Beyond COVID-19: How will Healthcare Providers leverage AI and Analytics to minimize "Supply Chain Disruption"​ in the post-Pandemic era?

Beyond COVID-19: How will Healthcare Providers leverage AI and Analytics to minimize "Supply Chain Disruption" in the post-Pandemic era?

I would like to dedicate this blogpost to our fearless Doctors, Clinicians, Nurses, Technicians and First Responders in the US of A and across the World, as they put their health and their lives at risk to heal and save the rest of us, in the days and weeks ahead – God bless them!

CONTEXT

The COVID-19 Pandemic which our government and most of the world did not foresee in time, has resulted in a chaotic and uncoordinated response at best, leading to an unprecedented supply chain disruption and crisis in the healthcare industry.

As of early March, the US only had 12 million N95 respirators and 30 million surgical masks— just 1 percent of what is estimated to be needed during this pandemic. It’s a shortage with many causes, including a failure to stockpile supplies, confusion between state and federal agencies, and the lack of preparedness plans. Part of the problem, experts say, is the supply chain. The U.S. has been making fewer masks, gowns and gloves domestically, and instead relied on importing those items from other countries.

Here are 5 shocking yet eloquent vignettes of the crisis-triggering stock outs and shortages from the novel Corona virus and their implications, that the Healthcare industry will likely not forget and work hard to pre-empt and prevent or minimize, going forward:

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Emergency room doctor with plastic bag taped across his face given the acute shortage of Masks, Gowns, Gloves and Personal Protective Equipment (PPE) which is unprecedented!

1.  Insufficient supply of Masks, Gloves, Gowns and Personal Protective Equipment (PPE) to protect Doctors, Nurses, Technicians and First Responders, as well as Testing Kits and Ventilators triggering a Crisis!

The Open Cities Community Health Center in St. Paul, Minn., is considering shutting down because it doesn’t have enough face masks. Doctors at Barnes Jewish Hospital in St. Louis are performing invasive procedures on coronavirus patients with loose fitting surgical masks rather than the tight respirator masks recommended by health agencies. At a Los Angeles emergency room, doctors were given a box of expired masks, and when they tried to put them on, the elastic bands snapped.

With coronavirus cases soaring, doctors, nurses and other front-line medical workers across the United States are confronting a dire shortage of masks, surgical gowns and eye gear to protect them from the virus, and are being constrained to use plastic and garbage/trash bags as substitutes (photo above) which is shocking and unacceptable!

 In interviews, doctors said they were increasingly anxious, fearing they could expose not only themselves to the virus, but their families and others. [Ref 1 & 2]

 Unfortunately, the $ BNs of tax dollars headed for hospitals and states as part of the $2.2 trillion coronavirus response bill won't fix the problem facing doctors and nurses.

The problem isn't a lack of money, experts say. It's that there's not enough of those supplies available to buy. What's more, the crisis has revealed a fragmented procurement system now descending into chaos just as demand soars, The Associated Press has found. [Ref 3]

2.  Hospitals, State Governments and the FEMA are bidding against each other triggering "Price Gouging" and driving up prices as much as 1000%!

Hospitals, state governments and the Federal Emergency Management Agency (FEMA) are left bidding against each other and driving up prices.

The cost of personal protective equipment (PPE) and ventilators is skyrocketing -- more than 1,000% in some cases -- as the coronavirus pandemic continues.

The federal government's Strategic National Stockpile is nearly empty, and states have been left to find Personal Protective Equipment (PPE) supplies on their own. The surge in demand has left importers, suppliers and purchasers scrambling. And price gouging has exacerbated the problem, leading to price increases of over 1000% relative to prevailing prices before COVID-19 happened! [Ref 4].

3.   Scamsters from all over the World are exploiting the Supply Shortage in the US and attempting to dupe Federal, State agencies and Hospitals!

As state governments and hospitals have scrambled to obtain masks and other medical supplies during the coronavirus pandemic, scammers attempted to sell a fake stockpile of 39 million masks to a California labor union.

The Los Angeles Times first reported on Sunday [Ref 5] that the FBI had uncovered the scam, which has been traced back to a broker in Australia and a supplier in Kuwait. The investigators discovered the scam because they were looking into whether the supply could be intercepted by the federal government through the Defense Production Act.

 This is hardly an isolated incident and is happening across the globe with alarming regularity.

