVID-19 will be a tremendously exaggerated threat, but it will most certainly be followed eventually by a bug that is not. The key element is our preparation for threats generally, not the lethality of this threat in particular.

Irv Lichtenwald is president and CEO of  Medsphere Systems Corporation, the solution provider for the CareVue electronic health record.

What You Should Know:

– Jump Technologies offers new supply chain solution free of charge to help hospitals manage utilization of critical supplies and avoid stockouts during high volume COVID-19 response.

– From a single screen, hospitals can easily see where existing supplies are located (in hospital storage or in a warehouse); track consumption by department, clinic, or user; and forecast potential stockouts.

The rapid spread of the novel coronavirus (COVID-19) has placed unique pressures on the hospital supply chain, forcing facilities to maintain a detailed picture of what inventory they have available, where it’s located, and how fast it’s moving – all of which is essential to treating the high volume of patients with COVID-19 symptoms.

To help hospitals achieve this critical balance and to ensure health care providers have the proper equipment to safely perform their jobs, Jump Technologies announced it will offer its new Allocated Inventory Solution at no cost to help hospitals take control of their inventory during this global health crisis. 

The Jump Technologies’ solution runs in the cloud and does not require any special hardware, so it can be set up quickly and with no disruption to hospital operations. Supply chain staff can be up to speed on using the system with just a 30-minute training session.

Key elements of the Allocated Inventory Solution include:

– From a single screen, hospitals can easily see where existing supplies are located (in hospital storage or in a warehouse); track consumption by department, clinic, or user; and forecast potential stockouts. 

– The new solution does not require integration into the hospital ERP or EMR and does not require access to sensitive data such as patient information or pricing. 

– Because it is a cloud-based solution, it is safe, simple, and secure for hospitals.

“At times like this, it’s vitally important for hospitals to have a clear picture of allocated and sequestered inventory so they understand the resources available to them and whether they are at risk of running out of essential supplies before their next shipment,” said John Freund, CEO of Jump Technologies. “Because we understand the challenges this pandemic creates for hospital supply chain, we are waiving our fees to ensure as many hospitals as possible have access to tools that will give them insight into high-demand supplies that are essential to treating patients.”

– Global Healthcare Exchange (GHX) announced it has acquired Chicago-based Lumere, a provider of evidence-based data and analytics solutions that enable healthcare organizations to build clinically integrated supply chains and optimize medication formulary management. 

– As reimbursement models move from fee-for-service to fee-for-value, GHX believes Lumere’s capabilities will extend its value to more directly improve patient outcomes at the lowest cost by empowering customers to make evidence-based purchasing and utilization decisions. 

Global Healthcare Exchange (GHX) today announced it has acquired Chicago-based Lumere, a provider of evidence-based data and analytics solutions that enable healthcare organizations to build clinically integrated supply chains and optimize medication formulary management. Financial terms of the deal were not disclosed. Key Lumere leaders, including CEO Hani Elias, CTO Will Danford and President/Chief Strategy Officer Eric Meizlish will remain with the combined organization.

Driving Healthcare’s Clinically Integrated Supply Chains

Founded in 2012, Lumere (formerly Procured Health) is an organization comprised of clinicians, researchers, software engineers and strategic advisors focused on helping health systems eliminate unwarranted clinical variation and cut unnecessary costs—specifically related to device and drug selection and utilization. By providing both physicians and hospital leaders with evidence-based data, information and analytics they’ve previously lacked, Lumere accelerates their ability to optimize patient care and decrease healthcare’s financial burden.

Lumere has emerged as the industry-leading source of technology solutions that drive evidence-based device and drug utilization and purchasing decisions. Spend on medical products and drugs represents one of the fastest-growing expenses for US health systems. The combination of Lumere’s capabilities with GHX’s unmatched network of providers and suppliers will enable the industry standard for device and drug intelligence needed to optimize patient value.

