-Srinivas Reddy Bendaram
As a pharmacist with experience in the pharmaceutical manufacturing sector, community pharmacy chains and hospital-based pharmacies, and in logistics and procurement for large hospitals, I have always had an interest in “Supply Chain visibility”. According to the research organization Gartner, supply chain visibility can be defined as “a capability that provides controlled access and transparency to accurate, timely, and complete plans, events, and data — transactions, content, and relevant supply chain information — within and across organizations and services to support effective planning and execution of supply chain operations.”
Supply chain visibility with regards to healthcare refers to the availability of real-time, online information regarding materials and resources (such as drugs, consumables, devices, instruments) needed by different stakeholders in the healthcare ecosystem. I have often raised issues related to supply chain visibility with stakeholders such as marketing personnel of pharma companies, supply chain managers, patients, doctors, and other allied health care professionals, especially in the context of the current Covid 19 Pandemic. Some of these pertain to:
- The availability and accessibility of critical and lifesaving drugs and other vital material resources from CFAs, vendors, pharmacies, and manufacturing companies during a pandemic and other health emergencies
- Providing real-time information/data visibility to relevant stakeholders such as hospitals/health facilities, patients, social organizations, policymakers, and regulatory authorities
- Quality checks for improving the quality of medicines/materials
- Preventive measures to decrease the prevalence of substandard and spurious medicinal products in the market.
- The role of digital health answering these questions
The Impact of a lack of Supply Chain Visibility
Supply chain visibility needs to be implemented across different levels of the supply chain including:
- Manufacturer
- Marketing Vertical of the Manufacturer
- Distribution Agencies
- Hospitals/Clinics/Pharmacies
- Patients
- Regulatory agencies
- Policymakers
Take the example of a manufacturer. Data generated through SCV and its analysis can give the manufacturer insights into demand assessment, raw material procurement, and production planning leading to higher financial efficiency within the manufacturing processes.
For a patient, this visibility gives him information on the availability of his medicines at stores closest to him and decreases the time taken to get these medicines in his hands
A policymaker can use this data to support local manufacturing and give incentives to manufacturers of medicines whose supply is lower compared to its demand, or to set up import/export policy to support the manufacturing of drugs that have a lower supply.
Current Scenario in the Healthcare Supply Chain
There are more than ten thousand manufacturing units, sixty-five thousand distributors/wholesalers, sixty-nine thousand hospitals (both public and private), and over 5.5 lakh pharmacists in the Indian healthcare ecosystem.
Even though the adoption of supply chain management systems has begun, there are issues with standard communication protocols that can help each of these systems connect with each other and share relevant data. A case in point is a distribution company using a supply chain module that cannot communicate with the hospital’s supply chain module, leading to a lack of information flow to the hospital regarding the status of the supplies available with the distribution company.
Supply chain visibility is the web that can connect these stakeholders to get high-quality supplies on time, in a cost-efficient manner.
Recommendations
The primary advice to any organization which seeks to establish supply chain visibility would be to build processes and systems that enable:
- Data Capture
- Data cleaning and compiling based on standards
- Data processing and analysis
- Information generation
- Stakeholder discussion
- Insights
- Healthcare facilities need to estimate their requirements for different drugs, consumables, and other materials every quarter based on the patients footfalls, both outpatient/inpatient, and communicate the same to approved manufacturers/vendors so that annual purchase contracts can be established based on accurate demand. This visibility of information regarding the demand for different drugs, consumables, and materials to the approved producers & distribution agencies also provides data to these organizations to optimize their raw material procurement, stocking, and production planning
- Establishment of business models similar to the bank credit/debit card modes where once the healthcare provider establishes an annual contract with the material supplier, the provider can withdraw what they require and when they require – As material is money, this will ensure that the supply happens as per the requirements of the providers, avoiding lengthy documentation processes internally and externally.
- The Healthcare provider’s Health Information System platform should enable the transfer of data regarding the materials receipts, payables, outstanding payments directly to the Enterprise Resource Planning system of the suppliers, similar to the SMS notification for bank transactions.
- Healthcare providers have to develop a digital hospital formulary under which information is available online to all the stakeholders in the hospitals regarding the inventory status across the organization
- Application of Scientific Tools/Methods in supply chain management
- Development of inter-operability standards within the supply chain systems so that the different systems of different stakeholders can communicate with each other
- Ensure the new solutions seamlessly integrate into the existing clinical workflows
- Ensure data privacy and enable sharing of non-PII data sets. (PII – Personal Identifiable Information)
- All the systems built and used in India should quickly adopt the standards recommended in the National Digital Health Blueprint of the Government of India.
Conclusion
The National Digital Health Mission is creating well-articulated and thorough standards and guidelines for an interconnected digital health ecosystem in India. Regardless of the path that health-system leaders pursue to achieve data visibility, four critical actions will build a solid foundation to support their efforts. They must secure stakeholder commitment to change, define an aligned roadmap that includes a stance on the role of digitization, build the relevant data capabilities, and implement interoperability within existing national structures.
As this system rolls out across the country, there is a need for the providers and payers to quickly adopt and adapt to this new environment. This adoption is a long-term project which requires research, collaboration, and capacity building between the different stakeholders within the healthcare system, so that we can reap the benefits this digital ecosystem brings.
References
- https://www.institutmontaigne.org/en/blog/private-healthcare-india-boons-and-banes#:~:text=India%20has%20a%20total%20of,all%20of%20India’s%20health%20infrastructure.
- https://www.mckinsey.com/industries/public-and-social-sector/our-insights/transforming-global-health-supply-chains-through-data-visibility
- https://www.hhmglobal.com/knowledge-bank/articles/supply-chain-visibility-in-healthcare-beyond-the-dashboard
- https://www.gartner.com/en/supply-chain/insights/healthcare-supply-chain-management
- https://medium.com/@drnanditabhargava86/the-hospitals-in-india-till-date-are-facing-issues-in-supply-chain-management-because-of-lack-of-2b5cb348f38c
- https://in.linkedin.com/in/dr-nandita-bhargava-3a8b08a2