4.   PPE Supplies ordered by the States and by Hospitals are being seized and confiscated by FEMA for the National Stockpile!

 This one is perhaps the most shocking and a lagging indicator of the lack of a coordinated national procurement strategy and the resulting confusion and chaos – FEMA seizing and confiscating PPE supplies ordered by the states and by hospitals and health systems! [Ref 6 & 7]

For weeks, the federal administration pushed states to procure their own ventilators and protective gear, like masks, gloves and face shields. But a new effort by the administration to create a hybrid system of distribution — divided between the federal government, local officials and private health care companies — has led to new confusion, bordering on disarray, and charges of confiscation.

 Although the President has directed states and hospitals to secure what supplies they can, the federal government (FEMA) is quietly seizing orders, leaving medical providers across the country in the dark about where the material is going and how they can get what they need to deal with the coronavirus pandemic.

Hospital and clinic officials in seven states described the seizures in interviews over the past week. FEMA is not publicly reporting the acquisitions, despite the outlay of millions of dollars of taxpayer money, nor has the administration detailed how it decides which supplies to seize and where to reroute them. [Ref 6 & 7]

Officials who’ve had materials seized also say they’ve received no guidance from the government about how or if they will get access to the supplies they ordered.

5.   Delayed, uncoordinated and chaotic approach to Testing for COVID-19 is resulting in massive shortages of testing kits and supplies across the nation!

Testing massively is key to proactive detection of those infected in the population and then separating them for quarantine and treatment from those who are not, as basis for gradually opening the economy. Manufacturing and contamination at the CDC delayed standardizing on a test followed by lack of leadership and coordination at a national level, that has resulted in a hodge-podge of testing procedures, protocols, instrumentation and equipment that is far for sufficient to comprehensively test a population of 330 MM people and gradually open the country for business. As well, if there are testing kits on hand, there is a shortage of swabs, re-agents and tubes needed to complete the test which are being procured from disparate suppliers with hospitals, health systems, the state and the federal government competing with each other, resulting in price gouging and inflated prices similar to that experienced with N-95 masks, gloves, gowns and PPE! [Ref 8].

Net net, if one were to scorecard COVID-19 Supply Chain Performance and Responsiveness given the above lagging indicators of failure, lack of leadership, mismanagement, lack of coordination and execution, it will be a “D” for abysmal failure on this front!

Given this Supply Chain Disruption and the resulting crisis, how can Hospitals and Health System prevent a recurrence in future?

So how can hospitals and health systems proactively craft a strategy to pre-empt and prevent a similar shortage and care giver protection threatening crisis going forward?

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Supply Chain Management (SCM) is the second largest expense of running a hospital only after labor. It is somewhat disappointing and frustrating that despite having a stable supply chain with 3 of the largest Pharma Distributors in the world delivering drugs, devices and supplies to hospitals in the US of A, we did not see compelling and transformational leadership in the wake of the COVID-19 corona virus, to address the critical shortage that has put the lives of both care givers and patients at risk in this pandemic.

It is time to critically think of a strategy to address the needs of what I will refer to a Emergency Response Inventory (ERI) comprising masks, gloves, gowns, PPE, ventilators etc. that will be critically needed when the next epidemic or disease outbreak happens, given the these are not ordered in large quantities in normal times.

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Figure 1. Emergency Response Inventory (ERI) Supply Chain Strategy Blueprint for Healthcare Providers to respond to an Epidemic or Disease Outbreak. Copyright Andy Dé. All rights reserved.

Figure one articulates a suggested strategy framework for hospitals and healthcare providers to re-think their Emergency Response Inventory (ERI) Supply Chain Strategy, Planning and Execution in the wake of the COVID-19 Pandemic and ensure they will never find themselves in a situation when they are constrained to risk the health and safety of their caregivers as well as that of their patients in the event of an epidemic or infectious/contagious disease outbreak.

The ‘X-Axis’ shows current and new Inventory Locations while the ‘Y-Axis’ examines the Inventory Fulfillment paradigm – in-house or outsourced. It is important to understand the implications of in-house vs. outsourced fulfillment. In-house fulfillment is the most prevalent model i.e. hospitals store sufficient inventory based on seasonally updated demand forecasting algorithms in their hospital warehouses or pharmacies using a Min-Max or more advanced models. Drugs, devices and supplies are ordered from large distributors like McKesson, Cardinal Health and Amerisource Bergen predicated on prices pre-negotiated by Group Purchasing Organizations (GPOs) in economic order quantities (EOQs) based on contracts and are consumed via OmniCell (or similar) dispensing equipment within hospitals by nurses and technicians. Once the inventory level reaches a minimum threshold, it triggers a replenishment or an electronic purchase order to re-fill the inventory in time to ensure it does not run out.