“Together, GHX and Lumere will provide an unmatched source of information that enables health systems to align purchasing and utilization decisions with evidence,” added Hani Elias, CEO at Lumere. “Our combined companies will help healthcare stakeholders deliver care that’s backed by data and guided by evidence, allowing drug and device expenditures to be supported not just by price but by clinical outcomes. Shining a light on outcomes will provide clinicians and hospital administrators with the information they need to help make the best decisions for every patient. I’m incredibly excited about the significant change our two companies can advance for healthcare.”

Acquisition Creates A Gold Standard for Device & Drug Intelligence to Optimize Patient Value

As reimbursement models move from fee-for-service to fee-for-value, GHX believes Lumere’s capabilities will extend its value to more directly improve patient outcomes at the lowest cost by empowering customers to make evidence-based purchasing and utilization decisions. Since its founding, GHX has created healthcare’s largest vendor-neutral modern digital trading network with access to hospitals representing more than 80% of licensed beds and a significant number of major suppliers in the US.

By combining the powerful assets of GHX and Lumere, GHX seeks to create the gold standard in data governance, providing a single source of trusted information for the management of devices and drugs used in the delivery of care. The Lumere acquisition also significantly extends GHX’s footprint in the pharmaceutical market, helping health systems more strategically manage the complex area of pharmacy cost.

“With health systems more accountable than ever for the results they deliver, the strategic imperatives of reducing cost and improving quality of care are more critical than ever,” said Bruce Johnson, CEO and president of GHX. “We’ll continue to support our customers in their evolution from reimbursement based on quantity to reimbursement based on quality. We will do this by combining the strength of the GHX platform and the industry’s most comprehensive repository of item and transaction data, with Lumere’s deep clinical data and machine learning powered analyticsto deliver the critical evidence-based insights healthcare needs. Like GHX, Lumere is a company focused on innovation and customer-centricity, and we couldn’t be more delighted to welcome them into our organization.”

2020 will mark the end of the beginning of Social Determinants of Health (SDoH).

One would be remiss not to give pause and to consider how much time it has taken to get to this pivotal period in US health and healthcare delivery and, focus on the cornerstone “why” healthcare must, with a fierce urgency, step into the twenty-first century of US healthcare delivery. Meaning, it has taken nearly seventy years to go from the World Health Organization identifying the profundity of SDoH influence on individual health to its emerging mainstream interventions of today and tomorrow. 

1. SDoH SaaS Mergers and Acquisition Activity

Over the past five years or so SDoH SaaS companies have been sprouting up across the US healthcare landscape. They include however are not limited to Unite Us, Healthify, Now Pow, Aunt Bertha, former TAV Health and the list grow’s on. There is a grave need to connect Hospitals, Physician Practice, Payer Organizations, and Community Based Organizations throughout the fifty states of America. Scalability will be crucial. As result, and given common denominators of the aforementioned SDoH SaaS solutions and capabilities of blockchain and artificial intelligence technology the market will likely see one or more SDoH SaaS Mergers and Acquisitions as the SDoH market streamlines. This emerging market will be the result of unprecedented SDoH sector investment from among diverse wealth investor resources. 

2. Value-Based Care

Value-Based Care is well understood by hospital and healthcare system executive leadership in the know to be the catalyst to expanding and scaling SDoH solutions across America. As result, given the antithesis impact of Fee for Service on SDoH, we will likely see further erosion of utilization of Fee For Service healthcare models, which will be the inherent aftermath of this new frontier we today call Social Determinants of Health. With an estimated $1.5 trillion dollars in healthcare spend cutting potential on the line, linked to SDoH, this transformational change is inevitable. 

3. Rise of Personalized Digital Physical Exam Screening (PDPES)

SDoH SaaS popularity has grown in large part due to its capability of reducing hospital readmissions, tracking, measuring, and proving whether SDoH has been addressed in real-time, thus so-called tracking The Whole Patient Journey beyond hospital walls. However, there exists an inherent flaw within this particular patient continuum construct. Meaning how can one claim with certainty to address SDoH and/or track the whole patient journey without including precision medicine at points of care?

