The healthcare industry provides a range of specialized services to patients that requires thousands of products including medications, medical devices, and consumables. And, while the healthcare industry must deliver these services, it is woefully inadequate, and lags most other industries in automating its supply chain.
Medical errors are now the third leading cause of death in North America, according to Johns Hopkins Medicine. (In other industries, an automated supply chain follows standards that identify products accurately with specific attributes, including who manufactured it, the ingredients, the product’s manufacture and expiration dates, when received, and when and where purchased by the consumer.
In 2013, the U.S. Food and Drug Administration (FDA) Unique Device Identification (UDI) Rule established a unique device identification system for medical devices. Under the rule, medical devices are marked with a Unique Device Identifier (UDI) that appears on the label and package of a device. UDIs are presented on device labels in both a human-readable format and a machine-readable format (e.g., a barcode).
Standardized product identification gives an identifying code, recognized globally. There is no regulation or policy requiring that healthcare adopt the GS1 standards for supply chain processes that align with other industries that use such standards. Managing inventory and procurement in healthcare is difficult, without a way of tracking details about a healthcare product as it moves from the manufacturer to the patient care setting. Most hospitals and clinics are unable to track or trace medications, joint implants, pacemakers, or other products that patients receive.
Despite the UDI rule and the creation of the FDA Global Unique Device Identification Database (GUDID), the healthcare industry continues to struggle with medical supply tracking because it lacks a digital strategy which integrates the components of their information management portfolio.
One way to leverage product standardization and improve supply chain integration, is by implementing a digital strategy that reduces the risk of harm to patients because of errors. Digital automation can trace a product’s origin all the way through to a patient outcome. A digital strategy can create a framework to alert providers of possible risks associated with the tools used in providing care before an adverse event occurs.
Healthcare organizations face several challenges with current electronic health record (EHR) capabilities:
- EHRs are not designed to capture metadata about medical devices or equipment used in patient care.
- While EHRs have matured to routinely generate medication alerts, they are not designed to assess what is known about a patient and the metadata from medical devices and equipment (e.g., implants, medical supplies, treatments, etc.) and alert clinicians to potential errors.
- EHRs cannot document medical supply utilization in a user-friendly manner.
- EHRs do not have advanced analytics to anticipate potential adverse events of care intervention.
Healthcare organizations that implement a digital strategy can use it to:
- Correlate the use of medical supplies in the treatment of patients.
- Analyze metadata about the tools of care with patient information that is already documented in the EHR to enhance quality algorithms and produce real-time proactive interventions “before harm occurs.”
Integrating metadata about medical supplies in the EHR provides the necessary advanced analytics that proactively alert providers and clinicians of potential adverse events and report medical supply metadata as causative factors in an adverse event. It may also be possible for an EHR to identify if an adverse event occurs, or if a caregiver over-rode an alert about a potential adverse event.
Redesigned digital tools
What if we were to redesign digital tools and processes in healthcare to achieve safer patient care?
This could mean that:
- Medical supply metadata becomes an essential component to the care delivery processes
- Digital integration of medical supply metadata into care delivery can provide a framework to assess potential adverse risks with using medical supplies on a patient and triggering proactive alerts.
- Integrating metadata can also increase transparency of medical supplies used and enhance the evaluation for causes of adverse medical events.
Metadata at the patient level can accelerate and ensure thorough awareness and notification if a medical supply is recalled or a contraindication is identified in the medical supply.
What if EHR and Enterprise Resource Planning (ERP) technologies were brought together? Could that improve the supply chain and patient care? From a technology perspective, how can this be done, effectively?
While EHR data focuses on the patient, ERP focuses on medical data. ERP data contains medical supply information including the manufacturer, supplier, contracting, batch/lot/serial/identifier tags, creation and expiration date and allergy information, such as to latex.
Integrating patient and medical supply information increases the transparency of data. It also enhances documenting the supplies used during patient care. Integrating these data enables the use of AI techniques to detect patterns of activity to proactively alert providers to issues identified by an algorithm. Integrating supply chain data can improve supply chain utilization and charging processes.
A clinically integrated supply chain
What might a clinically integrated supply chain look like? If it were to develop, supply chain professionals and clinicians would work together, share ideas, compare outcomes, and make informed decisions. Physicians leveraging a relationship with a supply chain professional, could receive guidance on pricing, outcomes and alternatives to drive down costs and enhance utilization associated with a product. A clinically integrated supply chain leverages global trade item numbers (GTIN) and electronic data interchange (EDI) to decrease errors that cost providers and suppliers through inaccurate invoices, payments and products.
Creating an automated process using Master Data Management (MDM) techniques allows providers and suppliers to catch discrepancies quickly, and address issues in real-time. In addition, leveraging the Internet of Medical Things (IoMT) provides for automation to track medical products throughout the supply chain.
The result of achieving a clinically integrated supply chain, could mean:
- Advanced analytics to monitor and measure expenditures, inventories waste and outcomes.
- A clinically integrated supply chain infrastructure synthesizes what’s known about the patients and medical suppliers to proactively affirm that a medical supply is safe for use. This is not happening today.
- A clinically integrated supply chain would exist in all care settings and could be shared between them (e.g., acute, sub-acute, ambulatory, primary care, specialty care, long-term care, etc.). This is not happening today.
Supply chain outcomes
Strategic supply chain outcomes are achieved by support and adoption of the HIMSS Clinically Integrated Supply Outcomes Model (CISOM). The CISOM evaluates and provides a roadmap for clinically integrated supply chain outcomes improvements, including focusing on these areas:
- Automating data capture for products, care processes, clinical teams, procurement, traceability of products and supplies
- Clinical integration of supply chain expertise in clinical programs, automated data captured at the point of care
- Data captured at the point of care, uploaded and translated into knowledge for forecasting purchases, productivity, and identifying value and safety
- C-suite leaders view the supply chain infrastructure as a strategic asset to the organization, mobilizing teams to advance the supply chain strategy.