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This system works fairly well under normal circumstances with predictable demand, but all hell breaks loose when massive and unforeseen quantities of supplies of items like the N-95 masks, gloves, gowns and PPE (sourced from China, Philippines, Thailand etc.) as well as testing kits and ventilators have to be ordered in a state of emergency, resulting in the massive supply chain disruption we are witnessing as we speak.

To prevent a recurrence, medium to large hospitals and health systems especially in states like NY, LA and CA which were hot spots experiencing a surge of patients which overwhelmed their hospitals and exposed their caregivers to unnecessary risk, will likely build new hospitals with additional beds, new testing centers both of which will need warehouses to stock inventory, especially ERI in quantities they do not stock under normal circumstances, as was the case when COVID-19 struck. I will coin a new acronym and refer to this as Emergency Response Inventory Fulfillment as a Service (ERIFS).

How do Healthcare Providers balance Operational Responsiveness against Financial Liquidity at a time when Revenue and Margins are under pressure?

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Figure 2. The financial implications of balancing Inventory in-stock versus off-Balance Sheet Inventory held by a Fulfillment Services Provider (FSP). Copyright Andy Dé. All rights reserved.

The financial implications of carrying inventory in-stock vs. that held for you by a Fulfillment Service Provider (FSP) for a fee-for-service (FOS) are significantly different. Inventory you carry in a warehouse or pharmacy is at the expense of your cash flow and appears on your balance sheet. On the other hand inventory that is carried for you for a ‘fee-for-service’ by a fulfillment service provider (FSP) who delivers it when you need it, does not appear on your balance sheet but on that of the FSP’s balance sheet and does not consume your cash flow – you only pay for the ERI when you need it. This will be critical for healthcare systems and hospitals who find themselves revenue and margin constrained coming out of the Pandemic, given their massive loss of profitable revenues from closing down elective surgeries, knee and hip replacements and diagnostic procedures which has presented a financial crisis they will need to address urgently. Many hospitals are already constrained to furlough workers and resort to executive pay cuts given the depth and breadth of this loss of revenues. [Ref 9]

The notion of an FSP carrying and drop shipping inventory on demand is fairly commonplace in the hi-tech and consumer electronics industry, but not so much in healthcare. OEM Contract manufacturers like Flextronics and Ingram Micro, source, manufacture and assemble branded electronic equipment, devices etc. and also pick, pack and drop ship them from their warehouses when an order is placed by a consumer with the brand owner like a Sony, Panasonic etc. This is a very efficient and scalable model which has been perfected to fine art in the hi-tech and consumer electronics industry and one that may be scalable for healthcare ERI as well.

Why do Hospitals and Health Systems need a Nationally Scalable Fulfillment Services Provider (FSP) for Emergency Response Inventory Fulfillment as a Service (ERIFS)?

Given the nation-wide crisis, chaos and confusion sparked by COVID -19, we have seen the emergence of Project N-95’ created by Andrew Stroup and a cadre of dedicated volunteers to address this challenge with globally crowd-sourced innovation and thought leadership which is indeed commendable.

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Sourced from Project N-95 web-site at https://www.projectn95.org/ [Ref 10]

Project N95 is the National Critical Equipment Clearinghouse (like a demand-supply matching electronic marketplace) for healthcare providers on the frontline during the COVID-19 crisis. They are a rapid response non-profit (510c3) organization run by volunteers who have deep experience in procurement, healthcare, government and technology from all over the world who have come together to make this platform a reality. [Ref 10]

Healthcare provider organizations report their critical equipment needs on the Project N95 website, and suppliers submit information about the products they have available. Then, Project N-95 volunteers conduct due diligence on all suppliers to help provider organizations make informed procurement decisions, quickly.

Given the instances of price gouging, scams, confiscation of hospital PPE supplies by the FEMA and other challenges articulated above, it is easy to see the measurable value of the service provided by Project N-95.

The $ Trillion question is what happens to Project N-95 once the COVID-19 crisis is behind us?