This vital inadvertent miss-step within the whole patient journey will give rise to augmentation of the traditional physical exam whether inpatient care or outpatient care, i.e., the Personalized Digital Physical Exam Screening (PDPES), a real-time objective health data screening solution that intervenes and may be used as predictive health solution transforming breakdown of genetic predisposition resulting from the zip code equals health and life expectancy healthcare inequity phenomenon under auspices of phenotyping. 

4. Redefining Closing The Loop on SDoH

Medical imaging can serve as a non-invasive yet direct measurement of various tissues and organs in the human body. MRI is a modality that can provide a deep look into the human body without any radiation or contrast agent. This data can further be processed automatically using artificial intelligence algorithms to create quantitative metrics that could provide actionable insights. Such meaningful data obtained routinely can be used as quantitative biomarkers of health status.  Accordingly, Closing the Loop on SDoH will be redefined and may be scaled expeditiously & universally due to the estimated $200 cost with a 10 – 15-minute time frame that fully completes the PDPES process. 

5. Hospital Supply Chain Beyond Hospital Walls

Closing the loop will also be markedly enhanced by new models of Hospital Supply Chain Beyond Hospital Walls into the local community. A significant issue and challenge of healthcare are labeling patients “noncompliant.” Often times this may result as patients post-hospital discharge are unable to procure (access) through prescription within the outpatient setting and local community the very pharmaceutical drugs, medical devices, and/or medical equipment that has been instrumental in getting patient health status stabilized or controlled. As a result, the patient may fall into noncompliant status and how they are then perceived thereafter by physicians, hospitals, and insurance providers may become detrimental to patient health and healthcare notwithstanding the total cost of care implications. 

6. Innovative Retail Pharmacy SDoH Over The Counter Solutions

Innovative Retail Pharmacy SDoH Over The Counter Solutions will transform the role of local pharmacies in patient health and healthcare. As added value service and/or revenue streams retail pharmacies will begin to offer social determinants of health solutions from health screenings to connecting patients further on in the SDoH continuum, i.e., food, clothing, transportation, temporary housing, employment, etc. The retail pharmacy is uniquely positioned to take the lead on Personalized Digital Physical Exams at the community level when and where it may matter most and become the premier catalyst to transforming population health.

PDPES is a physical health exam screening delivered by way of MRI technology that is upgraded without compromise to MRI technology efficacy. The result is quantitative objective physical health data. Whether through community pharmacy’s direct investment in MRI units on-site or, partnering with local MRI mobile and/or established brick and mortar facilities Personalized Digital Physical Exam Screening may be delivered without hassle factor to patient or healthcare provider. 

No one knows with absolute certainty what the further may hold. However, in matters of individual, community, population, and public health social determinants of health solutions shall forever remain a staple in healthcare delivery both within the US and all developing nations abroad. 

About JohnMatthew Douglas

JohnMatthew Douglas is the President and Founder of iPressForward LLC and has over 20 years of diverse US healthcare sector experience. During the span of his healthcare career, JohnMatthew has evolved to more greatly serve the community, population, and public health, most notably Social Determinants of Health. JohnMatthew’s passion to serve community and US healthcare delivery fuels his tireless career commitment.

In recent years under the company name iPressForward, LLC he has consulted venture capital investment firms, marketing agencies, and global startups sharing his passion, wisdom, and subject matter expertise understanding of social determinants of health, healthcare group purchasing, community health, and US healthcare delivery and systems. In addition,  he has severed as Board Trustee for the esteemed “Upstate, NY Leukemia & Lymphoma Society” advocating on behalf of blood cancer patients and, has collaborated fundraising and donating to blood cancer research and, supported the local community with the support and inspiration of his wife of 23 years, Sha Rose Douglas. 

– GHX Survey finds healthcare supply chain data and standardization key to accelerating healthcare’s shift  to value-based care.

– The survey highlights the role of healthcare supply chain data will play during the year(s) ahead in solving the cost-quality-outcomes equation.

Global Healthcare Exchange, LLC (GHX), a healthcare business and data automation company has announced the results of a survey conducted among its Best 50 provider organizations regarding healthcare supply chain priorities for 2020. The survey highlights the role healthcare supply chain data will play during the year(s) ahead in solving the cost-quality-outcomes equation.

Supply Chain Shift to Value-Based Care

Today’s supply chain professionals are tasked with bringing increased levels of automation and standardization to supply chain processes to support the healthcare industry’s shift to a value-based care model. Process and efficiency improvements rely on accurate accessible data. Survey results show respondents are implementing initiatives that will empower them to make data-driven decisions to improve efficiency, reduce costs and gain visibility into the true cost of care.

GHX Best 50 supply chain leaders identified two primary initiatives that will support the move to value-based care in 2020:

1. Better Use of Data and Standards to Support Value-Based Care

The shift to a value-based care model requires that the healthcare industry finally understand the true cost of delivering care, including the costs of products, which products deliver the best outcome at the best price and how to reduce clinical variation around what works best for the patient. Standardized supply chain data allows all stakeholders to understand the relationship between the cost to deliver care and the outcomes achieved.

Standardization enables supplier and provider organizations to take a more strategic and informed approach to a broad range of clinical and financial systems, including EHRs, patient billing, recall tracking, value analysis activities and comparative effectiveness research. For example, GHX Best 50 provider Franciscan Missionaries of Our Lady Health System (FMOLHS) is using standardized and enriched supply chain data to better understand the cost of providing patient care and how variation affects both cost and quality.

2. Supply Chain and Clinical Systems Integration

The integration of supply chain and clinical systems will become increasingly critical to reduce variation in costs and quality and accelerate the necessary adjustments to improve outcomes. To account for the products used during a care episode, prepare for recalls and capture a greater percentage of case charges, healthcare must ensure the systems supporting every aspect of care is connected and able to share timely and accurate data.

For example, Stanford Health Care has created tighter integration between its supply chain and clinical systems, which allows supply chain professionals and physicians to collaborate on standardization and cost reduction initiatives

Pulse Check for Healthcare Leaders

Our annual survey provides a pulse check regarding the direction in which these leaders are headed. In keeping with the theme of this year’s AHRMM Supply Chain Week, ‘Health Care Supply Chain: Advancing Health Care Through Clinical Integration,’ our survey found these Best 50 providers are not only pushing for greater levels of automation and standardization within supply chain processes, but also for ways to drive integration with clinical processes,” said  Bruce Johnson, president and CEO of GHX.

According to a recent report from Syft, health care leaders fail to leverage data analytics in their supply chains. This shortcoming could result in them missing out on millions of dollars. There’s an urgent need to optimize supply usage throughout the enterprise and patient care continuum while cutting waste.

In addition to the increasing downward pressure hampering revenues, statistics anticipate that supply chain costs will exceed labor-related expenses by 2022.

These factors cause an increased need for health systems to optimize supply chain management (SCM). Syft’s research mentioned a McKinsey study that predicted a reduction of 20-50% in forecasting errors, too. The increase in available, reliable data helps hospitals take decisive action.

More than half of executives polled believed SCM controls expenses while reducing waste. Moreover, they thought it could grow margins by at least 1-3%.

A 2018 Navigant survey cited by Syft in its research found that hospitals spend over $25 billion more than necessary in their supply chains. However, individual hospitals have opportunities to save an average of 17.7% in their total supply expenses. Often, they can do that through artificial intelligence (AI) and machine learning (ML).

The 3 Major Parts of the Supply Chain Where AI and ML Could Help

Analysts see AL and ML being particularly helpful in three main supply chain parts. The first is commodity supplies such as surgical drapes, needles, and labels. Syft’s data indicates those things account for about 18% of what a typical hospital spends.

Then, there are the medical and surgical supplies used in moderately invasive procedures. They include things like bone nails and grafts, aortal stents and tracheal tubes. Hospitals spend an average of $13,286 on these items, with the amount accounting for more than a quarter of total spending.