Who can provide Emergency Response Inventory Fulfillment Services (ERIFS) Nation-wide at scale for the Healthcare Industry?

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Figure 3. Emergency Response Inventory Fulfillment Service Provider (ERIFSP) to support Healthcare Provider Response in the event of an Epidemic or Disease Outbreak. Copyright Andy Dé. All rights reserved.

Given the critical need for a nation-wide Emergency Response Inventory Fulfillment Services Provider (ERIFSP) as elucidated above, who is best equipped to carry large quantities of ERI for a fee and offer fulfillment at scale, across the country?

While the 3 large Pharma distributors come to mind, I will predict that given the size of the investment, core-competencies and fulfillment infrastructure needed, AMAZON is uniquely qualified, experienced and equipped to fulfill this role (upper right hand quadrant in my strategy matrix in figure 1) for the following reasons:

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'Pillpack by Amazon Pharmacy' - an only Pharmacy acquired by Amazon for $ 753 MM in 2019, provides direct prescription fulfillment to customers, and aspires to drive $ 1.2 BN in revenues in 2020. PillPack sorts all of a customer’s medications by dose and delivers them right to their front door. Printed on the outside of each packet is the list of medications to take at the recommended time of day. Photo courtesy: Pillpack by Amazon [Ref 11 and 12].

  • Amazon excels at B2C order fulfillment arguably better than any other fulfillment services vendor, which it can and aspires to scale for B2B fulfillment
  • Amazon is one of the largest fulfillment service providers in the world with $ BN in cash that it can deploy to buy excess ventilators, PPE etc. at competitive prices and then hold inventory across its fulfillment centers based on projected demand based on COVID-19 data
  • Amazon has the cloud-based order management and fulfillment data and IT infrastructure and competencies that any hospital and health systems can plug-and play into, without significant investments on their part
  • Amazon has some of the largest and the most advanced fulfillment centers in the country. Amazon warehouses not only store products but also serve as distribution centers where associates pick, pack, and ship orders quickly and efficiently. Advanced robotics with machine vision, scanning machines, and computer systems in fulfillment centers can track millions of items in a day, which is a critical pre-requisite for this service.
  • Amazon aspires to significantly grow its presence in Healthcare and acquired an online pharmacy called ‘Pillpack’ for $ 750 MM in 2019. PillPack sorts all of a customer’s medications by dose and delivers them right to their front door. Printed on the outside of each packet is the list of medications to take at the recommended time of day. Not only that, patients receive automatic prescription refills and customer support 24/7.This makes business sense since the average Pillpack user in 2018 generated $ 5000 in revenue which is far more than the average Amazon Prime member who spends about $ 1,300 annually [Ref 11 and photo above]
  • Amazon has re-branded Pillpack to ‘Pillpack by Amazon Pharmacy’ with projected revenues of $ 1.2 BN in 2020 [Ref 12]. Providing ERI Fulfillment Services to hospitals and health systems would provide Amazon with the goodwill and leverage to become a one stop B2B2C ERI and Pharmacy fulfillment services provider, which is aligned with its long-term healthcare and life sciences strategy
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Amazon Fulfillment Center employing Robots working besides Employees to pick, pack and ship orders to customers. Photo courtesy: Amazon.

It will interesting to see if my prediction re: the need and emergence of an Emergency Response Inventory Fulfillment Service Provider (ERIFSP) indeed comes to fruition over 2020-21 and beyond.

Are you still using Excel for Healthcare Supply Chain Management (SCM)? Can you afford to do so in the post-COVID-19 era?

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The harsh reality and sobering fact are that supply chain practices in the healthcare industry lag those in other industries including retail, consumer packaged goods, hi-tech, consumer electronics and medical devices.

Microsoft Excel is still the predominant supply chain planning and execution tool in use by supply chain analysts in healthcare around the world despite its obvious limitations which have been articulated ad-nauseam over the last 3 decades!

The COVID-19 novel coronavirus and the ensuing supply chain disruption has totally exposed the weak links in the healthcare supply chain, and its implications for the health and safety of care givers as well as patient outcomes!

The $ Bn question for COOs, VP of strategic sourcing, procurement, inventory and supply chain management is, “Can you afford to continue using static supply chain tools like Excel and static weekly reports from your legacy ERP system to dynamically re-balance your supply chain and respond with the agility demanded in the event of another Pandemic, Epidemic or Disease outbreak?”