Finally, AI and ML could promote cost savings for so-called provider preference items. They’re the supplies that doctors choose to treat individual patients, such as spinal rod implants and tibial knee prosthetics. Medical facilities tend to spend more than half of their supply budgets on these things.

Now, let’s look more specifically at seven SCM areas that AI and MC could cause the biggest cost savings for the health systems utilizing them.

1. Supply Standardization

Some provider-preferred items are extremely costly, but standardizing them is a challenging task. Physicians lack the time and resources required to compare the associated costs and patient outcomes when assessing options in the marketplace.

However, AI could provide doctors with tools that give them near-real-time statistics about how certain supplies perform. Such information makes a supply standardization goal more straightforward.

2. Inventory Level Optimization

Health systems must speedily and accurately assess the demand for inventory. Otherwise, providers may hoard supplies to avoid running out, or delays could occur while waiting for replenishments. Hospitals often use the time-series method of forecasting demand. It uses past usage trends to predict future needs.

AI can improve upon traditional time-series forecasting by allowing health systems to continually update forecasts. AI also gets smarter with use.

3. Cost-Per-Case Capture

Hospitals have faced a decades-long problem where they handle cases without knowing the true associated costs. However, when depending on AI for SCM, they can look at supply consumption data and pinpoint instances where certain cases are not included.

AI can more accurately capture information about the supplies used, making it easier to calculate costs correctly. It’s also possible to drill down into the data and see the total costs per procedure or surgeon.

4. Operating Room Throughput

Having the right supplies on hand is crucial in an operating room. Any supply-related mishaps could cause patient complications, as well as frustration for the responsible surgeons. However, electronic health records (EHR) can play a role in keeping operating rooms stocked and measuring the associated throughput.

Kishore Bala, Syft’s chief technology officer, explains, “There’s a tremendous amount of rich data constantly flowing from EHRs and enterprise resource planning (ERP) systems. AI allows queries like cost variance analysis and procedure/inventory demand intelligence to update in real-time as new information comes in.”

Bala continues: “AI will revolutionize the operating room and materials manager’s ability to plan for and deliver critical supplies at the right time and place, and at the right cost. The vast potential for this technology is exciting.”

5. Procedural Throughput

Of course, the opportunities to cut costs by applying AI and machine learning to SCM don’t stop at operating room procedures. They extend to any other treatments happening within hospital operations. With the data-driven insights provided, health care facility managers can become more informed about the average supply-related expenses for particular procedures and make adjustments when necessary.

6. Expired and Recalled Supply Management

Excellent SCM also means accounting for expired or recalled items a hospital uses. If an executive uses AI to notice a trend whereby a certain product often expires before health professionals use it, they’d learn to purchase the item less frequently or in smaller amounts. This eliminates waste and provides transparency concerning, when, where and how often hospitals use particular supplies.

Artificial intelligence and machine learning might also illuminate an issue whereby a supplier encountered an above-average number of recalls in a span of months or years. If so, the hospital might have second thoughts about continuing to buy from that entity.

7. Labor Efficiency

The final SCM area where AI and ML could spur improvements is in labor efficiency. When hospital employees have the supplies they need to meet patient needs and otherwise perform their duties without encountering obstacles, their productivity should go up.

Strengthening Supply Chain Management

When healthcare facilities use AI and ML for enhanced SCM as suggested here, they can cut waste and variations in supplies while boosting efficiencies.

The payoffs can be significant and encompass monetary savings, as well as more streamlined processes and less wasted time.

Pediatric medical center Boston Children’s Hospital has partnered with Premier Inc. (PINC), a healthcare improvement company, to foster optimal management of its supply chain portfolio across the enterprise. The hospital signed a multi-year agreement with Premier for access to its industry-leading supply chain services, including Premier’s group purchasing organization (GPO) and PremierConnect® supply chain analytics.