The $ Bn question for COOs, VP of strategic sourcing, procurement, inventory and supply chain management is, “Can you afford to continue using static supply chain tools like Excel and static weekly reports from your legacy ERP system to dynamically re-balance your supply chain and respond with the agility demanded in the event of another Pandemic, Epidemic or Disease outbreak?”

Isn’t it time for you to consider investing in next generation self-service AI + Analytics platforms which will enable you to:

1.   Integrate, prep and blend data from multiple healthcare IT (HIT) systems like ERP, EMR, Revenue Cycle Management (RCM), Procurement etc. without having to hire a small army of consultants to do so?

2.   Empower your supply chain analysts with accurate, reliable and automated descriptive, spatial, predictive and code-free visual analytics platforms and tools to enable them to accurately forecast and then position supply to respond to a rapidly changing landscape or disease outbreak?

3.   Empower your supply chain Data Scientists with code-friendly, self-service AI+ Analytics Platforms which enable them to work with their machine leaning and natural language processing (NLP) algorithms to enable robust scenario and strategic planning and what-if analysis?

4.   Empower your C-Suite and line of business (LOB) leaders with accurate, reliable and right time decision support, enabling actionable insights for them to make critical decisions that prevent supply chain disruption and minimize financial losses?

Artificial Intelligence (AI), Descriptive, Predictive and Spatial Analytics enabled Use Cases to minimize Supply Chain Disruption, going forward

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Here is a listing of 10 (ten) high value AI (machine learning, NLP and deep learning) and Descriptive, Predictive and Spatial Analytics enabled Use Cases for you to consider deploying to minimize the debilitating impact of the next 'Epidemic or Disease Outbreak triggered Supply Chain Disruption':

SUPPLY CHAIN NETWORK DESIGN:

1. Descriptive and Spatial Analytics driven Insights to locate your next Hospital, Testing Center or Inventory Locations (warehouses) based on provider/patient ratios, patient driving distance, socio-economic determinants of health etc. to maximize ROI on your investments and optimize for Patient Throughput and Satisfaction.

STRATEGIC ASSET UTILIZATION:

2. Analyze the utilization of your most valuable assets like the ICU/ED, Operating and Observation Rooms (OR) based on patient flow, case mix variance etc. and improve Asset Utilization to augment Patient Throughput, Patient Experience and Satisfaction (HCAHPS Scores) and Hospital Revenues and Margins.

3. Re-purposing and re-deployment of unused hospital beds for Cardiovascular, Oncology, etc. to ICU / ED beds equipped with Ventilators and Medical Devices to cope with the surge of COVID-19 (and other epidemics and disease outbreaks) patients with serious life-threatening complications.

STRATEGIC SOURCING:

4. Comprehensive Spend Analytics to identify your most Important Suppliers and developing strategic partnerships with them predicated on supply performance indicators, metrics and KPIs for SLA compliance etc. This will also enable you to standardize on generics and lower cost alternative to expensive ethical drugs and potentially save $ MM in unnecessary spend.

5. Developing a Risk based Analytics Approach to Sourcing from International/Overseas Suppliers based on distance, cost and lead times and other relevant attributes and variables, and using spatial+predictive analytics to ensure you are sourcing from the most dependable suppliers overseas who will respond timely in times of a crisis.

DEMAND FORECASTING AND SUPPLY PLANNING

6. Predictive Analytics driven Demand Forecasting of drugs, devices, supplies and Emergency Response Inventory (ERI) like N-95 masks, gloves, gowns, PPE, testing kits and ventilators for “business as usual” and Emergency Response triggered by an Epidemic or Disease Outbreak.

7. Dynamic Re-planning of Inventory (such as those listed above) on a daily (vs. weekly basis) based on advance Just-in-Time, Demand Flow and other practices while ensuring the expired or about-to-expire drugs and devices are removed from the hospital supply to preclude risk of administration to patients. Some of these best practices are highlighted in the HBR article ‘How Hospitals Can Manage Supply Shortages as Demand Surges’, [Ref 13].

8. Collaborative Forecasting, Planning and Replenishment (CPFR) is a process in which your company not only collaborates and integrates planning, forecasting and other data points from within your own company—but also uses data points provided by your suppliers and your customers. This is a best practice in the Consumer-Packaged Goods (CPG) and Retail industries and has been deployed in the healthcare industry in countries like Taiwan, that can be enabled with next generation AI and analytics. [Ref 14].