As part of the implementation, Boston Children’s will leverage Premier’s vast database and knowledge of supply chain best practices to enable data-driven, evidence-based purchasing. With $60 billion in purchasing power and insights on 45 percent of U.S. hospital discharges, Premier member healthcare providers are able to attain best pricing while maintaining high-quality care.

“Premier and its more than 50 pediatric hospital members gladly welcome Boston Children’s to the alliance as our strategic partner in children’s healthcare improvement and innovation,” said David A. Hargraves, Senior Vice President of Supply Chain at Premier. “Premier’s insights, purchasing power, expertise and peer network are helping pediatric health systems create differentiated value for their patients. We look forward to working with Boston Children’s to design and implement a high-value supply chain system and vastly efficient care delivery model that complements the superior care they provide to their most precious patients each and every day.”

Slowly, but surely, supply chain management is evolving. GHX’s Bruce Johnson explains.

It’s hard to believe that after nearly a decade of embracing HIT, the U.S healthcare industry still has its share of technological growing pains. Perhaps there is no better example than supply chain management (SCM), where manual methods often remain the default despite the enthusiasm to take things virtual.

According to a recent survey conducted by Sage Growth Partners, most executives believe SCM is a priority and that improved solutions can positively impact costs and care quality; more than half of the 100 healthcare and supply chain executives surveyed believe it could increase margins by at least 1 to 3 percent. However, the survey also revealed that most hospital leaders were not investing in SCM and using outdated, manual processes (such as spreadsheets) for supply chain data.

Health executives stated that a lack of the right technology is a crucial barrier in reducing supply chain waste. However, Global Healthcare Exchange’s (GHX’s) Bruce Johnson would argue that the solutions to help healthcare organizations meet the challenges of SCM are out there— but you have to know what to look for and where to find it.

“In the era of value-based healthcare, providers and manufacturers are seeking to understand the true cost to deliver care and the efficacy of products being used to deliver it,” said Johnson, CEO of the cloud-based SCM solutions provider based in Louisville, CO. “To achieve this, the healthcare supply chain needs known and precise data. EHRs and ERPs are the core systems providing this information. GHX ensures that these systems are working from a common data foundation through the integration and enrichment of clinical supply and implant data.”

Since 2000, GHX has taken on the aim of helping both providers and their suppliers create efficiencies and reduce waste in the supply, leveraging the fact that organizations must satisfy the requirements of value-based care to receive reimbursement. Today, the company works to improve upon this goal by ensuring that their solutions are clinically integrated with an organizations’ existing technology (including EHRs and ERPs) to maximize data quality while reducing the headaches and hiccups that often come with the adoption of new solutions.

Johnson believes now is the time to make SCM a priority, as the demands on providers over the next decade will only make SCM more challenging. According to the Association for Healthcare Resource and Materials Management, supply chain costs are predicted to exceed hospitals’ labor costs by 2020. A Navigant report from 2017 also estimates that hospitals are wasting more than $25.4 billion on the supply chain and could individually save as much as 17.7 percent (nearly $11 million) per year, with the right supply chain improvements.

“A clinically integrated supply chain is critical,” said Johnson. “GHX is expanding its offerings to extend the value of our customers’ EHR investments. We are achieving this by leveraging our item data core to ensure that the right clinical supply and implant data is available at the right moment. Customers embarking on a modern-item data strategy will have confidence in their data as they look at product standardization for reducing clinical variation, contract utilization, and metrics that support the cost of care initiatives.”

GHX aims to achieve this by focusing on the capture, enrichment, and integration of data into business processes to deliver value to its customers. “We apply this approach to processes ranging from order-to-cash and pricing alignment to inventory management and clinical documentation. Our unified and curated item data core, coupled with healthcare’s largest digital trading network, allows us to extend the value of our customers’ investments in ERPs, CRMs, and EHRs,” he said.

Naturally, Johnson recognizes that competition is out there, but he does have some core recommendations for providers seeking to employ SCM solutions. “In today’s environment, a clinically-integrated supply chain requires four key pillars: a modern item data core that aligns and powers core enterprise systems; focus on utilization and adoption; a digital trading network to support a just-in-time supply chain process; and analytics that guide employees to areas for continuous improvement,” he said.

How important is an integrated solution? According to Johnson, it’s fundamental, citing that solutions that do not leverage the information from existing technologies don’t work because they often end up underutilized or there is a lack of adoption altogether. The most critical elements for SCM adoption success are to ensure the data powering the SCM is unified, known, precise and current and can effectively encourage trading partners to engage with SCM efficiently and consistently.

 “As SCM evolves, more of the business processes these systems support become deeply entwined with trading partners, “Johnson added. “Thinking through the complete process, understanding the data needs of that process and having a plan to measure and drive utilization, are keys to the successful adoption of SCM solutions.”

The Future is in the Cloud

Although growth has been slow, Johnson is confident that the accessibility of more sophisticated clinically integrated SCM solutions will move to accelerate the pace of the virtual SCM evolution. There is a significant movement to cloud-based ERPs; and with providers demanding precise data (in real time), that trend is expected to accelerate. While the EHR space hasn’t quite risen to the cloud quite yet, the fact that care is moving beyond the walls of traditional hospital systems to clinics, and even patient homes, indicates that inevitable change is in the air.

Johnson expects that the next five years will support a more rapid movement and adoption of cloud-based SCM solutions. Ideally, the industry will move its core SCM solutions to the cloud and begin capturing the value from an industry level for item data core, digital trading network, and compliance network.

As for the long-term impact cloud-based SCM solutions will have on U.S. healthcare:

“Ultimately, healthcare is driving towards the quadruple aim of balancing cost, quality, outcomes, and finances. Achieving this means the business of healthcare needs to become a data-driven environment; only this will truly bend the cost curve. Quantifying this is hard, but we envision an environment where a patient can consult with a provider and know in real time, the best care pathways, including the right clinical supplies and implants to achieve the best outcomes,” Johnson concluded.

Jump Technologies, a hospital supply chain solutions provider, today announced it has raised $2 million in funding led by Black Granite Capital and includes new strategic investor Mount Sinai Ventures and reinvestment by two large investors. The Eagan, MN-based company plans to use the latest round of funding to expand the company’s national sales efforts and support broader product development.

Supply Chain Management Is Often Overlooked in Hospitals

Inventory management in hospitals is often overlooked, resulting in $765B in waste annually in lost, unused, or expired supplies. Jump Technologies delivers a cloud-based hospital supply chain software solution called JumpStock, which integrates with any ERP system to help hospitals save money and improve clinical outcomes by providing actionable analytics that drives a new level of standardization of clinical and operational best practices.

Clinical Workflow Integration with Supply Chain

JumpStock integrates seamlessly into clinical workflows and delivers reports that help clinicians and supply chain professionals make informed decisions about supply utilization throughout their facilities – including high-cost areas like operating and procedure rooms. With JumpStock, hospitals can more easily standardize utilization of supplies, which allows them to save money and reallocate funds to clinical resources and technology that improve patient care and generate new revenue.

JumpStock also ensures that clinicians have the right supplies when and where they are needed so as not to slow down surgeries and other clinical therapies. For example, Jump Technologies’ customers, such as the Mount Sinai Health System, have been able to reduce stock-outs, which helps clinical practice, while increasing inventory turns, which improves the hospital’s bottom line.

“Health Systems need to drive innovation in business practices and technologies, not only in clinical care or practice,” said Les Grant, Corporate Director of Materials Management for Mount Sinai Health System. “Our partnership with Jump Technologies has enabled the development of a best-in-class inventory management solution that reflects the unique needs of our system and brings increased efficiency and support to our world-class clinical teams and the patients we serve.”

Driving the next level of innovation in healthcare will require significant collaboration throughout the industry. Today’s healthcare supply chain teams, who possess so much critical data and expertise, and work with nearly every stakeholder in the industry, are increasingly called upon to facilitate the collaboration necessary to attain three familiar healthcare goals: reduce costs, increase efficiency, and improve clinical outcomes. 