PROCUREMENT

9. Proactively detect and manage “Maverick Buying” (off-contract buying) and "Price Creep" happening in your Hospitals. Off-contract buying which is also referred to as “Maverick Buying” is rampant and if proactively detected, can identify the SKUs (usually the most expensive drugs and devices ordered at inflated prices) and the employees responsible, to minimize this wasteful and avoidable practice and save hospitals $ MM annually. Similarly identifying “Price Creep” from your suppliers can save your organization hundreds of thousands of $ each year, with advanced analytics.

CONTINUOUS IMPROVEMENT ENABLED BY ADVANCED ANALYTICS:

10. Descriptive and Predictive Analytics and Automated Reporting enabled Lean Six-Sigma for Continuous Improvement of Supply Chain Processes and Metrics-driven Performance. Manufacturing industries like automotive, hi-tech, CPG and consumer electronics have long adopted Lean Six-Sigma as a paradigm for continuous process improvement and augment performance metrics and KPIs on an annual basis. Key to enabling this is timely, accurate, reliable and automated analytics and reporting as well as transparency. Advanced self-service AI and analytics platforms can enable this level of transparency, decision support and automated reporting needed to enable a Lean Six-Sigma continuous process improvement culture in Healthcare. [Ref 15]

 In closing...

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The COVID-19 Pandemic has resulted in a chaotic response at best, leading to supply chain disruption in the healthcare industry, which is shocking, unprecedented and has threatened the health and safety of care givers and patients like never before!

In this blogpost, I have persevered to analyze Supply Chain Disruption and present a Blueprint for Emergency Response Inventory (ERI) Supply Chain Strategy and Planning, as well as the notion of an Emergency Response Inventory Fulfillment Services Provider (ERISFP) that will likely minimize this level of supply chain disruption and the resulting health and safety crisis for caregivers and patients in the event of the next Pandemic or Disease Outbreak.

My concluding questions for you….

 Was this post-Pandemic strategy blueprint for Emergency Response Inventory (ERI) Supply Chain Strategy and Planning and my vision re: An Emergency Response Inventory Fulfillment Services Provider (ERISFP) useful for you and your organization?

 What have I missed in this analysis and strategic blueprint from a supply chain strategy and planning perspective that is top of mind for you in these trying times?

As always, I welcome your comments and feedback here on this blogpost, and on Twitter at @HITstrategy. 

Disclaimer: The perspective and views expressed in this Blog post are my own and do not represent those of my current or previous employers.

#postCOVID-19 #PostPandemicStrategy #SupplyChainManagement #EmergencyResponseInventory #EmergencyResponseInventoryFulfillmentServices #ArtificialIntelligence #AI #HealthcareAnalytics #AIAnalyticsConvergence #ACO #HealthcareQuality #PatientSafety #ProtectingCaregivers #ValueBasedCare #AnalyticsProcessAutomation #Amazon #McKesson #CardinalHealth #AmerisourceBergen #ProjectN95 #FEMA

REFERENCES: 

1.  ‘At War With No Ammo’: Doctors Say Shortage of Protective Gear Is Dire’, Andrew Jacobs, Matt Richtel and Mike Baker, The New York Times, March 19th, 2020.

2. ‘Hospital Experiences Responding to the COVID-19 Pandemic: Results of a National Pulse Survey March 23–27, 2020’, Office of the Inspector General, US Department of Health and Human Services

3. ‘Providers in bidding war with states, federal agencies on medical supplies’, Modern Healthcare, March 29th, 2020

4. ‘Protective Equipment (PPE) costs increase over 1,000% amid Competition and Surge in Demand, Daniella Diaz, Geneva Sands and Cristina Alesci, CNN, April 16th, 2020

5.  FBI discovers promised stockpile of 39 Million Medical Masks was a Scam’, Jason Lemon, Newsweek, April 12th, 2020

 6. Hospitals say feds are seizing masks and other coronavirus supplies without a word’, Noam Levy, Los Angeles Times, April 7th, 2020

7. ‘Swept Up by FEMA’: Complicated Medical Supply System Sows Confusion’, Zolan Kanno-Youngs and Jack Nicas, The New York Times, April 6th, 2020

8.  Here’s where things stand on COVID-19 Tests in the US’, by Erin Garcia de Jesus, in Science News, April 17th, 2020.

9.  US Hospitals halt lucrative procedures amid Corona Virus crisis, job cuts follow’, by Robin Respaut and Rebecca Spalding, Reuters, March 31st, 2020

10. Project N-95

11. Why did Amazon acquire Pillpack’? The American Hospital Association (AHA), 2019

12.Amazon officially re-brands Pillpack as part of ‘Amazon Pharmacy’ by Gabriela Barkho, The Observer, November 18th, 2019.

13How Hospitals Can Manage Supply Shortages as Demand Surges’, Harvard Business Review (HBR), April 3rd, 2020

14.How CPFR can enhance your Supply Chain’, by Gary Marion, The Balance Small Business, February 2018

15. DMAIC – The 5 Phases of Lean Six-Sigma’, from Go Lean Six-Sigma.com

John Mayer

President & CEO at Value Genesys, Inc.

3y

Impressive analysis, 🎯 Andy Dé. I'm not sure that we would have ever created an "Emergency Response Inventory" sufficient to cover (even minimally) an event of this magnitude. But having an accurate model in place for both inventory and production capacities certainly would have helped. Of course, if we're willing to offshore 90%+ (of certain critical supply chains) to a single country, modeling won't help as much. Thanks for posting.

Raghu Ram

Visionary, Technologist & Investor | R2 Capital | Previously with Microsoft & Amazon

3y

Good summary. A few observations: 1) Planning for a situation such as COVID (or an act of god) will always be inadequate. We cannot anticipate nor can we stock/build up for such eventualities - it woudl be cost prohibitive. 2) GOvernment should be involved in supporting the industry and not being an active implementer - they are very inefficient and bureaucracy slows down (remember the $100 stapler pins ordered by DOD). 3) Promote investments of private enterprises and NGOs (such as Bill and Melinda Gates foundation) that are more focused on the goals. Yes, a private enterprise will be profit oriented - but they are at least not supported by tax payer $$$ and let the inefficent ones fail. Dont bail them out. 4) Invest for the long term on 2 key areas - education and infrastructure.

Reenita Das

Healthcare evangelist, strategist and voted top 100 women in Healthtech and Femtech. Co-author of State of Femtech and Board Member of Arab Health

3y

Great post Andy. Moving forward there is going to be a major disruption in supply chain for sure and it reveals how inefficient the system is currently. Well done

Great vision Andy for transforming the healthcare supply chain. Excellent problem setting. There has been so much mismanagement that you had plenty of material. This crisis cries out for a solution. Love your concept of ERISFP, with Amazon best positioned to fill the role. It bears noting that the Amazon supply chain strained under the demands of the pandemic. But they will certainly retool and optimize. I'm glad you focused on Project95. I believe there needs to be an analog for the public healthcare system. Inside and outside of this crisis, our government does not leverage its buying power to take costs out of the healthcare system. Costs we bear as taxpayers. The federal government should have stepped in to manage the supply chain on behalf of all states. The approach it took added costs to they system. Amazon and a [public sector] Project95 marketplace should co-exist and wield their massive buying power. Public policy will demand that we have a domestic supply chain. ERISFPs will have to account for this reality. I couldn't agree with you more that predictive analytics, machine learning, natural language processing and artificial intelligence are not being used at scale in the supply chain, in any industry, but particularly healthcare. Excel is still the tool of choice, even with the wealth of SCM solutions and services. Amazon is clearly on the leading edge of using these new technologies. Any other ERISFP will need to do the same. Thanks for advancing the discussion with such a detailed analysis and roadmap.

🎯 Pamela Baird, MBA, CKL

✔️Empowering people to change their lives ✔️ Making great introductions

3y

Insightful read, courtesy of Andy De that talks about the supply chain issues that face our healthcare providers and our nation.  First and foremost, a thank you for all of those who serve on the front lines, who are putting themselves and those around you at risk.  God Bless you, All!   Today, more than ever effective leadership is critical to navigating these turbulent waters.  They require increased communication, processes and a focus on specific objectives with a heightened sensitivity to all stakeholders, especially workforce development and redeployment. What is your organization doing to not only meet these times, but to look forward in your human capital management shifts as we anticipate the needs post COVID-19? I would love to hear your thoughts. Stay Healthy and well!  

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