GHX) has identified three key areas where supply chain’s collaboration will improve efficiency and outcomes while working to improve the quality of patient care. 

Three key areas in which supply chain collaboration between providers and suppliers is creating a significant benefit to healthcare: 

1. Supply Chain and Clinical Integration: Increasing levels of collaboration between supply chain and clinical teams, as well as improved integration of supply chain and clinical systems, will become increasingly critical to conduct value analysis, identify variation in costs and quality, and make necessary adjustments to improve patient care.

Today, most healthcare providers require clinicians to document supplies and implants at the point of use directly into the EHR. However, the industry continues to struggle with accurate or complete clinical supply capture at the point of care. A cloud-based industry-wide clinical item master can bridge the gap between item master management and the larger dataset needed for EHR clinical documentation leading to more accurate Total Cost of Care analysis. 

2. Automating Provider and Supplier Payments: Payment is the ‘last mile’ in the healthcare supply chain. Increased levels of automation can help facilitate significant cost savings and efficiency improvements to help overcome the high costs of today’s inefficient, manual, and error-prone payables processes. Electronic payment processes will benefit both healthcare providers and suppliers by increasing revenue, reducing back-office expenses and improving overall visibility across the procure-to-pay and order-to-cash cycles. Increased collaboration between supply chain and finance teams will open the door to improved transaction performance between providers and suppliers. 

3. Facilitating Population Health Initiatives: Population Health represents a major shift in how the industry thinks about patient care and the way it provides that care. The challenge of Population Health is matching the need with the resource, particularly once a patient is outside the four walls of the hospital. The industry’s supply chain teams, experts in sourcing, inventory contracting, logistics and delivery, are perfectly suited to solving the challenge of connecting patients to the clinical and community resources they need to improve overall health and outcomes. Providers can advance Population Health management by engaging with supply chain management teams.

“When we consider the transformation underway in healthcare today, it’s impossible to overstate the role that supply chain plays in facilitating critical changes,” said Bruce Johnson, president, and CEO, GHX. “AHRMM’s National Healthcare Supply Chain Week puts the emphasis on the great work healthcare providers are doing to drive continued industry innovation through collaboration.”  

Cohealo, a healthcare IT company for equipment sharing and planning, today launched Cohealo Track, a SaaS-based solution that leverages case information from a hospital system’s EHR to provide actionable insights into medical equipment utilization. On average, a health system’s medical equipment will sit idle for 58 percent of its lifespan, tying up finite capital planning budgets in redundant purchases that are estimated to be as high as 25 percent of a single hospital’s inventory. With Cohealo Track, hospitals can tackle this problem head on and reduce capital expenditures, decrease rental costs and improve efficiency.

Cohealo Track is the foundational analytics engine that powers Cohealo’s award-winning equipment sharing technology. By knowing where, when and how often medical equipment is used, Cohealo Track finds opportunities to optimize these assets and drive greater returns on a hospital’s capital investment.

Additionally, Cohealo Track solution enables health systems to:

– Identify assets that can be shared between facilities to improve surgeons’ access to equipment and maximize the usage of existing resources

– Pinpoint underutilized equipment and free up working capital by selling redundant equipment

– Find equipment that is being overused to prevent unplanned equipment downtime and lost revenue from equipment-related procedure delays

– Compare equipment utilization between service lines and facilities to benchmark performance and drive increased procedure volume

– Enhance current real-time location system (RTLS) programs by reducing the time required for clinical staff to manually locate and schedule equipment for their cases, all on a single dashboard

“Existing solutions to measure and improve equipment utilization, such as RFID chips and leasing services, fall short for addressing the needs of a large health system,” said Michael Kerner, former CEO at Bon Secours Hampton Roads. “Without a solution like Cohealo Track that provides valuable and accurate data on equipment utilization, executives are operating in a vacuum when it comes to making significant purchasing decisions.”